Flu Tweetchats with Sandro Cinti, M.D., and Matt Davis, M.D.
The first H1N1/Swineflu tweet chat took take place from 10 a.m. - noon Thursday, Oct. 22.
Sandro Cinti, M.D., an infectious disease expert at the University of Michigan Health System and VA Ann Arbor Healthcare System, answered questions from 10 – 11 a.m.
Matt Davis, M.D., a pediatrician and director of the C.S. Mott Children’s Hospital National Poll on Children’s Health and professor of public policy at the U-M For School of Public Policy, answered questions from 11 a.m. – noon.
Oct. 22 full transcript in chronological order
Part 1 with Sandro Cinti, M.D.
UMHealthSystem Welcome Dr. Cinti!
#H1N1swinefluchat
sandrocinti Hello
UMHealthSystem Q1 What are common symptoms
of H1N1 illness & how are they different from seasonal flu
illness?
reyn_j #H1N1swinefluchat
tvdeegan RT @UMHealthSystem: Welcome to
those of you who have joined us for chat! We will post a
new question every few minutes.
sandrocinti The symptoms of seasonal flu and
H1N1 are similar: fevers, muscle aches, sore throat, nasal
congestion. cont
sandrocinti Diarrhea and nausea and vomiting seem
to be more common with novel H1N1
UMHealthSystem Q2 When should a person seek
medical treatment if they suspect they have H1N1 flu?
ssieg Join me for a #H1N1swinefluchat TweetChat
at: http://tweetchat.com/room/H1N1swinefluchat #fb
sandrocinti Generally, people get better in 2-3 days
and should stay home while they have fevers. cont
UMHealthSystem Join TweetChat at:
http://tweetchat.com/room/H1N1swinefluchat
sandrocinti People with high risk conditions
(pregnancy, immune compromise, medical conditions
including diabietes, heart cont
UMHealthSystem Q3 How can one tell the
difference between H1N1 illness & seasonal flu illness?
sandrocinti lung, kidney problems should contact
their doctor. Children less than 2 years should also be
evaluated by a doctor
dngrifka 3 kids 5 1/2 months, 2.5 yrs and 5. no
daycare, only kind. who should get the vaccine?
LewisDonofrio How do you know the difference
between the flu and this new flu?
sandrocinti If you have flu-like symptoms, you
cannot differentiate between seasonal and novel H1N1.
dngrifka should 6 mth old get h1ni or reg flu shot?
both? too much?
UMHealthSystem Please reserve your questions
until after Dr. Cinti has had an opportunity to answer the
questions I've posted for him. :)
sandrocinti @dngrifka the 2.5 year old. The 5 year
old if he/she has a medical conditions. The 6 mo old cannot
get vaccine
sandrocinti @LewisDonofrio by testing only.
However, we are only testing hospitalized patients
Lurray71 So what if the virus evolves into the next
strain of flu? Are we doing anything to be ready for this?
UMHealthSystem Q4 Lots of people have flu now.
Is H1N1 still the prevalent strain? Can they assume they
have H1N1 & won’t need vaccine?
sandrocinti @dngrifka Vaccine cannot be given to a
6 mo. old. That is why we vaccinate family members as a
priority
krista225 Re: fluids. As diarrhea and vomiting can
be involved, are there physical symptoms to watch for in re:
to dehydration?
sandrocinti @UMHealthSystem 99.6% of flu right
now is novel h1N1. This will change as the season goes on.
cont
sandrocinti @krista225 dry mouth, sunken eyes,
dizzines on standing lethargy and tenting of the skin are
signs of dehydration
UMPublicAffairs 21-month old twins recvd their
1st shot of H1N1 yesterday. is it still effective if they aren't
able to get the 2nd shot?
UMHealthSystem Q5 If I am diagnosed with
suspected H1N1, should I get the vaccine if I can?
sandrocinti @UMPublicAffairs It may not be as
effective.
Healthteacher RT @sandrocinti:
@UMHealthSystem 99.6% of flu right now is novel h1N1.
This will change as the season goes on. cont
sandrocinti @UMHealthSystem suspected H1N1
means a definitive diagnosis was not made. You still need
vaccine
UMHealthSystem @sandrocinti To a previous
question, how will the mix of H1N1 to seasonal flu change
as the season goes on?
dngrifka confused..with a 6mth at home should
healthy 5 yr old get vacc? she is in school.
prknlot Dr. Cinti, what is the current availability of
the H1N1 vaccine in our region for the public and for
healthcare workers?
sandrocinti @UMHealthSystem We do not know.
H1N1 will probably predominate but there will be seasonal
flu
fionamaccool I am watching a live Twitter-based
chat on H1N1 and it is a weird (but I imagine cheap/easy)
way to engage people online
sandrocinti @dngrifka 5 yr old should get the
vaccine and is a priority in this situation
sandrocinti @prknlot It is trickling in. We have to
rpioritize distribution even among HCWs
UMHealthSystem @Baby_Diva Please tag your
questions with #h1n1swinefluchat to ensure he will
respond.
UMHealthSystem Q6 If I think I may have H1N1
flu, can I request a definitive test?
dagsieg if ur only testing hospitalized patients how
am i suppose to know if my sick kid has h1n1 and if we
need the vaccine?
sandrocinti@UMHealthSystem Very few people
are getting definitive tests cont
krista225 What is your response to the fears of the
vaccine being "too new" and "risky"?
prknlot To join today's tweet chat on H1N1, follow
#H1N1swinefluchat from 10 a.m. - noon. http://ow.ly/vSFJ
(via @UMHealthSystem)
sandrocinti @dagsieg unfortunately, the tests have
limited availability. This means most people will not know if
they have it
UMHealthSystem 135. Stay tuned for Dr. Matthew
Davis at 11 a.m. who is a pediatrician and can also answer
your pediatric questions.
cnewvine @UMHealthSystem is hosting a
#H1N1swinefluchat right now. Example: How can one tell
the difference between H1N1 illness & seasonal flu?
sandrocinti @krista225 The vaccine is made in the
same way as seasonal vaccine. All studies thus far show it is
safe
sandrocinti @cnewvine The symptoms are the
same. We can only diffeentiate by testing
sjeder my 18yo dau has mono, and we have a 15 yo
T1DM daughter at home. Do we wait to vaccinate the 18 yo
until mono is gone?
eharcler Since most people won't get tested should I
just treat it like a normal flu?
CindyHeflin @UMHealthSystem conducting
interesting swine flu chat
sandrocinti@sjeder you probably should wait to
vaccinate the 18 yo
UMHealthSystem Q7 Are the incidents & dangers
of H1N1 illness being exaggerated?
sandrocinti @eharcler Yes. Most do not need
treatment and ride it out at home
chirpdeb #h1n1swinefluchat it isn't really available
then it seems unproductive to talk about why you should get
sandrocinti @UMHealthSystem No. the virus is
very contageous and seems to affect mostly young people,
which is different cont
sandrocinti @UMHealthSystem cont Mortality
rates and hospitalizations are low, however
UMHealthSystem Q8 Are H1N1 deaths
predominately caused by inflammation/pneumonia, or are
deaths also caused by a cytokine storm?
sandrocinti @UMHealthSystem deaths seem to
result mostly from virus infecting the lungs, which fill up
with fluid cont
sandrocinti @UMHealthSystem cont bacterial
pneumonias occur secondarily in about 1/3 of patients
UMHealthSystem Q9 Will you be getting the H1N1
vaccine?
chirpdeb What is your advise about where to get
vacinated for H1N1 - Ann Arbor, Michigan. Local Dr. says
not yet available
sandrocinti @UMHealthSystem Yes
sandrocinti @eharcler Hand sanitizers are fine for
flu and more convenient to use
UMHealthSystem Q10 Does the strength of your
immune system at the time of contracting H1N1 play in to
the severity of complications?
sandrocinti @chirpdeb Public health may be
running some clinics for high risk people. the vaccine is
trickling in
chirpdeb Is there recommended advice how to
increase your immune system so that if your get h1n1 your
body is best capable to fight
UMHealthSystem Find H1N1 info on the Mich.
Dept. of Community Health site here: http://ow.ly/vVS7
UMHealthSystem Stay tuned for Dr. Matthew
Davis, a pediatrician, for more answers to your H1N1
questions at 11 a.m.
sandrocinti @UMHealthSystem Yes. People with
poorly functioning immune systems are at higher risk for
complications
chirpdeb usually don't get seasonal flu vaccine,
think getting only H1N1 vaccine - it there something wrong
with that stance
UMHealthSystem As Dr. Cinti formulates a
response to the final question of this hour, please stick
around. Dr. Davis will be on shortly.
sandrocinti @chirpdeb Both flus can cause
considerable illness. Remember, 40,000 people a year die of
seasonal flu
pfanderson Wowsa! Ask your #h1n1 questions of
UMich doctors. See the dialog here: #H1N1swinefluchat
UMHealthSystem Thank you Dr. Cinti for joining
us today. We'll take a 5-minute break. Dr. Davis will be on
shortly.
Part 2 with Matthew Davis, M.D.
Gary_Matthews Twitter dialog @UMHealthSystem:
Stay tuned Dr. Matthew Davis, a pediatrician,
more answers to your H1N1 questions at 11am
UMHealthSystem Good morning Dr. Davis! Thanks
for joining us today!
NPCHdavis @UMHealthSystem It's a pleasure to
be here to answer questions about H1N1 flu
pfanderson @UMHealthSystem I'm a med libn.
Folks ask all kinds of questions & have wrong ideas abt
#h1n1 . How 2 get info 2 them?
UMHealthSystem Q1 is it true children under age
of 6 months do not qualify for the nasal vaccination?
dngrifka should a 6 month old get the h1n1 vac
with 2 others at home? 5 yr old at school?
UMHealthSystem @pfanderson The best source for
info is always www.flu.gov
NPCHdavis @UMHealthSystem Actually, children
under age 2 years should NOT receive the nasal flu
vaccination. It has not been tested.
chirpdeb RT @UMHealthSystem @pfanderson The
best source for info is always www.flu.gov
NPCHdavis @dngrifka Kids 6 months and older are
recommended to get H1N1 vaccine. Will need 2 doses if
<10 years old.
NPCHdavis @NPCHdavis To be clear: kids under
6 months cannot get either nasal or inj vaccine for H1N1.
Other people in home should.
NPCHdavis @sjeder Child w/ T1 diabetes and flu
symptoms should be checked by doctor, & may benefit from
Tamiflu or other antiviral.
UMHealthSystem Q2 It is said the H1N1 vacc.
production process is similar to seasonal flu; how is it
different?
pfanderson @chirpdeb I know (I maintain local flu
information resource), but the general public don't. How do
we get this 2 them?
NPCHdavis @UMHealthSystem H1N1 flu vacc is
produced w/ same egg-based process as seasonal flu.
<continued>
NPCHdavis @NPCHdavis H1N1 flu vacc has same
basic structure as seasonal flu vacc, just different flu
proteins to match virus <cont>
UMHealthSystem @pfanderson It's always a
struggle to get accurate information to the public. That's
why chats like this are important.
NPCHdavis @NPCHdavis For this reason, we
expect same side effect profile for H1N1 flu vacc as
seasonal vacc, and tests support this.
UMHealthSystem Q3 Some reports claim
ingredients in the H1N1 vacc. are unsafe. Is this true?
NPCHdavis @UMHealthSystem H1N1 flu vacc
basic 'recipe' and process is same as seasonal flu vacc, but
w/ diff proteins. <continued>
NPCHdavis @UMHealthSystem That said, it is
possible to have a serious reaction to any medical treatment
or vacc. <continued>
pfanderson Our UMich HSL Guide for local #h1n1
information. Additions? http://tinyurl.com/yh32kev
NPCHdavis @UMHealthSystem For example, it is
possible for a person with an egg allergy to have a reaction
to H1N1 flu vacc.<cont>
pfanderson @UMHealthSystem I agree. I am
amazed by some of the questions I get. They break my
heart.
NPCHdavis @NPCHdavis Also, most flu vacc do
contain thimerosal as a preservative. This has not been
proven to be a problem.<cont>
NPCHdavis @UMHealthSystem If parents want
preservative-free H1N1 flu vacc for their young kids, it
should be avail later this fall.
UMHealthSystem Q4 Why does H1N1 affect
younger people more than older people?
NPCHdavis @UMHealthSystem Experts aren't
sure. But as docs we are certainly seeing this pattern in our
clinics & hospitals.<cont>
NPCHdavis @UMHealthSystem The
younger>older pattern for H1N1 flu likely has to do with
innate immunity of older people <cont>
UMHealthSystem @pfanderson We have a great
resource you are free to glean from: http://ow.ly/vWoS with
up-to-date info from us and CDC
NPCHdavis @UMHealthSystem ...who were
exposed to strains of swine flu in the 50s, 60s, & 70s. That's
why we think ... <cont>
NPCHdavis @UMHealthSystem ... that broad vacc
against H1N1 flu for kids and young adults is so important
this season.
chirpdeb tnx..Information reassuring, soon as
vaccine becomes available I will get both seasonal & h1n1
for my family & myself
UMHealthSystem Q5 Why is there a shortage of
H1N1 vaccine and what can I do to protect my children
until more becomes available?
pfanderson @UMHealthSystem Thanks! That is
one we already link to. Hurray!
NPCHdavis @UMHealthSystem H1N1 flu vacc is
in short supply because manufacturers needed to split their
capacity w/ seasonal flu vacc
NPCHdavis @UMHealthSystem There is also short
supply because H1N1 flu vacc has been more diff to make
than expected.
UMHealthSystem @pfanderson Then no need to
reinvent the wheel! We may do a regular chat on thsi topic
if there is interest.
pfanderson @NPCHdavis @UMHealthSystem 4
#ASD kid, son had flu vaccine but not #h1n1. He is
needlephobic. Heard nasal not effective
NPCHdavis @pfanderson Nasal H1N1 flu vacc is
expected to be protective, better than not vaccinating.
NPCHdavis @chirpdeb Alcohol-based sanitizer is
expected to be more effective against flu. May not smell as
good, but works better.
UMHealthSystem Q6 If my child has symptoms,
when should I take him to the doctor?
ssieg good Q6, we currently have a 9 year old at
home for day 2 with symptoms. congestions, sore throat,
cough, and fever..
UMHealthSystem Reminder, please tag all your
chat-related questions with #H1N1swinefluchat
NPCHdavis @UMHealthSystem Combination of
fever, cough, runny nose, esp vomit/diarrhea are concerning
for H1N1 --> contact doc.
UMHealthSystem From @virgo12345 Is this
vaccine different than the H1N1 vaccine in 1976?
NPCHdavis @ssieg Of course hard to say via
Twitter. But it's worth calling your child's health care
provider today for advice.
pfanderson @NPCHdavis Thx 4 this info. Needle
would traumatize him, but don't want to leave unprotected
either. Many cases in school.
ssieg we were told that by our provider that our 9yr
old was not high-risk and couldn't get flu nor H1N1 vacc
due to shortages:(
NPCHdavis @UMHealthSystem Yes -- 2009 H1N1
is different than swine flu virus in 1976, but similar in key
ways to ... <cont>
Virgo12345 What about worries of the Guilles
Barres Syndrome...has this vaccine been tested enough?
#H1N1swinefluchat about 2 hours ago from web
NPCHdavis @UMHealthSystem ... swine flu strains
in 50s, 60s, 70s. That's why we think elders are not getting
sick often w/ H1N1 now.
UMHealthSystem From @TweeterWidow If I had
burning frm Thimerosal in contact solution & can't have
mycins can I get seasna & H1N1 shots?
annarborcom Have questions about swine flu and
vaccine? Live Twitter chat going on with U-M expert right
now
NPCHdavis @ssieg Each state and each practice
are managing their available H1N1 vacc supply in their own
ways. <cont>
NPCHdavis @ssieg ... In our own system, a healthy
9yo would not be eligible for H1N1 flu vacc because of
shortage right now.
treedinAA Have questions about swine flu and
vaccine? Live Twitter chat going on with U-M expert right
now
pfanderson @ssieg We heard the same thing, but I
also heard that young adults have high mortality. Confusing.
NPCHdavis @Virgo12345 With flu vacc, we
always are worried about possibility of Guillan-Barre.
Because of such concerns... <cont>
ssieg @NPCHdavis, ur right the gov left it up to
states, and then states left up to counties. Mich not doing so
HOT my opinion:(
NPCHdavis @Virgo12345 ... this 2009 H1N1 flu
vacc has actually been through more clinical trials than
seasonal flu vacc.<cont>
NPCHdavis @Virgo12345 ...Results by this point
do not show higher risk of Guillain-Barre than in population
as a whole.
dngrifka were any clinical trial done on infants or
young kids?
NPCHdavis @UMHealthSystem Contact irritation
with thimerosal is unusual. There is NO thimerosal in the
inhaled flu vacc.
UMHealthSystem Q7 Why does it seem like teens
are getting sicker but they're not higher on the priority list
for vaccination?
dngrifka how long should i wait to give regular
(yrly)vaccinations on kids w/getting h1n1 vac?
NPCHdavis @dngrifka Yes -- clinical trials for
H1N1 flu vacc included infants and toddlers.
Virgo12345 Should I DEFINITELY get my 3
children--ages 10, 13, and 16 vaccinated? I'm so confused
over all the hype.
NPCHdavis @dngrifka Not sure if you mean how
much time should pass between different flu vacc?
dngrifka yes and between their yearly vacs?
NPCHdavis @UMHealthSystem Teens are getting
sicker w/ H1N1 than seasonal flu. But it's younger kids w/
highest hosp rates
MedicalMile RT @UMHealthSystem: Find H1N1
info on the Mich. Dept. of Community Health site here:
http://ow.ly/vVS7
NPCHdavis @Virgo12345 H1N1 flu vacc is
recommended for all age 6 months-24 years, and those w/
hi-risk conditions ...<cont>
kkwaugh Live Twitter chat going on with U-M
expert right now
UMHealthSystem This chat will conclude at noon.
You'll find the full transcript online at http://ow.ly/vWRA
NPCHdavis @Virgo12345 ... age 25-64 years.
Challenge right now is supply. Most areas of US not yet
vacc teens against H1N1 <cont>
NPCHdavis @Virgo12345 ... unless they have
heart or lung illnesses (eg, asthma).
NPCHdavis @dngrifka Generally speaking, it's
wise either to vacc at the same time or to wait 4 weeks
in-between doses. <cont>
UMHealthSystem Q8 Will you be getting the H1N1
vaccine?
NPCHdavis @dngrifka ... That allows the vaccines
to stimulate the immune system and have a full response b4
the next vacc.
stove037 Should I get my 4 year old first available
vaccine (nasal) or wait for the injection which will be a
week or more later?
NPCHdavis @UMHealthSystem Yes, I will be
getting the H1N1 flu vaccine when it is available for me. I
have already ... <cont>
Virgo12345 How do you reply to people that are
afraid of the reactions to the H1N1
vaccine?
NPCHdavis @UMHealthSystem ... received the
seasonal flu vacc. Right now, I agree w/ the priority for
H1N1 vacc of ... <cont>
NPCHdavis @UMHealthSystem ... very young
children (<5 yrs old) and older children with heart and lung
conditions.
NPCHdavis @stove037 Given current levels of
H1N1 across the US, I would advise getting the available
vacc now.
NPCHdavis @Virgo12345 I say to patients:
reactions to H1N1 vacc appear generally same as reactions
to seasonal flu vacc.
UMHealthSystem As Dr. Davis wraps up responses
2 the last few Qs, plz be sure 2 follow @UMHealthSystem
for future chats on imp. hlth info
MedicalMile RT.UMHealthSystem Q8 Will you be
getting the H1N1 vaccine?
UMHealthSystem Q9 If I’ve gotten the seasonal flu
vaccine, am I protected against H1N1?
NPCHdavis @UMHealthSystem Seasonal flu vacc
is NOT expected to provide protection against H1N1 flu.
Virgo12345 Thank you for your time and guidance!
I will be vaccinating my children thanks to this chat.
UMHealthSystem Thank you so much Dr. Davis! I
hope everyone found this to be helpful. Stay tuned for more
chats in the future!
(END)
