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:
Dr. Enoch Choi:
Will the benefits of the 2009 H1N1 influenza vaccines outweigh the risks? Is this something I should talk to my healthcare provider about?
Currently the 2009 H1N1 influenza virus (sometimes called “swine flu”) seems to be causing serious health outcomes for:

   1. healthy young people from birth through age 24;
   2. pregnant women; and
   3. adults 25 to 64 who have underlying medical conditions.

Seasonal influenza vaccines are highly effective in preventing influenza disease. The expectation is that a vaccine against 2009 H1N1 influenza would probably work in a similar fashion to the seasonal influenza vaccines. CDC and FDA believe that the benefits of vaccination with the 2009 H1N1 influenza vaccine will far outweigh the risks.

Vaccination is the best way to prevent influenza infection and its complications. This is the reason that CDC, national health organizations, and healthcare providers intensively promote vaccination for seasonal influenza, and the reason why so much work i
IF swine flu is suspected, at what point should they go to en ER? What is the symptom indicating real danger? Very high fever, trouble breathing? Both?
Dr. Enoch Choi:
ask your doctor if you have symptoms concerning for H1N1: fever 100 deg, and either sore throat or cough.  if you get worse, ask when you need to be seen.  Very high fever or trouble breathing are serious symptoms that would require prompt evaluation
Dr. Enoch Choi:
if you suspect your are seriously ill, contact your doctor
Dr. Enoch Choi:
in the future, the goverment is developing guidelines on when you should refer yourself to the ER
Dr. Enoch Choi:
those have not been published yet'
Am TTC and taking asthma meds. Should I try to get the H1N1 shot now? Also, can I get H1N1 and seasonal shots in the same visits if offered?
Dr. Enoch Choi:
Patients with asthma are at high risk and should get both shots.  it's up to them to get both in the same visit.  
Dr. Enoch Choi:
The nasal spray is not able to be given at the same time, since the body can't develop antibodies as adequately against both at the same time.  The nasal spray is not indicated for those with asthma
Why get the seasonal shot if most of the flu is H1N1??
Dr. Enoch Choi:
Although right now, we are only seeing H1N1, and at even higher rates than the peak of this spring, it is expected that seasonal influenza will start spreading in another month.  it's important to get both
What are the basic flu symptoms?  I always have this argument with my husband who has claimed he had the flu when I thought he just had a bad cold.  The flu does not typically involve nasal congestion, runny nose, etc. correct?
Dr. Enoch Choi:
Dr. Enoch Choi:
How do I know if I have the flu?

You may have the flu if you have some or all of these symptoms:

    * fever *
    * cough
    * sore throat
    * runny or stuffy nose
    * body aches
    * headache
    * chills
    * fatigue
    * sometimes diarrhea and vomiting

*It’s important to note that not everyone with flu will have a fever.
Dr. Enoch Choi:
At my institution, we require a temperature of 100 degrees and either sore throat or cough
Dr. Enoch Choi:
it's not easy to tell if it's flu or a cold sometimes.  when it's really bad, it may be more likely the flu
If you have a newborn, does the baby have to wait until 6 months to get the vaccine? (assuming the mother did not get the vaccination)
Dr. Enoch Choi:
yes, those under 6 months cannot develop adequate antibodies to the immunization.  Because of this, it's recommended that those in the same household be immunized
What are the options for those that are allergic to eggs?
Dr. Enoch Choi:
see above.  egg challenge at an allergist's office to see if they're really allergic.  immunize the rest of the family.  hand washing and alcohol hand rub.  put a mask on anyone coughing/sneezing
If you get H1N1 once, can you get it again?
Dr. Enoch Choi:
you can't tell if you've had it, so the next time you're sick
Dr. Enoch Choi:
you can't tell if it's H1N1 or not
Dr. Enoch Choi:
it's expected that if you did get H1N1 your body would have antibodies to protect you from future waves of the pandemic
I've heard that thimerosol will be in multi-dose vials to prevent contamination of the solution, but that it will not be in single dose vials. Also that while Squaline is not currently an additive, it is likely to become one as demand for the vaccine exceeds supply.
Dr. Enoch Choi:
Thimerisal is in multi-dose vials.  it is not in single dose vials.  Mercury is not proven to cause any illness.  squalene is not in any current H1N1 shots.  it is used in europe
Dr. Enoch Choi:
squalene has not been proven to cause any illness
can you estimate when you think H1N1 vaccine will be avaliable to everyone who wants it? I live in Nebraska and I am trying to get pregnant and my doctor has me on the waiting list.
Dr. Enoch Choi:
it's in such limited supply that the govt has directed seasonal influenza manufacturers to switch to H1N1 (so there's no more seasonal shots available for now).  it's expected that in a month they may switch back.  can't say when it will be available to everyone
Dr. Enoch Choi:
there is no prediction that we will run out of seasonal vaccine since increased capacity was planned.  it will just be delayed in delivery
Dr. Enoch Choi:
more on adjuvants: