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Ask André Picard

Reader questions on H1N1 answered Add to ...

Q: Are smokers more at risk of swine flu?

A: Smokers are not at greater risk of contracting H1N1. But studies show that if smokers - and their children - are infected with influenza, they are at greater risk of complications. There is no reason to believe it is any different with H1N1. This is not surprising as influenza is a respiratory illness.

Q: I keep reading that there is an "epidemic" and a "pandemic," which implies there is an imminent threat. But I just don't see an epidemic or pandemic out there, just a lot of fear-mongering.

A: Epidemic and pandemic are technical terms that refer to the geographical spread of a disease, not its severity. H1N1 is a pandemic because it has spread to virtually every country in the world since it first surfaced in humans in March. To date, swine flu has been classified as mild.

Q: There is flu every year. Is this year any different?

A: The flu always travels from West to East across the country. It usually starts in November, peaks in January, and peters out by March. With H1N1, the flu season has started much earlier this year. Does that mean it will be done earlier? That's possible. But a more likely scenario is that there will be a second wave of influenza after Christmas, probably with a seasonal strain.

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Q: I've had the flu before. What's the big deal?

A: The "flu" has become a catch-all term but it is not a cold, or a gastrointestinal bug. Influenza (H1N1 or otherwise) is unpleasant and will put you out of commission for about a week: You suffer fever, coughing, chills, muscle aches, and extreme fatigue; many people have trouble getting out of bed. The vast majority of those infected will get better with rest and plenty of fluids but, in some cases, the symptoms can be so severe that they can result in hospitalization and death.

Q: How do I know if my flu is the serious kind?

A: The flu is a respiratory illness. A person who has trouble breathing should seek immediate medical attention, as should someone with persistently high fever (particularly children). H1N1 can be treated with antivirals if treatment begins early enough. One of the distinguishing factors of those who have died of H1N1 far is that they waited too long to seek treatment.

Q: How is the flu treated?

A: Generally, bed rest will do it, but when symptoms are more serious there are two prescription drugs available, the antivirals oseltamivir (Tamiflu) and zanamivir (Relenza).

Q: Can I take antivirals to prevent getting the flu?

A: Some countries, like the U.K., has used antivirals extensively as a prevention measure. In Canada, the approach is different: They are used almost exclusively for treatment.

Q: Can the flu really kill you - I mean, it's just the flu?

A: The little H1N1 viruses in your body are not carrying knives to stab you in the heart. But the virus can, in some cases (about one in 1000), get deep into the lungs, causing pneumonia. The lungs fill with liquid and a person essentially drowns. Patients with severe infection are put on respirators and sometimes even heart-lung machines but about one in five die. People with the flu are also susceptible to other bacterial infections.

Q: If you go to a hospital with H1N1 symptoms and are tested for H1N1, how long does it take to get results to determine if you do indeed have H1N1?

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