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.

1. What is swine flu?
It’s a new strain of Influenza A, coming from a pig. The pig has contracted one human strain, two pig strains, and one bird strain of the flu. These all combined to make a new strain. Pigs are a Grand Central Station for flu and other viruses.

2. What are the symptoms?
They’re similar to regular flu viruses, but the gastrointestinal symptoms are more severe. They include:

• Severe fatigue
• Headache
• Sore throat
• Nasal congestion
• Vomiting
• Diarrhea
• Nausea
  *Keep in mind regular flu season is over, so if you are experiencing flu-like symptoms, call your doctor. Do NOT go to the ER.

3. How do you get it?
Mostly by infected people coughing/sneezing around you, also passing it by touch is likely.

4. How is it passed?
You can pass it on to other people by coughing/sneezing on or near them, and possibly even touching surfaces that they later touch (and then touch their face, eyes, nose, etc.).

5. How is it treated?
There’s no ‘cure’ for it, but you need:

• Isolation/Rest
• Fluids
• Keep fever down
• Consider anti-viral drugs such as Tamiflu and Relenza, but keep in mind this strain is resistant to many older anti-viral drugs.

6. How do you protect yourself?

• Frequent hand-washing
• Avoid sick people
• Don’t cough or sneeze on others
• Stay home if you’re sick!

7. Can you catch it from eating pork products?
While people in Mexico likely contracted this from handling infected pigs, eating pork products should be safe. Keep in mind to cook pork to a temperature of 160° Fahrenheit to kill any viruses.

8. Is traveling safe?
Travel to Mexico is still statistically quite safe; the problem is still mainly one of perception, as the actual risk remains low. I would also consider the psychological effects this could have on children; consider what precautions they might take at airports, with customs officers wearing masks, etc.

9. How long does it last?
The virus can incubate a day or two before symptoms occur. It takes about a week to recover from the full-blown virus.

10. Is this real or hype? Do I need to be worried?
The danger is getting a lot of hype, but it is real. You probably don’t need to be worried, though.

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 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