Do you know your swine flu? Quiz and Q&A

Do you know your swine flu? Quiz and Q&A
(Readers questions follow article)
By Liz Szabo, USA TODAY
Here are answers to questions you may have about swine flu:

Q: What is swine flu?

A: It's a common respiratory disease in pigs that doesn't usually spread to people. When pigs catch this flu, many get quite sick, and 1% to 4% die, according to the World Health Organization. In the past, people have sometimes caught swine flu if they worked directly with pigs.

VIDEO: Reporters Liz Szabo and Dan Vergano answer your swine flu questions

Q: How is this swine flu virus different?

A: This strain appears to be a subtype not seen before in humans or pigs, with genetic material from pigs, bird and humans, according to WHO. Unlike most cases of swine flu, this one can spread from person to person, said Richard Besser, the acting director of the Centers for Disease Control and Prevention, at a White House press conference Sunday. One of the confirmed cases in the USA caught swine flu from a spouse, who had been to Mexico.

Q: Is the disease being overhyped?

A: Flu is a serious disease that kills about 36,000 people every year. Pandemic flu has killed millions of people in outbreaks in the past century. Although new cases are proving more mild, the 2009 swine flu has killed at least 20 people and is a novel form of the virus new to people's immune systems, spreading daily to more countries and receiving intense attention from public health officials around the world.

Q: How do you catch it?

A: You can get sick if someone coughs near you, because the disease spreads through microscopic respiratory droplets, says Martin Blaser, former president of the Infectious Disease Society of America. You also can get sick from touching a surface where droplets have landed, then touching your mouth or eyes. Although people are contagious before they show symptoms, they are most likely to spread the virus when they're coughing, Blaser says.

Q: What are the symptoms?

A: The most common symptoms are fever, fatigue, lack of appetite and coughing, although some people also develop a runny nose, sore throat, vomiting or diarrhea, according to the CDC.

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Q: What should you do if you have flu symptoms?

A: Stay home. Don't go to work, school or travel until you've been free of symptoms for a day, Blaser says. If possible, ask in advance about working from home in case you or family members become ill.

A small number of people are at higher risk, because they have been to Mexico — or have had close contact with someone who has.

Those who don't fit that profile probably have an ordinary flu, Tallman says. Most people can recover from the flu just fine at home. Stay in bed, drink lots of fluids and take acetaminophen for pain. Wash your hands frequently, and cover your mouth when you cough.

Q: When should you call the doctor?

A: If you're sick and have been to Mexico, or have close contact with someone who has, call your doctor for advice about being tested and treated, Tallman says. Patients should see a doctor if they have trouble breathing, vomit uncontrollably, become delirious or have other types of "altered mental status," says Mary Klotman, chief of infectious diseases at New York's Mount Sinai Medical Center.

Q: How can people protect themselves?

A: As always, people should wash their hands frequently and cover their coughs, Besser said.

Q: Does antibacterial soap kill swine flu?

A: Soap and alcohol-based cleansers kill viruses, and flu is a virus. But antibacterial substances kill bacteria, not viruses.

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The best preventive practice is to wash your hands often with soap, don't pick your nose or rub your eyes, and if you feel sick, stay home and call your doctor.

Q: What about face masks?

A: There are two types of facial protection, says William Schaffner, a professor at Vandebilt University School of Medicine. Surgical masks are designed to keep germs in — so you don't infect someone else, while N95 respirators are designed to keep germs out, so a sick person doesn't infect you.

Right now, there's no need for the general public in the USA to wear either, because swine flu cases are still very rare, Also, masks that are worn properly tend to be uncomfortable, Schaffner says. A properly worn surgical mask will fit snugly over both the mouth and nose, which can make a person feel warm and even claustrophobic. A N95 respirator, which must be properly fitted to form an airtight seal agains the skin, can make it hard to breathe.

Q: Is there a vaccine against swine flu?

A: No, but government scientists could try to create one, according to the CDC. "We've identified the virus," Besser said. "Should we decide to manufacture a vaccine, we can work toward that goal very quickly."

Even if scientists can make a vaccine, however, there likely won't be enough to vaccinate everyone, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Government officials would likely have to ration the vaccine, giving priority to people with critical jobs, such as healthcare workers and others. CDC scientists don't know if this year's flu vaccine offers any protection.

Q: What about antivirals? Can they prevent swine flu?

A: This strain of swine flu does appear sensitive to the antiviral drugs Relenza and Tamiflu, but not to amantadine, or Symmetrel, and rimantadine, or Flumadine, Besser said. With normal seasonal flus, if taken within the first 48 hours after symptoms appear, antivirals can help people recover a day or two sooner. Doctors sometimes prescribe antivirals to household members of people with the flu to prevent them from getting sick.

Q: So should we all take Tamiflu, just in case?

A: No.

EXPERTS: Tamiflu, Relenza work on swine flu but only sickest should get it

Antiviral drugs are a precious commodity, and doctors have to use them judiciously, Osterholm says. And overusing antiviral medications could actually make Americans more vulnerable, by encouraging the growth of resistant strains of flu viruses, Blaser says. The best way to make sure that antivirals keep working, he says, is to use them sparingly.

Q: What is the incubation period for the flu?

A: In most cases, infected people develop symptoms within one to four days, Blaser says.

Q: Should people who have recently traveled to Mexico be concerned?

A: Only if they have flu-like symptoms, such as a fever, cough and body aches, or in some cases vomiting, says Thomas Tallman, head of emergency preparedness at the Cleveland Clinic. If it has been more than a week since you returned from Mexico and you aren't sick, you can relax.

Q: Were pigs the carriers of this virus?

A: It's closer to say that pigs were the mixing bowl for this virus. Birds can't pass bird flu to people. But pigs are uniquely susceptible to getting flu viruses that infect birds. Experts have long worried that a pig would catch a bird strain of the flu and then the virus would mutate inside the pig to a form that could also infect other mammals. That may be what happened in this case. Pigs can also be infected with more than one influenza virus at a time, allowing the viruses to share genes, called "genetic reassortment," creating new and potentially much more virulent viruses.

Q: Can you catch swine flu from eating pork?

A: No, according to WHO. Pigs coming in to slaughter facilities are monitored for flu symptoms, and those that are ill are not allowed to enter the food supply. Cooking also kills the virus. People who work with pigs, however, can catch the virus. The Department of Agriculture is conducting tests to confirm that the food supply is safe, said Janet Napolitano, secretary of the Department of Homeland Security.

Q: What does it mean for the government to declare a public health emergency?

A: While the declaration "sounds more severe than it is," Napolitano said Sunday, it will free up funds and allow health officials to use medications and tests that aren't normally used. The government also issued a public health declaration during recent floods in North Dakota and Minnesota, she said, and noted that the government often issues such declarations when hurricanes are approaching. The federal government is also releasing 25% of the 50 million doses of antiviral medications in the nation's Strategic National Stockpile, Napolitano said. The Department of Defense is also making 7 million doses available.

Contributing: Elizabeth Weise and Dan Vergano, USA TODAY

ANSWERING READERS' QUESTIONS

Selected questions that USA TODAY readers posted in the comments section below:

TESTING

http://www.usatoday.com/news/health/thumbs-squares/avatar-th.jpgQ: darlad1 asked: When your doctor does a swab test how long does it take to find out if you any type of flu virus, then how long does it take to confirm the type of virus?

"Most often, your doctor will conduct a rapid diagnostic test to determine what type of influenza you have -- A or B," says Aaron Glatt of New Island Hospital in New York, a spokesman for the Infectious Disease Society of America. "These results are available usually within a very short time frame (hence the term 'rapid'). Swine flu is an influenza A type, so those with influenza B are unlikely to be infected with that strain. However, not everyone with influenza A has the H1N1 virus which causes swine flu. If you do test positive for influenza A, the sample is sent to a reference laboratory where it will be tested for H1N1 virus infection. The amount of time it takes to get those results usually depends on the time it takes to get the sample to the lab and then how much time passes before the lab runs the next batch of tests. All of this can be done the same day, if necessary."

SYMPTOMS

http://www.usatoday.com/news/_photos/2009/04/28/pierced-th.jpg• Q: PiercedPsycho asked: Sounds like the regular flu. Why freak out?
A: That's the big question. Experts at the Centers for Disease Control and Prevention say they have to be aggressive, because they have no idea if this outbreak will fade away or turn into a deadly pandemic. So far, most Americans have recovered on their own without being hospitalized. But today's new of a toddler's death in Texas -- he had traveled there from Mexico -- shows that this outbreak has the potential to be serious.

• Q: elejohn asked: We've been told about the flu symptoms, but what actually causes death?
A: Beyond compromising the lungs, the flu can impair organ function across the body. That's why people with underlying heart and kidney disease are so vulnerable to the flu, says William Schaffner, a professor at Vandebilt University School of Medicine. The flu can damage the lungs, lead to bacterial pneumonia, which can be deadly. Pneumonia causes many of the 200,000 hospitalizations due to flu each year, as well as many of the 36,000 annual deaths.

TRANSMISSION AND PROTECTION

• Q: whezz asked: I wonder if people living far away from pigs have any risk of this?
A: How close you live to pigs won't affect your chance of getting this disease. While pigs can become infected with it, it's being transmitted person-to-person now, without pigs, say the CDC and World Health Organization.

• Q: debsews2002 asked: Can you get swine flu by touching raw pork from the grocery store?
A: You cannot. Pork meat does not contain the virus. Even pork lungs do not, according to the National Pork Producers Council. About the only way you could get the virus from a pig would be if you tracked down a pig that was sick with this particular flu strain and then had it cough in your face. But WHO, the CDC and a number of other international and national health organizations are busily looking for pig herds infected with this virus, and they haven't been able to find any yet. It may have infected one herd, been transmitted to humans and then died out in the pigs. Authorities are still investigating.

• Q: jollygirl16 asked: [If] someone coughs the virus onto a doorknob, how long does the virus live on the doorknob?
A: "We know that some viruses and bacteria can live two hours or longer on surfaces, such as doorknobs and desks. Frequent handwashing will help you reduce your the chance of getting contamination from these common surfaces," says Georges Benjamin, American Public Health Association director.

http://www.usatoday.com/news/_photos/2009/04/28/shaggy-th.jpg• Q: Shaggy asked: Are masks purchased at local stores strong enough to protect against viral-infected droplets?
A: There are two types -- surgical masks are designed to keep germs in, so you don't infect someone else, while N95 respirators are designed to keep germs out, so a sick person doesn't infect you. Right now, there's no need for the general public in the USA to wear either, because swine flu cases are still very rare, says Schaffner.

http://www.usatoday.com/news/_photos/2009/04/28/yogi-th.jpg• Q: Yogi_Bears_Tie asked: Does wearing gloves help?
A: "Masks and gloves are extra layers of protection against a virus. Currently, neither are being recommended for the general public," Benjamin says. "It is more important that people are washing their hands frequently, covering their mouths when they sneeze or cough, and avoiding close contact with people who are ill. If you are the caregiver of someone with influenza, gloves and masks are extra steps that can be taken to protect yourself from transmission if you are picking up soiled tissues or in other close contact with germs."

• Q: JMGN asked: Should we be concerned if we acquire a product that was "Made in Mexico"?
A: No, Schaffner says. The flu virus doesn't live on surfaces long enough to travel on products, such as clothing or pottery.

1976 SWINE FLU

• Q: Bunny3 asked: Because my husband was a dental tech, back in the late '70s, his employer had everyone get what was then considered a swine flu vaccine. Was this considered a one-time, forever vaccine back then???
"No, someone who was vaccinated for the swine fly in the 1970s can not assume that they are still protected today, as the virus can change and mutate," Benjamin says.

TRAVEL

• Q: ypaganelli asked: My husband and I going to Orlando ... are there precautions we should take in airports, planes, etc.? He won the trip and we really don't want to cancel.
A: Experts say that people should take the same precautions -- such as washing their hands after going to the restroom and before eating -- everywhere. Although people do spread the flu by coughing, a sick person has to be within about three feet of you -- and usually within an enclosed space -- to make you sick, Schaffner says. That's because the flu virus clings to microscopic respiratory droplets that fly into the air during a sneeze or cough. These droplets quickly land on the ground. You're less likely to breathe in a flu virus in the big, open space of an airport terminal than if you were in a small space, such as a taxi cab.

• Q: Reg Santos asked: Is it OK to take Tamiflu as a preventive medication while traveling in the infected areas of Mexico?
A: "The CDC recommends that travelers from the United States going to Mexico who are at high risk of severe illness from influenza (for example, persons with chronic conditions such as diabetes, lung disease, heart disease and the elderly) take antiviral medications for prevention of swine influenza during travel," Benjamin says. "Individuals should consult with their physician for specific recommendations."

PEOPLE AT EXTRA RISK

• Q: hulliefan asked: I'm a cancer patient undergoing chemo. My immune system is always in a compromised state ... Is there anything I can do along with my my usual protection routine (handwashing, mask, staying out of high risk places) in order to not contract this flu?
A: Your usual protection routine sounds exactly right, says the American Cancer Society's Terri Ades. You don't need to do anything else to protect yourself from swine flu, but it is reasonable to be even more vigilant and careful about following your doctor's advice, just because this illness adds yet another threat. People with AIDS, who also have compromised immune systems, also should be extra careful. People going through chemo should also track local news, because local health officials may have specific advice for people in areas with high numbers of cases, she says.

• Q: onthegomom asked: If a young child or infant were to catch this would it be worse than an adult getting it?
A: Because this new type of swine virus has never been seen before, doctors don't yet know who is most vulnerable. Newborns are usually more vulnerable to regular influenza, however, partly because their immune systems aren't yet fully developed, Schaffner says. Frail elderly people, especially those with underlying health problems, are also more likely than others to die of regular, seasonal influenza.

ANIMAL SOURCE?

• Q: Narob asked: Since this new virus has bird, pig, and human genetic material, what was the manner in which the recombination between the genes in these three organisms occured? Where and how would this have occured?
A: That's unknown at this point. Past swine flu outbreaks have involved pigs becoming infected with avian influenzas and then the pigs acting as a kind of Petri dish, eventually creating a swine-avian hybrid influenza strain, which then evolves into something transmittable to humans. Researchers are still trying to figure out exactly how this one came about, according to WHO.

• Q: redhat44 asked: I understood the bird flu is one of several viruses which may have combined to create this new strain. My hubby doesn't think I should be feeding the birds, many of which are going to be returning from wintering in Mexico. Do I need to take precautions?
A: It's unlikely that migratory birds are carriers of this virus. While the pigs that it evolved in were likely also infected with avian forms of influenza, the virus that's causing all the problems now is no longer an avian virus, according to CDC.

--By Elizabeth Weise and Liz Szabo, USA TODAY

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