There has been a lot of push back when it comes to the H1N1 flu vaccine. Of course, as with any medication, there could be side effects because not all immune systems are created equal.

But what people have to remember is their reasons for not supporting the vaccine – mainly because of the fear that it was rushed and long-term side effects are not yet known – are some of the same reasons preliminary reports of possible side effects could also be coincidental. For example, if someone has a heart attack after receiving their H1N1 flu shot, are they going to assume it’s directly related to the vaccine or attribute it to unhealthy lifestyle decisions?

The Associated Press recently published an article on this topic that looked at how the government will be intensely tracking the side effects of this vaccine and separating legitimate medical concerns from inevitable coincidences.

This is a proactive plan. The government is going to be putting information together for the public in an effort to stop the spread of false rumors and try to put the public at ease.

One major focus will be miscarriage since they are encouraging pregnant women to get the vaccine and miscarriages are quite common anyway.

Like the seasonal influenza vaccine, medical professionals expect the side effects associated with the H1N1 flu vaccine should be minimal. The most common side effect with all flu vaccines is soreness at the injection site, and sometimes people feel achy.

Many Americans are concerned about the safety and efficacy of the newly developed H1N1 flu shot because of a similar vaccine that was linked to a swine flu-like outbreak at Fort Dix in 1976.

Guillain-Barre occurs naturally following upper respiratory illnesses, digestive illnesses and on rare occasions – is associated with drugs and vaccines. However, the frequency is still 1-2 per 100,000 people.

I’ll be keeping a close eye on this, and if anything is reported, I’ll be the first one to let you know.

With concern over the H1N1 flu reaching an all-time high – Americans are scrambling to find ways to either prevent the virus, cure it if they get it or try to get out of getting the flu shot. And as a result, many people are turning to the Internet for help.

I have said it a thousand times and I’ll say it again: It’s not safe to buy medication over the Internet from sources that are not reputable!  There are thousands of medications available on the Web, and more and more companies are popping up each day offering fast access and delivery of both over-the-counter and prescription medications. We know the dangers associated with buying drugs online, but for some reason, people continue to do it!

In fact, it poses such a problem, that in the midst of the H1N1 flu pandemic and the hysteria it’s created, the FDA felt the need to warn consumers about purchasing products over the Internet that claim to diagnose, prevent, treat or cure the H1N1 flu virus. Trust me — nothing could be more dangerous than thinking that you can fight the H1N1 virus with unregulated medications available on the Web.

The FDA issued the warning after the agency purchased and analyzed several products online that were marketed as Tamiflu, which is an antiviral drug that slows the severity of the flu. After checking out the products, many of them were found to be unsafe.

Here is an excerpt taken directly from the FDA press release:

“One of the orders, which arrived in an unmarked envelope with a postmark from India, consisted of unlabeled, white tablets taped between two pieces of paper. When analyzed by the FDA, the tablets were found to contain talc and acetaminophen, but none of the active ingredient oseltamivir. The Web site disappeared shortly after the FDA placed the order. At the same time, the FDA also purchased four other products purported to diagnose, prevent, treat or cure the H1N1 influenza virus from other Web sites.”

The products that the FDA analyzed contained varying levels of oseltamivir, and were not approved in the U.S. And furthermore if you’re ordering medications from other countries, most of them will not even arrive in time to treat someone suffering from the H1N1 flu! It’s just not worth it, people! When you order medications that are not regulated, you’re putting yourself and/or your loved ones at risk for getting counterfeit or contaminated products, and the effects can be deadly.

So instead of logging onto the Internet the next time you need a prescription drug – pick up the phone and call your doctor. After all — that’s what we’re here for.

 Click here for more information from the FDA on how to protect yourself.

With the change in seasons now fully upon us, days are getting shorter, and the risk of seasonal affective disorder is turning into very real suffering for literally millions of Americans.  Most of this suffering can be prevented, if people recognize the cause of their symptoms and get help.

Seasonal affective disorder (SAD) most often visits patients during the fall or early winter.  It has also been called “winter depression” or “winter blues,” but its symptoms mimic major depression of any other kind—the distinguishing characteristic in this case being its connection to less sunlight.   Those symptoms can include sadness, tearfulness, decreased concentration, decreased self-esteem, low energy, alterations in sleep patterns and appetite, loss of interest in hobbies and work and, in severe cases, thoughts of suicide.

If you have struggled with repeated bouts of depression in the past, it’s very important to figure out if you can identify this kind of seasonal pattern.  But SAD doesn’t necessarily manifest itself with serious symptoms every year, so all of us need to be alert this year to whether we’re burdened by it.

SAD costs the economy dearly in lost productivity from employees, employers and entrepreneurs fighting its symptoms.  But it will also inflict an additional and very substantial financial burden on the millions of families directly affected, at a time when so many families are struggling already.  That’s one reason why SAD may be a bigger threat this year than the H1N1 flu, even though SAD gets a lot less attention.

SAD responds to the same treatments used to fight non-seasonal depression.  Psychotherapy is tremendously helpful, as is exercise and, when indicated, medication.  Another promising and safe treatment is transcranial magnetic stimulation (rTMS), which involves repeatedly stimulating a particular area of the brain using magnetic waves. 

I have seen many, many of my patients also benefit tremendously from the use of bright light therapy, which involves sitting for a short time each day in front of specially designed portable lights (which are relatively inexpensive and widely available) that replicate sunlight (without exposing the user to any damaging “tanning” light).   One of these devices is called the goLite, but just Googling “bright light therapy for depression” will bring up lots of choices.  If fall and winter and “down” times for you, then get one of these lights and use it.  It could change your life—for about $150.

It’s time we took SAD very seriously, given the fact that it causes so much damage to so many lives and is so responsive to treatment.  It’s the psychiatric epidemic that comes every year—and one we already know how to defeat.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

Here is the latest about the novel A(H1N1) swine flu pandemic virus, and what we are doing about it. Also check out my new Ebook: “Swine Flu; the New Pandemic.”

The best way to decrease the amount of circulating AH1N1 flu virus is to vaccinate as many people as possible. This is known as herd immunity.

The current H1N1 though mild, has infected millions and hospitalized more than 10,000 here in the U.S., killing close to 1000, so mass vaccination is warranted.

Unfortunately, once the vaccination program starts, it will be TOO easy to blame ANY deaths on the vaccine. This happened in Great Britain with the HPV Vaccine, where Cervarix is expected to cut deaths from cervical cancer by 650 and 1.4 million women have already been vaccinated, the vast majority with no problems. Yet a single death which was later found to be unrelated to the vaccine caused hysteria.

Though the 1976 swine flu vaccine was linked to several hundred cases of Guillain Barre Syndrome (paralysis) for a pandemic that never happened, this time there is a real pandemic, and the vaccine has been well studied in clinical trials and found to be very safe and has not been linked to GBS.

This vaccine is made the same as the yearly flu vaccine, with hen eggs, and will be just as safe, with the major complication in the vast majority of cases being local irritation around the injection site.

In discussions with senior officials at the CDC I have determined that it is acceptable to give both the seasonal flu shot and the H1N1 swine flu shot at the same time.

The CDC also recommends H1N1 vaccines even for those who believe they have had the disease. Serological tests to confirm immunity are considered unreliable and are not readily available.

The flu mist inhaled vaccine is being released this week. Since it is using an attenuated (weakened) live virus, it should not be given to pregnant women, those with chronic conditions, or those who are immunocompromised. It has also not been tested in the elderly.

The injectable inactived H1N1swine flu vaccine will start becoming available in two to three weeks. It uses an inactivated (dead) virus, and can NOT give you the flu. It is safe in all except for those with severe egg allergies. It should be given first to health care workers, pregnant women, children, and those with chronic conditions. 250 million doses should be available by sometime in November, and I will be recommending it for all.

Swine flu parties are a bad idea. They are an example of deliberate infection to provoke immunization. Since flu is so easily transmissable, it can easily get beyond the party and spread to someone who is more likely to have a severe outcome, such as a pregnant woman, a young child, or someone with a chronic condition.

The risk of the flu is far greater at this point than the risk of the vaccine. It is still a very mild virus, but must be taken seriously, as flu is tricky, and can kill. Coming out of the southern hemisphere, whose winter just ended, the prevailing strain of H1N1 swine flu is a good match for the vaccine.

For daily updates on the H1N1 swine flu strain, twitter me at marcsiegelmd.  I will post my latest articles, updates, and answer questions.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel’s new Ebook: Swine Flu; the New Pandemic, will be published in early October. Dr. Siegel is also the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.” Read more at www.doctorsiegel.com

If you are a child:

• Children have not shown any immunity to this new strain of flu.
• Kids are super spreaders of flu, with schools being petri dishes for spread.
• Children should wash hands frequently for at least 30 seconds with soap and water, use hand sanitizers, and sneeze or cough into their sleeve.
• Children who have fatigue, fever, sore throat, nausea, or muscle aches, should STAY HOME and the family pediatrician should be consulted.
• Rapid flu tests are about 60% sensitive for H1N1 swine flu, and a presumptive diagnosis can be made by a child’s doctor, based on symptoms.
• Kids with the flu should stay home for at least two days after symptoms resolve.
• The H1N1 swine flu vaccine will be available beginning in late October. ALL children should take it, especially those with chronic illnesses. It will likely be offered in schools. It is not clear yet whether children will require one or two shots.
• The use of Tamiflu (anti-viral) in children is somewhat controversial; recent studies from the UK appear to show that it isn’t well tolerated or effective, though previous studies have shown that it is safe, shortens the course of illness, and can also prevent spread (80-95%) if given to close contacts. This was the experience of several summer camps in Maine this summer, where Tamiflu was also well tolerated.
• Secondary bacterial infections are common, and should be treated promptly with antibiotics.

If you are an adult:

• Especially at risk are adults with chronic illnesses such as COPD, Crohns Disease, Rheumatoid Arthritis, HIV, cancer, etc. These patients should be especially careful, take Tamiflu early for flu symptoms, be on the lookout for secondary infections including bronchitis, pneumonia, sinus and ear infections.
• The H1N1 vaccine should be given to these groups as soon as available, as well as pregnant women (currently in clinical trials), health care workers, and close contacts of those with chronic conditions.
• New studies just published in the New England Journal of Medicine show that the new vaccine works in 7-10 days, is well tolerated, and provides immunity with a single dose.
• Elderly patients appear to have partial immunity to this H1N1 swine flu strain, if born before 1957, probably because of exposure to a related virus when they were younger, but should still be considered for this vaccine, especially if they have chronic medical conditions.
• Those who had H1N1 swine flu in the Spring or Summer are likely immune. There may be a blood test available to test this.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel’s new Ebook: Swine Flu; the New Pandemic, will be published in early October. Dr. Siegel is also the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.” Read more at www.doctorsiegel.com

I’ve been getting many e-mails over the past couple of days concerning swine flu.  So I’ve decided to answer a few of them here.

Dear Dr. Manny,
If I had the swine flu in 1976 after I received the swine flu vaccine as a college student, do I have any anti-bodies that may help ward off this version of the virus?
                  —Amy Gorman
                  Lutherville, MD

Probably not. This current swine flu’s genetic makeup is different from the swine flu from the ‘70s, and therefore the vaccination won’t be protective for you. But the silver lining is that this current swine flu is less lethal, and there may components in it that more Americans have been exposed to. So you may have a greater chance of being protected already which can minimize the symptoms.    

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Dear Dr. Manny,
We have friends who have returned from a trip to Mexico City two weeks ago. How long would it take for swine flu symptoms to show up if they were infected?
Thank you for your time,
—Alan

The typical incubation time for a virus is 48-72 hours.  So if your friends have been back for two weeks, and don’t have any symptoms, you can feel confident that they are safe. 

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Dr. Manny,
My wife and I are very concerned of the complications swine flu/treatment would pose to her pregnancy. Are the approved drugs for treatment approved for use during pregnancy?
Thanks,
Ben Demaline
Jacksonville, FL

Yes, all of the current flu treatments can be given to pregnant women. As a matter of fact, we tend to be more aggressive in treating the flu in expectant mothers because pregnancy can make flu symptoms worse and put the patient at higher risk. That’s why it’s recommended that all pregnant women get flu shots annually.

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Dr. Manny,
I will be flying to Las Vegas next week with a two-hour layover in Atlanta. I had a liver transplant five years ago and have done really well. Do you think that I should wear a mask at the airport and on the plane? I am very concerned about the large crowds and would like your opinion.
Thank you for any answer!
G. Savage

As a liver transplant recipient you are probably taking immunosuppressant therapy drugs and therefore you do have to take precautions to avoid exposure to the swine flu ― or any kind of flu. Even though I’m not a big advocate of wearing masks, I do feel that you should wear one. But remember: Not all facial masks are created equal, so get one that has been proven to protect against viruses. There are many supply stores that carry this specific mask for viruses. Also, try to wipe down all the surfaces on your airplane seat with antibacterial wipes. Be sure to wash your hands before, during and after the trip. And avoid any contact with anyone who you suspect might be sick. I know that this is a big stretch, but until we know exactly the extent of the spread, in your particular case, I would be extra cautious. I hope that this doesn’t ruin your vacation! 

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Dr. Manny,
I have no choice but to commute using public transportation everyday.  How should I take precautions against the swine flu?
                  Thanks,
                  —Paul

If you can avoid public transportation, especially crowded subway cars, then do it.  But if you can’t here’s what you can do:

• If you are a healthy individual you can just use antibacterial products, including wipes and gels, chronically throughout your trip.
• Avoid contact with people who are coughing or appear sick.  If they are in your car, move to another one. 
• As soon as you get home or to the office wash your hands, wipe down your cell phone, iPod or any device that you used during your trip. 

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Dear Dr. Manny,
I’m a chronic nail biter and I’m really concerned about the swine flu.  What should I do?
Best,
                  —Mel

First and foremost — wash your hands. Your hands are the most common tool for picking up germs and viruses in general. So if you are a nail biter, this would be the perfect incentive for you to quit. Also, biting your nails can make you ingest things other than viruses that you don’t want to have in your body.

 I don’t want to be picky, but I have to admit that as a fear expert I was more affected by President Obama’s statement a few weeks ago in response to the emerging swine flu threat that we should all wash our hands, then I was to Vice President Biden’s blatant misstatement about not flying on planes. Let me explain: clearly, we carry many bacteria and viruses on our hands, and in fact most of our stomach viruses as well as cold viruses are passed back and forth this way. It is hard to fault anyone for recommending hand washing, but consider that Obama’s statement carried the subliminal message that we might be carrying this virus, despite the fact that the statistical chances of that then and now remain extremely low.

The president followed that up by asking Congress for $1.5 billion to prepare us for this flu, an amount that seems totally reasonable until you consider what other health care needs it might be taken away from. Stockpiles of the anti-flu drug Tamiflu will have to be discarded if they aren’t used in 5 years, and we still have no idea what the extent of spread or severity of this swine flu virus will be. Preparing a vaccine seems wise, taking needed resources away from current pandemics like TB, HIV, or even the yearly flu does not.   It is paramount that at a time when our government is considering expanding the system for health coverage, that issues of allocation and proper use of resources be at the top of the list.

The Centers for Disease Control and Prevention has been front and center during the initial stages of the swine flu outbreak, and they have been very effective at identifying and tracking the virus, somewhat less effective at explaining it in context during press conferences (this may have something to do with the nature of the beast – press conferences themselves immediately become amplified).

I have more of a bone to pick with the World Health Organization in terms of their poor conveyance of contextual information. The WHO all too often seems like “fright night” though they too have been tremendous when it comes to “boots on the ground.”

Check out my article in today’s Slate magazine about how the WHO has dealt with swine flu.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.”  Read more at www.doctorsiegel.com

The following statements are where I think we are currently on the new swine flu H1N1 influenza A strain. I’ve also communicated with Drs. Ann Schuchat and Nancy Cox at the CDC, who responded that they agree with these comments.

• The H1N1 influenza A is a new strain — a swine flu strain — with some genetic components that are characteristic of human and bird flu viruses. It bears watching and tracking, as any new influenza does.
• It is spreading human to human, and may have the attack rate of a typical yearly influenza A, but this is particularly difficult to determine because of both the overreporting (everyone thinks they have it), and under reporting (we are not really tracking the full spectrum of disease as we are not testing those with mild symptoms). It is also too early to really determine transmissability, because there are too few cases.
• Virulence appears to be low and if this continues, it will be a mild pandemic at worst. It currently appears to be very transmissible, but the outbreak could wane further if transmissability decreases. A severe pandemic will likely result only if it mutates into a more virulent strain. But assessment of the strain’s virulence is also based on a limited number of cases.
• It is worthwhile to begin preparing a vaccine, but we don’t yet have the upgraded technology (mammalian cell culture, reverse genetics) in regular use for flu, so we may have to rely on the older technologies (using hen eggs to provide a medium for growing the dead virus). This has yet to be determined.
• It is likely to wane soon due to summer weather, but bears watching carefully over our summer in the southern hemisphere, and mapping carefully for resurgence in the fall.
• Since the WHO designations for pandemic alert don’t include severity of illness or even true extent of illness, raising the pandemic alert levels have led to the public misperception that massive deaths are about to occur, which is part of the reason why the fear level is so high. It is best to provide calm accurate contexted information to avoid this, as I point out in “False Alarm; the Truth About the Epidemic of Fear.”

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.”  Read more at www.doctorsiegel.com

Cases of swine flu, or H1N1, are climbing and spreading to more states.  At least 141 people in the U.S. have been infected, and one Mexican boy visiting Texas has died.  Many more cases will be diagnosed—likely many thousands—before the spread of the illness ebbs.  Public health officials and journalists warn of a pandemic, an epidemic of infectious disease that sweeps across a large geographic area, such as a continent, or around the whole world.
 
The toll of this new flu may turn out to be disastrous, but there’s no current evidence that a calamity is brewing.  Thus far, every American who has contracted the illness has survived.  Even if there turns out to be 250,000 cases this year, the number will still be dwarfed by the toll of diseases like cancer, heart disease, diabetes, asthma, depression and alcoholism on our population.
 
What the 141 cases of H1N1 flu have already proven, however, is how vulnerable we are to panic.  Americans are on edge, uncertain about the economy and uncertain about the direction our President is leading us.  Ultimately, for all but those with the steadiest of nerves and most solid sense of self, we are a nation collectively experiencing a sense of impending doom—one of the hallmarks of panic disorder.  H1N1 may or may not cause serious physical suffering for our population, but its emergence will cause serious psychological suffering for a nation already traumatized by deep doubts about whether the solutions to our collective problems reside in bailouts, embracing dictators and apologizing for our national shortcomings.
 
 Some might say that connecting our reaction to H1N1 flu to the economic crisis and cultural crisis at hand is too great a leap, that we are as steady on our feet emotionally as a population as ever.  I don’t think so.  I’ve been at my work 16 years, seeing adults and adolescents facing every imaginable twist and turn of fate.  Never before I have seen as many individuals who feel disempowered, unable to mount any resistance (words intentionally chosen) to the stressors impacting them.
 
Our psychological resistance to trauma of any kind is down right now.  That’s one reason that Air Force One flying low near Ground Zero was such a grand faux pax:  It re-traumatized thousands of people who don’t have emotional bandwidth to spare.  It’s even possible that our psychological stress could reduce our resistance to physical illnesses, including H1N1.
 
 It’s time for a real public health initiative, rolled out through private health care providers and, perhaps, community health educators, that targets two certain epidemics already sweeping the nation:  anxiety and depression.  They may not be spread by coughing and sneezing, but they have the capacity to paralyze us emotionally and cost our nation dearly.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com.

Did you know that your mouth contains one of your body’s best defense systems against the cold and flu? Protecting and enhancing your oral health can go a long way towards helping to boost your immunities and prevent the spread of infection. According to the U.S. Centers for Disease Control and Prevention (CDC) colds are one of the most common causes of absenteeism with up to 22 million work and school days lost each year. Don’t let a cold or flu interrupt your life this year… fortify your front line and follow these healthy smile tips today!

1)     Gargle with warm crystal salt water.

In our dental offices, we offer a Himalayan crystal salt treatment that helps to reduce inflammation and restore the mouth’s important pH balance on a cellular level. Himalayan crystal salt is very pure, has 84 important trace minerals, and does not burden the body the way chemically processed table salt does. It is more ‘bioenergetic’ and pure than sea salt much of which is also industrially “cleaned.” At home, begin with a thorough daily brushing of your teeth, tongue and then gargle with a homemade crystal saltwater solution. If you can find Himalayan crystal salt in a health food store or online, that’s always preferable. Warm crystal salt water helps heal inflammation in the mouth, promotes sinus health and is soothing for sore throats as well.

2)     Brush three times a day.

Brushing your teeth and tongue three times a day, preferably with a mild non-detergent, chemical-free toothpaste and alcohol-free mouthrinse will help keep your mouth clean and healthy. An unhealthy oral environment, with decay and gum disease, has also been shown to compromise the proper function of your immune system and can make you more susceptible to respiratory infection. In many instances, this can reduce your protection against the common cold or flu.

3)     Change and sanitize your toothbrush

Your toothbrush is a veritable incubator of viruses and bacteria – some removed from your mouth during brushing, and some from the environment (especially your cosmetic or toiletries case). It is a good idea to change your toothbrush immediately after any illness. Regular sanitizing and also changing your toothbrush monthly will also help keep harmful germs at bay year-round.

4)     Eat an antioxidant rich diet.

Antioxidant rich foods such as lightly cooked or raw greens, plant-based foods and hormone-free meats will not only help keep you lean, but may also aid your body’s natural defense systems. When you do feel ill, you my want to try a mega-green fresh power juice or an antioxidant infused water.

5) Exercise and manage stress

Exercise helps to boost the immune system, helps improves circulation and helps reduce stress. Runners, for instance, may often have a very low incidence of gum disease. Healthy habits are especially important during the winter months. Try to get as much sleep and exercise as our full lives allow. Take time for yourself. Stress will help deteriorate your defenses and may quickly lead to illness.

6) Avoid smoking.

Smoking may irritate oral and nasal passageways, strangle blood circulation and may make you more susceptible to infection. Try to limit or avoid all types of smoking, including second hand smoke.

Dr. Gerald P. Curatola is a renowned aesthetic dentist and pioneer in the emerging field of rejuvenation dentistry, which improves patients’ overall health and appearance by integrating total wellness with cutting edge oral care and restorative procedures. In addition to his private practice, research, and work as a Clinical Associate Professor at NYU College of Dentistry, he is an internationally sought after speaker, author and expert who has been featured widely in print and broadcast media. For more information, go to DrGerry.net