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1:02

Good afternoon, and welcome to our chat with Dr. Juan Dumois, pediatric infectious diseases expert at All Childrens Hospital, St. Petersburg. He is joining St. Petersburg Times health reporter Letitia Stein and health and medicine editor Charlotte Sutton to talk about H1N1 (swine) flu. So please give us your questions for the doctor.

Dr. Dumois, you were just telling us about a family you know with a two-year-old boy. You said you recently saw him, and he seemed fine and healthy. But the next day, he was in the hospital due to swine flu. What happened? Why is this flu striking so quickly?

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Dr. Dumois: He had probably caught the flu when I saw him looking well, but quickly the symptoms evolved and progressed to the point that he had to be hospitalized the next day. He, like most of us, had no prior immunity to this strain of flu, and being so young, he was not able to fight it off readily and so got sick very quickly. He's stable in intensive care now. It's too early to know his prognosis, but I feel optimistic.

1:05	[Comment From Darlene] The vaccine package inserts all state the vaccines have not been tested for carcinogenic, mutogenic potential, or reproductive damage. Vaccines have side effects. How then can the CDC, govt., etc. state the vaccine is safe for all.

1:08

Dr. Dumois: No flu vaccine will ever show evidence of testing for those three listed possible effects, because those would require long-term (months to years) animal and human studies that aren't practical for a product that needs to be put out within a few months to provide protection during the flu season. However, previous flu vaccines have never shown any of those types of side effects. So we know that the new vaccine is safe based upon studies that are done every year, with every new flu vaccine, on several thousand volunteers. The swine flu vaccine is made in the same way as the seasonal flu vaccine has been made for years.

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[Comment From Dan in Largo]
I have a question about the fatalities linked to swine flu. I understand the need for medical privacy, but it is frustrating to hear someone who died had an “existing medical condition”. That information is only useful if the public knows what medical conditions can prompt a fatal case of swine flu. Could you go into detail about these “existing medical conditions” and why is it they have led to fatalities?

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Dr. Dumois: Although the CDC does not release such detailed information right away other investigators have given us some preliminary information about these underlying conditions. The most common are common lung disease, especially asthma, conditions that weaken the immune system, and diabetes. Persons with chronic lung disease are more susceptible because their lungs just can't handle the damage caused by the virus. Persons with diabetes have a weakening of their immune system that makes it hard to fight the virus. Pregnant women are more susceptible to severe disease or death from the flu because their pregnancy weakens their immune system. This is a natural phenomenon that occurs in order to prevent the woman's body from rejecting the baby as a "foreign body.'' Furthermore, the enlarging baby pressing upward on the lungs, affecting normal lung function and increasing the lungs' susceptibility to damage from the flu.

1:13	[Comment From Kimberly] How is it most commonly spread?

1:15

The flu is most commonly spread by touch. If I have the flu, and cough into my hand, and then touch a doorknob, it can exist on that doorknob for 24 hours. The next person who touches that doorknob will get the virus on their hands. If they touch their mouth, nose or eyes before cleaning their hands, they will become infected, even if they were nowhere near the infected person. This is why frequent hand cleaning or use of hand sanitizers is a relatively effective way of avoiding the flu when you're out in public. You can also acquire the flu if a sick person coughs or sneezes in your direction and you're standing within six feet of them. If you're standing farther away when they cough or sneeze, the infected particles will settle out of the air before they get to you.

1:16	[Comment From Chris] Thank you Dr. , my son was just diagnosed with H1N1 and was sent home and told to bring him back if he worsens..nothing was prescribed...any ideas?

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Dr. Dumois: If your son is over 5 years old and has no underlying medical conditions, then it's more likely that he will recover fine from the flu without requiring any medications. The warning to bring him back if he worsens is a very important one. Worsening of symptoms after an initial improvement and loss of fever could be a sign that a bacterial pneumonia has occurred as a complication of the flu. Some specific signs of worsening would be: new fever, worsening cough or difficulty breathing, lips or skin turning blue, or the child is acting more lethargic. Any of these signs would warrant returning him to the doctor. Children under 5 or who have underlying medical conditions may be better candidates for treatment with flu medicine (Tamiflu or Relenza) in order to avoid their higher risk of complications.

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