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Dr. Dumois answers your flu questions

Dr. Juan Dumois, pediatric infectious diseases expert at All Children's Hospital in St. Petersburg, joined the St. Petersburg Times on Friday for a live online chat about swine flu. Here are just a few of his answers to readers' questions. For more on issues such as underlying conditions that increase the flu's severity, when to keep a child out of school, how vaccines have changed since the 1976 swine flu and whether herbal remedies are effective, please go to

How is the flu most commonly spread?

The flu is most commonly spread by touch. If I have the flu, and cough into my hand, and then touch a doorknob, it can exist on that doorknob for 24 hours. The next person who touches that doorknob will get the virus on their hands. If they touch their mouth, nose or eyes before cleaning their hands, they will become infected, even if they were nowhere near the infected person. This is why frequent hand cleaning or use of hand sanitizers is a relatively effective way of avoiding the flu when you're out in public. You can also acquire the flu if a sick person coughs or sneezes in your direction and you're standing within six feet of them. If you're standing farther away when they cough or sneeze, the infected particles will settle out of the air before they get to you.

My son was just diagnosed with H1N1 and was sent home and I told to bring him back if he worsens. Nothing was prescribed. Any ideas?

If your son is over 5 years old and has no underlying medical conditions, then it's more likely that he will recover fine from the flu without requiring any medications. The warning to bring him back if he worsens is a very important one. Worsening of symptoms after an initial improvement and loss of fever could be a sign that a bacterial pneumonia has occurred as a complication of the flu. Some specific signs of worsening would be: new fever, worsening cough or difficulty breathing, lips or skin turning blue, or the child is acting more lethargic. Any of these signs would warrant returning him to the doctor. Children under 5 or who have underlying medical conditions may be better candidates for treatment with flu medicine (Tamiflu or Relenza) in order to avoid their higher risk of complications.

What's better: the injectable or nasal swine flu virus, specifically when it comes to school age kids?

Either the injectable or nasal spray vaccines should be effective in school-age children. However, the nasal spray vaccine is not recommended for children with asthma or other chronic medical conditions. Those kids can get the injectable vaccine safely. For school-age children without underlying medical conditions, it's a matter of preference of getting the injection versus the spray.

When will the H1N1 vaccine be available to the public in Pinellas County?

Persons who are in highest risk groups targeted to first receive the swine flu vaccine currently can get it at the Pinellas County Health Department clinics. However, you would need to check with the clinic to confirm whether they have the nasal spray or the injectable forms of the vaccine. Anyone over six months of age can receive the injectable form, but only persons 2 to 49 years of age with no underlying medical conditions can get the nasal spray. Check the department's Web site: www. for more information. For Hillsborough, go to www.

The entire transcript of Dr. Juan Dumois' chat is available by clicking here.

Dr. Dumois answers your flu questions 10/23/09 [Last modified: Friday, October 23, 2009 5:28pm]
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