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.

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

If swine flu weren’t such a serious problem, I would have found it humorous when pork companies began demanding that we change the name of the virus to H1N1. People without a vested interest in pork might also consider that a good idea from the point of view of decreasing fear (pigs are slimy ugly creatures that make loud scary noises), until they discover that H1N1 was also the designation of the 1918 Spanish flu that killed over 50 million people worldwide.

Speaking of flu fears fed by the specter of 1918, have a look at my oped in Monday’s NY Post. I also want to provide you some with some flu-prevention tips:

• Wash your hands often and don’t cough or sneeze on people or wipe your hands on common surfaces — not because of swine flu, but to prevent the spread of any respiratory virus.
• If you are suffering from lethargy, high fever, muscle aches, headache, sore throat or nausea, call your physician. He or she can help you determine if you need to be tested for flu. Do not go to your local emergency room with mild or moderate symptoms because our ERs are already becoming clogged with patients with colds and allergies.
• If you are one of the rare people who have had contact with an actual case or possible case of swine flu, also contact your physician.
• Listen to public health announcements coming from our federal, state, and local officials, but consider that they may also see their role as describing the worst case scenario. Learn to diffuse the language of fear. Risk assessment needs to be rational. Be reassured that this appears to be a weak virus, that it is not spreading rapidly, and mostly that it doesn’t seem to be very deadly.
• Isolating sick people and their contacts is the best way to contain an emerging virus, not to quarantine entire regions. It is doubtful that travel restrictions will help at this point, and closing the border may be counterproductive, as panicked sick people will likely try to escape (as has occurred historically).

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

A week ago, when I first heard the story about the so-called fat virus, I was suspicious. What medical commentator wouldn’t be. Was this yet another science fiction story masquerading as science? So I contacted the principle researcher in the field, Dr. Nikhil V. Dhurandhar at the Pennington Biomedical Research Center in Baton Rouge, LA. Dhurandhar was kind enough to immediately email me his last several studies on the subject, published in the International Journal of Obesity, Diabetes, Archives of Virology, and elsewhere. The studies convinced me of several things:

* Dhurandhar’s research, conducted over the past 6 years, is impressive but it is not entirely new — though the news media has suddenly attached to it.

* The previous research conducted in animals is substantial. The virus in question, a respiratory adenovirus known as AD-36, one of 50 adenoviruses to cause cold-like symptoms, has shown that mice, chickens, and monkeys all put on greater than two times more body fat than normal in the months following infection with this virus.

* The virus causes this effect by stimulating adipose (fat) cells in the body to replicate, and by improving the sensitivity of these cells to insulin, so more sugar is absorbed. Over time, resistance to the virus should occur as antibodies develop, but long-term studies haven’t yet been done.

* It is unethical to inject this virus into humans, but Dhurandhar has checked humans for the presence of this virus and has found that almost a third of obese people have been exposed to it, three times the number of thin people who have antibodies to the virus. This associated finding doesn’t prove that the virus leads to weight gain in humans, but it is suspicious.

* A vaccine may one day be developed against AD-36. In the meantime, the technology exists to check people at risk for obesity to see if they have the virus.

* The focus on this virus should NOT take needed attention away from the most common causes of obesity including sedentary lifestyle, poor diet, and low thyroid (found in 1/3 women). AD-36 may be a contributing factor in a minority of patients, but it is not an explanation or an excuse for the growing obesity epidemic.

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

It’s that time again - to hear the familiar coughing, sneezing and other symptoms of the common cold lurking out there this fall! How are colds spread? Well they grow mainly in the nose where they increase in number.  During the first 2-4 days (when germs are most likely to spread) they are found in the in nasal secretions.   

The common cold virus is most easily spread on contaminated fingers and hands after an infected individual “touches” or rubs their nose, eyes and/or various objects and surfaces. 

A recent review of thousands of patients studied was published in the Cochrane Database of Systematic Reviews.  These studies looked at if you would receive benefit from taking daily Vitamin C (about 200mg/day).  Those who took daily Vitamin C did not see a reduction in suffering. 

However, those individuals who were “highly stressed” (for example, marathon runners) had about a 50 percent reduction in the number of days they suffered with a cold. 

Here are some avoidance strategies:

1. Don’t forget to wash your hands vigorously with soap and water for at least 20 seconds after touching various objects, surfaces or another person’s hands (it physically helps to remove cold viruses).

2. Avoid rubbing or touching your eyes and nose.

3. Avoid directly facing an individual who is coughing and sneezing.
 
3. Know that not all germicidal lotions will adequately kill cold viruses.

4. Use liquid hand sanitizers frequently, especially when hand washing is not possible.

5. Limit your exposure (even brief contact) to those “sufferers”, especially during the first several days of their cold symptoms.

6. Stay home when you are “infected” with a cold virus.

7. Indoor air purification may assist in reducing exposure and/or transmission of to airborne cold viruses, at least in some clinical studies. 

8 . Getting adequate rest and sleep,  as well as a balanced diet is a good first step in keeping your immune system from getting overly stressed and thus will be better prepared to fight off illnesses such as flu and colds.

 Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Health authorities said a 70-year-old woman died and a 57-year-old man is critically ill in a Boston hospital after each was given a kidney from an infected donor, reports The Boston Globe.

The kidney was infected with a hard-to-detect virus, health officials said, which came from a 49-year-old homeless man who suffered irreversible brain damage and cardiac arrest.

The donor carried a germ called lymphocytic choriomenigitis virus, which is most often transmitted by rodents and usually unnoticed by healthy people who do not suffer anything more than flu-like symptoms, according to the newspaper.

The virus also killed three transplants patients in Massachusetts and Rhode Island in 2005.

Organs perish quickly and they are tested for diseases such as AIDS, hepatitis and herpes, but not usually viruses such as lymphocytic choriomenigitis. And, since the demand for organs is so great, recipients will often take the organs of homeless people, the newspaper said.

New outbreaks in China reported Wednesday put the number of children infected with hand, foot and mouth disease above 15,000 and the death toll has risen to at least 28 across the country.

A 2-year-old girl in the southern province of Hunan died of the disease after being in a coma, the provincial health bureau said on its Web site.

Another death was reported in the neighboring Guangxi region, Guangxi health officials said but did not give any details. The official Xinhua News Agency said the victim was a 3-year-old boy who died May 3.

Two kindergartens in Beijing were temporarily shut down Tuesday after children there showed symptoms of the disease, Xinhua said. There have been 1,482 cases in Beijing, most in kindergartens, it said.

So far, 15,799 outbreaks of the disease have been reported throughout the country this year, Xinhua said.

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