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>
Once you have gotten the virus are you then immuned to it? Does your body build up antibodies to fight it or can you get it again?  
Dr. Enoch Choi:
you're immune to the current strain, but it can mutate, causing later epidemics with the new mutated strain
Does using hand sanitizer help just as much or more than using soap?
Dr. Enoch Choi:
hand sanitizer is excellent and as good as soap, but needs to be washed off after many appolications
What is a definition of a pandemic? Can a state declare a pandemic or is it bigger than that?
Dr. Enoch Choi:
WHO has raised the alert level to stage 4. Stage 4 is limited person-to-person spread.   Stage 5 is a pandemic, where there is sustained person to person spread, such as if the sick US residents returning from Mexico gave it to their contacts (e.g. family & coworkers)
Dr. Enoch Choi:
  The regular flu leads to many deaths per year.  What is the difference in expected outcomes when compared to swine flu?
Dr. Enoch Choi:
We don't know yet.  in USA it's been mild.  Not so in Mexico.  It's too early in the epidemic
What makes this flu worse than the regular flu, and when should someone be concerned enough to see the dr?  I have twin boys who were 2 weeks premies, and they have asthma, they are 5 years old now.  What should I look out for?
Dr. Enoch Choi:
if you have temperature 100deg or more, flu like symptoms (and/or vomiting/diarrhea) and travel to Mexico or adjoining state in USA, call your doctor.  Worsening symptoms in folks with asthma would be fast breathing and shortness of breath.
Your tweet a couple days ago said call, don't come in, if you think you're infected. Is that still your advice and why is that the case?
Dr. Enoch Choi:
Yes, i've tweeted regularly to call, don't come in.  if you're not sick enough, we have enough folks to care for.
There has been speculation the deaths in Mexico are linked to inferior medical care, can you comment on why the death rate is so high there?
Dr. Enoch Choi:
can't say, but it's very concerning.  Because the USA strains are identical to mexico's strains.
What is the truth behind what they have been saying "the stronger the immune system the sicker you can get if you were to get this flu"?
Dr. Enoch Choi:
My concern (personal conjecture) is that the young adults dying of pneumonia in mexico from swine flu have ARDS where the lungs break down, get leaky, and fluid fills the alveoli where you need oxygen to be absorbed.  Folks drown in their own fluid.
My understanding is that the last time there was a pandemic that the virus came once, then went away and then came again more deadly in its effects.  Is it correct to think that it may come back in the fall, worse?
Dr. Enoch Choi:
yes, new mutations can cause new epidemics
How long do you think before this spreads possible out of control?
Dr. Enoch Choi:
it's out of control.  now we just have to see how bad it gets
Hi Enoch. My kids' preschool is nearby a high school that has just been closed for 7 days due to a "possible" swine flu case. My preschool officials are discussing closing our school for the remainder of the week, as a precaution. What is your perspective on this? Is it just fear based or are these reasonable precuations to be taking? Thanks!
Dr. Enoch Choi:
hi linsey!  another fellow tweeter!  You're the one who told me about San Jose, California's Branham High School closing, i'm sorry to hear your preschool is nearby.  The santa clara public health department would be the one to weigh in on school closures.  I'd ask your preschool officials to ask them.  So sorry for your worry.
Hi Dr Choi, I am an internist. What tests you would do if a patient now comes in your clinic with flu like there any blood test and what lab should I send the patient to confirm it?
Dr. Enoch Choi:
Dr. Neela! Hi!  CDC guidelines for testing in an area without swine flu cases:
Dr. Enoch Choi:
instructions on specimen collection:
Dr. Enoch Choi:
personally, i'm suiting up with gown, N95 that i've been fit tested for, bonnet, shoesies, and seeing them in a negative pressure isolation room
Dr Choi-are they going to be able to stop people from hoarding anti-virals, ridiculous move on their part if not needed.
Dr. Enoch Choi:
nope, people will be unethical.  we're out locally in retail pharmacies.  My own clinic's pharmacy is very judicious in dispensing so we have enough, and expect to get more, but will only dispense to those who fit criteria
What about taking medication made from pigs, e.g., Armour thyroid?
Dr. Enoch Choi:
Does taking 1000 mg daily of ribavirin as part of HCV therapy for the last 45 weeks afford any protection against the swine flu?