Swine flu chat transcription

The Daily News hosted its first-ever online chat today. We asked Dr. Ron Hershow, an infectious disease expert at UIC, about swine flu, and readers had some great questions. Below is the chat.

12:01 Alex Parker
Friday, May 01, 2009 1:01 PM
Hi everyone. I'm Alex Parker, public health reporter for the Daily News. We're lucky to have Dr. Ron Hershow, associate professor of infectious disease at the University of Illinois at Chicago, with us. He's going to be taking your questions about swine flu.

12:01 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:01 PM
Hi Everybody! Looking forward to taking your questions.

12:02 Alex Parker
Friday, May 01, 2009 1:02 PM
Ron, we've heard a lot about swine flu recently. What are the major differences between this new strain and the regular flu?

12:04 Alex Parker
Friday, May 01, 2009 1:04 PM
And just so our readers know, Dr. Hershow is typing his answers as he gets them, so please be patient.

12:04 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:04 PM
The regular flu is something that emerges every winter. It often bears a close resemblance genetically to strains that circulated in the previous season. The swine flu, however is a totally new virus that emerged recents probably from pigs. It is completely new to us, and therefore we have no immunity to it which gives it the potential (and we're not sure it will realize that potential) to spread widely and extensively around the globe--> pandemic potential

12:04 Comment From Peter Sachs
Friday, May 01, 2009 1:04 PM
Dr. Hershow, it appears so far that H1N1's mortality rate in Mexico is much higher than anywhere else. Why such a big difference?

12:06 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:06 PM
We are waiting for detailed data from Mexico. We certainly know that people have died in Mexico. What we don't know is the total number of people infected with the virus. Even garden variety season flu kill people--> 0.2-0.8 % mortality. Without knowing the total infected we can't calculate the mortality rate which would give us a sense of how deadly this strain is.

12:07 Comment From Ryan Ludwig
Friday, May 01, 2009 1:07 PM
Hi Alex, Dr hershow...is it known how swine flu was introduced to the illinois area?

12:08 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:08 PM
Not precisely. We know that this virus originated in Mexico and we know that due to Chicago's high Mexican-American population that travel and visit is frequent from Mexico. It seems likely that travelers from Mexico (either Mexicans or tourist [as was the case in New York school clusters] brought it with them.

12:09 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:09 PM
By tourists I mean American tourists.

12:09 Alex Parker
Friday, May 01, 2009 1:09 PM
Ron, is the hype surrounding swine flu appropriate? We know the regular flu kills 36,000 Americans a year. We've had one death in the U.S. so far. Why are we so scared?

12:12 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:12 PM
We are concerned because influenza is so unpredictable. We know that at least once in history a new flu strain emerged that had a devestating global impact. The Spanish Flu of 1918-1919. The concern is that this strain will mimic that catastrophe. Without immunity to protect us, this strain could spread widely. We don't yet know how severe the disease caused by this strain will be, though. We have to monitor it carefully and get more information from the Mexican experience.

12:12 Comment From Laura
Friday, May 01, 2009 1:12 PM
Why isn't the media covering the important topic of nutrition?

12:14 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:14 PM
I don't think they have much information linking nutritional issues to the current evolving situation. One hypothesis to explain why flu was more deadly in Mexico (if indeed it was), would be that malnutrition may have been more common among affected people. Here again, however, this is just speculation. We need data from the Mexican experience.

12:14 Alex Parker
Friday, May 01, 2009 1:14 PM
Ron, is there any misinformation about the virus out there? Any myths?

12:17 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:17 PM
We are just beginning to hear reports about the actual genetic make-up of this virus and comparisons with other strains of flu that have caused pandemic. To my mind, these data are very preliminary and until carefully sifted through by peer review, I would not rely to heavily on these reports. However, some preliminary information is reassuring, suggesting that this strain lacks some of the genetic signature sequence that seem to be necessary for lung penetration and severe disease. But again, I would advise caution before being reassured by this early data.

12:18 Alex Parker
Friday, May 01, 2009 1:18 PM
We've got two travel/transit related questions from readers...

12:18 Comment From Peter Sachs
Friday, May 01, 2009 1:18 PM
The CTA is still only cleaning its trains/buses once every 14 days. Should they be doing it more often as a way to limit transmission paths for the virus?

12:18 Comment From Ryan Ludwig
Friday, May 01, 2009 1:18 PM
I fly quite frequently, is there anything to VP Biden's remarks about avoiding public transportation? Is this flu known to be any more infectious that the more common strains we encounter year to year?

12:20 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:20 PM
Peter, It's hard to know what an appropriate cleaning schedule would be. Given the volume of travel on CTA, it would be hard to keep up with the potential for contamination. More importantly, I think users should obey basic hygiene rules. Don't use public transport if you are ill, use hand sanitizer frequently, avoid touching your nose and mouth (easier said than done, admittedly).

12:22 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:22 PM
Ryan- I think VP Biden's remarks were either misunderstood or taken out of context. I think we are not at the point we're we are advising people to avoid air travel (except non-essential travel to Mexico) and other forms of public transportation. We do not yet know how transmissable this flu strain is. We need more time and data to assess that

12:22 Comment From Robin Phillips
Friday, May 01, 2009 1:22 PM
With this strain seemingly affecting young adults more than the traditional groups that are hit hard by flu, does it mean that fitness and general health are unlikely to be of much benefit in fighting off this virus?

12:22 Alex Parker
Friday, May 01, 2009 1:22 PM
Great question, Robin.

12:25 Alex Parker
Friday, May 01, 2009 1:25 PM
We'll take a few more questions for Dr. Hershow. So if you have any get them in now before we close shop.

And if you have more, you can email me at alex@chitowndailynews.org. I'll be doing some follow up on my blog, Chicago Health Matters.

12:25 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:25 PM
I believe that eating, sleeping well, exercising are all things that strengthen the immune system. In the Spanish Flu however, it was the immune system that was thought to contribute to the severity of the disease. In that singular example, young healthy people had an exaggerated immune response leading to general whole body inflammation that caused leaky blood vessels to cause respiratory failure. We have no evidence that this strain is acting this way, although again we need more data from Mexico where many people have died.

12:26 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:26 PM
In general, I believe that being in good health will be a good thing in this situation

12:26 Alex Parker
Friday, May 01, 2009 1:26 PM
We know that two U of Chicago med center staffers had probable cases, so that's a good segue to this question?

12:26 Comment From Megan
Friday, May 01, 2009 1:26 PM
Are medical professionals at a greater risk for catching swine flu?

12:27 Alex Parker
Friday, May 01, 2009 1:27 PM
And, FYI, Chicago Health Matters can be found at www.chicagohealthmatters.com.

12:28 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:28 PM
Yes, I believe they probably are. Some of the sketchy data from Mexico suggests that a fairly high proportion of cases were health care workers. Risk can be lessened through the prompt identification of patients, isolation precautions and wearing personal protective equipment (respirators)

12:28 Comment From Robin Phillips
Friday, May 01, 2009 1:28 PM
Is the name 'swine flu' a name that has been latched onto by the media rather than it being an accurate name? It seems to me that it is just a new strain of flu. Is that correct and why we are seeing the term H1N1 adopted instead?

12:29 Alex Parker
Friday, May 01, 2009 1:29 PM
Yesterday, the WHO announced it would use the scientific name, as the pork industry was complaining about the use of "swine flu." Egypt slaughtered its entire pig population...even though you can't get the virus by eating pork.

12:30 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:30 PM
The strain identified from these early cases does have genetic sequence similar to known circulating strain that have affected swine populations. Again, the virology data is very preliminary though and we should wait until these data are exposed to the peer review process. It does appear though that the "swine" nomenclature may be appropriate

12:30 Alex Parker
Friday, May 01, 2009 1:30 PM
Still, it hasn't stopped the media from using swine flu, which is admittedly sexier than H1N1.

12:30 Alex Parker
Friday, May 01, 2009 1:30 PM
OK, last question here, and I think it's a good one.

12:30 Comment From Megan
Friday, May 01, 2009 1:30 PM
If Swine Flu becomes a pandemic, what will that mean for Chicago?

12:34 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:34 PM
It depends on the magnitude of affected cases, the severity of disease that results. It's really impossible to predict. It may mean that people just have to continue to obey these basic hygiene rules. We already know that it is leading to school closures. It may also disrupt businesses and services, banks post office, medical care faciltiies, grocery stores, etc. So on thing people can do is to make sure that you have a supply of your prescription medication. over the counter meds for fever, a two week food supply--> bottled water, ready-to-eat canned goods, etc. Radio with battery. It's impossible to say whether all this will be necessary, but it doesn't hurt to prepare.

12:34 Alex Parker
Friday, May 01, 2009 1:34 PM
OK, that concludes this chat.

Thank you, Ron, for your time and great answers. And thank you, readers, for joining our first ever online chat and for posing some very good questions.

We hope you'll join us in the future, as we plan on doing more of these for our various beats, including health, public housing, education and labor.

12:34 Comment From Ryan Ludwig
Friday, May 01, 2009 1:34 PM
Thanks Alex, and Dr. Hershow.

12:35 Ronald C. Hershow, M.D.
Friday, May 01, 2009 1:35 PM
Your very welcome and Thanks for the great questions.

12:35 Alex Parker
Friday, May 01, 2009 1:35 PM
Thanks again, everyone. If you have any feedback about this chat, feel free to email me: alex@chitowndailynews.org.

Remember, wash your hands, cover your coughs and sneezes, stay home when you're sick, and encourage others to do the same.