City of Houston eGovernment Center

Swine Flu questions answered by Catherine Troisi, PhD,
HDHHS Office of Public Health Practice

(Questions and answers start with the most recent - this web page was last updated on November 20, 2009 at 2:45 PM)

(Note: vaccination sites are subject to change, types of vaccination available are also subject to change - please check the H1N1 information page for updates)

Question: Today is Nov. 18, 2009. I am in a high risk group. Where can I go to get the H1N1 vaccine? (11-18-2009)

Answer: Locations are listed here - HDHHS to target high risk groups with new H1N1 vaccine shipment

Question: I do not live in the Houston city limits - can I get my children vaccinated at the Houston clinics? (11-17-2009)

Answer: Yes, you can get your children vaccinated at the Houston clinics.

Question: Will the injections given to 3 year olds starting on Monday, November 16, be from single dose syringes/vials or multi-dose vials? Thank you for your response. (11-13-2009)

Answer: Both presentations will be available as well as the intranasal vaccination (LAIV).

Question: Why is the swine flu vaccine not available anywhere in the west Houston, Cypress area? I have checked with doctors, clinics and hospitals in this area and no one seems to know. Some say maybe December or January. Yet for weeks now, the other areas of town have been giving shots for free to anyone in line. My husband is a cancer patient over 65 and is at high risk. Also my young grandkids are at risk. We are willing to pay for shots and can't find them anywhere in this area of town. (11-12-2009)

Answer: Continue to check with your usual private providers to see if they have received any vaccine. Also, Cypress is outside the City of Houston and would be in the jurisdiction of Harris County Public Health and Environmental Services - you can check for H1N1 vaccine information on their website.

Question: I would like to know why none of your H1N1 Clinics are located on the northwest side of town? Take a look at where they are. You totally left off the northwest side of the map. (11-12-2009)

Answer: The closest clinic to the northwest side of Houston is the Acres Homes Multi-Service Center clinic located on West Montgomery Road. The Northwest WIC clinic (on Hammerly) was relocated due to weather concerns.

Question: I called a health clinic regarding H1N1 shot. They only have nasal but my child is diabetic. When we are going to get the injectable shot? (11-9-2009)

Answer: Have you checked with your regular health care providers? More vaccine should be sent to all providers, private as well as public, this week, so keep checking our website.

Question: Our son has autism. I am now 34 weeks pregnant and am trying to find the perservative free shot we have heard about. Although they say the regular one is safe I don't feel comfortable. Where can I get a perservative free swine flu shot or order one? (11-2-2009)

Answer: You can obtain a single dose, thimerosal, or preservative free injection at HDHHS health clinics; there is an extremely limited supply available for pregnant women and children older than four years old. Also, please check with your primary and specialty care physicians.

Question: I am trying to find out where to get the H1N1 vaccine near my area (zip 77095), but I can't open the link to the list of locations. Is there another way to find the locations? (11-2-2009)

Answer: The web pages have been revised so that the locations are now listed directly on the main information page and a map has been added to show the general location of the clinics as to where they are within the City of Houston.

Question: If someone has a light cough since last tuesday 10-27-09 can he still get the H1n1 vaccine? He is 7 years old. (11-2-2009)

Answer: According to the Vaccine Info Sheet for LAIV which if the person is otherwise healthy we would recommend - "If you are moderately or severely ill, you might be advised to wait until you recover before getting the vaccine. If you have a mild cold or other illness, there is usually no need to wait."

Question: Are the shots being given to pregnant women single-dose syringes or are they from multi-dose vials that contain thimerasol preservative? (10-30-2009)

Answer: Vaccines given to pregnant women are single-dose and do not contain thimerosol.

Question: I am 31 weeks pregnant. I have made it my choice to NOT stand in line at a "clinic." My immune system is not familiar with that surrounding. These clinics are also giving healthy people the shot when they should have to wait. I have friends that have seen this 1st hand. When will Walgreens/CVS, Dr. offices and normal "will pay for H1N1 shots" be open? (10-30-2009)

Answer: Vaccine providers receive their vaccine from CDC through the Texas Dept of State Health Services (DSHS). DSHS decides who gets the vaccine and how many doses they receive. Information regarding the next shipment of vaccine to providers has not been released.

Question: My 3 1/2 year old asthmatic son received the H1N1 vaccine injection this week at a health clinic. I keep hearing comments that he actually needs to go back in a couple of weeks for another one. Is this correct? (10-30-2009)

Answer: Yes, children under age 10 years of age need to receive a second dose of vaccine four weeks after the first dose.

Question: I got my son the swine flu injection. Does he need another injection? He is one year old. (10-30-2009)

Answer: Yes, he will need another dose of vaccine in four weeks.

Question: I am in the high risk group because I'm pregnant and in the health care field. Tried to go to a couple of clinics today but they all ran out of the day supply. These clinics operate on first come first serve basis. How can I get the vaccine since I can't get out of work early enough to get to these clinics in time? (10-30-2009)

Answer: Please check with your ob/gyn or regular medical provider as vaccine has also been distributed to private providers. Your employer may also have received vaccine for priority patients.

Question: I want to know WHY with a limited supply of the H1N1 vaccine that the powers that be are NOT following the CDC guidelines at Houston area wic clinics today, giving out the vaccine... people like my husband, who is a severe asthmatic and a healthcare worker, CANNOT FIND it, and myself who is entering the 3rd trimester in my pregnancy.. so you SUGGEST people follow the guidelines.. how about you ENFORCE them, so the people that need it can get them. (10-30-2009)

Answer: Thank you for voicing your concerns about the Houston Department of Health and Human Services (HDHHS) influenza clinic procedures. As you know, unfortunately vaccine supplies are limited right now, although by December enough vaccine should be available for everyone who wants to get vaccinated. CDC ships out vaccine to the states, who redistribute it to medical providers (local health departments, pharmacies, clinics, private MDs, hospitals, etc.). So far, the Houston/Harris County area has received approximately 100,000 doses of vaccine. HDHHS received approximately 25% of that amount, corresponding to the percentage of uninsured in the area. HDHHS serves as a safety net for certain services for those who do not have a private medical provider. Vaccine was ordered in sufficient quantities to immunize the clients fitting the CDC priority guidelines who normally patronize our clinics. However, we are a public health entity and do not turn any one away.

Question: I am a Director for Varnett Public School we have 3 campuses. All of our students are low-income and un/underinsured. We would like to sponsor a H1N1 vaccination drive. We have had quite a few H1N1 cases so far this year. And we want to show our parents as well as the community that we are committed to the health and well being of the community. If possible, what would we have to do to arrange for it? (10-30-2009)

Answer: At this time we don’t have enough vaccine supplies to sponsor a school vaccination clinic. However, we expect to have enough vaccine by the end of November and will be setting up school clinics at that time. Our planning chief will contact you as we get closer to that date.

Question: My husband and I are both diabetic. Do we qualify and should we get the
H1N1 vaccine? We live in Brazoria County. (10-29-2009)

Answer: Please check with your usual medical provider and/or the Brazoria County Health Department to see if they have vaccine available. The policy of HDHHS is to not turn anyone away.

Question: Why are all of the H1N1 vaccines in Harris county so far going to public clinics where the uninsured go, and not private clinics for people who ARE insured? This is the third time I have sent this question, and you have yet to post it with an answer. (10-29-2009)

Answer: Your statement that all the vaccine sent to Harris County was given to public clinics is not correct. Vaccine is allocated and shipped to each medical provider (doctors, clinics, pharmacies) by the Texas Department of State Health Services.

Question: Can children under 24months get the H1N1 shot at the free clinics? (10-29-2009)

Answer: Yes, children 6 months to 24 months can receive the injectable vaccine free at HDHHS clinics.

Question: I have a friend that had serious form of cancer last year with both chemo and radiation of bronchial and sinus airways. Where should he et injection? I am a nurse. Where can I get the shot? (10-29-2009)

Answer: He should check with his usual medical provider first to see if they have received vaccine shipments. Information about the city of Houston vaccine clinics are at www.houstonflu.org. We have a limited amount of injectable vaccine available.

Question: Will vaccines be available tomorrow? (10-28-2009)

Answer: Yes, they will be available. See www.houstonflu.org for more information.

Question: What percentage of the vaccines that Harris County has recieved up to this point have been given to public clinics that offer free shots? (10-28-2009)

Answer: We only know the number of vaccines we receive - we don't have access to amount of vaccine sent to other providers.

Question: If my son with asthmatic problems has not received a regular flu shot this year, will it be ok for him to get the H1N1 vaccine if I find it available? (10-28-2009)

Answer: Yes, he can receive the nH1N1 vaccine but it is recommended that he get the seasonal vaccine as well. He can receive both vaccines at the same time or separately.

Question: I have two of my children that have heart murmur - do they have to take a specific kind of swine flu shot? (10-28-2009)

Answer: Please check with your medical provider to get his/her recommendations. We are not able to provide specific medical advice over the internet since we are not familiar with their histories.

Question: My doctor does not have an appointment for Swine Flu vaccinations open until late November. I am not eligible for WIC, etc., and I can afford to pay for the vaccine if I can just obtain it. Can I go to a HDHS clinic and receive the vaccine -- and PAY for it? I have a toddler and a baby at home. Thanks! (10-28-2009)

Answer: Although we are targeting priority populations for the vaccine, we will not turn anyone away. You (and your children, if over 6 mo of age) can get the vaccine at one of our clinics as long as we have vaccine available.

Question: The clinic today says the injections today are for pregnant and children with health problems. So, I did not go. When will there be a clinic for adults with comprimised immune systems and health problems? I have made tons of calls. No one seems to know anything. It seems healthy people are being taken care of at the clinics, but the group that they suggested be vacinated first. I am glad they are at least getting to the pregnant women and at comprimised children. But where do I go? (10-28-2009)

Answer: HDHHS clinics serve as a safety net for Houston residents but we will not turn any one away. However, our supplies of inactivated vaccine, the only kind you can receive, are limited right now. We will be getting more vaccine in (although we don't know when) so keep checking our website houstonflu.org.

Question: Will there be another day for the H1N1 vaccine besides October 28 at the clinics listed and where? (10-28-2009)

Answer: Check our website www.houstonflu.org for more details.

Question: I am pregnant - do I need a doctor note to receive the H1N1 vaccine? (10-27-2009)

Answer: No you do not need a note.

Question: I am going to try and get the H1N1 flu shot tomorrow, My family doctor does not have it. I am at high risk, I have had pneumonia three times and every time that i get sick it goes straight to my chest causing bronchitis. How can I prove that I am at high risk? (10-27-2009)

Answer: The HDHHS vaccine sites do not ask for proof that you are high risk.

Question: I am 55 years of age with RA, asthma and on methotrexate and remicade, immunosupressing drugs. I can only take the injectable form of the vaccine. My doctor does ot expect to get the vaccine. I noticed the clinics were for nasal or someinjectable for pregnant and children. When will I be able to get the vaccine? (10-27-2009)

Answer: You are member of a priority group for vaccination and so can receive the inactivated the inactivated vaccine in our clinics (first come,first serve - we have limited doses right now of inactivated vaccine). Check out times and locations at houstonflu.org.

Questions: Where can a 6 year old with complications go for the h1n1 vaccine? Pediatrician does not have it yet. --- Any update as to when the H1N1 flu shot will be available in the Houston area? --- I have a two month old and I am very worried about getting a vaccination for the swine flu. Since my child is not old enough to get the vaccination, are my husband and I able to get the flu shot now , because infants are high risk, and this is the only way that we can keep her well? Also, how do I find out where to get the SHOTS?? --- Could you please tell me where to get H1N1 shots in houston? --- Where can i get the h1n1 vaccine. I have chronic ulcerative colitis and my defenses are usually very low. I am 55 years old. Please let me know. --- My daughter is a teacher and is pregnant, her OBGYN has told her she needs to get a swine flu vaccine, but he ordered 300 units and will only receive 50 where can she get the shot? There have already been 4 cases in her school. --- My 6-year old son has asthma and his doctor said for him to get the H1N1 vaccine. His pediatrician does not have the vaccine. Where can I get him the injectable vaccine? Thanks! --- When will the vaccination be available? --- Where can I get the H1N1 vaccine in Houston? (10-27-2009)

Answer: The state of Texas is slowly receiving vaccine right now and we expect to have a larger supply by November. You can check with your primary care physician to see if they have received any H1N1 vaccine. The H1N1 vaccine is available in our health clinics; however, we have an extremely limited supply. Please call our health clinics ahead of time to verify if they have any vaccine.

Question: How long from exposure would it take to get the flu? (10-27-2009)

Answer: The incubation period (time from exposure to when you start having symptoms) is usually from 1-4 days but can be as long as 7 days.

Question: I read that the USA is allowing adjuvants in the H1N1 vaccines. The US has never before approved these adjuvants for vaccines in the past because of their possible side effects...mainly autoimmune diseases. The WHO states on their website that adjuvants ARE being used in the vaccines prodiced by Novartis and GlaxoSmithKline. Please specify if these H1N1 vaccines are being made available in the USA and in Harris County. (10-27-2009)

Answer: Adjuvants are not licensed for influenza vaccines in the US. No influenza vaccines in the US contain adjuvant.

Question: I am HIV positive. Will H1N1 vaccines be available for individuals like myself? Are there certain steps or measures we'll have to take to obtain a shot? What should we do? Is the regular flu shot all we'll be able to recieve? (10-16-2009)

Answer: Yes, there will be H1N1 vaccine available for you since you are a in a target priority group. There are no steps or measures you need to take except to check with your primary care physician to see if they have received the injectable H1N1 vaccine, and watch the HDHHS webpage to see when the injectable vaccine will available in the clinics. You will be able to receive both the seasonal flu shot and the H1N1 shot this flu season.

Question: Where and when can children under 6 get the mist vacine? We live in COH on the Westside. (10-6-2009)

Answer: The first doses of vaccine are just reaching medical providers. Watch the HDHHS webpage to see when it will available in the clinics. Commercial pharmacies (Walgreens, CVS, etc) will also start offering the vaccine soon as will pediatricians.

Question: Where can my 86 year old father get a swine flu vaccination? (10-6-2009)

Answer: As of October 6, 2009, nH1N1 (swine) flu vaccine is not available yet in the Houston area. Please keep checking our website for clinics where immunizations can be received once vaccine is shipped.

Question: Where do I get the shot I am on the liver transplant list? Do I need to bring letter from the Tx Liver center to show them?

Answer: No letter necessary. You’re in a priority group and are eligible to receive the vaccine first. The HDHHS clinics have not received vaccine yet but please watch the website for when we get vaccine in and begin immunizing.

Question: If someone in my household has a confirmed case of the flu (season or H1N1), what cleaning precautions would you recommend to disinfect my home? I'm mainly concerned with the toilets, sinks, and tubs. Is there a certain brand/kind of cleaner you would suggest?

Answer: There isn’t a particular brand of household disinfectant that you should use. Simply follow the directions on the disinfectant product’s label to clean bathroom surfaces, bedside tables and children’s toys. Here are a few more tips on household cleaning:

Update from Dr. Troisi: The role of the Texas Department of State Health Services and Texas Laboratory Response Network laboratories, of which the Houston Public Health laboratory is a member is primarily surveillance:

We are only testing samples from priority populations with influenza-like illness:

In addition, there are sentinel providers who submit all samples from patients with influenza-like illness to our laboratory for testing. By testing samples from these populations, the health department can monitor what is happening in the community. You can follow what is happening by signing up for our twitter account at HoustonHealth or monitoring our website at houstonflu.org. Private physicians are able to send samples to commercial laboratories for testing. However, treatment of the patient does not usually depend on the result and so many opt not to do so.

Question: How about setting up a flu center? I have to run my daughter in this morning and resisted going in earlier because of it seems silly to expose others in a health place. I remember a few years ago having to go to Texas Children's Hospital with a concussion possible and was amazed to see the entire emergency room filled with... pediatric flu cases. Probably not cost effective and exposing children that really need to be in the E room - separate center. (9/22/09)

Answer: Thank you for your suggestion. This concept is under consideration by the Texas Medical Center and its member organizations, and Houston Department of Health and Human Services (HDHHS) and Houston Fire Department are participating in those discussions. However, HDHHS doesn't provide this type of primary care.

Question: I was in contact monday and tuesday with a child who was diagnosed with swine flu on thursday. I took the seasonal flu shot on tuesday after leaving the child a TCH. Wednesday I woke up with a headache, fever of 100.2, weakness, body aches. I got tested for flu on thursday and was negative but have cough, stuffy nose, and mild headache, no fever. I'm on temaflu, antibiotic, and a cough syrup. If I do have swine flu, was it too early after exposure for the test to be negative, do I test again? (9/22/09)

Answer: The rapid test for influenza that is used in doctors' offices can react negatively even when a person is really infected with influenza (and the test can not distinguish between seasonal and nH1N1 influenza). However, the treatment for nH1N1 infection is the same as for seasonal flu so, except for unusual circumstances, it doesn't matter which flu you have.

Question: If an employee has a family member at home with a confirmed case of H1N1, should the employee come to work? Is it possible for that employee to spread H1N1 at the office even though they don't appear to be ill? (9/22/09)

Answer: In general, you do have to stay home if you have been exposed to nH1N1 influenza. You should, however, take normal precautions – clean your hands and cover your cough/sneeze. However, if you work in a healthcare setting or among those at higher risk of complications such as pregnant women, children under age 2 yrs, or any age with a chronic disease, such as a neuromuscular disorders, diabetes, kidney disease, immunosuppression, etc., you may want to consider not exposing these susceptible populations to influenza, as you can be infectious 24 hrs or so before you start showing symptoms.

Question: How many deaths have occurred due to H1N1 flu in Harris County? (9/18/09)

Answer: The only reported death due to H1N1 was a 22-month old who died in April.

Question: How does one find out the number of confirmed cases of swine flu in their area to date? (9/18/09)

Answer: HDHHS, following the guidance of CDC and the Texas Department of Health and Human Services, is not counting cases of H1N1 this fall. We will test enough specimens to determine that disease is present in a school and will test samples from high-risk groups, but will not have total numbers in the community. We will, however, follow carefully hospitalizations and deaths due to influenza.

Question: I am concerned that I have some symptoms of swine flu but I do not have insurance. What can I do, who should I need to contact? (9/14/09)

Answer: A list of clinics to which you can go if you don’t have insurance can be found at Project Safety Net at www.slehc.org/CHI/CHIS/PSN/Index.cfm. Primary Care Clinics (FQHC) are

However, CDC states that seeking medical attention is not necessary unless you are in one of the high –risk groups (pregnant, under 5 years of age, any age with chronic disease). Further information from the CDC website (cdc.gov) is given below:

What should I do if I get sick?
If you live in areas where people have been identified with 2009 H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people. CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Stay away from others as much as possible to keep from making others sick. Staying at home means that you should not leave your home except to seek medical care. This means avoiding normal activities, including work, school, travel, shopping, social events, and public gatherings.

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed.

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:

In adults, emergency warning signs that need urgent medical attention include:

Question: My son was tested for the swine flu on 8/17/2009 and my daughter and I were tested on 8/19/2009. How long does it take to get the results?

Answer: Turn around time for testing results depends on the laboratory it was sent to.

Question: I work for pulmonary doctors in Houston, Texas and am being asked if we will be able to get swine flu vaccines for our patients.

Answer: Yes, when the H1N1 vaccine becomes available (late Oct or early Nov) you will be able to get vaccine. You can find additional information at http://www.dshs.state.tx.us/swineflu/default.shtm. You can also sign up for twitter alerts about the situation in Houston at HoustonHealth.

Question: What is the normal number (from 2008) of people that have the influenza A during the summer months (June 1-Sept)? How much has that increased with the new flu H1N1 strain in this same time period this year?

Answer: We had no cases reported in June through September in 2008. At the moment, we do not have comparison data for this period since it is only the end of July 2009. However, the following are the cases of influenza A reported to Houston Department of Health and Human Services from April 26th through July 29th in 2008 and 2009. We had 18 cases reported in 2008 whereas 447 cases in 2009. Of course, the 447 cases reported in 2009 are primarily novel influenza A (H1N1). Please do keep in mind that we do not have accurate counts captured for seasonal flu A due to sudden change in reporting/testing procedures during this period (the outbreak of H1N1) in 2009.
April 26 – July 29, 2008 – 18 cases reported
April 26 – July 29, 2009 – 447 cases reported
(Information provided by the HDHHS Bureau of Epidemiology)

Question: Is the City of Houston ready for an outbreak of Swine Flu?

Answer: The City of Houston is preparing staff and infrastructure in the event of an 2009 influenza H1N1 outbreak by upgrading laboratory facilities, making arrangements for surge capacity for the lab, conducting exercises for staff about influenza, and planning for distribution of vaccine (which is not available yet). We are also preparing for hurricane season and are developing procedures in case we have both a hurricane event and influenza outbreak.

Prior to July 22, 2009

Question: I work as an optician for an optometrist. A patient was seen in our office who had a confirmed case of the Swine Flu. Apparently upon scheduling her appointment, she notified the receptionist that she had been cleared and was okay to be out and about. Was it safe for anyone to be around this patient? I thought there was no vaccine and can someone have a relapse? Also, if a patient is "cleared," shouldn't there be some type of documentation that they should have brought in?

Answer: The guidance is that patients are not infectious seven days after symptoms resolve. Relapses are rare and the patient would have symptoms.

Question: Has anyone that has been hospitalized recovered and been released?

Answer: HDHHS does not know of any hospitalizations in Houston due to swine flu. There are people hospitalized other places and yes, most have recovered.

Question: Can we travel in Hong Kong? Is it safe?

Answer: Asia does not have as many cases as the North American continent so far so yes, Hong Kong is safe.

Question: Can you release information regarding the percentage of nonsubtypeable A that are confirmed as H1N1 by the CDC?

Answer: 99 percent are subtype 2009 H1N1

Question: I suspect I have the flu even though I have had a flu shot. I am too sick to go to the doctor. Should I report this to someone in case it is the virus from Mexico?

Answer: It is not necessary to call the health department but please call your healthcare provider. Influenza can be a very serious disease and you should obtain medical advice.

Question: How long does will it take to receive my results from the swab I had taken on May 23rd?

Answer: Samples are triaged for testing - if you had a fever and cough/sore throat when the sample was taken, it should have been tested already and results sent to your doctor. If not, sample was frozen for testing at a later date this summer.

Question: I have a woman who works for me whose son has tested positive for H1N1. We have been in contact with her and some of us have flu like symptoms - no one with fever over 100. Should we be tested as a precaution or should our work environment be sanitized in any way? Can the mother of a positive child carry the H1N1 to work with out being positive herself? The family is on Tamiflu - will this help in not passing the virus?

Answer: One of the defining characteristics of influenza is fever over 100 degrees. However, should you be concerned, you should call your healthcare provider. It's always good to clean surfaces - 10 percent bleach will work well to kill most viruses. It is possible, but not likely, that someone could transmit virus without being sick themselves. Tamiflu will decrease amount of virus shedding.

Question: Can someone explain to me why we are closing schools for flu in April when the same schools & others had hundreds out a few months ago for flu with no closures. No one closed schools when children were dying of bacterial meningitis which is deadly & harder to detect than flu. It seems we are terrifying the public (parents) unnecessarily.

Answer: Influenza is much more contagious than meningitis and can spread easier through large groups.

Questions from May 5

Question: When will the test be finished for the case at Harvard elementary?

Answer: Testing of samples by the CDC is taking longer than usual because of submission of so many samples. We hope to have results this week.

Question: Do we have a determined possible range of # of days from exposure to symptoms showing? Are any other children at the closed schools showing symptoms? When will the tests done on the Harvard and Hamilton cases be done?

Answer: The incubation period (time from exposure to symptoms) ranges from 1-7 days. There are some children at Lyons Elementary school who are exhibiting influenza-like illness (ILI) and they are being closely monitored. Hamilton Middle school has reopened.

Question: Was the case at Hamilton Middle School a "suspected case" or a "probable case"? what information lead to the clearance of Hamilton Middle School by the City Health Department?

Answer: The case at Hamilton was a suspected cases but did not test positive for influenza A.

Question: I have a four month old baby, I am concerned about her. What is the prognosis if she gets infected?

Answer: So far most cases of 2009 H1N1 influenza have been mild with few hospitalizations. However, should your baby become ill, please seek medical care.

Questions from May 4 through April 30

Question: My daughter had a high fever, with no other symptoms until day 3, she vomited. The nurse did not advise I bring her in until day 5. By that time, if she did have flu, it would have been too late to start a Tamiflu treatment. Why didn't they want to test her for flu earlier? I think for tracking purposes, we would want to know how many people get flu. Is it possible the flu may not have been detectable after 5 days? If it's not flu what causes such a high fever for so long?

Answer: Many pathogens can cause a fever in children. According to CDC guidelines, influenza should be suspected when the patient has a measured temperature 100 degrees Fahrenheit and recent onset of at least one of the following: nasal congestion, sore throat, or cough.

Question: What were the ages of the people that died in Mexico and how many were
there?

Answer: As of Friday, May 1, nine people in Mexico have died due to confirmed 2009 H1N1 infection, although more than 150 deaths due to the virus are suspected. CDC has reported the ages of 7 of them - two were 5-19 years of age; three were 20-39 years of age; two were 40-59 years.

Answer: Rapid flu test positives are considered priority specimens at the lab right now, but due to the volume they are receiving, the usual turn around time of 12-24 hours may take longer. The usual way to report is through your doctor and they can receive results over the weekend. The doctor would then contact the patients. While waiting for the results, you should continue follow the doctor's advice about how to treat the patient. The treatment for the new flu is not any different from the treatment for seasonal influenza A.

Question: My daughter has no health insurance and is sick at the moment with flu
like symptoms. Is there a clinic she can go to and be tested for free?

Answer: Please check the list below of Federally Qualified Health Centers (FQHCs). You can also check out Project Safety Net at www.slehc.org/CHI/CHIS/PSN/Index.cfm.

PRIMARY CARE SERVICES CLINICS (FQHC)

Question: Has the City of Houston asked large groups to stay away from city parks
at this time due to the swine flu?

Answer: No, at this time we are not making this recommendation and it's doubtful we will. It's safer to be outside because sunlight kills the virus.

Question: Can you release information regarding the percentage of nonsubtypeable A
that are confirmed as H1N1 by the CDC?

Answer: CDC reported May 1 that 99 percent of nonsubtypable influenza A samples tested in the last 48 hrs were 2009 H1N1.

Question: My child had some very similar symptoms over a week ago, but he has
recovered and regained his appetite. Now that he is well, is there a way
to tell if he had the swine flu? I would be curious to find out because the last two days of the illness he was in daycare. I don't think any other kids got sick, but would hate to think that we could have passed it on to them, and then to schools through their school age siblings.

Answer: There is not an antibody test available yet so we wouldn't be able to test to see whether or not he had the 2009 H1N1 influenza.

Answer to above four questions: HDHHS is following Texas Department of State Health Services and Centers for Disease Control and Prevention recommendations and they have not recommended closing large gatherings. HDHHS has not recommended mandatory closing of large gatherings. Of course, it is always the parents' prerogative to withdraw their child from the competition.

Question: Is the City zoo going to be open on Monday? We have schools taking
field trips and are concerned.

Answer: The zoo is operating normal hours.

Questions: Do backyard chickens increase he risk to a family regarding swine flu? Can pets like dogs and cats get the swine flu?

Answers: No, this virus is not found in birds, so there is no increased risk. No, influenza viruses are not spread between humans and dogs and cats.

Question: If a child contracts the swine flu and is currently in a daycare setting, does the daycare have to shut down and if so for how long?

Answer: Yes, following TX Department of State Health Services guidelines, HDHHS will close a school or daycare with a confirmed or presumptive case of 2009 H1N1 influenza. The length of time is 14 days.

Question: How are you monitoring Day cares?

Answer: We do not routinely monitor day care centers but instead respond to reports from doctors' offices and laboratory reports. Should a child enrolled in a daycare center become ill with 2009 H1N1, HDHHS will carefully investigate.

April 29, 2009 questions and earlier questions

Question asked by many: Is the Volleyball Tournament at George R. Brown Center, the Cinco de Mayo events, Offshore Technology Conference, etc. going to be cancelled?

Answer: At this time, HDHHS is not mandating cancellation of group events, although it is possible this may change. We are following Department of State Health Services guidelines, which is that organizers weigh the risk versus the benefits of holding the event.

Question: What if a person doesn't have any medical insurance and has symptoms of swine flu?

Answer: Please check the HDHHS website (www.houstonhealth.org) for a list of Federally Qualified Health Centers (FQHCs) to which you can go. Look in the health centers section.

Question: What am I to do if I receive a positive test using influenza A/B nasal swab? Where do I send results?

Answer: If this is a report from a Doctor's Office, then the doctor should report findings to local health dept. If in Houston, contact the HDHHS Bureau of Epidemiology at 713-794-9181.

Question: My wife and I went on a cruise in late February and returned about March 1. We had visited two ports in Mexico. I got sick two days before the cruise ended and she got sick the last day of the cruise. We were both sick for most of March and could not get over it. We both visited two or more doctors but the sickness still persisted. Would there be any reason for us to be tested to see if we had Swine Flu?

Answer: HDHHS does not think that there would be any reason for you to be tested for swine flu at this point. If you did catch swine flu on your cruise (and so far there’s no evidence that the virus was circulating that early), you would no longer have the virus. Your immunity levels might be able to tell us whether or not you had it, just for your own information, but HDHHS is not doing that testing yet.

Question: A family at our school is returning from an extended stay in Mexico. They want to know if they should wait few days to see if they have any symptoms of flu before they allow their 4 year old son to return to school.

Answer: If the child is ill, then yes. If the child is not exhibiting flu-like symptoms, then it’s okay to go to school.

Question: Do we need to wear masks to work?

Answer: No. Wearing a mask is not recommended at this time.

Question: My grandson has the flu and fever for the last two days. We have no insurance and the doctor wants $250 to test for swine flu. Are there any other options?

Answer: HDHHS does not provide primary care. We would suggest you contact Ask a Nurse at Gateway to Care - 713.633.CALL (2255).

Question: I have two sons that have been sick. One is six and he has had fever since Sunday and sore throat. The other one is 18 months and he had fever for three days and a cough. He doesn't have fever anymore, but continues to have a rough cough at night. He acts like he is going to vomit, but he doesn't and he is not eating well. Should I be worried about this?

Answer: HDHHS is unable to provide specific medical advice over the Internet - please contact your health care provider.

Question: My husband and I plan a cruise to Cozumel and Progresso Mexico. As of right now, the cruise line has not made any itinerary changes. Should we consider postponing our vacation?

Answer: Right now the Centers for Disease Control and Prevention (CDC) is advising that unnecessary travel to Mexico be postponed, and although I can't predict the future, I think it'd be unlikely that this advice changes in the next two weeks. Check with your cruise line to make sure they haven't changed the itinerary however, before you consider canceling.

Question: When should someone with flu-like symptoms seek medical care?

Answer: Fever over 100 degrees is the general guideline but in the very young or very old, you may want to be a bit more cautious and go in earlier. Also, many other conditions can cause these symptoms.

Question: Since yesterday I started to have a sore throat, then runny nose, sore ears, nasal congestion and a little back pain. At this point i've been reading a lot of symptoms online but i'm not sure about them...Am I at any flu risk???

Answer: As you've noticed, "flu-like" symptoms are not very specific and we can't diagnose over the Internet. The best advice is to check with your health care provider who knows you and assess the situation. You could start with a phone call.

Question: How long does it take for the Centers for Disease Control (CDC) to determine if a person has H1N1?

Answer: Samples are first sent to the HDHHS laboratory where we test to see if there is influenza A present and if so, is it a common subtype of influenza. That takes 12 -24 hours. If we can't identify it, then it gets sent to the CDC for sub typing. It takes one to two days to get those results back.

Question: There was a vaccine in the mid to late 70's for swine flu. Why isn't is available now?

Answer: Those are good questions. The 1976 virus, although called swine flu, appears to have been a completely different virus and so the vaccine made against it back in 1976 would not work.

Question: When did this swine flu start? Did it start in Mexico?

Answer: We don't have all the answers yet but the first case identified were in mid-March in Mexico.

Question: What is the incubation time prior to developing symptoms? Can you give advice as to what businesses in the Houston area should be doing in regards to educating employees? Should we be encouraging employees to work from home at this point, or is it still safe to be gathering in an office setting? If someone at our company were to be diagnosed with this flu, what steps would the company need to take? Would we have to shut down the building and for how long? Thanks!

Answer:

ASK HDHHS ABOUT THE SWINE FLU