Q. If you are starting second trimester of pregnancy and have the flu is it safer for mom and baby to tough it out or take the Tamiflu? I am worried about side effects on my unborn grandchild. My daughter does not know what to do. - VM, Largo

A. Your daughter should speak with her doctor, but obstetricians I've talked to believe the anti-viral medication Tamiflu helps alleviate potential serious symptoms for pregnant women with the flu. There's risk to everything, but most doctors and government scientists believe Tamiflu poses no harm to mother or child and may help speed recovery.


Can you get a shot if you have a dairy allergy?
Q. My son is 21 months old and has severe allergies to dairy products. Can he still get the swine flu shot? I was told that the base of the flu shot contains eggs. - Monica, Laurel, Md.

A. People with allergies to eggs should not get the vaccine, which is literally grown in chicken eggs. While the Centers for Disease Control and Prevention hasn't set any restrictions involving persons with dairy allergies, I suggest you touch base with your pediatrician first to make the best decision for your son.

Got a flu shot; still need swine flu vaccine?
Q. I already have a flu shot. Do I still have to get an H1N1 vaccine? - Nelson, Carson, Nev.

Q. If you get the vaccine are they 100 percent sure that you won't get the swine flu? - Denise, Tampa

A. Getting a vaccine is completely up to you. The United States H1N1 vaccination program is completely voluntary for most of us. Some states, such as New York, require health care workers to get the vaccine. Also, active members of the military have orders to get vaccinated too.

But if you're wanting to avoid getting sick with the flu, health officials say the best prevention is separate vaccinations against both seasonal and swine flu. That's because the vaccines contain protection from different viral strains. One won't do a thing to help prevent the other.

Unfortunately, there are no guarantees the vaccine will work. Scientists say there's a 90 percent chance it will prevent you from developing flu symptoms.


If you're 80 or better, should you get vaccinated?
Q. If a person is 80 years of age, or better, should he or she be getting the swine flu shot? Otherwise in good health? - Robert, Venice

A. Seniors are encouraged to get an annual seasonal flu vaccine and the swine flu vaccine, health officials say. Swine flu has proven to affect young people most, and pregnant women are at particular risk, but it still poses a risk to all people, including seniors. That's especially true for seniors with chronic conditions such as emphysema.

Seasonal flu, as always, is a serious health risk to seniors.

The cost for getting a 'free' vaccine?
Q. How much will doctors charge for giving the free vaccine? - Chubby, Largo

A. The United States government purchased nearly 260 million doses of the H1N1 vaccine because it considers the new virus a public health emergency. Local public health clinics will administer the vaccines for free. But private doctors and clinics - such as your neighborhood pharmacy - will likely charge an administrative fee. It basically pays for the workers doing the vaccinations. Most local private clinics already charge between $15 and $25 for seasonal flu shots, so expect to pay about the same for H1N1 vaccination.
So far, at clinics in the Tampa Bay area, the charge for swine flu vaccine has been on the lower end because private providers can also obtain the vaccine at no cost.

What to do about swine flu and blisters?
Q. My 12-year-old son has swine flu and is now developing blisters on his palms? They are clear blisters and don't hurt. - Julie, Chesapeake, Va.

A. Call or go to your doctor's office for medical treatment immediately. Blisters on the palms are not a common symptom of the flu.

What's the sequence for different vaccines?
Q. After the seasonal flu shot, how long do you have to wait to get the swine flu shot? - Carola, Tampa

Q. Am I supposed to get the seasonal flu shot before I go and get my H1N1 shot or can I get the swine flu shot? - Cami, Hurricane, Utah

A. This whole vaccination thing is a bit confusing, partly because there's three different ways to get vaccinated. For people 9 and older, you can get seasonal and swine flu shots at the same time if you get shots, or one nasal spray vaccine and one shot. You will have to wait 21 days between vaccines if you prefer the nasal spray option only.

There are different rules for kids. Those 9 and younger need two doses of the swine flu vaccine 21 days apart, regardless of the way it's administered. Also, those getting seasonal vaccine for the first time may need to follow a similar two-dose regimen.  Of course, people with special medical conditions, and parents of young children might want to touch base with their doctor ahead of time.


Can I pass along swine flu if I'm vaccinated?
Q. Can you get swine flu if exposed to someone who received nasal vaccine? - Roberta, Great Neck, N.Y.

Q. If I take the swine flu shot and get low grade symptoms, can I pass the flu on to some one? - JR, Chicago, Ill.

Q. If your child is given the nasal vaccine, what's saying the parents in the house will not get the H1N1 virus from them? I mean, they are being injected with the live virus? And if there is a two-week old infant in the house, should the children vaccinated stay away from the infant child? - Edward, Browns Mills, N.J.

A. Most people don't realize that you can still carry a flu virus after you've gotten a vaccine in either a nasal spray or shot form. The difference is that you carry the virus, but don't get sick. This applies to all people with the vaccination, regardless of age. Hillsborough County Health Department Director Doug Holt told me chances are much less that vaccinated people are carrying the virus than those who opt not to get it. But it's very important that all people continue to be diligent about hand washing, coughing and sneezing into your sleeve and using hand sanitizer. You won't get the flu, but you might share it with someone nearby.

Can you get vaccinated if you're sick?
Q. Can my child get the shot when he already has a slight cough/cold? - Corinne

A. The Centers for Disease Control and Prevention recommends people with a fever wait and recover before getting vaccinated. Those with nasal congestion also may want to wait. That's because a vaccine doesn't protect for several days and could aggravate existing illness. The CDC also says people with diarrhea or minor upper respiratory-tract infection can get the swine flu nasal spray vaccine.

What's the difference between vaccinations?

Q. What's the difference between the nasal vaccine and shot, and which one should we get? - Wendy, Harrisburg, Pa.

A. There are three kinds of vaccines: a nasal spray, a single dose shot, and shots that come from a multi-dose vial.

The nasal spray is what's called a live vaccine, meaning it carries a trace of the actual virus. The Centers for Disease Control and Prevention said the following people should not get the nasal spray: children younger than 2, children younger than 5 with a history of wheezing, pregnant women, people 50 and older, persons with compromised immune and respiratory systems, children or teens taking aspirin therapy, people who have had Guillan-Barre syndrome, and those with severe allergic to chicken eggs. The nasal spray does not have Thimerosal, a preservative containing traces of mercury that is the source of much debate over vaccine safety.

The single-dose shots are individually packaged by the drug maker and also do not contain Thimerosal.

'Swine flu' stuck even after pigs discounted

Q. Where does the term "swine flu" come from? - Evelyn, Houston

A. The H1N1 virus known as the swine flu has nothing to do with pigs. But it got the name, according to the Centers for Disease Control, because initial lab tests showed many of the genes in the virus were similar to those in flu viruses normally seen in North American pigs. Eventually, researchers learned the virus is much different and includes genes from viruses seen in humans, European pigs and Asian birds. But despite the best efforts of the pork industry, the name has stuck. It's important to know you cannot get swine flu by eating pork. Humans interacting with live pigs can sometimes be exposed to a flu virus.

How can you tell one flu from another?

Q. Lately I am hearing that many kids are getting a "touch" of the swine flu. How do they know the difference between the viruses? - Valerie, Livermore, Calif.

A. Doctors aren't really testing any more for different kinds of flu, because all of them stink. Your standard symptoms for both swine and seasonal include a fever of 101 or more, sore throat and dry cough. Swine flu has been the predominant flu strain in the United States since April, and is far more contagious to younger people than the traditional seasonal flu, The traditional seasonal flu season is expected to start in November or December, adding to the misery.

How does the swine flu spread?
Q. How does swine flu spread? - Ankur Gupta, Madurai Tamilnadu, India
A. Swine flu was first detected in the United States in April, and spreads primarily through human-to-human contact. That's why sneezing and coughs are such a worry. People carrying the virus can unintentionally leave it lingering in the air, or on countertops or computer keyboards. That's why health officials are so militant about hand washing, hand sanitizers and asking people to cover their coughs.

Sick but no fever, so what is it?
Q. My daughter and I are both sick, but have no fever. I am reading lots of Web information that U.S. officials assume there is fever with H1N1, but that other countries have found possibly 50 percent of cases have no fever. Where can I find a reliable source on this? - J. Schult, Cortland, N.Y.

A. There is so much information out there, it's impossible to know what's true. The only way to be certain if you have the flu is to visit your health care provider and ask them to perform what's called a rapid test. They swab inside your nose, and test for influenza. If you just feel lousy and don't want to see the doctor, read up on the topic at http://www.flu.gov - the official U.S. swine flu site.

Had it in August; still need vaccine?
Q. My 6-yr-old has already had the swine flu in August 2009. Can she get it again and worse? Should she get the nasal vaccine just in case? I don't know what to do. - Susan, Naples

A. If your child tested positive for the H1N1 virus specifically, she will be immune from getting it again. However, I would suggest you check with your doctor since nearly all clinics are only doing a quick general test for any influenza virus. The swine flu vaccine, like the seasonal vaccine, only bolsters the chances she won't get hit with the flu again.

Can classmate still spread the flu?
Q. A girl at my school had the swine flu and was only out for four days from school and she says she is cred. Is it safe or can she still pass virus on? - Chary, Lake Elsinore, Calif.

A. Swine flu affects every single person differently. As a general rule, most people are done carrying the virus about 24 hours after the fever disappears. Your friend's parents probably considered that before sending her back to class.Your best chance to stay healthy is to keep on practicing good hygiene: frequent hand washing, using hand sanitizers and coughing into your bent elbow.

Can child get both vaccines at once?
Q. My county is about to begin offering the Swine Flu vaccine through school. The Seasonal Flu vaccine is being offered at the same time. Is it safe for a young child (mine is 5) to have both at the same time? - Hope, Riverview

A. Children, ages 9 and younger, will need two doses of the swine flu vaccine, given about 21 days apart, according to the Centers for Disease Control and Prevention. A child getting seasonal flu shots for the first time also may need a similar multiple dose vaccination. I suggest you talk directly with your pediatrician on the sequence.

Can live virus in nasal mist spread?

Q. If someone receives the H1N1 nasal vaccine, can they infect others by sneezing due to the fact that they are vaccinated with a live virus? - Jamie, Paintsville, Ky.
A. In clinical studies, transmission of vaccine viruses to close contacts occurred only rarely. The current estimated risk of getting infected with vaccine virus after close contact with a person vaccinated with the nasal-spray flu vaccine is low (0.6%-2.4%). Because the viruses are weakened, infection is unlikely to result in influenza illness symptoms since the vaccine viruses have not been shown change into typical or naturally occurring influenza viruses.

Shot or mist for kids with sickle cell?

Q. Is the swine flu shot or the swine flu nasal mist best for children under 18 who have sickle cell trait? Also my 8 year old has sickle cell trait and has to take a monthly shot for allergies to dust mites. Which swine flu option is better, the swine flu shot or the swine flu nasal mist? Also is it true that children under the age of 10 need to have a second dose of the swine flu vaccination? How much time should be between the 1st vaccination and the 2nd vaccaination for children under the age of 10? Thanks. - Angie, Winter Springs

A. It's important that you are vaccinated against the flu in order to prevent complications from influenza. Based on your question, either vaccine would be appropriate, however, it's best that you consult your doctor. In general, seasonal flu vaccine for children 6 months to 8 years old should come in two doses separated by at least four weeks. This applies to children who are receiving influenza vaccine for the first time or who failed to receive the second dose in the preceding year.

Doctor knows best with breast cancer patient

Q. I have metastasized breast cancer now in my bones and am on chemo. My doctor said because of my age I didn't need an H1N1 shot, however with my compromised immune system wouldn't it be a good idea? - Andrea, Whittier, Calif.

A. You did the right thing in consulting your doctor. As he is treating you for a chronic condition, he would be in the best position to advise you.

Torn over safety, mom seeks assurance

Q. How safe is this H1N1 shot or nasal spray? I have heard it has caused some pretty serious problems. ... I love my children. I want them to be safe but I'm not sure what is best at this time? I am a single mother of three and my children have recently been offered the shot at school. What happens to the parent or parents at home after the children have been treated?
If I understand correctly they're being given the actual virus and it's very contagious, and at this time it's only being offered to school children and health-care workers? So if I was convinced that the shot itself wouldn't be a threat to my children and they have it then I would be putting myself and anyone whom comes around me or my children in danger. Do you have confirmed info that might help me not to be so torn about what would be the best thing to do? - Rhonda, Palatka

Q. My child's daycare is offering the nasal H1N1 vaccine. Is this safe for young children? - Mary, Inverness

A. This seems to be the biggest question on people's minds right now. And it's a decision each family must make individually after considering how best to protect against this illness, which is mostly mild but carries very real health risks.

The voluntary swine flu vaccine has been tested the same way government officials handle the testing for the annual seasonal flu vaccine. Thousands of predominantly healthy individuals were given the vaccine in clinical trials. They were watched for possible side effects and complications. The Food and Drug Administration approved the vaccine for use before any doses were made and distributed.That being said, you may want to read up on the pros and cons of vaccination before making a decision.

How much time between shots?

Q. How soon after you get the normal flu shot can you get the H1N1 shot? - Donna, Davenport

A. The answer depends on how you're receiving the flu vaccination. You can get shots, and you can get a nasal spray.
If your seasonal flu dose comes in either form, you can get a swine flu shot in the same sitting - no waiting. However, if you get the nasal spray for seasonal flu, and want the nasal spray for swine flu, too, you will have to wait at least 21 days between them, the Centers for Disease Control and Prevention says.

Why don't more people sneeze into elbow?

Q. My child came home from school saying that they learned to cough and sneeze into their elbow with Germy Wormy, and I was totally taken aback. I always covered with my hands. But I went to the website and now I get it, hands touch, elbows don't!! Kids can touch 300 surfaces in half an hour and they hate to wash their hands. This is a simple thing that can make a huge difference. There is also an entertaining DVD that teaches them in a fun way the elbow cough, as well as other important hygiene habits. - Mary, California

A. I confess I haven't yet seen Germy Wormy, but it sounds cute and raises an important point for people curious about what they can do to stay healthy. Frequent hand washing and coughing and sneezing into your elbow are critical to stop the spread of the influenza virus. Even people with the flu vaccine can still serve as carriers of the illness, health department officials say. So stay clean regardless.

Where, oh where, can we get vaccinated?

Q. Where can I get a swine flu vaccination for my family? My wife is pregnant and does clinicals at the hospital. Her school canceled the vaccination. My daughter goes to daycare and I'm in the age group that's at risk. What do we do? - Christopher, Tampa

Q. Can my 1-year-old get the swine flu vaccine and where? -Liz, Marietta, Ga.

A. The Centers for Disease Control and Prevention recommends both the seasonal and swine flu vaccine for anyone 6 months old and older. It is not safe for infants younger than 6 months. Young children, especially those with respiratory problems, are at very high risk.

If you want a swine flu vaccine, you should first contact your primary health care provider and see if he or she has the vaccine. Your pediatrician can also best tell you how urgent a concern it is in your particular case. But be prepared to wait. Across the country, people are aggravated by the slow release of swine flu vaccines and its limited distribution to the public. Federal officials say they may not be broadly available until mid-November.

Priority groups - via schools, obstetricians, hospitals and pediatricians - are getting the vaccines first in most communities. That's so those most at risk can get a chance to be vaccinated first. Children and pregnant women are among that group.

Is swine flu the same as influenza A?

Q. My daughter got diagnosed with Influenza A. Is Influenza A the same thing as Swine Flu (H1N1)? I have heard it is I would like to just know for sure since they did not test for the swine flu (H1N1)? - Michele, Beecher City, Ill.


A. The answer is yes. Swine flu - or the H1N1 virus - is categorized as a Type A influenza. There also is a type B influenza. Most doctors are doing basic flu tests to see if a person with symptoms has one of these two types of flu. More than 95 percent of all Type A influenza right now is believed to be swine flu.

Q. I have heard that if you have sensitivity to eggs you should not have the swine flu jab? Is this true? - Kath, United Kingdom

A. Flu vaccines are made with eggs, so anyone with allergies to eggs should avoid vaccination, the Centers of Disease Control and Prevention says. People who have previously had a negative reaction to a vaccine also should avoid it.

Where do high-risk patients get vaccine?

Q. I have seen that high risk persons can get the swine flu vaccine, but nothing is ever mentioned where these high risk people can get the vaccine. Where do high risk people go to get the vaccine? - Debbie, St. Petersburg

A. If you fall into the high-risk groups, you should first contact your medical provider to see if he or she is offering the H1N1 vaccine. If not, you'll have to wait until more vaccine is available in the community through shot clinics like the ones we see at local pharmacies and walk-in clinics.

The CDC says people who are at high-risk of complications from either H1N1 or seasonal flu are children younger than 5, but especially children younger than 2; adults 65 and older; pregnant women; and people with medical conditions including cancer, blood disorders, chronic lung disease, diabetes, heart disease, kidney disorders, liver disorders, neurological disorders, cerebral palsy, brain or spinal cord injuries, mental retardation or developmental delay, neuromuscular disorders, and weakened immune systems.

What can Tamiflu do for children?

Q. Can Tamiflu be given to children (my daughter is 6 years old) to help prevent symptoms? And if so, why didn't my doctor offer it when we know she more than likely has swine flu? - Bobbie, Centreville, Va.

A. Antivirals like Tamiflu only help to lessen the symptoms and severity of the virus. They do not prevent it.

Can pandemic flu survivor pass down immunity?

Q. My 91 year old mother is a survivor of the 1918-1919 pandemic. As long as she can remember, she has never had another flu since. Nor have I contacted a flu to the best of my knowledge. Is it possible for the children of the pandemic survivors to have built up an immunity to flu viruses? - Leon, Lakeland

A. The new 2009 H1N1 virus does not seem to be affecting people 65 years and older in the same way that seasonal flu usually does. Most people who have gotten sick from this new virus have been younger. In fact, people 65 and older are the group that is least likely to get infected with this new virus. There have been relatively few infections and even fewer cases of serious illness and death with this new virus in people older than 65. Laboratory tests on blood samples indicate that older people likely have some pre-existing immunity to the 2009 H1N1 flu virus. But while people 65 and older are the least likely to be infected with 2009 H1N1 flu, those that do become infected are at greater risk of having serious complications from their illness.

If you're 40, is injectable vaccine better?

Q. Thanks for all the great questions/answers. I'm a police officer and wondering if I should get the nasal H1N1 shot now, and also get the injectable version later? I've heard the injectable is 50 percent better for my age group (I'm 40). -Jamie, Rockford, Ill.

A. We got help from the Hillsborough County Health Department on this question. Here's what they say: "The study you are referring to has been acknowledged by the CDC. However, it is a single study and more data are needed to confirm if one is better than the other. Both vaccines are expected to be to be effective against the 2009 H1N1. For individuals greater than nine years of age, only one vaccine is recommended." Go here to find the CDC's Q&A concerning the intranasal mist.

Older people worry they won't get a shot

Q. My mother is 87, has COPD, and other health issues. When can I find a Swine Flu shot for her? Can I get one? I have high blood pressure but am basically healthy. I am 62. We are very worried. - Dianne, Ormond Beach

A. Again, the health department weighs in: "The most important thing for you and your mother to do is get a seasonal flu shot now and then the H1N1 flu shot when it's available. Currently, the H1N1 flu is affecting people in the age group of 4 to 46 more often than any other group and the effects of the seasonal flu seem to be worse on this group, too.

"Based on your mother's condition I would first check with her doctor and see if he or she is a Florida Shots H1N1 vaccine provider. If so, you'll be able to receive the shot from your doctor. Otherwise, the H1N1 vaccine will be available in the community in the coming weeks.

"Currently the nation is experiencing a delay in H1N1 vaccine shipments. Your local county health department will be publicizing when and where vaccines will be available."

If swine flu hits young, why are old dying?

Q. The CDC says that swine flu hits kids the hardest. But the statistics show the overwhelming majority of fatalities are adults. So isn't it more severe in adults under 65? - Erik, Seattle

A. You're right that swine flu fatalities do happen most in adults. It's the less serious and far more prevalent minor cases where public health officials worry about children and teens.
This past week in Florida, nearly 14 percent of all hospital emergency room visits were children ages 0 to 19 with flu-like symptoms, the state Department of Health reports. Only 6 percent of visits were adults 20 to 49 who reported flu-like symptoms, and 2 percent were adults 50 and older with those symptoms. Remember that far more than 1 million Americans have been hit already by swine flu, and a vast majority suffered mild or moderate symptoms for a few days. Public health officials are targeting that larger group in hopes it can decrease the chances of more death.

Can you catch the virus again?

Q. Once you have had the H1N1 virus, can you catch it again? - Diane, Yorba Linda, Calif.

Q. If you get the swine flu can you get it again and do you need to still get the vaccine? - Beth, Hudson

A. You both ask one of the most common swine flu questions out there. And it's getting asked because the answer isn't easy or clear.
The specific H1N1 or swine flu virus can be caught only once, as your body will become immune. But it's important to know that there are very few people who know for sure that it's swine flu they caught. Swine flu has hit well over 1 million Americans since April. Because it is so widespread - and the symptoms are mostly mild - public health officials stopped asking doctors to do the specific test for the virus. Most doctors are doing what's called a rapid test, which only shows you may have a type of flu. So you're sick, but you really can't be certain with which virus.

Now onto vaccines. Swine flu vaccine is designed to prevent the specific H1N1 virus strand. The seasonal flu vaccine, which already is widely available, prevents three different viral strands scientists predict will be flying around this winter.

Each vaccine protects against specific viruses and will not help with the other. The good news is that all the vaccines are voluntary, so you get the final say whether swine or seasonal flu vaccines are best for you.

Should you be offering advice?

Q. Do you really think it's in the readers' best interest for someone who is not a medical professional to be giving medical advice to the masses? It seems as though they are receiving no other advice than to see their physician. - Jamie, Tampa

A. I agree that trained medical professionals should be the only ones issuing advice. We're here to try to clarify confusion about all the information out there. Details about vaccines, for example, change on an almost daily basis and we want the community to have the most updated information available. We're tapping our sources for information, and in the case of detailed medical information, we're asking staff from the Hillsborough County Health Department to answer questions directly.

Q. As a health care worker in a small office in Pasco County, where and when can our staff receive H1N1 vaccine? - Jen, San Antonio

A. Health care workers all over the country are asking this exact question. And no one seems to have a clear answer.

Vaccines for swine flu, or H1N1, are being distributed as soon as they are released by the pharmaceutical companies. More than 259 million doses of the vaccine will be manufactured. Delivery, however, is far slower than anticipated and the flu already is widespread. Just yesterday, Oct. 21, the availability problems prompted some local health department officials revise their plans for vaccinating priority groups, such as health care workers.

That means you will have to continue to wait. Your best bet is to find out from your office supervisors whether they ordered the vaccines directly from the state Department of Health or if you have to wait for distribution through the Pasco County Health Department.

Swine flu shot safe after shingles?

Q. I had the seasonal flu shot and right after I had a painful case of shingles, so would it be safe to take the swine flu shot? I am 80 years old. - Joan, Plant City

A. I'm not a medical doctor, and would encourage you to speak directly with your health care provider about shingles. It's an uncomfortable illness that many older persons must live with daily. Your question, however, raises an important point about vaccines and different types of viruses. The swine flu wave hitting the United States is a different strain of virus from shingles and seasonal influenza. Vaccines are available for all three viruses, but none of them should present more than mild side effects for most people. Here's what we know about the different bugs:

Swine flu, or H1N1, is a virus caught by human to human interaction - such as sneezes and coughs. Symptoms are mild for most of the more than 1 million Americans who already have had it: a fever of at least 100 degrees, a sore throat and body aches. It usually runs its course in three to five days.

Seasonal flu is an influenza strain similar but distinct from swine flu. Its symptoms also include fever and body aches, but it tends to hit older people more seriously than the swine flu. It, too, can be spread through human contact.

Shingles is a virus related to chicken pox. In fact, people who have had chicken pox as children are at risk of having shingles emerge later in life. It's a virus that lingers in your body and can reappear throughout life. Symptoms include burning or shooting pain and tingling or itching, usually on one side of the body or face. The pain can be mild to severe. Blisters then form and last one to 14 days, according to the National Institute of Allergy and Infectious Diseases.

Shingles lives in the blisters that develop, and that's the only way it can be spread, says the American Academy of Family Physicians. If you have shingles blisters, wait until you are completely healed to be around babies less than a year old and pregnant women.

I don't know if it's more than a coincidence that the shingles appeared when you got your seasonal flu vaccine. Your doctor will be the one to best answer that specific question.

Aren't pregnant women a priority for shots?

Q. I am pregnant in my third tri-mester with two small pre-school children. The news tonight showed special education children receiving the injectable vaccination today in Hillsborough County and detailed schedules for all other school aged children. However, the OB/GYN and pediatrician do not have any information as to when they will receive the vaccination. Do you have more information about these other high risk groups that seem to be getting missed? - Katie, Tampa

A. You're right that special education students in some local schools did get the swine flu vaccine starting on Tuesday, Oct. 20. It's the first vaccine in shot form available locally that can be taken by high-risk individuals, such as developmentally disabled children and pregnant women.

If the last few weeks is an indication, deliveries are arriving constantly, but in small amounts for those most at risk for complications. The Hillsborough health department said today, Oct. 21, that more will be available next week to OPB/GYNs.

But the announcement came amid news that manufacture of the vaccine is behind schedule. Even priority groups can't be served if nothing is available.

The state Department of Health is distributing the vaccine as it becomes available in two ways. It's either going to local health departments, which are targeting schools in particular, or e than 3,000 private doctors who have placed orders for vaccine. 

I suggest you call your OB/GYN and ask if he or she has signed up for the "Florida Shots" program, which is where private doctors request vaccines. If so, you'll likely receive notice as soon as it arrives.

If your OB/GYN is not on the list, call the health department, explain your situation and ask how you can best get a vaccine once it becomes available. That way, you'll be ready to go once it's here.

Why not vaccinate before school started?

Q. Why did they open the schools, why not wait until everyone had the shot and then open the schools, seems like a lot of people could avoid getting ill.- Sandy, Largo

A. When it comes to issues like infectious diseases, timing is everything. And in the case of swine flu, everything went bad early on.

Swine flu was first identified as a new virus in April, and the Centers for Disease Control and Prevention quickly tried to slow the spread of the disease, which we all now know has hit people worldwide and killed thousands. Scientists started developing a vaccine for swine flu as soon as they knew about it. But it takes about six months for a safe, acceptable vaccine to be developed, tested and produced. That's why you're only seeing the vaccine arrive now.

And that's also why you see a separate vaccine for seasonal flu; that vaccine's production was already underway in April, when H1N1 emerged as a fast-spreading virus.  It would have been a logistical nightmare to keep tens of millions of students out of school until now. And it likely wouldn't have made a big difference anyway, considering the disease spread a lot this summer at summer camps and other places where kids are known to congregate.

Until now, advice about hand washing and coughing into your elbow were the best prevention available.

Can it be swine flu without a fever?

Q. I have sore throat and severe chest pain but no fever. Can it be swine flu without fever? - Crystal, Ozark, Ark.

A. I'm sorry you don't feel well, and I hope you've talked with your doctor or visited a local health clinic to get professional advice.

I can only share with you what we've learned so far about swine flu's symptoms. Yes, fever is the most common symptom people with flu experience, but it is not the only one. A sore throat and body aches can be a big part of the illness as well.

The most important thing to remember is that flu - like any disease - manifests differently in every person it hits. Some people may be so sick they're in bed for days. Others may have a mild bout where they don't even realize their stuffy nose is the high-profile swine flu.

That's why it's important that you touch base with a doctor, or at least send yourself to bed if you're feeling sick. Young children, pregnant women and individuals who already have compromised respiratory and immune symptoms are extremely vulnerable. You may feel OK, but the virus you share may hit someone else far more seriously.

Q. Why do some people die and others don't? Do they die in their sleep? Why can doctors not help them? - Lisa, St. Petersburg

A. Thanks for your question, Lisa. Sometimes the simplest ones are the most important. Like any disease, influenza affects each person differently. And sadly, some people have died from the swine flu, including more than 110 in Florida. Those who are most at risk for getting severely ill and dying from swine flu are people with already-compromised respiratory systems. That includes small children, whose bodies are not developed enough to easily fight the swine flu strain, and pregnant women.

Others with respiratory diseases like emphysema also are likely to get seriously ill if exposed to the bug.

These people don't necessarily die in their sleep. It's the infection in their respiratory system that's responsible for the death.

It's important to remember that it's not just swine flu that's deadly.

Every year, seasonal flu is responsible for more than 36,000 deaths nationwide. What's different this year is that swine flu is grabbing a lot more headlines. It's a new, unknown type of influenza scientists are still trying to figure out.

No one wants to see death from something as treatable as flu. That's why so many doctors are suggesting people get vaccinated for both the seasonal and swine flu.

Vaccination is the best known prevention to the disease. 

Shots coming for pregnant women?

Q. When will the "shot" versions be available for pregnant women? Where can we get it? - Pete, St. Petersburg

A. Great question. I'm sorry to say there's no specific answer. State public health officials in charge of distributing the swine flu vaccine are on call, waiting for the arrival of the first injectable doses to arrive, likely in the next few weeks.

Once they arrive, they will go immediately to local doctors and clinics serving pregnant women, one of the most vulnerable groups to this virus.

Drug makers are creating the swine flu vaccine in three ways: in a nasal spray form, in individual syringe doses, and in multi-dose vials, from which health care workers can draw multiple doses of the vaccine into individual syringes.

Pregnant women and persons with serious medical conditions should only get the injectable forms of the vaccine. That's because the nasal spray is made with a live, weakened virus, which may be riskier for people with compromised immune systems.

When will college students get vaccine?

Q. When will the colleges have the vaccine to give to the college students? I called HCC Dale Mabry Campus and they stated they know nothing? They don't seem to care. It will take someone to die before anything gets done there. They are in the age bracket of 24 and younger? Plus, they are around thousands of students daily. - Linda, Tampa

A. Some higher education officials are as frustrated as students are, waiting for the vaccines to arrive. The medical director at the University of South Florida student clinic, Egilda Terenzi, says she expected the vaccines to arrive two weeks ago. She's looking for them any day now. She said the university will follow Centers for Disease Control and Prevention guidelines to determine who should be vaccinated first. Here are the priorities, straight from the CDC Web site:

• Pregnant women

• Persons who live with or provide care for infants aged less than 6 months (e.g., parents, siblings, and daycare providers)

• Health-care and emergency medical services personnel

• Persons aged 6 months-24 years, and

• Persons aged 25-64 years who have medical conditions that put them at higher risk for influenza-related complications.

Got flu? 'Miserable' comes with the territory
Q. I went into the ER Wednesday night and they said I have the H1N1 flu. My chest hurts SO bad that I could break down and cry, and I can't seem to get the fever to break. Is there anything other than Tylenol that I can do for the chest pains? They also say that it is supposed to run its course in 3 to 5 days. I have been sick with the pains and fever for 7 days now. Should I go back in? - Amy, Northfield, Minn.

A. I'm sorry you're feeling this sick, and I would encourage you to speak directly with your doctor, or return to the emergency room you visited last week.

In general, swine flu is a mild influenza, but that doesn't mean you won't be miserable. Fever is the most common symptom, as are body aches. Most doctors offer an anti-viral medicine, such as Tamiflu, to help lessen the symptoms.

I can't speak to your specific condition, but know it's best for you to return to the same health care provider for more treatment. They can answer your questions best.

Can a body build immunity to swine flu?

Q. I'm wondering if someone has had symptoms of swine flu i.e. high fever, cough, body aches, etc and H1N1 has not been confirmed but most likely is the illness does the body build up immunity to swine flu and is it still recommended that the person receive the vaccine? - Karen, Oldsmar

A. Thanks for your question. It's one I've heard a lot from people who think, but are not certain, they had swine flu. The Centers for Disease Control and Prevention, and many local doctors I've spoken with, suggest that you play it safe and get both the seasonal and swine flu vaccine this year. That's because the tests most docs are using for influenza are not foolproof, and do not test for the specific seasonal or swine flu strains. Tests doing that are expensive - about $300 - and would be too time-consuming for a doctor's office overrun with coughing, feverish patients.

Yes, there is a chance you did develop immunity to the virus. But know that the only way to know for sure that you have had swine flu is to undergo the expensive tests, which mostly are being used on people already in the hospital. Health officials hope folks heed their advice.

Send a sick boy home from day care?

Q. I have an in home daycare. My question is one of the mommies has tested positive for H1N1. Her child was sick last week with many symptoms but, tested neg. What precautions can I take to keep myself and the children safe? Can her child contract it and pass to us? He is getting better from what he had and has returned to school. He still has a cough, no fever. Please help. I just want to keep everyone safe. - Mellisa

A. It sounds as if you have a good understanding of the most important issue about flu season: fever. According to the Centers for Disease Control and Prevention, that's the single best indicator for a person to know if a child may have the flu. If the boy or any of your children show signs of a fever, he's likely they have an infectious virus. And that's a sign he should stay home.

He should return only when the fever is gone, without the help of medicine such as Motrin, for 24 hours.

And you are right to wonder about the flu tests. Many of the so-called "rapid tests" being done by doctors are showing up negative even when a person shows all the symptoms of flu (fever, cough, sore throat and aches). A test to determine if it is indeed swine flu is simply too costly and time consuming for clinics to offer right now.

Many doctors I speak with - including my children's pediatrician - say the flu test is not a good indicator of flu. They say if a child shows the symptoms for more than a day, treat it as if it is the flu. And right now, 97 percent of all flu cases are swine flu, so it's fair to assume that you should follow all the safety rules including:

• Frequent hand washing
• Teaching children to cough into elbow and not hands
• Throwing away tissues as soon as they are used once
• Wiping down surfaces with disinfectant wipes (germs can linger for up to 8 hours).
• Using alcohol-based hand sanitizer