I’ve been getting a lot of questions in response to a recent blog I wrote about monitoring H1N1 vaccine side effects, so I wanted to take the time to address some of your concerns. I know the overload of information on this pandemic can be confusing, but I’m here to help, so keep the questions coming and I’ll do my best to answer them for you.

I thought I heard that the H1N1 vaccine is bad for pregnant women as it has long term effects on the baby. Now, I find nothing on Fox about that. Can you PLEASE clear this up? My daughter is 6 months pregnant and does not know what to do!!
 
You must have heard wrong. We have been saying right from the beginning, as we say every year for the regular flu shot: Pregnant women are considered a high-risk group. Pregnant women have an underactive immune system as well as compromised respiratory capacity, so if a pregnant woman gets the flu, she could have serious side effects, which may not only jeopardize her health – but that of her unborn child. So get both flu shots!

Once you have had H1N1, can you get it again in the same season? What about next season? Can we get it again after it mutates?

We do not know the complete answer to this question however, if you have had the current H1N1 flu strain, you probably have immunity to this specific strain of the virus. So this season, you may have nothing to worry about. However, if the virus mutates or a new strain of H1N1 virus emerges, past exposures to the current flu strain may not be protective.

My son is 15 months old and he is borderline asthmatic. Should I get the vaccine? So many people say yes, and so many people say no. I’m so confused and don’t know what to do!! Please help!

The answer to your question is, yes. The CDC is specifically looking at children with asthma. Many of the complicated H1N1 cases we’ve seen have been in asthmatic children. The combination of viral pneumonia and asthma in a small child could be quite devastating and deadly. So talk to your pediatrician and strongly consider vaccinating your child. And don’t forget to get yourself immunized.

If the H1N1 vaccine is not available, will the pneumonia vaccine help protect your lungs from getting pneumonia if you get the flu?

The pneumonia vaccine is targeted to protect against bacterial pneumonia – specifically pneumococcal pneumonia. This will not offer protection against a viral pneumonia – which can be a complication of the flu. So talk to your doctor before you make any decisions.

There’s no doubt that this H1N1 flu, also known as swine flu, has been a real doozy. With more than 1 million people infected in the U.S. alone and approximately 263 deaths, attention must be paid to a potentially worsening condition.

I typically don’t like to scare people into paying attention to health care issues, but I do think that as soon as a vaccine becomes available here in the U.S. for the H1N1 virus, you should get it.

I recently learned of two alarming cases where pregnant women became affected with the H1N1 virus. Any type of flu can be quite devastating for a pregnant patient. The reason for the significant effect in pregnancy is that pregnant women typically have suppressed immune systems and their pulmonary compliance is significantly altered due to the pressure from the pregnant uterus. So when they get the flu, it could very quickly turn into a deadly pneumonia with very high degrees of complication for both the mother and the unborn child.

That was just the case with these two recent reports — one from Australia where a mother fell ill from the swine flu and ultimately the baby died in utero, and in the other case, a woman in Florida had to deliver at 27 weeks of gestation due to the flu, and the infant ultimately died from complications associated with his prematurity.

So the message is loud and clear: This new virus is very contagious. We don’t have natural immunity, and if you have any risk factors — especially if you’re pregnant — get the vaccine as soon as it is available.

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Sarcoidosis is known for its deep swirls of inflammation called granulomas. This rare disease is probably due to a disruption of the immune system, either by a virus or toxin, and it certainly runs in families. Black people are affected at least three times more often than whites, (35 cases per 100,000 compared to 10 cases per hundred thousand), and this health disparity is most disturbing in terms of outcome, with 13 times more deaths in blacks.

This is because sarcoidosis, which can involve the lungs, lymph nodes, eyes, and brain, tends to affect black people at a younger age (comedian Bernie Mac got the disease in the 1980s), and is far more likely to be chronic or recurrent in blacks, as it was with the famous comedian. Despite Mac’s publicist’s assertion that his sarcoidosis was in remission and hadn’t sickened him since 2005, and despite his statement that it wasn’t a factor in his deadly pneumonia, I find this difficult to believe.

My take is that Bernie Mac most likely fell in the group of 20 to 30 percent of sarcoid patients who end up with severely scarred lungs with little reserve lung capacity left. I think Mac’s more than two decades battling the disease (the mainstay of treatment is the steroid prednisone) speaks to the probability that his lungs were no longer in shape to fight off bacteria.

Pneumonia doesn’t usually kill a 50 year old unless the patient has badly damaged lungs to begin with. In that case, an infection can quickly rifle through the scar tissue and fill what’s left of the lungs with pus and fluid. The lungs die, and the patient does too.

I suspect Mac would have wanted his death to serve as a wake-up call for early diagnosis and treatment of chronic lung diseases. Most sarcoidosis can be suspected by the findings on a simple chest x-ray, and though the majority of cases go away without treatment, it still makes sense to be vigilant.

I remember when a physician, Dr. C., came to see me for a routine physical, and the swellings in the center of his chest x-ray made me immediately suspicious of sarcoidosis. When I uttered my concern, he became so anxious that he fainted and fell off his chair. Luckily, he wasn’t hurt in the fall, and though he did turn out to have the disease, he was also in the majority group (which unfortunately Mac was not) where it remitted spontaneously.

Dr. C’s case, like Mac’s, was a reminder to me that sarcoidosis is a puzzling, unpredictable, scary disease that needs to be approached rationally rather than emotionally.

Marc Siegel MD 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 (Wiley 2005) and Bird Flu: Everything You Need to Know About the Next Pandemic (Wiley 2006). Read more at www.doctorsiegel.com

A 9-month-old boy suffering from “bubble boy” disease has been moved from pediatric ICU to a sterile room after a cord blood transfusion breathed new life into him.