EDITOR'S NOTE: On Wednesday, Sept. 16, Raising Arizona Kids (@RAKmagazine) and Banner Good Samaritan (@BannerGoodSam) co-hosted a live Twitter chat featuring infectious disease specialist Felipe Gutierrez, M.D.. Following is the transcript of that event. 

RAKmagazine: We'd like to welcome infectious disease specialist Dr. Felipe Gutierrez from Banner Good Samaritan Medical Center to our H1N1 Twitter chat. Thank you.

Dr. Gutierrez: Thank you for having me.

RAKmagazine: Let’s jump right in. Why all the concern over H1N1? What is it? What's the big deal? 

Dr. Gutierrez: H1N1 is an influenza just like any other, except that it has not been seen in the human population before. The last time where we had a new virus like this, many people died. So, concern is raised for what can happen with this one. 

RAKmagazine: How is it different from seasonal flu? Does it matter if I know the difference? 

Dr. Gutierrez: Major difference appears to be the age of people affected. Seems like greatest number are in the younger population. The seasonal flu typically affects those 65+, very young and those very sick. This one seems to affect otherwise young, healthy people. Those who have been the sickest, by and large, have had other medical conditions. 

RAKmagazine: Great lead into our next question. Who is at risk? 

Dr. Gutierrez: Those with greatest risk are those with underlying medical conditions, such as neonates and pregnant women. However, we are all at risk in that we do not have a natural immunity given fact that it is new virus to us. 

RAKmagazine: To clarify, what is a neonate?

Dr. Gutierrez: Neonate is considered those 6 months or younger. However, those under 5 years old are at increased risk, too. RAKmagazine: What are the symptoms? 

Dr. Gutierrez: Most common symptoms are: fever, cough, sore throat and generally feeling lousy. Also, significant number of people are experiencing nausea, vomiting & diarrhea. Not typical for seasonal flu. 

RAKmagazine: When should I go or take my child to the doctor? What should I expect when there? What should I ask? 

Dr. Gutierrez: Healthy children should recover without complications. So, medical attention not usually needed. However, warning signs of more severe H1N1 include: inability to keep liquids down, respiratory distress, pale/blue skin, extreme irritation, and being very tired. When you're at the doctor's office, report what you are seeing your child experience (symptoms). But, treatment/testing is often not necessary. 

RAKmagazine: Is the virus spread strictly through the air or also by touching something an infected person has touched?

Dr. Gutierrez: Virus spreads by droplets from coughing/sneezing. It can also contaminate material surfaces, which can infect people. 

RAKmagazine: (via question from audience) What preparation can we do at home to get ready? What would you recommend for a child with asthma?

Dr. Gutierrez: Prep would be lots of soap/hand gel, as well as tissues and a family plan for caring for the sick. Where you have high-risk members of family, vaccination for seasonal & swine flu highly recommended. In the case of a child with asthma, I would recommend the child be vaccinated as well as the family members.

RAKmagazine: Are hand sanitizers (which kill bacteria) a valid precautionary measure? Can they make the virus mutate?

Dr. Gutierrez: The virus naturally mutates frequently. It is not thought that the use of hand sanitizer will promote further mutation. That said, I strongly recommend people use hand sanitizer.

RAKmagazine: (Question from the audience) Is this new vaccine safe? The vaccine given in the 70's had serious issues. Is the cure worth the risk?           

Dr. Gutierrez: We are aware of previous issues. So far, the vaccine has proven to be safe and no major issues have been seen at this time.

RAKmagazine: Is it true that this virus has a longer period of contagion than other flu viruses?

Dr. Gutierrez: At this time, we do not yet know if this is the case. It is possible.

RAKmagazine: How should I take care of someone who has the flu? What if I have more than one child?

Dr. Gutierrez: If a child is sick, isolate them from others in the home. Also continue strict hygiene with frequent hand washing. 

RAKmagazine: (Question from audience) What are the hospitals doing to prepare for a large number of flu patients in the ER?

Dr. Gutierrez: At Banner, we are having ongoing discussions/planning in event that the flu season becomes greater threat.

RAKmagazine: How can I keep my family safe from getting a flu virus? What are some tips for prevention? 

Dr. Gutierrez: Prevention is key! Good hygiene, vaccination and doing our part to not spread the virus when we are sick. Other prevention tips can be found on the Banner Health Web site at http://www.bannerhealth.com/Services/Health+And+Wellness/Flu/Flu+Prevention+Tips.htm.

RAKmagazine: How can I protect my children at school? What types of behaviors should I teach them?

Dr. Gutierrez: Again, hygiene is key. Schools should likewise do their part to educate and prevent infection.

RAKmagazine: (Question from the audience) I have a 3 year old and I am pregnant. Do I go to my OB to get the vaccine or to my regular doctor?

Dr. Gutierrez: Whoever can provide it first. But, you should absolutely get vaccinated. The seasonal vaccine is available now. The H1N1 vaccine will be available in mid October or early November. Also, pregnant women are on the priority list.

RAKmagazine: What are colleges saying or doing about the virus? What should I tell my child to do?

Dr. Gutierrez: All educational institutions have received guidance from the CDC. Individual schools should have a plan in place. Call the school and ask them! Tell your child the same prevention tips: vaccinate, practice good hygiene, stay home when sick and don't go to class. 

RAKmagazine: Let’s talk about the #h1n1 vaccine. Who qualifies to receive the vaccine shot? 

Dr. Gutierrez: The vaccine has designated high priority groups. The program will be expanded as the vaccine becomes more available. The priority list is on the CDC Web site. It includes pregnant women, health care workers, and children 6 months to 25 years old.

RAKmagazine: (Question from audience) Do we need to worry about H1N1 vaccine not being well tested in the rush to get it to market?

Dr. Gutierrez: New vaccine prepped in the same fashion as the seasonal vaccine. Testing likewise is similar.

RAKmagazine: How will vaccine be allocated and when will it be disbursed? Will there be enough for those who want it? 

Dr. Gutierrez: Government agencies are charged with distribution. The priority groups are first, then the general population. It is unknown whether supplies will be an issue at this time.

RAKmagazine: (Question from audience) Do children need one dose of the vaccination or two?

Dr. Gutierrez: Likely those under 9 years old will need 2 doses. But, final recommendation is pending on this.

RAKmagazine: If I qualify for the vaccine, where do go? What should expect? Who can I contact? How much does it cost?

Dr. Gutierrez: Vaccine should be very low cost. You should contact PCP office in early to mid October and ask them, or contact the County health department.

RAKmagazine: (Question from audience) Which flu shot is recommended? The H1N1 or the annual seasonal flu shot? I also heard we should wait 30 days in between receiving the H1N1 vaccine and the seasonal flu shot. Is this true?

Dr. Gutierrez: There is no cross protection, so we recommend getting both seasonal and H1N1 shot. No official recommendation given at this time on the wait period. However, co-administration should not be a problem.

RAKmagazine: (question from audience) Is it safe to breastfeed if the mom has the flu?

Dr. Gutierrez: Probably a high risk. I would not routinely recommend it. I would advise individuals to consult with their doctor. You can get the vaccine and/or take TamiFlu if you are breastfeeding.

[EDITOR'S NOTE: After this transcript was published, a local mom wrote to tell us about articles from the American Academy of Pediatrics and the Centers for Disease Control that directly address this question. Thank you to Elizabeth Hayward of Scottsdale for providing the following links: Read the AAP article and the CDC article.]

RAKmagazine: (question from audience) Are there any known side effects from the vaccine? How long do the side effects persist after the H1N1 shot is administered?

Dr. Gutierrez: Side effects include pain at injection site, possible fever and malaise. However, it does not give you the flu! Side effects should be short-lived and should subside within a day or two.

RAKmagazine: How many reported cases in Maricopa County?

Dr. Gutierrez: Last week, approximately 109 cases reported in Arizona. Over half were in Maricopa County, but activity wide spread in Arizona. You can check State Health Department Web site for a weekly update.

RAKmagazine: I heard that you shouldn't get the vaccine if you are allergic to eggs. Is that true? 

Dr. Gutierrez: This is true in vaccines produced in egg culture. You can check with PCP or County Health Dept to see if vaccines produced in cell culture available. 

RAKmagazine: Will a health care worker let you know before receiving the injection or ask if you have an egg allergy?

Dr. Gutierrez: A consent form is typically signed before a vaccine is administered. You should be informed about egg allergies.

RAKmagazine: Last question. If I am a generally healthy person (adult), should I worry about getting the vaccine?

Dr. Gutierrez: As the vaccine becomes available the CDC may recommend a "generally healthy person (adult)" get the vaccine.

RAKmagazine: That concludes our questions. Thank you to Banner Good Samaritan and Dr. Gutierrez for taking time to answer our questions today!

Dr. Gutierrez: Thank you for having me. If you have follow-up questions, The BannerHealth.com flu page is a great resource: bit.ly/10C9t1, as is the CDC website.

RAKmagazine: Also, Raising Arizona Kids magazine's website has a collection of resource links and articles at http://ow.ly/pxzT.