Ask Dr. Marie: Five FAQs About H1N1 Flu

Many doctors are getting the same questions from the public regarding swine flu.

April 30, 2009, 6:38 PM

May 3, 2009— -- I can't turn on the television or radio or pick up a newspaper without hearing about the new flu strain. Note: I am personally calling it the "new flu strain" rather than the "swine flu." And, I confess, although I am not overly alarmed by what we know so far, my public health training has me concerned and intrigued by this story, too.

As I do countless radio interviews for ABC News on the subject, I find that everyone is asking the same smart questions.

Although pigs are great incubators for many different strains of viral influenza, there is no evidence that pigs are infected. Even if pigs are infected somewhere in Mexico, eating cooked pork products would not pose a risk for influenza (although other infectious illnesses, like trichinosis, can occasionally arise from poorly cooked pork).

Influenza viruses live in the respiratory tract and infect our nasal and upper respiratory passages, not our gastrointestinal tracts. The confusion, I think, comes from naming this the swine flu rather than just calling it what it is -- a new flu strain. Still, calling it the swine flu is understandable because this new strain has a mixture of genetic material, including material that originated from pig viruses.

We will only know in retrospect, likely next year after the next flu season has passed, whether to be very worried. Because all influenza or flu viruses are constantly changing and mutating, there is no way to know so early in the research of this virus what exactly will happen.

And, as historians have long reminded us, the pandemic of 1918 started with a mild outbreak of the flu in the spring followed by a devastating and deadly flu season the following fall and winter. When it comes to risking our health and, potentially, our lives, it is always better to be safe than sorry -- even if that means directing much of our attention in the media to understanding more about this virus.

The U.S. Food and Drug Administration-approved face masks work well in a hospital setting where a patient is known to be at risk for an infection. Immune-compromised patients wear masks to protect them from others germs and patients with certain contagious diseases, such as tuberculosis, that are passed on through the respiratory tract.

There is no good evidence that face masks would work in the community, although it makes sense that they could be of some help. What does work is to minimize contact with the virus by washing or sanitizing our hands frequently, staying home if we are sick, and avoiding sneezes or coughs into our own hands or within six feet of others.

A face mask needs to be changed frequently because our own breathing will cause the mask to get wet. A wet mask allows more viruses and bacteria to pass through.

Finally, a face mask doesn't prevent tiny particles such as some viruses from getting through, so it may not work anyway. To me, face masks give a false sense of security and may tempt someone who is sick to go out in the community and potentially infect others.

The two newest antiviral medications, Relenza and Tamiflu, may help prevent caregivers and household contacts from getting the flu. But for people who are already infected and sick, they must be taken early in the illness to do any good. Research has shown that they shorten the illness by a day or so, but I know of no evidence that they will prevent deaths or severe illness.

What worries me the most about advertising these drugs is the fear that people will take them indiscriminately and resistance to the drugs could develop quickly. Of course, this warning applies to antibiotics for bacterial infections, too. But the flu virus seems to mutate faster than most other infectious agents.

Researchers have already identified the genetic code of the new flu strain and, with more information on the severity and kind of strain that is infecting people, laboratories are hopeful they can come up with the right combination of strains to give us the greatest protection next fall.

And to those who worry about side effects from the vaccines, I can reassure you that today's vaccines have much less viral material and more of a safe generic adjuvant or "irritant" in them to get the immune systems attention and, so, are thought to be much safer.

Swine Flu Questions for Dr. Marie Savard

I welcome your thoughts and questions.

Dr. Marie Savard is an ABC News medical contributor. Her new book, "Ask Dr. Marie: Straight Talk and Reassuring Answers to Your Most Private Questions," will be available in August.

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