Your Questions Answered

Our regular updates on the H1N1 virus have sparked a lot of questions among our readers, so we've provided a list of your most frequently asked questions and their answers in order to keep you informed, allay your fears, and help keep you safe and healthy.

Q: At what point should I seek medical attention if I believe I've been exposed to the swine flu?
A: You should seek medical attention if you've been suffering from any flu-like symptoms (such as fever, headache, body aches and cough) for more than 24 hours. Let your healthcare professional know if you suspect you've been exposed to the H1N1 virus (widely known as the "swine flu") because of recent travel to Mexico or contact with someone diagnosed with the disease.

Q: If I received a swine flu vaccine during the swine flu outbreak of 1976, am I safe from infection by the current swine flu virus?
A: No. The vaccine you were given to guard against the H1N1 virus is unlikely to provide protection against the current strain of the virus. But a new vaccine is being developed and could be available as soon as June, 2009.

Q: Can I get swine flu from eating pork products?
A: No. The flu is not spread through food, so there is no danger of getting swine flu from consuming pork products.

Q: Can I be infected with swine flu if I handle a pig fetus during a classroom dissection?
A: No, it's highly unlikely for you to be infected in this way. The preservatives used to prepare a pig fetus for dissection should kill any virus the fetus may have been exposed to.

Q: Can my pets become infected with swine flu?
A: Not likely. According to veterinarian Michael Watts, "There is no evidence that dogs, cats, or 'pocket pet' species can be infected with the new H1N1. Although the virus contains some genetic material from an avian influenza virus, there is no evidence this strain can infect birds." Even so," the doctor says, "You should contact your veterinarian any time your pet develops symptoms of a respiratory infection."

Q: How effective is the use of facemasks in preventing swine flu infection?
A: Masks can be effective when used properly. The mask should fit snugly over your mouth and nose, and it should be changed every couple of hours, because prolonged exposure to your own moist breath can turn the mask into a sponge that soaks up outside germs, making you even more susceptible to infection.

Q: I'm pregnant. Should I take greater precautions than others when it comes to the swine flu?
A: Yes. There's evidence that pregnant women could be at higher risk for complications when it comes to infection with H1N1, so pregnant women should be tested for H1N1 and get treatment immediately if they test positive.

Q: How can frequent travelers avoid becoming infected with the swine flu?
A: Frequent travelers should take the precautions everyone else does to prevent infection, including washing hands frequently and avoiding contact with sick people. Make sure to use disposable paper towels in public restrooms for drying hands, turning off faucets and opening doors.

Q: Why has there been such a high death rate for those infected with swine flu in Mexico?
A: The World Health Organization is still investigating the spread of H1N1 in Mexico and why mortality from the virus has been so high in that country. Some experts point to the poverty of the victims, the large concentration of people in such a small area, and the hesitation of those inflicted to seek swift medical attention as possible answers.

Q: What are my chances of a full recovery should I be infected with the swine flu?
A: Excellent. The anti-viral drug treatments Tamiflu and Relenza have proven extremely effective in combating the H1N1 virus. Just make sure you keep a close eye on your health and get treatment if you come down with symptoms that point to the swine flu.

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Swine Flu: What You Need To Know

Swine Flu Update - Tuesday, May 5, 5:00pm:

A 33-year-old Texas woman, already suffering from other health problems, died today from the H1N1 virus. Though not yet reflected in today’s report from the Centers for Disease Control and Prevention, this makes the second H1N1 death in the United States. Last week, a toddler from Mexico died from the flu in a hospital in Texas.

According to many experts, most of the confirmed cases in the U.S. have been much less severe than expected. "We have started to see encouraging signs that this virus may be mild, and its spread may be limited," said Homeland Security Secretary Janet Napolitano in a press conference.

Also today, President Felipe Calderón lessened the national alert level in Mexico, where the flu has apparently begun to taper off. The government did cancel Cinco de Mayo festivities, though, as a precaution.

Swine Flu Update - Tuesday, May 5, 8:00am:

With 403 confirmed cases in nearly 40 states, U.S. health officials are backing off severe public alerts. Most of the cases have been milder than expected, and school closings do not seem to help stop the spread.

“So far, the severity of illness in this country is similar to that of [seasonal] flu, and that's very encouraging, said Richard Besser, acting director of the Centers for Disease Control and Prevention.

On a global scale, H1N1 has sickened at least 1,124 people in 21 countries. The virus appears to be easing off in Mexico, where it hit the hardest.

Swine Flu Update - Monday, May 4, 3:00pm:

After four days with most of the country’s operations shut down, Mexican officials announced today that many businesses will reopen on Wednesday. The Mexican Health Ministry said Saturday that the worst of the virus is over.

Meanwhile, China has quarantined dozens of Mexican travelers, leading Mexican government officials to say their citizens are being unfairly targeted.

Here in the United States, the Centers of Disease Control reports confirmed cases 36 states, up six states since Sunday. However, most of the 279 cases have been relatively mild. "While we're not out of the woods, we're seeing a lot of encouraging signs," said CDC Acting Director Richard E. Besser in a press briefing today.

Swine Flu Update - Monday, May 4, 8:00am:

The World Health Organization’s official tally lists 985 confirmed cases in 20 countries. Colombia and El Salvador are the latest countries joining the list.

Responses in different parts of the world are causing political tensions, not to mention travel problems. Roughly 70 Mexican travelers have been quarantined in Chinese hospitals and hotels, leading Mexico authorities to claim discrimination. On Saturday the Chinese government cancelled all flights from Mexico, leaving many Chinese travelers stranded.

Adding to the overall controversy is the statement by Mexican health officials that the H1N1 flu is easing off. Some health experts claim WHO may have overreacted with warnings that a pandemic is imminent.

“I’m not predicting the pandemic will blow up, but if I miss it and we don’t prepare, I fail,” WHO General Director Margaret Chan said in a recent interview. “I’d rather over-prepare than not prepare.”

Swine Flu Update - Sunday, May 3, 6:00pm:

Latest totals have reached 898 confirmed cases in 18 countries, with Colombia reporting the first confirmed case in South America. Here in the United States, 226 confirmed cases have been reported across 30 states, the most recent being in Pennsylvania.

In Mexico, Health Secretary Jose Angel Cordova said evidence suggests that the H1N1 flu is on the decline in that country, with 506 confirmed cases and 19 deaths. The epidemic has slowed, Cordova said, because of the government’s lockdown on schools and businesses and ban on public events.

Meanwhile, the World Health Organization urges that any farm animals possibly infected with H1N1 must be contained and monitored. The concern follows an outbreak among pigs in Alberta, Canada, where the virus was apparently spread when a farm worker, after becoming ill in Mexico, unknowingly infected the animals. Health officials are working to understand how the virus was passed from person to pig.

Swine Flu Update - Sunday, May 3, 10:00am:

The number of confirmed cases continues to rise, but the World Health Organization says there are still no signs of a pandemic.

According to the latest tally from the Centers for Disease Control and Prevention, 21 states have reported 160 confirmed cases in the U.S., with one death. WHO announced 787 confirmed cases in 17 countries. Officials stress that a pandemic indicates the geographic spread of a disease, not the severity. To become a full-fledged pandemic, H1N1 would need to spread across communities in at least one other country in a new region of the world.

On Saturday, Canadian health officials reported that a herd of pigs in Alberta had become infected, apparently by a farm worker who became ill on a recent trip to Mexico. This is the first reported case of H1N1 showing up in pigs, and the first case where the virus has apparently crossed from human to animals. Both the farm worker and the 2,200 pigs have recovered.

In a joint statement released Saturday, the United Nation’s Food and Agriculture Organization, WHO, and other international health groups said the H1N1 virus cannot be spread by eating pork and pork products. "To date there is no evidence that the virus is transmitted by food," the statement said.

Swine Flu Update - Saturday, May 2, 10:00am:

The first confirmed case of H1N1 in Hong Kong has led to the quarantine of close to 300 people after health officials determined that a hotel guest had contracted the virus.

After a 25-year-old Mexican man stayed in the hotel and later became sick, officials ordered some 200 guests and 100 staff to remain in the hotel for seven days to stop the spread of the virus.

On Saturday morning, the World Health Organization said that although it is still preparing for a pandemic, the sharp rise in the number of confirmed cases of swine flu to 658 was due to the confirmation of suspected cases in Mexico as opposed to newly reported instances. While the majority of cases have been in Mexico, a total of 16 countries now have confirmed of H1N1.

"What the increase reflects is that we are moving forward in confirming many of the cases that have been left untested for some time, so in an way that's reassuring," said WHO spokesman Paul Garwood. "So we haven't seen, say, a spike in new cases or new influenza cases appearing in Mexico City, for example," Garwood continued. "It's just the fact that this reporting backlog is bearing fruit and we're seeing the results of that."

Read Dr. Paul Auerbach's blog about who should get tested for the virus.

Swine Flu Update - Friday, May 1, 9:00am:

The warning level remains at Phase 5 on a six-step scale, indicating that a pandemic is imminent. So far 11 states have had confirmed cases of the H1N1 virus, commonly called swine flu. Today the number of confirmed cases worldwide rose to 331, up from 257 on Thursday, according to the World Health Organization.

During a pandemic, a new virus affects people in several parts of the world at the same time, with mild to severe consequences. “Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world,” said WHO General Director Margaret Chan in a statement on the organization’s web site. “On the positive side, the world is better prepared for an influenza pandemic than at any time in history.” U.S. officials and drug manufacturers are working on a vaccine.

Swine Flu Update - Wednesday, April 29, 9:30am:

The CDC has confirmed the first fatality in the US from swine flu, a 22-month-old child who traveled from Mexico to Houston, Texas for treatment.

"I can confirm very sad news coming out of Texas that a child has died from the H1N1 virus," Richard Besser, MD, acting director of the CDC, said in an interview with CNN. "As a parent and a pediatrician, my heart goes out to the family."

This is the first death attributed to the outbreak in the US, where the reported cases have to date been relatively mild compared to those in Mexico. Health officials have been warning the public for several days that that could change.

Swine Flu Update - Monday, April 27, 4:30pm:

The World Health Organization’s Emergency Committee met today and recommended that the level of influenza pandemic alert be raised from a phase 3 to a phase 4. This indicates that the likelihood of a pandemic has increased, not that one is certain. Epidemiological data about the human-to-human transmission and the ability of this specific virus to cause community-level outbreaks led to the decision. The WHO is not recommending the closing of borders or the limiting of international travel at this time.

Visit the World Health Organization’s website for more information on a phase 4 pandemic alert.

Here’s what you need to know about swine flu:

Why is Swine Flu in The News?
The number of fatalities in Mexico coupled with reported cases in the US, Canada and New Zealand brought the outbreak to the attention of health officials and the media. Also of concern is the fact that the strain in Mexico is attacking healthy young people, a trait usually associated with pandemic flu bugs.

What is Swine Flu?
Swine flu is just what it sounds like…a strain of flu that effects pigs and usually remains just that. Sometimes a strain of swine flu will mutate and is contracted by humans. This strain appears to be a mixture of swine, avian and human viruses and mutated viruses concern health officials due to their resistance to existing vaccines. A high fever, consistent cough, sore throat and possibly vomiting and diarrhea are the most common symptoms of swine flu, but those symptoms can be caused by countless other conditions as well. If you or someone you’ve been in close contact with has recently returned from Mexico and your flu-like symptoms persist, contact your doctor. Only a lab test can identify swine flu.

No vaccine for swine flu exists currently, but the Center for Disease Control has begun the steps needed to create one, in case that becomes necessary. This season’s flu shot does not offer protection to this virus.

What is the Government Doing?
Since this is a quickly developing outbreak and there are still many unknowns, the White House has likened their efforts to preparing for a hurricane. "Really that's what we're doing right now. We're preparing in an environment where we really don't know ultimately what the size or seriousness of this outbreak is going to be," Homeland Security Secretary Janet Napolitano told reporters. The act of declaring this a public health emergency clears the way for shipping roughly 12 million doses of flu-fighting medications from a federal stockpile to states that may need them. The Center for Disease Control says that isn’t currently needed, as the cases in the US are less severe than those in Mexico.

While the government is taking the right precautions, it’s important to point out that this is not a global pandemic — at least not yet. The true number of cases, why the Mexican cases are more severe and how easily the virus spreads are sill unanswered.

Can Swine Flu be Treated?
Yes. This specific strain can be treated with Tamiflu and Relenza.

How to Protect Yourself
The most common question on everyone’s mind is “how can I protect myself?” The good news is that common health tips that help stop the spread of seasonal flu can be effective with preventing swine flu as well. The following are recommended steps from the CDC:

• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.
• If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them. What is the best way to keep from spreading the virus through coughing or sneezing?

At this point, the best advice is to take the right precautions and to not panic. The CDC will be issuing statements and advice as more information is known. Follow the developments on Healthline.com and other major news outlets.

Healthline’s Chief Medical Officer, Dr. Paul Auerbach will be posting ongoing updates about this outbreak in his blog.

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Drinking Milk After the Expiration Date

Question: Can I Drink Milk After The Expiration Date?

Answer: This is a common question we receive at Healthline and there’ve been plenty of headlines over the past year to keep food safety issues on everyone’s minds. Chances are most of us can confess to pulling a carton of milk out of the fridge, frowning when noticing the expiration date has passed and then unscrewing the lid to subject it to the “smell” test.

When milk is pasteurized, most of the truly harmful bacteria are destroyed. But even pasteurized milk begins to deteriorate pretty quickly and really only remains “fresh” for a couple of days after the expiration date. Keep in mind that other factors, such as leaving the milk out at room temperature for too long, can cause the milk to spoil faster. Even the temperature of your refrigerator, which is typically lower than that of the cases at the supermarket, can have an impact.

While the bacteria that causes milk to turn sour and spoil can cause food poisoning and be dangerous for young children or those with compromised immune systems, it is unlikely that drinking spoiled milk could kill an adult, but that’s assuming you can get past the smell and taste to drink it.

If you have drunk milk past the date on the carton and are concerned, remember that the FDA gets involved in regulating package expiration dates in a surprisingly few number of instances. That’s not because they aren’t keenly interested in public safety, but instead that in most cases, the dates have to do with the quality of the food and aren’t indicators of safety.

The Bottomline: Use common sense. It isn’t likely to kill you, but drinking smelly milk a couple days past the expiration date has some obvious health risks.

What Package Terms Mean:

“Sell By” – This is really meant to be used as guidance for the store or market to direct them when to remove items from the shelf. Lots of shelf-stable products, like canned fruits and vegetables, have sell-by dates and you really shouldn’t purchase these products after their respective dates.

“Best If Used By” or “Best Before” – This term refers to the flavor or quality of foods and in most cases, products will be safe for some length of time after their best-before dates. Packaged baked goods, for instance, often use a best-before date to indicate when the product will start to taste stale.

“Use By” – Products display a “use by” date as more of an expiration date. This should be treated as a slightly less formal expiration date and is also the last date that manufacturers are going to vouch for a product’s quality.

“Expiration Date” – It is safer to discard products after their expiration date. While other terms have some ambiguity, treat this one as what it says.

Read more about food safety.

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What is Supplemental Health Insurance?

Even if you have a robust employer-provided health insurance plan, you may be surprised to discover what isn’t covered by the plan and what you have to pay out-of-pocket for your health expenses like doctor visits and prescriptions. When you start to add up your medical expenses (and those of your spouse and children) it might make sense to consider a supplemental health insurance plan. These plans can help lower your insurance costs, expand the number of healthcare providers available to you and also expand the services you can receive at a discounted cost. Your individual needs will help determine what kind of supplemental plan would serve you best, as specific plans have specific goals.

Supplemental Dental Plans

Many employer-provided dental plans are great at covering major procedures, but may be less effective at paying for regular maintenance like teeth cleanings, fillings and check-ups. A supplemental dental plan can help lower your out-of-pocket costs for your more common dental needs. Another option could be a dental discount program. These aren’t quiet insurance plans, but can offer discounts on services at member dentists.

Plans Covering Alternative Medicine

Very few employer insurance plans cover alternative or complementary medicine like acupuncture, massage therapy or the services of a chiropractor. Depending on your individual needs and how frequently you use these types of services, a supplemental insurance that helps cover the costs of alternative treatments might make financial sense for you.

Medicare Part D

Seniors often find themselves paying out-of-pocket costs for prescriptions. A Part D plan is a supplemental insurance plan that helps cover costs that fall in the “gap”, the difference between when your plan has paid a certain amount for covered medications and until your drug costs hit a specific limit ($3850 in ’08). Learn more about Medicare Part D.

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Finding the Right Supplemental Dental Insurance

40% of Americans are not receiving the dental care they need. And 70% of Americans either don’t have dental insurance or the ability to pay for full-price dental work out of pocket. Even those who have work-sponsored dental insurance may be surprised by how little many of the programs actually cover. That reality coupled with the rising cost of dental care has led many people to secure either supplemental dental insurance or a discount dental plan or both.

Supplemental dental insurance is meant to cover costs not covered by your primary dental insurance. Most work-sponsored plans cover the most expensive procedures but skip more common needs, which can over time be quite expensive. If you are considering finding a supplemental dental insurance plan, start by getting the complete details of what your current plan covers and what it doesn’t. Then work with your dentist to create an estimate of your dental needs for the next two years. This should include regular cleaning and maintenance, any other expected work and some buffer for emergencies. From there you can match your needs to the right supplemental plan.

Discount dental plans aren’t technically insurance plans, but they will help lower your dental costs. A dental discount plan leverages the large quantity of their members to secure lower prices for their members. When you visit one of the member dentists, you’ll receive special (and often significant) discounts on treatments and procedures. A discount dental plan can cost as little as $5 per month and can save several times that on an annual basis. When selecting a discount dental plan, check to make sure that your regular dentist is in the group.

When you’re ready to compare supplemental dental plans, visit an online resource like www.esurance.com or a company specializing in supplemental plans like www.reassurancehealth.com.

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