As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Connie in California:

"My family will be flying for the holidays. Should we be concerned about being in an enclosed space for five hours?"

Answer:

Connie, more than 2 million people are expected to be flying over this holiday weekend and many have the same concern as you. The Centers for Disease Control and Prevention points out there are not many studies about the spread of flu on airplanes, but anytime people are in close quarters the chance for germs spreading is much higher.

If you are sitting next to someone who is coughing excessively or seems ill, that’s when you are most at risk. According to researchers at Purdue University, you’re most likely to get sick from the people sitting in your row or the row behind you. They actually developed an animation showing how germs move around an airplane. If you’re in this situation, there are things you can do to lessen your risk of getting sick. Point the air vent away from yourself and towards the sick person – that may help push the germs back at that person. Also, turn your body away from the person who seems ill and as we’ve been saying – don’t touch your face. Dr. Julie Gerberding, the former director of the Centers for Disease Control and Prevention, adds that you could ask a flight attendant whether a mask could be given to that person or if that person or you could be moved to another part of the plane. Gerberding also points out that the air on planes is circulated through a HEPA filter, so if you are several rows away from a sick person you’re unlikely to catch his or her germs.

Keep in mind, you can go a long way in protecting yourself by taking some simple steps. I know we talk about this all the time, but wash your hands frequently with soap and water. If soap and water aren't available, you can carry those alcohol-based hand sanitizers. Cover your nose and mouth with a tissue while sneezing and encourage people around you to do the same thing and avoid touching your eyes, nose and mouth. We touch our hands to our faces a lot. In addition, some people might consider carrying a disposable mask, especially if you're feeling sick yourself. Finally, the CDC recommends that you get vaccinated, if you can. That’s sometimes harder than it sounds. For more information, check out flu.gov and CNN’s special report on H1N1.  Have a safe trip, Connie

By Saundra Young
CNN Medical Senior Producer

Every year I get a seasonal flu shot. CNN sponsors flu clinics for employees, so luckily I never have to go "in search of.” My 12-year-old daughter always gets one too.

So the first week in October, I called her pediatrician to schedule a seasonal flu shot. I thought I was ahead of the game. To my surprise, I was told they were out of both the shot and FluMist, but that they were expecting a new shipment mid-October. Since then I have called her office once a week. Nothing. Finally last week they told me they did not know when they would get another batch, and suggested I check with local clinics and other providers such as pharmacies and supermarkets.

I visited a clinic, called numerous supermarkets and pharmacies. Everyone was out, and none knew whether, or when, another shipment would arrive.

According to the Centers for Disease Control and Prevention, as of last week, 94 million doses of seasonal flu have already been distributed. Total production for this season is 114 million doses.

So where did all that seasonal flu vaccine go? CDC Spokesman Llelwyn Grant says the number of people getting seasonal flu vaccine this year is higher than has been seen in previous flu seasons. He attributes the numbers to all the attention given to H1N1. "People are more vigilant in getting vaccinated based on H1N1 activities. They are proactively getting ahead of seasonal flu before it kicks in. Awareness has been higher. That's why seasonal flu vaccine is moving faster than in previous years."

Grant says health officials have not seen much seasonal flu yet. A few pockets maybe, but the majority of cases are still H1N1. He says seasonal flu season generally really starts to percolate around November or December.

Unlike with H1N1, the federal and state governments are not involved in the actual purchasing of seasonal flu vaccine. Whoever orders that vaccine is doing so directly from the manufacturer. So while it may seem like a shortage, the amount of vaccine produced this year is about the same as the last few years. Still, Grant says he understands the frustration. "We are encouraging folks to continue looking. There is more to be distributed. The good news is we have yet to see any seasonal activity really manifesting itself here in the United States. That is the one good piece of news."

So, I find myself waiting for the last 20 million doses to be distributed. Coming soon, I hope, to a clinic near me. Keeping my fingers crossed that I find one with vaccine before the seasonal flu finds my daughter.

I even popped on the American Lung Association's flu clinic locator Web page. Both the CDC and Maryland's Department of Health and Mental Hygiene pushed me to their "find a flu shot site." It didn't help. Most of the clinics that did surface were for H1N1 shots only. The eight that were listed as having seasonal flu vaccine were all in Virginia. Bold type instructed me to "please call ahead to confirm availability."

Is anyone else having this much trouble finding a seasonal flu shot?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

As a  feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Shannon:

"I have a 4-month-old infant and I recently had myself and my 6-year-old son vaccinated for H1N1. My question is, will my infant also gain my immunity to H1N1 through my breast milk? I hope so." 

Answer:

This is a great question and a huge concern for many parents whose children are less than 6 months old and therefore too young to get the H1N1 vaccine. Unfortunately, there is no clear answer to your question, Shannon, so the best we can do is spell out what we do know.

We know that any time you breastfeed your 4-month-old, you pass on potent antibodies (proteins that your immune system produces to fend off disease in the body) that protect him or her against a whole range of infections.

We also know a bit about other vaccines and breast milk, for example, the pneumococcal vaccine that protects against things like pneumonia and meningitis. According to the National Institute of Allergy and Infectious Diseases, mothers who received that vaccine produced antibodies that were detectable in their breast milk, and passed them on to their babies. What is not as clear is whether those antibodies actually conferred immunity to their newborns.

The Centers for Disease Control and Prevention guidance about breast milk and the flu vaccine is a tinge more hopeful, albeit far from conclusive: "By breastfeeding, mothers can pass on to the infant the antibodies that their bodies make in response to the flu shots, which can reduce the infant's chances of getting sick with the flu."

While experts wrestle with this question, you have already taken a positive step – and significantly reduced your baby’s chances of getting the H1N1 virus – by getting yourself vaccinated. The next step is to create a "cocoon of protection" around your baby by making sure that other caregivers in the family also get vaccinated.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Ann J. Curley
CNN Medical Assignment Manager

Many of our readers are still asking questions about H1N1 and seasonal influenza. Today we’ve got a question from Patty:

I am a 63-year-old health care worker in relatively good health, and I’m caring for a 2-month-old infant (my granddaughter). I have had a reaction to thimerosal in the past. It was used as a preservative in contact lens solution.

Is thimerosal used as a preservative in either seasonal flu vaccine or H1N1 vaccine? Are there available alternatives to these vaccines? How would I access them?

Thanks,
Patty Holly

Patty,

Thank you for your question. It’s important that you make your health care provider aware of your sensitivity to thimerosal, which is a preservative used in many products, including some vaccines, nasal products, and eye solutions.

According to the Centers for Disease Control and Prevention, the 2009 H1N1 influenza vaccines approved by the FDA are being manufactured with and without thimerosal.

Multi-dose vials of flu vaccine need to contain a preservative to prevent bacterial contamination, which can occur when multiple syringes are inserted into the same bottle.  However, some manufacturers also produce single-dose flu shots, which do not require any preservatives.

The nasal flu vaccine – both for seasonal flu and H1N1 – is always thimerosal-free. However, it is recommended only for people ages 2 to 49 who have no underlying health problems. The nasal spray vaccine is made from a weakened live virus and is not recommended for people with autoimmune disorders, pregnant women, and patients with certain chronic health problems, including diabetes, heart disease, asthma, and lung disease. Unfortunately, you can’t take the nasal flu vaccine because you are 63. You can find more information about the live vaccine here.

Ask your doctor for a thimerosal-free flu shot. If he or she doesn’t have one, you can visit the CDC’s H1N1 Web site and check out its “flu shot locator” .  It has links to the Web site of each state’s health department, with specific information about where vaccine can be found.

The Centers for Disease Control and Prevention has a lot of useful information about both seasonal flu and H1N1 flu on its Web site. Also be sure to check out CNN.com’s flu page.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

As a new feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here are two questions for Dr. Gupta.

From Kat in College Park, Maryland:

“Is it possible to get swine flu (or regular flu, for that matter) twice in the same season?”

Answer:
Once you’ve had the flu, your chance of getting it again in the same season is low. Your body builds antibodies to protect against it. This basically means if you contract that same exact strain, your body fights it off naturally, typically before you’d notice any symptoms. There are a couple of concerns, though, and one that we've been talking about almost since the beginning, and that is that the virus can mutate. It can start to change. If it mutated, a couple of things could happen. A person who has already had H1N1, would no longer be protected. But also, the people who get the vaccine being shipped out now, which is designed specifically to protect against this strain of H1N1, also wouldn’t have protection if it mutates. 

From Vanessa in Gholson, Texas:

“My kids are sick with flu-like symptoms. I’m not sure if I should take them to the doctor but would like to confirm if my children have H1N1 or not. Should we go?”

Answer:
Great question and one I’ve been getting a lot from viewers. Should a person with flu-like symptoms go to the doctor? For the vast majority of people reading this right now, the answer is no. You will have a few miserable days but most likely not need any medical attention whatsoever.

There are some high-risk groups that would need medical attention, but, a good rule of thumb is if you think you are sick enough that you would have gone to the doctor a few years ago for flu-like symptoms, then you can go this year as well. But don't treat this differently simply because it has a different name of H1N1.

As far as getting tested, this is really interesting. When we first started reporting on this virus back in the spring, health officials were trying to figure out exactly what the virus was and confirm whether it was H1N1. They were doing a lot of testing then to help investigate what areas of the country it spread to. But now we know this virus is pretty much everywhere. And the CDC isn’t recommending health providers test for it in most cases because they don't need that information anymore.   Also, the patient probably wouldn’t be medically treated any differently from the treatment for seasonal flu.

As a regular feature of CNNhealth.com, our team of expert doctors answers readers’ questions. Here’s a question for Dr. Gupta.

From Birgitta in Newcastle, Washington:

I think I already had the swine flu but do not know for sure if it was swine flu, do I take the vaccination anyway? Is it safe to take if I suspect that the flu I had was swine flu?

Answer:

Tens of thousands of people right now, like Birgitta, are suffering from or getting over the H1N1 virus. Those numbers will continue to swell as the flu season wears on, and these questions will inevitably come up over and over again.

Incidentally, I can relate. I contracted the H1N1 virus recently while reporting on the war in Afghanistan, and I was miserable for days. I got my immunity to H1N1 the hard way, so I can take a pass on the vaccine this year. But what about people who are not as sure, like Birgitta?

The bottom line is, unless you got a laboratory test confirming it, you cannot be sure that you actually got the H1N1 virus. There are several strains of influenza floating around out there this season, two of which are H1N1 and seasonal influenza. There are a handful of other strains you could have contracted.

The old adage, "Better to be safe than sorry," may apply here. Unless you're sure you had H1N1, the Centers for Disease Control and Prevention recommends that you get vaccinated. Even if you did, in theory, get H1N1 the CDC reports no evidence that subsequently getting the H1N1 vaccine would cause problems for you.

You can think about your vaccination like an insurance policy. If you did have H1N1 during your recent illness, then you're protected. If you did not, you're also protected.

If you're wondering when the vaccine will be available, the largest shipment of H1N1 vaccine is scheduled for mid-October. By then, the first 45 million doses of the vaccine will be ready, with another 20 million doses shipped out each week until December.

And don't forget, the CDC recommends that you get the seasonal flu vaccine as well.

By Miriam Falco
CNN Medical News Managing Editor

The U.S. Department of Agriculture symbolically slapped the news media on the hand Thursday for perpetuating the term "swine" flu in reports about the new H1N1 strain of influenza that's spreading across the world.

In a written statement and during two telebriefings, the USDA reminded reporters that since last Spring they have “consistently asked that the media stop calling this ‘novel’ pandemic virus ‘swine flu.’”

So what's the big deal? Health officials say the H1N1 virus more closely resembles the pandemic Spanish flu of 1918 than a swine flu. The USDA says struggling pork farmers are being hurt in a big way when the virus is called “swine flu.” USDA officials stress that “ you cannot get infected with 2009 pandemic virus from eating pork or pork products."

"Each time the media uses the phrase ‘swine flu’ a hog farmer, their workers and their families suffer,” says USDA Secretary Tom Vilsack in a statement posted on the USDA Web site. “It is simply not fair or correct to associate the 2009 pandemic H1N1 influenza with hogs, an animal that does not play a role in the ongoing transmission of the pandemic strain."

USDA officials point out that China is not importing U.S. pork because of the erroneous belief that eating pork is tied to the spread of this new type of flu.

I am a member of the news media and I have used both H1N1 and “swine flu” in my stories because some people know the virus only as “swine flu,” which is what it was originally labeled.

So how did the confusion start?

Back in the spring, when we first heard about "swine" flu, it was given that name because initial tests showed it resembled some known viruses that have circulated in pigs. However, the CDC explains on its Web site, "…further study has shown that this new virus is very different from what normally circulates in North American pigs." The agency explains that this new H1N1 virus has genetic material from viruses found in European and Asian pigs, as well as genes from birds and humans. Plus, USDA officials point out that this is a human virus because it was first detected in humans. They say there are no reports of H1N1 circulating in any swine herds here in the United States. They acknowledge that Canada, Australia and Argentina have found H1N1 in a few pigs. And Deputy Agriculture Secretary Dr. Kathleen Merrigan says she wouldn’t be surprised if the H1N1 virus does eventually surface in U.S. pig herds. But she stresses that pigs infected with the virus would not be sent to market.

Health officials keep reminding us that the best way to avoid getting sick with this new H1N1 flu virus is to take the following precautions:
- Wash your hands frequently.
- Cough into a tissue or your sleeve, not into your hand.
- Get a regular seasonal flu shot now, and the H1N1 flu vaccine when it becomes available, allowing the highest risk groups to get their shots first.

And please don't call it swine flu.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Caleb Hellerman
CNN Medical Senior Producer

We're still waiting on federal guidelines for how day care centers and preschools should handle the H1N1 flu virus. They were promised last week, but the date has slipped amid behind-the-scenes debate over how far the guidance should go: Should they match the advice for K-12 schools, which say that students who are out sick can come back after just 24 hours without a fever? Or should the day care guidance be more restrictive, since young kids are more prone to complications – and tend to transmit more virus?

In the meantime, I’m watching the debate play out in miniature at the pre-school of my 3-year-old daughter and 15-month-old son. As it happens, my wife helps research flu guidance for the CDC, as do two other parents at the preschool. They helped write a preparedness plan for the school, which goes well beyond the CDC's guidance for K-12 schools – and is stronger than the basic advice the federal government is currently considering for daycares.

My wife and her colleagues recommended that students who are sick with respiratory symptoms stay away for at least seven days. One of them, a senior CDC flu scientist, told me that children with H1N1 typically shed virus – i.e., it's in their mucous and other secretions – for five to 10 days. She said that fits with published research on other flu strains, showing that young children often shed virus for seven days or even longer.

But the head of the school is pushing back. She’s OK with a seven-day restriction for toddlers, but wants it at five days for 3- to 6-year olds, and “24-hours fever-free” – the CDC’s K-12 guideline – for elementary-school-age students. More than that would be too hard on parents, she says. My wife and her friends want to include a warning that the rules are not meant to stop the spread of flu.

In the midst of all this, I talked with Dr. D.A. Henderson of the Center for Biosecurity, who oversaw the CDC's response to the global flu pandemic of 1957. He thinks the guidance to date has been too intrusive – that keeping sick students home longer than usual won't stop the spread of H1N1 and would lead to serious disruptions – including a shortage of health care workers staying home with their kids.

No easy answers, and a lot of disagreement, even among medical professionals. Just one more example: Yesterday, Dr. Sanjay Gupta visited a doctor at Children's Healthcare of Atlanta, who reminded us that for most people, even young children, H1N1 is not likely to cause more than passing symptoms. Dr. Jim Fortenberry said that parents should not bring their kids to the ER unless they seem dehydrated, are younger than 12 weeks, have fever for three days or have a fever that returns after being gone for 12-24 hours. That's all well and good, but he didn’t mention CDC guidance – which says that people in high-risk groups (including children younger than 5, as well as pregnant women and people with medical conditions such as asthma) – who have flu-like symptoms (fever higher than 100 PLUS a cough or sore throat) – should take antiviral medication right away, as a precaution. If you’ve got a child with those symptoms, you don’t have to go to the ER, but do call your doctor right away.

The head of my preschool wants to finalize and send out guidelines by tomorrow. As of now, she and the parents on the health committee have to make their decision without official CDC guidance.

Are you a parent? Have you received guidance from your child's day care on what to do if your child becomes ill?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Jennifer Adaeze Anyaegbunam
CNN Medical News Intern

This year my back-to-school to do list looks a bit different than it has in previous years. Select senior year courses, check. Purchase school supplies, check. Don’t get swine flu. Um—I’ll try?

Colleges represent a diverse and mobile population. Individuals don’t sleep enough, eat right, practice the best hygiene, or make the healthiest choices. Say you’re at a party, and there is only one used cup left, do you drink from it? In college, too frequently the answer is yes! And if you don’t drink from the dirty red cup, your best friend might. Let’s face it, on campus there are only a few degrees of separation so I’m wondering how I will separate myself from the latest H1N1 viral outbreak.

Swine flu is spread via the same mechanism as regular seasonal influenza. When people with these viruses cough or sneeze the virus is released into the air via tiny in respiratory droplets. You can contract swine flu by coming in contact with these droplets or touching a surface contaminated with these droplets containing the H1N1 virus up to 8 hours after it was deposited.

There were a few cases of swine flu on my campus at the end of last semester. According to the Centers for Disease Control and Prevention (CDC), avoiding contact with the sick and frequent hand sanitizing can help reduce the risk of spreading the flu. I interviewed some of the members of Harvard’s class of 2009 to find out exactly how swine flu had affected their commencement ceremony, and apparently the seniors I spoke with saw these CDC tips in action. According to graduate Devin Smith, the Dean of the college, “… announced that swine-flu had, in fact, worked its way into Harvard graduation and instructed graduates, family, and friends to refrain from hugging and shaking hands.” Matthew Clair, another recent graduate, noted that everyone at graduation seemed to be coughing and sneezing but, “besides the hand sanitizer they squirted into our hands before we received our diplomas and the general paranoia, graduation proceeded as usual.”

So when I return to campus, will my life proceed as usual too?

Clinical trials for a swine flu vaccine are in progress, and public health officials are hopeful that the swine flu vaccine will be ready for public distribution by mid-October. Due to the number of swine flu cases in my demographic, the CDC’s Advisory Committee on Immunization Practices has suggested that college-aged students are among the first to get the H1N1 vaccine this fall. The CDC will be updating their recommendations for swine flu prevention and preparedness for institutions of higher learning later today, but so far the organization does not recommend that colleges dismiss lectures or other large gatherings—so unfortunately, summer vacation will not last until mid-October when the vaccine becomes available.

If you do happen to get sick, public health officials recommend that you self-isolate and stay home until at least 24 hours after your fever breaks. Many college students live in dorms so isolation may be difficult. But before you burn all of Sally’s belongings or douse John with holy water you should consult these CDC tips for those living with someone with swine flu.

Exposing yourself to swine flu may seem like the easiest way to build a natural immunity to the H1N1 virus and/or get excused from your midterms. I know the thought has crossed your mind, but don't do it. Swine flu has been mild for many people, but deadly for others– so you should probably devise an alternate, less fatal scheme (or maybe just study).

Until the vaccine becomes available, I hope that for my sake and others’, those living in communal environments practice healthier habits and take active steps to prevent the spread of swine flu. So, always cough or sneeze into your sleeve or a tissue, and if you must drink from the red cup, wash your hands after!

College students, will you be getting vaccinated? Do you think this vaccine should be required for all those living in communal environments?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

From CNN.com blogger, Dick:

"Hand sanitizer has been recommended but the bottles say, "Effective against bacteria," with no mention of viruses. What gives?"

Answer:

That is a good question. There are not a lot of data actually on how effective those sanitizers are against viruses. There have been some studies done over the years and the conclusion is washing your hands with soap and water is still probably the best idea. If you are having a busy day and it is hard to get to a sink, then carrying a bottle of hand sanitizer would be a good idea.

In essence, it makes your hands very inhospitable to viruses. You put it on your hands and viruses simply don't want to cling to it. So it does reduce the amount of a virus that can cling to your hand but it does not kill it. Alternatively, it also can’t harm you in any way. We get a lot of questions from concerned viewers asking if sanitizers could actually cause antibiotic resistance down the road. Many studies have looked into the issue and all evidence points to the answer being no.

At the end of the day, basic principles apply to avoid getting a virus. Avoid touching your mouth, eyes and nose as much as possible. If you cough or sneeze, cover your mouth and nose with a tissue or your sleeve. If you're sick, stay home and avoid close contact with others. Some viruses can live for hours on surfaces such as ATMs, doorknobs, even money.

So be methodical about good hygiene, all year long! Remember that the number of 2009 H1N1 cases will most likely decrease over the summer months because viruses just don't transmit that well in the heat. But in the fall and winter, we're all going to have to remember what the new H1N1 strain was like and be extra vigilant so this doesn't get out of control.