Health Chats
Swine Flu: A Cause for Panic?
Wednesday Apr 29, 2009, 01:00PM - 02:00PM (EST)
Palo Alto Medical Foundation
Urgent Care, Palo Alto, CA
Do you have swine flu? Dr. Enoch Choi, MD, an Urgent Care provider in the San Francisco Peninsula, will help answer questions on how to tell swine flu from a cold, and from seasonal influenza. Swine flu has not yet been proven to be a serious enough virus to declare this to be a pandemic, but nations around the globe are discouraging travel to USA and Mexico. Just how dangerous is this virus? How can you protect yourself? How can you stay healthy? Come ask these questions and more from a physician on the front lines, treating folks coming back from Mexico with upper respiratory illnesses that match the CDC's protocols for treating suspected swine flu patients.<br><br> <img src="">&nbsp;&nbsp; Missed Dr. Choi's first chat? Due to the demand, we have scheduled a second <a href="">Swine Flu Health Chat</a> <img src="">&nbsp;&nbsp; Visit the <a href="">Swine Flu community</a> to continue the discussion and exchange information about swine flu. <img src="">&nbsp;&nbsp; Learn more about Swine Flu from Dr. Enoch Choi's blog post <a href="">Do I have Swine Flu?</a> <div style="margin: 10px; float: none; height: 85px; border: 1px solid #E5E5E5; padding:10px 25px;"> <div style="background: transparent url('') no-repeat scroll 9px 10px; float: left; padding-right: 25px;"> <a href="/health_videos/Dr-Nancy-Snyderman-Talks-About-Swine-Flu/show/1833" style="color:#006CC8; text-decoration:none;"><img src="" alt="Video_overlay" style="height:69px; width:94px; border: 0 none;"/></a></div> <div style='padding-top:23px;font-size:14px;'> <a href="/health_videos/Dr-Nancy-Snyderman-Talks-About-Swine-Flu/show/1833">Dr. Nancy Snyderman Talks About Swine Flu</a> </div> </div>
Hi! I was wondering since we have no case of the flu here in Winnipeg at this point is it safe to take the public transit and if there is someone sneezing and stuff around you in the bus how can you protect you becase really you don't know if he/she has the normal flu or the other one
Dr. Enoch Choi:
Follow Canadian recommendations for instructions on social distancing.  I suspect if you haven't had cases in your vicinity they have not advised against using public transit.  Swine flu or not, stay away from folks who cough and sneeze!
Palo Alto Medical Foundation is including a pretty strict criteria of recent travel to Mexico or LA (for suspected swine flu).  At this point, with the flu in so many places and transmission between people, it seems like this sorting criteria may be invalid.  Thoughts?
Dr. Enoch Choi:
I'm not a spokesperson and am not speaking on behalf of PAMF but I am an urgent care partner there and am seeing patients today using this criteria.  As of right now, the criteria are travel to Mexico or bordering US state.  The criteria change as the county public health department responds to the CDC guidelines.  stay tuned at:
I am currently suffering from dust allergy and sneeze a lot and blow my nose a lot. Is my immune system weakened?
Dr. Enoch Choi:
I live in Mexico, just south of Guadalajara on Lake Chapala. Should I do anything different to protect myself from contamination? I wash my hands frequently, and when I go out I use the Purell hand cleaner. Some people are wearing the surgical masks.
Dr. Enoch Choi:
follow your local public health guidelines.  consider these as well:  wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.
Dr Choi, Do you think having too few facilities that can confirm swine flu is painting an inaccurate picture of the actual spread of the virus, for instance, states that currently aren't reporting any cases can cause it's citizens to not take precautions, but in reality there could be several cases sent away from said states just waiting for testing??
Dr. Enoch Choi:
This is possible.  strict case criteria are necessary so we can capture those who are likely to be ill.  It possibly can cause less severe illness in folks, we don't know yet.
is this swine flu something really really serious or something dramatized by the media? Also if it is something to worry about, how about sick people, people taking chemo, people that are taking HCV treatments whose immune systems are low? How should these people be treating themselves and home life IF this is something to really worry about? Thank you.
Dr. Enoch Choi:
We can't say how serious it is yet.  Only 1 of 91 cases died in USA so far.  Health officials expect more deaths, if we parallel Mexico's experience.  It's not understood why less USA patients have gotten more severely ill.  Immunocompromized pateints should follow their local health advisories.  IF they say to stay home, then do so.
I would love to get your thoughts on what is driving the media attention. Seems to me that the % chance of infection/death is so low compared to the "regular" flu - that the only reason for panic would be if we thought this new strand was going to rapidly proliferate and mutate in a way that couldn't be contained.
Dr. Enoch Choi:
So far that's true.  IT's because it's a novel virus and we dont' know how it will behave.  Noone in the world has antibodies to this.  It's likely to cause a pandemic based on it's spread to date (my opinion, not an official prediction), but who knows how sick it will make people.  It's already spread widely, who knows how it will mutate
If you have come in contact with someone who could have the virus, how long does it take to see symptoms?
Dr. Enoch Choi:
2 to 7 days
Don't all flu's develop from swine and ducks in Asia?
Dr. Enoch Choi:
influenza is from many sources.  it's not necessarily from swine and ducks in Asia.  this particular strain H1N1 mutated from a pig influenza virus
When the Swine Flu was introduced in 2005, Where was it first identified, and how many cases were there?
Dr. Enoch Choi:
swine flu has caused outbreaks in the past, most recently 1976.  that outbreak was from limited spread of a mutated virus.  Until last month, the swine flu you refer to since 2005 has been from direct contact with pigs or close <6 ft contact.
If I had contact with someone infected how long should I wait to see if I'm infected too?
Dr. Enoch Choi:
2 to 7 days
There has been discussion regarding whether or not you can catch the flu by consuming meat product from a pig that was a carrier of the virus
Dr. Enoch Choi:
no, and i had bacon this morning.  i really would have liked to try the woven-bacon-roll-with-sausage-and-cheese my buddy had last night.   but he ate it all.  stingy guy.
I hear your supposed to stay away from sick people, but I have a 2 1/2 year old son who has been very sick with fever, loss of appetite, and a horrible cough for 4 days now. I find it hard to stay out of his face. He is constanlty coughing on me. I don't think he has swine flu but I'm getting worried now that it's been reported in the state we live in. We haven't been anywhere except where we live in Bloomington, IN.
Dr. Enoch Choi:
even if your son has a fever >=100 degrees and flu symptoms, if he hasn't travelled to Mexico or adjoining US state, he doesn't fit criteria for swine flu.  These guidelines for taking care of a person with swine flu could apply in greneral to your son too:
Should people not Travel to Texas right now also. I had a trip scheduled for next week but I am thinking about putting it off due to the swine flu. I have a 10 year old that has severe asthma and has had pneumonia 3 times. I don't want him getting sick. Let me know your thoughts. Thanks
Dr. Enoch Choi:
Follow travel advisories from the CDC before your trip.  I just got back from travel.  Follow the advisories.  If they say not to do go, don't go.  So far, they say it's ok.  
Can people get the vaccine if they are a high risk patient such as severe asthma?
Dr. Enoch Choi:
there's no swine flu vaccine yet, they're working on one.  when they get it, if it's injectable, asthma would not typically contraindicate one from getting a shot.
What is the incubation period of the flu?  For how long are people contagious?
Dr. Enoch Choi:
Incubation is up to a week.  Folks are contagious a few days before symptoms show up, and then as long as they're coughing.