House Staffer Infected With MSRA

ABC News, April 2009

Congressional staffers are privy to many Washington, D.C., insider perks -- but catching a bacterial infection at the House of Representatives gym is not one of them.

A House staffer reportedly has been infected with a drug-resistant superbug, possibly from a gym used by some members of Congress.

A House staffer reportedly has contracted the superbug known as Methicillin-resistant Staphylococcus Aureus (MRSA), and some who work in the Capitol have speculated that the origin of the infection was in a gym possibly used by some lawmakers, according to a report from the congressional newspaper, The Hill.

A statement The Hill received from the House chief administrative officer said that a House employee who is also a member of the House Staff Fitness Center (HSFC) reportedly contracted the common bacterium, which, in humans, is typically found on the skin and in the nose.

The identity of the infected staffer has not yet been released, nor have there been any further reports of infection.

Meanwhile, the HSFC reportedly has scrubbed down the gym with a germicidal cleaning product.

Interim Guidance for Swine influenza A (H1N1): Taking Care of a Sick Person in Your Home

From the CDC
April 25, 2009 18:30 EDT
This document provides interim guidance and will be updated as needed.

Swine influenza A virus infection (swine flu) can cause a wide range of symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. People with swine flu also can have vomiting and diarrhea. Like seasonal flu, swine flu in humans can vary in severity from mild to severe.

Severe disease with pneumonia, respiratory failure and even death is possible with swine flu infection. Certain groups might be more likely to develop a severe illness from swine flu infection, such as persons with chronic medical conditions. Sometimes bacterial infections may occur at the same time as or after infection with influenza viruses and lead to pneumonias, ear infections, or sinus infections.

The following information can help you provide safer care at home for sick persons during a flu pandemic.

How Flu Spreads

The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

People with swine flu who are cared for at home should:

Check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema

Check with their health care provider about whether they should take antiviral medications

Stay home for 7 days after the start of illness and fever is gone

Get plenty of rest

Drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated

Cover coughs and sneezes.

Clean hands with soap and water or an alcohol-based hand rub often and especially after using tissues and after coughing or sneezing into hands.

Avoid close contact with others – do not go to work or school while ill

Be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention

Medications to Help Lessen Symptoms of the Flu

Check with your healthcare provider or pharmacist for correct, safe use of medications. Antiviral medications can sometimes help lessen influenza symptoms, but require a prescription. Most people do not need these antiviral drugs to fully recover from the flu. However, persons at higher risk for severe flu complications, or those with severe flu illness who require hospitalization, might benefit from antiviral medications. Antiviral medications are available for persons 1 year of age and older. Ask your healthcare provider whether you need antiviral medication.

Influenza infections can lead to or occur with bacterial infections. Therefore, some people will also need to take antibiotics. More severe or prolonged illness or illness that seems to get better, but then gets worse again may be an indication that a person has a bacterial infection. Check with your healthcare provider if you have concerns.

Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye’s syndrome.

For more information about Reye’s syndrome, visit the National Institute of Health website at:

Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.

Teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.

Children younger than 2 years of age should not be given over-the-counter cold medications without first speaking with a healthcare provider.

The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.

Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS). Examples of these kinds of medications include:



Advil®, Motrin®, Nuprin®



Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. Importantly, these medications will not lessen how infectious a person is.

Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications—don’t double dose! Patients with kidney disease or stomach problems should check with their health care provider before taking any NSAIDS.

Check with your health care provider or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu.For more information on products for treating flu symptoms, see the FDA website:

When to Seek Emergency Medical Care

Get medical care right away if the sick person at home:

Has difficulty breathing or chest pain.

Has purple or blue discoloration of the lips.

Is vomiting and unable to keep liquids down.

Has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry
has seizures (for example, uncontrolled convulsions).

Is less responsive than normal or becomes confused.

Steps to Lessen the Spread of Flu in the Home

When providing care to a household member who is sick with influenza, the most important ways to protect yourself and others who are not sick are to:

Keep the sick person away from other people as much as possible (see “placement of the sick person at home”).

Remind the sick person to cover their coughs, and clean their hands with soap and water or an alcohol-based hand rub often, especially after coughing and/or sneezing.

Have everyone in the household clean their hands often, using soap and water or an alcohol-based hand rub.

Ask your healthcare provide if household contacts of the sick person, particularly those contacts that may have chronic health conditions, should take antiviral medications such as oseltemivir (Tamiflu®) or zanamivir (Relenza®) to prevent the flu.

Placement of the sick person

Keep the sick person in a room separate from the common areas of the house. (For example, a spare bedroom with its own bathroom, if that’s possible.) Keep the sickroom door closed.

Unless necessary for medical care, persons with the flu should not leave the home when they have a fever or during the time that they are most likely to spread their infection to others (7 days after onset of symptoms in adults, and 10 days after onset of symptoms in children).

If persons with the flu need to leave the home (for example, for medical care), they should cover their nose and mouth when coughing or sneezing and wear a loose-fitting (surgical) mask if available.

Have the sick person wear a surgical mask if they need to be in a common area of the house near other persons.

If possible, sick persons should use a separate bathroom. This bathroom should be cleaned daily with household disinfectant (see below).

Protect other persons in the home

The sick person should not have visitors other than caregivers. A phone call is safer than a visit.

If possible, have only one adult in the home take care of the sick person.

Avoid having pregnant women care for the sick person. (Pregnant women are at increased risk of influenza-related complications and immunity can be suppressed during pregnancy).

All persons in the household should clean their hands with soap and water or an alcohol-based hand rub frequently, including after every contact with the sick person or the person’s room or bathroom.

Use paper towels for drying hands after hand washing or dedicate cloth towels to each person in the household. For example, have different colored towels for each person.

If possible, consideration should be given to maintaining good ventilation in shared household areas (e.g., keeping windows open in restrooms, kitchen, bathroom, etc.).

Antivirals can be used to prevent the flu, so check with your healthcare provider to see if some persons in the home should use antiviral medications.

If you are the caregiver:

Avoid being face-to-face with the sick person.

When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.

Clean your hands with soap and water or use an alcohol-based hand rub after you touch the sick person or handle used tissues, or laundry.

Caregivers might catch flu from the person they are caring for and then the caregiver might be able to spread the flu to others before the caregiver shows symptoms. Therefore, the caregiver should wear a mask when they leave their home to keep from spreading flu to others in case they are in the early stages of infection.

Talk to your health care provider about taking antiviral medication to prevent the caregiver from getting the flu.

Monitor yourself and household members for flu symptoms and contact a telephone hotline or health care provider if symptoms occur.

Using Facemasks or Respirators

Avoid close contact (less than about 6 feet away) with the sick person as much as possible.

If you must have close contact with the sick person (for example, hold a sick infant), spend the least amount of time possible in close contact and try to wear a facemask (for example, surgical mask) or N95 disposable respirator.

An N95 respirator that fits snugly on your face can filter out small particles that can be inhaled around the edges of a facemask, but compared with a facemask it is harder to breathe through an N95 mask for long periods of time. More information on facemasks and respirators can be found at

Facemasks and respirators may be purchased at a pharmacy, building supply or hardware store.

Wear an N95 respirator if you help a sick person with respiratory treatments using a nebulizer or inhaler, as directed by their doctor. Respiratory treatments should be performed in a separate room away from common areas of the house when at all possible.

Used facemasks and N95 respirators should be taken off and placed immediately in the regular trash so they don’t touch anything else.

Avoid re-using disposable facemasks and N95 respirators if possible. If a reusable fabric facemask is used, it should be laundered with normal laundry detergent and tumble-dried in a hot dryer.

After you take off a facemask or N95 respirator, clean your hands with soap and water or an alcohol-based hand sanitizer.

Household Cleaning, Laundry, and Waste Disposal

Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.

Keep surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.

Wash linens (such as bed sheets and towels) by using household laundry soap and tumble dry on a hot setting. Avoid “hugging” laundry prior to washing it to prevent contaminating yourself. Clean your hands with soap and water or alcohol-based hand rub right after handling dirty laundry.

Eating utensils should be washed either in a dishwasher or by hand with water and soap.

For More Information: The Centers for Disease Control and Prevention (CDC) Hotline (1-800-CDC-INFO) is available in English and Spanish, 24 hours a day, 7 days a week.

CDC: Swine Flu Questions and Answers

QUESTIONS & ANSWERS: Swine Influenza and You

What is swine flu?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people.

Are there human infections with swine flu in the U.S.?
In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were first reported in Southern California and near San Antonio, Texas. Other U.S. states have reported cases of swine flu infection in humans and cases have been reported internationally as well. An updated case count of confirmed swine flu infections in the United States is kept at CDC and local and state health agencies are working together to investigate this situation.

Is this swine flu virus contagious?
CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it not known how easily the virus spreads between people.

What are the signs and symptoms of swine flu in people?
The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

How does swine flu spread?
Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

What should I do to keep from getting the flu?
First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.

Are there medicines to treat swine flu?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

How long can an infected person spread swine flu to others?
People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk and then touches their own eyes, mouth or nose before washing their hands.

How long can viruses live outside the body?
We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent handwashing will help you reduce the chance of getting contamination from these common surfaces.

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

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?
If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water. or clean with alcohol-based hand cleaner. we recommend that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

What should I do if I get sick?
If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing
Bluish skin color
Not drinking enough fluids
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough
Fever with a rash
In adults, emergency warning signs that need urgent medical attention include:
Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Severe or persistent vomiting

How serious is swine flu infection?
Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.

Can I get swine influenza from eating or preparing pork?
No. Swine influenza viruses are not spread by food. You cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Hand Washing Helps to Prevent Swine Flu

Monday, April 27, 2009

WASHINGTON — The acting head of the Centers for Disease Control said Monday that people can best protect themselves against the swine flu threat by taking precautions they were taught as kids, like frequently washing their hands.

Asked what individual steps should be taken, Richard Besser replied: "The things that we learned when we were little, covering a cough ... staying home when you have a fever, frequent hand-washing. If people do these things, it will decrease the spread in our communities."

Besser also said the U.S. government is being "extremely aggressive" in the steps it has taken, or is considering, to protect the American public. He said he didn't think he would personally recommend traveling to parts of Mexico where the new virus has taken hold, but noted that no decision has been made on a possible travel ban.

Besser said he was not reassured by the fact that so far in the U.S., no one has died from the disease.

"From what we understand in Mexico, I think people need to be ready for the idea that we could see more severe cases in this country and possibly deaths," Besser said. "That's something people have to be ready for and we're looking for that. So far, thankfully, we haven't seen that. But we're very concerned and that's why we're taking very aggressive measures."

Besser said there can be no one-size-fits-all approach when the severity of the problem varies from area to area. "You cannot see an outbreak occur at the same level in all places," he said.

He also said the government has worked hard to have the necessary medications in place in such a scenario and already has begun distributing them to states.

Asked in one interview why the United States was not issuing travel bans and quarantining passengers at airports, as some countries have done, Besser said: "We are being extremely aggressive in our approach to this outbreak and each day we're evaluating what we're undertaking and we'll make additional measures as necessary. What you're going to see in an outbreak like this is different things taking place in different parts of the country based on what's going on there."

He said that beginning Monday, screening for the illness would being at U.S. borders.

"What we're going to be doing at the borders, and that will be taking place starting today, is doing passive screening, asking people about fever and illness, looking for people who are ill and handing out cards that let people know what's going on in Mexico and what's going on here so people can take action to protect and prepare," Besser said.

The CDC was posting guidelines on its Web site Monday for health departments and members of the public to decide what to do in the event of illness.

The Next Flu Pandemic: What to Expect

THE STAR PRESS • APRIL 25, 2009 (Background source: U.S. Health and Human Services)

A flu (influenza) pandemic is an outbreak caused by a new human flu virus that spreads around the world. Because the pandemic flu virus will be new to people, many people could get very sick or could die. Seasonal flu shots do not protect people from pandemic flu.

Flu pandemics have happened throughout history. They occur from time to time, and some are worse than others. Three flu pandemics happened in the 1900s. Near the end of World War I, the 1918 Flu Pandemic was the most severe flu pandemic of the century. It killed about 675,000 people in the United States and between 20 to 50 million people around the world.

If you check your family’s history, you may find how your family was affected at that time. Almost everyone was touched in some way by the 1918 Flu Pandemic. Other flu pandemics in the 1900s were less severe. Public health experts say it’s not a matter of IF a flu pandemic will happen, but WHEN. We cannot predict when the next flu pandemic will happen.

We have learned from past flu pandemics that during a pandemic, limiting contact among people helps to slow the spread of the virus and helps to save lives. Being around other people makes you more likely to get sick or to make others sick. The flu could spread and more people could get sick.

Until a vaccine can be made, limiting contact among people will be our main tool for helping to contain the disease and to prevent others from getting it. During a flu pandemic, health officials may ask you and your community to take actions to help limit contact among people. Your daily routines could change for several months. In all flu pandemics, sick people will be asked to stay home. Most people with pandemic flu can be cared for at home. During a flu pandemic, hospitals may only have room to care for patients who are the most ill or require special care.

Make plans now to be able to stay home for at least 10 days if you are sick with pandemic flu. Staying home will keep you from giving it to others. Make a plan for who will take care of you and your household if you get sick. In more severe flu pandemics, even people who are not sick may be asked to stay home.

Household members may be asked to stay home if a person in the household is sick with pandemic flu. This is because other household members may be infected but not sick yet. They could spread the pandemic flu virus to others. Household members may soon get sick, too. Make a plan for your household if everyone has to stay home.

In severe flu pandemics, students may be dismissed from school. Schools, after-school functions, and child-care programs may be closed. Parents may be asked to protect their children by keeping them from being with other children outside of school. Find out what your school or child-care program is planning to do in a pandemic. Plan how you will take care of your children if they need to stay home and how you would limit contact with others.

In severe flu pandemics, people may be asked to limit contact with others in the community and workplace. Places where people gather, such as theaters and places of worship, may be closed. Events such as sporting events or concerts may be delayed or cancelled. Businesses may allow some people to work from home or change work shifts to limit contact between workers. Ask your workplace or community groups what they plan to do.

You and your community need to start planning now while no flu pandemic exists. You need to be ready when the flu pandemic first arrives in your area. Information will be given on local TV, radio, websites, and in the newspaper. Limiting contact among people early will save more lives.

Making plans now will help you to be ready for the next flu pandemic, which could last up to several months. You can look at planning guides to help you, your family, your workplace, and your community at

* Make a list of important contacts for home, school, and work.

* Talk with your neighbors, workplace, and school about how to plan for staying home if you or your household members are sick.

* Think about services you may need and make plans with your service providers.

* Although the flu pandemic may last several months, buy and store at least 2-weeks supplies of food, water, medicine, and facemasks. (Food and supplies may be hard to get during a pandemic.) When you have to stay home, these supplies will support your family and pets.

Be aware, plan ahead, and share with others what you have learned. Together, we can help protect ourselves, our families, and our communities.

A new pandemic flu virus will spread easily from person to person, mostly through coughing and sneezing. When a sick person coughs or sneezes near you, you can breathe in droplets that have the virus. The droplets also could land on surfaces you may touch with your hands.

Get in the habit of washing your hands often and covering your coughs and sneezes. These actions can help you stay healthy now. They also may help protect you and your family during a flu pandemic.

Teach your family the importance of these habits and have them practice now:

* Wash your hands often with soap and water. If there is no soap and water, use an alcohol-based hand gel. Wash your hands before eating, drinking, or touching your face.

* Cover your mouth and nose when you cough or sneeze. Throw used tissues away in a trash can, and wash your hands. If you do not have a tissue, cough or sneeze into your sleeve and not into your hands.

For more information:

* Contact your local or state health department.
* Visit
* Call 1-800-CDC-INFO (232-4636).


Swine Flu Survival: Three Ways to Protect Yourself

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The dreaded swine flu is spreading, infecting Americans in four states and killing at least 80 in Mexico. The World Health Organization (WHO) warns of a "public health emergency."

"This virus has clearly a pandemic potential," says Margaret Chan, director general of WHO.

The disease itself sounds especially ominous, spreading quickly from human to human. It's "a completely novel virus," says the Centers for Disease Control and Prevention (CDC). Indeed, the new strain is a mixture of human virus, bird virus, and pig viruses from all over the world. Experts say this new variant of swine flu seems particularly worrisome because people are getting sick without any contact with pigs. Even worse, young, healthy people are dying at a striking rate, a telltale sign of the worst flu epidemics.

(Swine flu fears aren't new in the United States. In February 1976, a 19-year-old army private at Fort Dix, New Jersey, died within 24 hours of becoming infected with swine flu. Soon, 500 soldiers were afflicted and the US government began a controversial nationwide vaccination campaign. Ultimately, some 40 million Americans were inoculated. As a result, several hundred people developed Guillain- Barré syndrome, a serious neurological condition, and the immunization program was stopped.)

What's going to happen this time? Without question, the disease will spread farther and wider. At this point, as the CDC says, it can't be contained or controlled.

What can you do to protect yourself? Experts offer a a few suggestions:

1. Wash Your Hands Frequently. It may sound obvious, but hand-washing with soap and water for around 20 seconds is the single best thing you can do (if you're going to go out into the world and interact with other human beings). The CDC estimates that 80 percent of all infections are spread by hands. If you can't wash your hands regularly, try hand-sanitizers with 60 percent alcohol content.

2. Practice "Social Distancing." That's the fancy term for staying away from other people if you're sick or if you're concerned that they may be infected. Again, it may sound obvious, but experts believe it's worth repeating: Isolation reduces your chances of getting infected or infecting others.

3. Recognize the Symptoms and Get Help. Swine flu symptoms are similar to regular flu: Fever, body aches, sore throat, cough, runny nose, vomiting, diarrhea, and lethargy. If you don't feel well, seek medical attention. The current swine flu is resistant to two of four antiviral drugs approved for combating the flu. Symmetrel and Flumadine are apparently no use against this strain but Tamiflu and Relenza appear to work.

What are the chances of a global pandemic? "The situation is uncertain and unpredictable and likely to be a marathon more than a sprint," says Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention.

No doubt, swine flu will dominate headlines in the days ahead. Every case will be carefully tracked and deservedly so.

For more information, the CDC has set up a toll-free hotline: 1-800-CDC-INFO. Or check out the CDC Website.

Wash Hands to Help Prevent Catching Swine Flu

Originally written by Maggie Fox, Health and Science Editor, Reuters
April 25, 2009

WASHINGTON (Reuters) - Worried about swine flu? There is one easy way to protect against infection, health experts agree - handwashing.

Global health officials are worried about an unusual new strain of flu that may have killed as many as 68 people in Mexico, with 1,000 showing possible symptoms. It has infected at least eight people in the United States. Officials at the U.S. Centers for Disease Control and Prevention and the California Department of Public Health said they expected to find more cases in the coming days and weeks.

Little can be done to prevent an outbreak of flu from spreading, health experts caution, but they say common sense measures can help individuals protect themselves. Number one is hand-washing, they say - a surprisingly effective way to prevent all sorts of diseases, including ordinary influenza and the new and mysterious swine flu virus.

"Cover your cough or your sneeze, wash your hands frequently," advised Dr. Richard Besser, acting CDC director.

Influenza can spread in coughs or sneezes, but an increasing body of evidence shows little particles of virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes. Alcohol-based gel or foam hand sanitizers work well to destroy viruses and bacteria.

Anyone with flu-like symptoms such as a sudden fever, cough or muscle aches should stay away from work or public transportation and should see a doctor to be tested.


"If you have the flu, then you shouldn't be getting on the bus or getting on the plane and traveling," Besser told reporters in a telephone briefing.

"Social distancing" is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community.

Flu experts have also long advised against trying to stockpile personal supplies of antivirals.

Tamiflu and Relenza are two drugs shown to work against the current strains of seasonal influenza. Tamiflu or oseltamivir, invented by Gilead Sciences Inc and marketed by Roche AG, is a pill while GlaxoSmithKline's Relenza, known generically as zanamivir, is inhaled.

Both drugs treat a flu infection, making it less serious and perhaps making the illness last fewer days. But they must be taken within 48 hours of the first symptoms to do any good.

They can also prevent infection with garden-variety flu if taken, for example, by a family member caring for a sick relative. No one knows if they will do the same with the new swine flu.

And the average person is not going to know when, precisely, to begin taking the drug. Many infections look like flu, says pediatrician and immunologist Dr. Anne Moscona of Weill Cornell Medical College in New York.

Viruses and bacteria alike can evolve resistance to drugs they encounter frequently. "If you have Tamiflu at home and you take it for a cold or give it for a respiratory virus that is not influenza, we will be unable to use these drugs when we encounter a lethal strain of flu," Moscona says.

(Editing by Mohammad Zargham)

Stomach Bug Crystallizes an Antibiotic Threat

New York Times Article By TARA PARKER-POPE
Published: April 13, 2009

Earlier this year, Harold and Freda Mitchell of Como, Miss., both came down with a serious stomach bug. At first, doctors did not know what was wrong, but the gastrointestinal symptoms became so severe that Mrs. Mitchell, 66, was hospitalized for two weeks. Her husband, a manufacturing supervisor, missed 20 days of work.

A local doctor who had worked in a Veterans Affairs hospital recognized the signs of Clostridium difficile, a contagious and potentially deadly bacterium. Although the illness is difficult to track, health officials estimate that in the United States the bacteria cause 350,000 infections each year in hospitals alone, with tens of thousands more occurring in nursing homes. While the majority of cases are found in health care settings, 20 percent or more may occur in the community. The illness kills an estimated 15,000 to 20,000 people annually.

“It’s been the worst thing I’ve ever tried to get through in my life,” said Mrs. Mitchell, who remains weakened by the ordeal. “I really did think I was going to die.”

What is so frightening about C. difficile is that it is often spurred by antibiotics. The drugs wipe out the targeted illness, like a urinary tract or upper respiratory infection, but they also kill off large portions of the healthy bacteria that normally live in the digestive tract. If a person comes into contact with C. difficile, or already has it, the disruption to the beneficial bacteria creates an opportunity for the harmful bacteria to flourish.

The public health community has been sounding the alarm for years about the overuse of antibiotics and the emergence of “superbugs” — bacteria that have developed immunity to a wide number of antibiotics. But the C. difficile problem shows that the threat is not generalized or hypothetical, but immediate and personal.

“One of the things that we counsel consumers about is to make sure that an antibiotic is really necessary,” said Dr. Dale N. Gerding, an infectious disease specialist at the Stritch School of Medicine at Loyola University in Chicago. “There are many good reasons for taking an antibiotic, but an illness like sinusitis or bronchitis winds up being treated with antibiotics even though it will go away by itself anyway.”

Even appropriate use of antibiotics can put a person at risk. Dr. Gerding said his own adult son came down with a C. difficile infection after taking antibiotics for tonsillitis.

The typical treatment for C. difficile is another course of antibiotics, typically the drug vancomycin. But the situation can quickly turn tragic. The Centers for Disease Control and Prevention has reported on several cases of pregnant and postpartum women who developed life-threatening C. difficile infections after being treated for minor infections. In some instances, a C. difficile infection can be treated only by emergency surgery to remove the patient’s colon. Doctors say many patients report that they continue to suffer from regular bouts of diarrhea even after the infection is gone. About 20 percent of patients with the infection suffer a relapse, and C. difficile support groups have emerged on the Internet.

In the case of the Mitchell family, Mr. Mitchell had been taking antibiotics for another health problem, and the treatment apparently led to his C. difficile infection. Mrs. Mitchell probably contracted the illness from her husband. The spores from C. difficile are hardy, and contaminated surfaces must be scrubbed down with bleach to eradicate the germ. Doctors say Mrs. Mitchell’s illness is unusual because most people are protected by their own bacterial flora and wouldn’t be vulnerable to C. difficile if they had not been taking antibiotics, even after close exposure. The risk of contracting C. difficile outside the health care setting remains low, at about 7 cases per 100,000 people, studies show.

C. difficile is not a new illness, but it appears to be spreading at an alarming rate. The rate of C. difficile infection among hospital patients doubled from 2001 to 2005, according to an April 2008 report from the C.D.C. The rise in C. difficile cases around the world is linked with the growing use of all antibiotics, particularly a class of drugs called fluoroquinolones, which came into widespread use around 2001. The use of acid-suppressing drugs, including proton pump inhibitors like Prilosec, also may be a risk factor, although studies have been contradictory.

In addition to becoming more common, C. difficile is also becoming more deadly. Several years ago, the mortality rate from a C. difficile infection was around 1 to 2 percent. But today, various studies estimate that the death rate is 6 percent. The reason is that a hypervirulent strain has emerged that emits higher levels of toxins than earlier strains.

Many patients are far more familiar with another superbug, methicillin-resistant Staphylococcus aureus, or MRSA, which can cause a severe and potentially deadly skin infection. MRSA started off primarily as a hospital-based infection but has become increasingly common in the community.

Hospitals may become more motivated to control C. difficile if the Centers for Medicare and Medicaid Services decides to withhold reimbursement for cases of hospital-acquired C. difficile infections. The system already withholds reimbursement for certain other preventable hospital infections.

In addition to careful use of antibiotics, patients and hospital visitors should always be vigilant about hand washing, and visitors should not sit on a patient’s hospital bed or use a patient’s restroom if it can be avoided. Patients should always report severe diarrhea symptoms to a doctor, particularly if they have taken antibiotics recently.

“Up until about 2002, this was a very mild disorder and very few people ever died from it,” said Dr. Perry Hookman, a gastroenterologist and associate professor of medicine at the Miller School of Medicine at the University of Miami. “But in the past few years the bugs have become hypervirulent, more severe and now it’s a global threat.”