Health Chats
Swine Flu Chat
Tuesday Oct 20, 2009, 12:00PM - 01:00PM (EST)
Palo Alto Medical Foundation
Urgent Care, Palo Alto, CA
Fall is here, school is back in session, and once again it’s time to gear up for flu season. This year will have special challenges, as we are preparing for both seasonal flu and H1N1 (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.<br><br> The pandemic H1N1 flu (aka “swine flu”) began in April, and circulated in daycares, schools and camps over the summer but dropped off until very recently increasing to widespread levels again in many states. Virtually all the flu around now is the pandemic H1N1 virus. The H1N1 virus also predominated in the recent winter months of the Southern Hemisphere, which typically spreads north as we have our winter. There is concern that we are now experiencing a second wave of H1N1 this fall with the return of children to school. <br><br> <img src="">&nbsp;&nbsp; Learn more about Swine Flu from Dr. Choi's blog posts:<br> <a href="">2nd Wave of H1N1 Widespread Across America, Get Immunized!</a><br> <a href="">Do I have Swine Flu?</a> <br><br> <img src="">&nbsp;&nbsp; Read the chat transcript from Dr. Choi's most recent <a href="">Swine Flu Health Chat on May 8, 2009</a>.
Dr. Enoch Choi:
no H1N1 at CVS or other pharmacies yet, very limited supply, mostly at public health departments
How can I tell the H1N1 from the regular flu?
Dr. Enoch Choi:
you can't.
Is there more that pregnant women can do besides exercise and hand washing, to prevent the H1N1 virus?
Dr. Enoch Choi:
get the immunization, avoid those who have a fever and are coughing or have sore throat, use alcohol hand rubs when water is unavailable
Dr. Enoch Choi:
Why are children with no underlying health problems also now dying of this disease? Is H1N1 mutating? The early and sudden fatality rates are a cause for concern....
Dr. Enoch Choi:
unknown if it's mutating.  a greater number of people are getting infected, so a greater number of young people are getting severely ill
I have 2 young children 1 2 1/2 years old and another 6 months old. Would you recommend H1N1 and seasonal flu vaccines?
Dr. Enoch Choi:
Dr. Enoch Choi:
Initial Target Groups Are:
When vaccine is first available, ACIP recommends that programs and providers administer vaccine to people in the following five target groups (order of target groups does not indicate priority):

    * pregnant women,
    * people who live with or provide care for infants younger than 6 months (e.g., parents, siblings, and day care providers),
    * health care and emergency medical services personnel,
    * people 6 months through 24 years of age, and,
    * people 25 years through 64 years of age who have certain medical conditions that put them at higher risk for influenza-related complications.
Dr. Enoch Choi:
Dr. Enoch Choi:
when there is more suppply, the target groups will be enlarged
Dr. Enoch Choi:
Thank you for this chat. I am very confused about the H1N1 vaccine. I am 5 months pregnant and unsure whether or not to get the vaccine. I read so many conflicting stories. I am scared to get it, and not to get it.
Dr. Enoch Choi:
be more scared of the potential complications if you get H1N1 - miscarriage, severe pneumonia, long hospitalization, even death.
Dr. Enoch Choi:
Dr. Enoch Choi:
"Why does CDC advise pregnant women to receive the 2009 H1N1 influenza (flu) vaccine (shot)?

Getting the flu shot is the single best way to protect against the flu. It is important for a pregnant woman to receive both the 2009 H1N1 flu shot and the seasonal flu shot. A pregnant woman who gets any type of flu has a greater chance for serious health problems. Compared with people in general who get 2009 H1N1 flu (formerly called “swine flu”), pregnant women with 2009 H1N1 flu are more likely to be admitted to hospitals. Pregnant women are also more likely to have serious illness and death from 2009 H1N1 flu.

When a pregnant woman gets a flu shot, it can protect both her and her baby. Research has found that pregnant women who had a flu shot get sick less often with the flu than do pregnant women who did not get a flu shot.  Babies born to mothers who had a flu shot in pregnancy also get sick with flu less often than do babies whose mothers did not get a flu shot."
I had surgery recently and one of the incisions is still not closed. I am also on medicines that lower my immune system and I am allergic to the flu shot. I am in college and half my class is sick. What can I do to protect myself?
Dr. Enoch Choi:
ask your doctor.  wash hands frequently.  avoid those who are coughing or have sore throat
How long after exposure to H1N1 will symptoms start to appear?
Dr. Enoch Choi:
it is thought to be 4 to 7 days following exposure
Do you agree the death rate is less than 1%?
Dr. Enoch Choi:
it's so early in the pandemic, it is changing, i can't tell.  
Dr. Enoch Choi:
Dr. Enoch Choi:
The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report has increased and exceeds what is normally expected at this time of year. In addition, 11 flu-related pediatric deaths were reported this week; 10 of these deaths were confirmed 2009 H1N1, and one was influenza A virus, but unsubtyped. Since April 2009, there have been 86 confirmed pediatric 2009 H1N1 deaths; 39 of these have been reported to CDC since August 30, 2009.
I have a question about the swine flu vaccination and my 2 year old daughter. She has had this problem every time she gets sick. She has to be nebulized and I am afraid that if I give her the vaccination that she will end up in the hospital because she can breath. Am i right to think this should i still give her the vaccination? What are the risks for her and for giving it to my 4 year old son?
Dr. Enoch Choi:
the shot is indicated for both 2 and 4 year olds.  risks of getting H1N1 exceed the risk of getting vaccinated
How safe is the H1N1 vaccine for children ages 3 and 6 yrs.?  I am a little concerned about having my children receive this vaccine because I have heard the vaccine contains the mercury based preservative Thimerosal.  Thank you for taking the time to answer my question.  
Dr. Enoch Choi:
safer than getting H1N1.  there is thimerosal free H1N1 shots available.  mercury is not proven to cause any illness.
Were there trials for the swine flu vaccinne and how effective is the vaccine? What are the chances of getting swine flu from the vaccine?
Dr. Enoch Choi:
there were short trials.  the vaccine's efficacy has been determined to be potent enough to use worldwide.  you can't get H1N1 from the shot or the nasal spray.