So far, the swine flu has claimed few people in comparison to the yearly flu numbers.  However, it seems that in many of the cases where there is no apparent reason for death, a bacterial superinfection may have been the cause.  A few of the cases that have been reviewed by the CDC did, in fact, have a super-infection with bacterial pneumonia.  This means that doctors may need to redefine their approach to the worst cases of the flu, and consider adding antibiotics to treat for a bacterial infection, even in patients with the flu for which a bacterial pneumonia has not been diagnosed.  Bacterial pneumonia or superinfection were the most common cause of death in the last few pandemics.  We have to increase our level of suspicion for these types of infections in patients with severe flu symptoms, or patients that progressively get worse.  Treating earlier in its course will likely save lives.  Read more here.

In NY, the State Health Department adopted emergency regulation over the summer making flu shots mandatory for all hospital, home-health and hospice workers.  Now, whether hospitals are going to enforce this with their employees is another question.  Do we have a right to choose whether we get vaccinated or not against an illness that is self-limited for the majority of people?  Do we have a right to choose what is put into our bodies?  Apparently, there are those, like Dr. Julie Gerberding, the former director of the Centers for Disease Control and Prevention, who think making vaccinations mandatory is for the greater good.  In this case, mass vaccination of healthcare workers with the flu shot would serve the purpose of saving the few.  Whether this has been shown by the evidence to be true is still up to debate.  However, where does individual sovereignty end?  How much should our government protect us against ourselves?  People should have the right to choose to not get a flu vaccine if that is in their belief system.     Read about it here.

This year's flu season is coming early.  In its weekly press briefing, the CDC reports that flu activity is being reported in all 50 states, with 21 states reporting widespread activity.  Perhaps, a mild summer and early fall are the perfect storm for the coming wave of influenza in the Northern Hemisphere.  The novel H1N1 strain continues to be the dominant strain reported in the US, and it continues to show mild to moderate disease, with general susceptibility to the anti-viral agent Tamiflu.  It continues to spread most widely among children and young adults, with the SouthEast showing the highest rates right now (likely because children there started school before Labor Day).  You have to wonder, though, if there is observer bias.  This year more than any other year, parents and adults will be more likely to make a doctor's visit for flu symptoms, for which they would have usually just stayed at home and let it run its course.  People are nervous about the potential deadliness of the "swine flu,"  yet all reports show that it is no more virulent (or deadly) than the regular flu.  You can read more about this update here.

Google is teaming up with the CDC to offer a flu-tracking engine that they have been developing over the last f ew years.  It is based on the fact that web searches for flu symptoms and treatments increase when there is a flu outbreak.    When compared to the CDC's own actual disease tracker, the two graphs mirror each other pretty well, except that Google is reporting in real time, which is 2 weeks ahead of the CDC.  This is pretty useful information for keeping track of flu activity in your area.  Check out the website here.

The Health Protection Agency, the official body overseeing public health in England, sent a letter to 600 Neurologists warning that the swine flu vaccine could potentially cause an increase in Guillain-Barre' Syndrome, a neurologic disease described in a previous post.   An increased risk of GBS was found in the 1976 Swine Flu Vaccine, which caused the U.S. government to withdraw the vaccine weeks after a vaccination effort had been started.   The U.S. Centers for Disease Control and Prevention, on the other hand, has been understating this risk, advising that the new, fast-tracked swine flu vaccine is safe for the general public, including children.  Read more here.

Things may seem very obvious, but if you are to survive this "swine" flu season unscathed, it's a good idea to stock up on some Vitamin D before the end of the summer (which is practically over).  The skin converts Vitamin D to its active form using the energy from the Sun's UVB rays.  This reaction produces approximately 10,000 IU of vitamin D after a 10 minute exposure.  So, it doesn't take that long to get your daily dose of Vitamin D, without increasing your risk of skin cancer.  Always use SPF 15 or greater sunblock when out in the sun for longer.  And check out the upcoming eBook, "The Ultimate Swine Flu Survival Guide" for more information about how Vitamin D can be used as a preventative for the swine flu.

The CDC is understating the potential of Guillain-Barre' Syndrome (GBS) from the H1N1 (swine flu) vaccine.  GBS is a rare disorder in which the person's immune system attacks its own nerve cells, causing loss of muscle control, weakness and possibly peripheral paralysis leading to respiratory failure.  In its worst form, GBS is life-threatening.   The 1976 swine flu vaccine program was halted because of an association with a slightly increased risk for GBS and a less than aggressive swine flu, with only limited cases.  Rest assured that if GBS rates go up due to the vaccine, the CDC will be monitoring closely in a retro-preventive kind of way.  See http://www.cdc.gov/h1n1flu/vaccination/gbs_qa.htm