Cold and Flu

Questions and answers about the "Common Cold"; symptoms in the upper respiratory tract like sneezing, scratchy throat, and runny nose, but adults don't typically have fevers. Colds are usually caused by the rhinovirus (up to 40% of colds), or Coronaviruses (about 20%), but there are more than 200 viruses that can cause the common cold. Also questions about the seasonal flu, also called "regular flu", caused mostly by Type A and Type B Influenza viruses. Flu starts with similar symptoms as a cold only it hits faster and harder and usually includes fever in adults. Although the "stomach flu" is a common term, it is not a real diagnosis. The proper medical term for stomach flu is gastroenteritis (an intestinal disease, sometimes viral but also bacterial), it is often mistaken for influenza because the flu can sometimes include vomiting and diarrhea.

13,758 Questions
Cold and Flu
Infectious Diseases
Viruses (biological)

How can you protect yourself and others from viruses and flu?

Avoid close contact with people who are sick and maintain a social distancing.

Conditions and Diseases
Cold and Flu
Infectious Diseases
Immune System

Why do you get Muscle ache with flu?

Muscle aches caused by a flu virus cannot be accounted for by fluid loss from excretions and emesis alone, because often muscle aches are the first sign of the flu, long before vomiting or diarrhea may ever occur (and they do not occur in most flu infected folk). Instead, it is the increasing body temperature (the fever that is one of the body's most effective responses for killing off heat-susceptible invaders) that causes an increase in water usage at the cellular level. Full body dehydration then almost inevitably occurs, as the flu-infected usually have their thirst and appetite mechanisms decreased as well. However, as the previous writer puts it: One of the most notable symptoms of having the "flu"the is a persistant (and often disgusting!) loss of fluid. This can be a result of vomiting, diarrhea or often a combination of the two. Within this fluid are precious ions (electrolytes) that enable all the good stuff in your body to happen: Muscle contractions, nerve impulses, even basic cellular metabolism! One of the most important (as far as your muscles are concerned) is potassium -- [although calcium, magnesium, and sodium are all equally important but just dont get the same amt of press]. Low potassium levels mean special ion channels in your muscle cells cannot function properly, and that leads to a sensation of "exhaustion", much like you just finished a marathon. Without potassium (and other molecules such as ATP) your muscles just can't function! If you have the flu and you'd like to beat the muscle ache, chow on some high potassium-sodium ratio foods such as avocados or dark green veggies (think spinach); [bananas are merely ok regarding this K/NA ratio, much more important than is absolute amount of potassium alone]. Gatorade or other (preferrably lower in sugar) sports drinks can help both replenish lost electrolytes (like potassium!) AND water, a great two-fer when you're socked in with this bug (watch the sugar level or you'll end up low on potassium again, if you get my drift!).

Workplace Health and Safety
Cold and Flu

How sick is too sick to go to work or school?

This is often a really tricky call to make. You don’t want to miss important information or let work pile up in your absence, but you also don’t want to get others sick.

However, when a fever is involved, the choice is simple: Stay home. You should wait at least 24 hours after the fever’s gone before returning to the outside world. This can be especially helpful in preventing the spread of seasonal flu.

Other symptoms tend to have more wiggle room, and the choice often ends up being a complicated dance of trying to balance how important it is to be there, how contagious you are, how flexible your work or school is, and how much your symptoms would impact your quality of work.

Cold and Flu

How long did the 1918 flu pandemic last?

The 1918 influenza pandemic ended in the summer of 1919. The disease was first detected in the U.S. in March 1918, and it surged three separate times. The second wave of illness (in the fall of 1918) was responsible for most of the deaths.

Cold and Flu
Body Temperature

Can you catch a cold from being in the cold?

No. For example, people in Alaska don't get more colds than people anywhere else. We do have more colds in winter than in summer, but not because of the cold (see more on why below). Cold weather conditions play no role except as mentioned below about absolute humidity levels in the winter. One of the expert scientists (Bill Nye) said that you can not catch a cold from being cold; you catch a cold from germs and being cold has nothing to do with it. Plenty of tests have been conducted proving this.

The old belief that freezing temperatures cause illness started before people knew about germs; however, it continues to be passed along to others as a legend today and is not an evidence based finding from studies - just based on anecdotes and incorrect associations.

It has been scientifically studied with double blind test groups and there was no difference found in the rate of infection with common cold viruses when the study groups were exposed to cold temperatures or heat via different methods. The results of those studies were peer reviewed. "No" has become the current most accepted answer to the question by scientists and medical professionals.

Then why do we get more colds and flu in winter and cold weather?

It had been long held that this was most probably due to school children returning to schools and people being in closer proximity indoors in winter where they could pass all their germs around more easily. One of the most commonly cited studies used as a basis for this hypothesis was the "Seattle Virus Watch", done by John Fox, Carrie Hall, and friends.

Another hypothesized explanation had been that our Vitamin D production is lower in winter due to less exposure of our skin to sunlight, and since Vitamin D improves the immune system's ability to fight off infections, our defenses are made weaker in winter with Vitamin D deficiency. Another commonly held belief was that in drier air our mucous tissues dry out and can crack, making the viruses more easily introduced to the body. Some combination of all these factors may be at play.

However, the most recent studies have all seemed to point more to the different absolute humidity levels in winter compared to those in summer. Cold and flu viruses like it dry. See the related question below, "Why does the flu have a season?" for more details about these recent findings.

Check out the discussion section for comments, anecdotes, and discussion.

It is often believed that colds and flu and other infectious diseases can be caused by cold weather, changes in temperatures, being wet outside, or having wet hair, etc. None of this is correct information.

People also often say that being cold affects your immune system so you are more susceptible to infections. This is also not correct. When this is discussed, it doesn't just mean feeling chilly or even getting "goosebumps" or shivering. Hypothermia can have negative effects on your entire body including the immune system, but just being cold is not hypothermia. When medical studies use that term, it is used to refer to a specific measurement of core body temperature.

Hypothermia is not the same as being cold, it is a specific medical diagnosis and:

  • It is defined as a core body temperature that is at or below 95 F (35 C).
  • Needs to be treated if body temperature goes below 95 F (35 C).
  • Becomes life threatening below body temperatures of 90 F (32.2 C).
  • Affects motor coordination through impact to the nervous system at 95 F.
  • When the body temperature drops that low, at the start of a hypothermic condition, symptoms can include intense uncontrollable shaking and shivering, then if your body continues to get colder, the shivering stops when the core temperature gets between 90 F and 86 F.
  • It causes heart rate, respiratory rate, and blood pressure to rise during the first stages of hypothermia as your body tries to increase metabolism and warm itself, but these vital signs fall once the temperature gets 90°F (32.2°C).
  • Creates coma at below 86 F.
  • Heart rate becomes very irregular below 82 F and death can soon follow.

The reason the disease is called a "cold" does come from the myth and misunderstandings from back when it was thought that upper respiratory viral infections were caused by cold since most often occurred in cold times of the year and when they had no clue about disease-producing microbes. We know that is incorrect now, but the popular name of the "common cold" has not changed to its more proper name: a Rhinovirus infection.

Cold and Flu
Strep Throat

How do you get rid of a sore throat?

If you have a sore throat, you should get plenty of rest and drink plenty of fluids. You should consider visiting a doctor, especially if your sore throat worsens, has spots, or continues for days. A humidifier or cold vaporizer can help as well to make the air more moist and soothing.

One of the better home remedies for a sore throat is a salt water gargle. It is very soothing. Be sure that a child is old enough to know how to properly gargle before using this. It should not be swallowed. Try this for the gargle:

1 teaspoon of table salt to 8 ounces of warm water. Gargle the solution and then spit it out. Warm water (but not hot) is more soothing. Do this a couple of times a day.

There are many over the counter products for sore throats, too. Ask the pharmacist at your drug store for recommendations of the best products available for your specific symptoms.

The most common cause of a sore throat is a viral infection, such as a cold or the flu. A sore throat caused by a virus usually resolves on its own with symptomatic care. A bacterial infection is less commonly the cause, but if it is due to bacteria, you will need to see a doctor to determine if you need antibiotics.

According to Otolaryngologists, some indications in adults that you need to see a physician with a sore throat are:

  • A very severe sore throat
  • A sore throat that lasts longer than a week
  • Difficulty swallowing
  • Difficulty breathing
  • Difficulty opening your mouth
  • Joint pain
  • Earache
  • Rash
  • Fever over 101 F
  • Blood in saliva or sputum (phlegm)
  • Recurrent sore throats
  • Lumps in your neck
  • Being hoarse for more than two weeks

In children, if the sore throat is not gone by the next day, contact your pediatrician for advice. Also get urgent medical care if children have any of the following with the sore throat:

  • Difficulty breathing
  • Difficulty swallowing
  • Drooling (can indicate an inability to swallow)

Other helpful suggestions from contributors:

  • Bradosol Lozenge's are very good for relieving sore throats.
  • Difflam Spray used for discomfort in the mouth and throat is also very good.
  • If your sore throat condition gets worse speak to a pharmacist or your doctor for some advice.
  • Take Advil and drink really cold Mountain Dew. The Advil alone does work a little but something cold also brings down inflammation.
  • Honey and lemon... Can use concentrated lemon juice from supermarket.... Even better with whiskey in it
  • Take a zinc supplement and 'gargle' warm salt water.
  • I also enjoy drinking hot green tea mixed with honey.
  • Use chamomile tea with cinnamon, eat licorice, eat ice cream or squeeze lemons and drink the sour juice, seriously.
  • Warm salt water gargling and B complex vitamins will help. It may be necessary to give an antibiotic.
  • Tylenol or throat sore medicine.
  • Since sore throats are sometimes caused by bacterial infections, and because it can cause a mucus film to build up on the throat, you can gargle with warm salt water. This will help in two ways: 1. Salt has natural antibacterial properties, which can help clear the infection. 2. By gargling with warm salt water, it will help rid the throat of the mucus film lining the throat, and help promote faster healing and give temporary pain relief.
  • If it's a post nasal drip sore throat the best thing to do is drink a lot of ice water to clear the excess mucous out.
  • If it's itchy it might be allergies so you could use Benadryl. If it lasts a long time or you have spots on your throat you should contact a doctor. Also, throat lozenges or cough drops help a lot.
  • Try a raw clove of garlic or raw ginger. They act like antibiotics and can clear up most sore throats. Make sure you eat something first and have something on hand to wash it down.
  • Honey and lemon... Can use concentrated lemon juice from the supermarket instead of squeezed lemon.... Even better with whisky in it
  • You can drink pickle juice or eat a few pickles.
  • If it's a post nasal drip sore throat the best thing to do is drink a lot of ice water to clear the excess mucus out. If it's itchy it might be allergies so you could use Benadryl. If it lasts a long time or you have spots on your throat you should contact a doctor. Also, throat lozenges or cough drops help a lot.
  • If the sore throat is that sore, you may have a bacterial infection, like strep throat, that needs antibiotic treatment. If is is not better after several days, if you see white spots on the back of your throat or swollen tonsils, and/or a high fever, you should get an examination by a health care professional.
  • Ask your pharmacist to help you choose the best over the counter sore throat relief medicine if the warm salt water gargles do not help. Drink plenty of liquids and check your temperature often. Also rest your throat. That would mean, less talking/singing, etc.
  • Whenever I get a sore throat, my dad makes me drink lemon juice, steam my face, eat oranges, drink tea, and gargle with salt water. I went to the doctor a month ago for a sore throat and he told me that I should keep eating lemons, gargling with salt water, and drinking non-caffeinated tea. Of course, I'm sure this depends on your exact symptoms. So, if these don't work, ask your doctor for more solid advice.
John Quincy Adams
Cold and Flu
Strep Throat

What is Quincy throat?

Quinsy is an abscess between the back of the tonsil and the wall of the throat. It's also known as a peritonsillar abscess. It happens when infection spreads from a swollen tonsil to the area around it, usually during a severe case of tonsillitis. The symptoms of quinsy are similar to tonsillitis and include: * a worsening sore throat, usually on one side, * fever, * difficulty opening the mouth * difficulty swallowing * drooling rather than swallowing your own saliva and * swelling of the face and neck. Quinsy is now rare because most people get effective treatment for tonsillitis early enough to prevent it. Quincy may be suspected if you have a sore throat that gets a lot worse very quickly, or tonsillitis with more severe symptoms than normal. Quinsy is treated in hospital. The abscess that has formed has to be aspirated (the pus is sucked out) and antibiotics may be needed to prevent the infection spreading. An operation to remove the tonsils (tonsillectomy) may be recommended a few months after quinsy.

Cold and Flu
Death Rate

How many people die annually from flu?

It is estimated that 36,000 people die each year, in the US alone, from seasonal flu.

Cold and Flu
Infectious Diseases
Swine Flu (H1N1/09)

Can you catch the same flu twice?

If you are exposed to an identical version of the flu that you had previously after you have recovered fully from it the first time, then your body should have developed immunity to all genetically identical kinds of flu and you would not get it a second time. However, the flu can change by mutations and if it does change enough that the immune system no longer sees it as identical, then you would not have immunity to the mutated strain. This is a similar concept to why we need different seasonal flu vaccine every year and why there are no vaccines for the common cold.

You can get the flu twice in one season, but it would not be the same flu virus.

Cold and Flu
Sinus Infections

What does it mean when you see blood while blowing your nose?

that your having a nose bleed.

if you get one:

hold a Kleenex up to your nose, while pinching the uppermost portion of you nose , and holding you head down.
If you are not bleeding a lot, it can be from cold air, dry heat in the house. I live in British Columbia where we can have rain and damp, then have freezing weather and the next day it's warm. Even the furnace being on in the house is drying. Look at your skin and if it looks dry, you bet your nose is dry. Even air conditioning can do it to you. You can use a little KY Jelly or vasoline inside your noise to keep it moist. As long as you are not bleeding profusely then there is nothing to worry about. If you've been blowing your nose often you've probably just given yourself a nosebleed by rupturing the blood vessels at the back of your nose. It's no big deal. It heals on its own. There are nose drops specially suited for this condition. Also saline nose spray can help. Try drinking more water and blowing your nose less. Everytime you blow your nose, you can be breaking up your clots. Give your nose time to heal, about a week. == ==

Cold and Flu
Swine Flu (H1N1/09)

How long are you contagious after taking Tamiflu?

Tamiflu is an antiviral medicine and is mostly used to help you get better once you have already caught the flu. It shortens the duration of the symptoms and makes them less severe when taken within 48 hours of your first symptoms. So, the criteria for when you can consider yourself no longer contagious is the same with or without Tamiflu. But the length of time can vary from individual to individual. According to the CDC, you can consider yourself no longer contagious after 24 straight hours from your last fever (when not taking fever reducers). That will likely be sooner for someone taking tamiflu than it is for someone who is not.

Cold and Flu

How do you treat a cold?

You know the drill:

Drink plenty of fluids and rest in bed, you've heard it a million times, but it does help. There is no cure for, or vaccine to prevent, a common cold, which is caused by viruses. Antibiotics do not help a cold since they are for only bacterial infections. Fluids are needed to help loosen secretions, support your immune and lymphatic systems, and to prevent dehydration. Rest gives your immune system energy resources to fight the invader and make you well. Eat a healthy diet for the same reasons. Supportive care with treatment of the individual symptoms is all that is currently available for treating the common cold with home remedies and over the counter medicines and preparations. You usually can not get rid of a cold fast, the viral infection must be fought off by your immune system, which takes time, typically around a week to ten days.

Treating individual symptoms:

You can make yourself less miserable while your body is fighting it by treating the symptoms that are making you feel so bad. Use over the counter treatments or home remedies for symptoms, such as: fever reducing medicine (not aspirin for anyone under 18, though, due to risk of Reye's Syndrome), cough medicine and expectorants (guaifenesin as a main ingredient will help loosen congestion), analgesics (acetaminophen, ibuprofen, etc.) for aches and pains, lozenges or sprays for sore throats, lip balm for dry lips, soothing eye drops for red itching eyes, saline nasal spray to cleanse your nasal passages and/or a Netti Pot for sinus discomfort and stuffiness, petroleum jelly or lotion for a red sore nose. Antihistamines can help the runny or stuffy nose as well as any watery eyes, clogged ears/Eustachian tubes, and sinus congestion.

Fever can be good:

Usually a cold does not cause a high fever like the flu does, but it does cause a low grade fever in most cases. This is part of the body's ammunition against pathogens, since many types have a narrow window of acceptable temperature range and raising your body temperature slightly can inactivate some virus particles. Unless you have a fever over 102, it is best to avoid fever reducer medicines if you can, so that this mechanism can work against the cold virus.

However, any amount of fever in infants should always be reported to their pediatrician to determine if fever reducing medicine is needed and what other tests and treatments the infant may need. Slight variations in body temperature make a much bigger difference in the small bodies of infants and they have an immature immune system that can not protect them like that of adults.

Sore nose, aches and pains:

Use facial tissues for your nose that have lotion in them if your nose gets sore and red, and/or apply petroleum jelly to keep the irritated area dry and protected. Soak in the tub or take showers to help achy muscles, clear off the toxins from your skin that are released in your sweat, help you relax and rest, and to provide soothing humidity to your body's mucous tissues and respiratory passages.

Healthy diet:

Eat a well balanced nourishing diet for your body to have energy and nutrients it needs for healing, including protein. Include as many vegetables and fresh fruit as possible. Eat lots of chicken soup, this traditional Old World/Jewish remedy has been scientifically tested and it does help people recover faster from colds. Home made chicken soup is best (because it contains some love), but you can get good chicken stock in special boxes in the soup aisle at the grocery that is very good. As a last resort, use canned chicken soups or broths (some are available in low sodium recipes). Do not use instant bouillon, it will not be as effective, and it contains way too much salt (an occasional cup, if you are allowed that amount of sodium in your diet will give some relief just from drinking something hot, but herbal teas will do the same thing and have no salt).

Herbs, etc:

Try mint or oregano tea or good quality pure oregano oil. Put a few drops of oregano oil in a capsule (fill remainder with olive oil) and swallow with juice or water. Shark oil capsules are also good. Basil leaves have been proved to have antioxidants that fight cold-like symptoms, too.

Drink warm liquids:

Sip warm liquids of any kind to add fluids, soothe throats, and moisturize dry and irritated mucous membranes. Here is one old Russian recipe for Lemon Drink for colds: Bring water to a near boil (or boil it and then let it sit for a few minutes to cool slightly). It is very important that it is not boiling when you put your lemon in, that makes the lemon less effective for some reason (some say that it kills the enzymes in the lemon, but that may or may not be the reason, just don't put the lemon in while the water is boiling). Juice a few fresh lemons and put the juice in the hot, but not boiling, water. Add some honey which will help soothe your throat and give you other healthy ingredients for your immune system and add good flavor. Do not use sugar, use the honey. This drink is very good, so enjoy it, but it is powerful and works like medicine to flush out the cold in a few days, if you drink it at least four times a day. It is a great source of Vitamin C. Often recipes suggest adding some lemon zest, too, to boost the flavor and enhance the efficacy.

Some people add an ounce of whiskey to the lemon drink. It is a major ingredient in most cough medicines (acts as a cough suppressant) and will help a cough and help you rest, just do not use more than an ounce at a time or it can add to dehydration and cause more harm than good. Or others will try the very generous application of an Apricot Brandy Hot Toddy which will also help them get plenty of bed rest.

Sore throat:

Gargle warm salt water for a sore throat. See also many other suggestions to help sore throats in the related question below.

Supplements, vitamin C and zinc:

Vitamin C Supplements may help, and studies have shown that Zinc lozenges can be effective if used early in the viral infection to prevent as many infected cells and give your immune system an advantage over the virus. Zinc supplements seem to be less effective than lozenges, the direct contact with the mucous tissue on and near the infected cells seems to be important to efficacy.

Prevent further spread of the virus:

Remember to avoid passing your cold on to others. Stay home, wash your hands, throw away tissues used for coughs and sneezes and keep your germs to yourself. See the related question below for how to protect others from catching your cold.

Positive thinking:

If you get cranky and have a bad attitude you are going to make yourself think it is really worse than it is and turn off folks who might otherwise want to do things to help you. A positive attitude helps our bodies heal and stay healthy. Try watching funny, happy and uplifting movies while you can't do anything else. Cuddle up with the stuff that makes you feel good, like a stuffed animal, warm PJs and blankets (warm them by putting in the clothes dryer for a few minutes before using them), create pleasant aromas, candle light, and soft music. Remind yourself how it could always be worse. A little "switch" in your brain might click, making it the best cold you've ever had and making you feel a little better.


There are some people who say the following works. It may be only placebo effect (which is better than no effect at all!), but you might try to see if this does anything for you: Cut a room temperature fresh onion in half and put it in a bowl near your bed while you sleep. Anecdotal reports say this can get rid of the cold over night. If it works for you, keep doing it, since it can't hurt. It could merely be that the tears that the onion may cause helps to wash away irritants from your eyes, clear the nasal passages, etc. from the inside out. Use of this at night may help along with eye wash/drops, nasal saline wash, nose drops, drinking lots of fluids, and showering or bathing for soothing humidity in the daytime.

Some people report they believe this works because, when you cut an onion, you break open onion cells and that allows the release of amino acid sulfoxides that form sulfenic acids. Enzymes that were kept separate inside the onion can mix with the sulfenic acids to produce propanethiol S-oxide. This is a sulfur compound and is what gets in your eyes to react with your tears to form sulfuric acid. Sulfuric acid burns, stimulating your eyes to create tears in an attempt to wash away the irritating compounds.

MoreThe viruses that cause the common cold mutate often and rapidly and spread easily. Too quickly for us to prepare a vaccine before they change again. There is a large pool of viruses that can cause the common cold and each of them is undergoing mutation at any given time.

This means that every cold that you get in your life time is different. They are each caused by a unique virus, and once you've had one variety you will never get that variety again. Although you can (and we all do) catch the next generation of mutations. Even though a cold is very common, it is certainly not simple. That is why scientists have not yet found a cure for the common cold.

However, they are currently working on a cure that is promising. They believe that cold viruses can be "attacked" from a different direction. The viral antigens can be neutralized as they currently are ~ by antibodies attaching to the antigen coat. A different approach has been conceived and is under trials. The new attack is a move from the coat to the stem of the virus, then it doesn't matter how much or how fast the coat changes during mutations.

Humorous answerA remedy for the common cold suggested by Dr. Richard Gordon, from the "Atlantic Monthly":

At the first sign of a cold, go to bed with a bottle of whiskey and a hat. Place the hat on the left-hand bedpost. Take a drink of whiskey and move the hat to the right-hand bedpost. Take another drink and shift the hat back again. Continue this until you drink the whiskey but fail to move the hat.

By then, the cold is probably cured.
common cold is mainly due to viruses.

symptomatic treatment and take rest.

Conditions and Diseases
Cold and Flu
Swine Flu (H1N1/09)

What is the current situation with the H1N1-09 Pandemic Swine Flu?

Update June 20, 2013:

The CDC has issued the following media advisory:

The Advisory Committee on Immunization Practices (ACIP) voted today, 13 to 0, in favor of recommending FluBlokduring the 2013-2014 influenza seasons for vaccination of persons 18 through 49 years of age with egg allergy of any severity. FluBlok was licensed by the Food and Drug Administration (FDA) in January 2013. Unlike current production methods for other available seasonal influenza vaccines, FluBlok does not use the influenza virus or chicken eggs in its manufacturing process.


Flu vaccines for the 2012-2013 flu season in the US:

Flu vaccines have been around for decades, successfully preventing the flu, with very few untoward side effects.

This year's trivalent seasonal flu vaccines will protect against the following three strains of influenza:

  • Type A/California/7/2009 (H1N1) ~ the "swine flu vaccine",
  • Type A/Victoria/361/2011 (H3N2), and
  • Type B/Wisconsin/1/2010.

There is also a new vaccine in the 2012-2013 flu season that is FluMist Quadrivalent. This new vaccine includes two Type B strains of flu instead of one. It contains B strains from both the B/Yamagata/16/88 and the B/Victoria/2/87 lineages in addition to the same strains of the Type A viruses (H1N1 and H3N2) that are included in the trivalent vaccines for this season. See the related questions below for more info.

For the 2012-2013 Flu season in the US, the following vaccines for influenza are approved for use:

  • AFLURIA Trivalent made by CSL/Merck
  • AGRIFLU made by Novartis
  • FLUARIX Trivalent made by GlaxoSmithKline Biologicals
  • FLUMIST made by MedImmune Vaccines, Inc.
  • FLUMIST QUADRAVALENT made by MedImmune Vaccines, Inc.
  • FLULAVAL Trivalent made by ID Biomedical Corporation of Quebec
  • FLUVIRIN Trivalent made by Novartis
  • FLUZONE made by Sanofi Pasteur, Inc.
  • FLUZONE - High Dose made by Sanofi Pasteur, Inc.
  • FLUZONE-Intradermal made by Sanofi Pasteur, Inc.
_____________________________________________________________________________For the 2011-2012 flu season in the US, the Food and Drug Administration (FDA) announced the approval of six vaccines on July 18, 2011. These approved trivalent vaccines will all contain vaccine for the H1N1/09 "Swine Flu" and two other viruses suggested by CDC for this season (see more below). These approved vaccines are:
  1. Afluria (CSL Limited)
  2. Fluarix (Glaxo Smith Kline Biologicals)
  3. FluLaval (ID Biomedical Corporation)
  4. FluMist (MedImmune Vaccines, Inc.)
  5. Fluvirin (Novartis Vaccines and Diagnostics Limited)
  6. Fluzone, Fluzone High-Dose, Fluzone Intradermal (Sanofi Pasteur, Inc.)

The Fluzone Intradermal is a new formulation for administration in the layers of the skin (intradermal injection) instead of the intramuscular (IM) injection. Fluzone Intradermal administration uses a microinjection system with a very fine needle. Approved for those aged 18 through 64.

The CDC-approved trivalent vaccines for this flu season will protect against the following three virus strains:

  1. A/California/7/09 (H1N1)-like virus (Pandemic (H1N1) 2009 influenza virus)
  2. A/Perth/16/2009/ (H3N2)-like virus
  3. B/Brisbane/60/2008-like virus

The H1N1/09 Swine Flu Pandemic is over, the world now has entered the post pandemic phase per the World Health Organization (WHO).

World Health Organization's Director-General, Margaret Chan, announced on August 10, 2010 that the Pandemic Phase is over and we have entered the Post Pandemic Phase.

The virus has killed more than 18,000 since April 2009, this figure is approximately 4% of the 250,000 to 500,000 annual influenza deaths.

There may be some ongoing cases in limited locations around the world, however, the specifics and counts of cases are no longer being tracked by CDC, WHO, the US states, and most other countries, now that the pandemic has been declared over. Influenza cases are monitored, but specific H1N1/09 counts (and the lab tests needed to isolate the specific virus to be able to count them correctly) aren't routinely being done.

The CDC publishes a weekly influenza surveillance report for the US called FluView that gives influenza-like illness statistics with some information from the US laboratories about results of testing they have done that gives a rough idea of the numbers of H1N1/09 still being found in positive lab tests. See the related question below or the related links section below for links to the weekly report. CDC also has an International Flu Report that you can access from the related question or link sections below.

UPDATE March 26, 2011 International Flu Report from CDC:The CDC report indicates that the presence of H1N1/09 is still seen, but in fewer locations and smaller numbers. Those places that are still finding infections of this influenza virus are (see also the related links below for the full report):


According to WHO's EuroFlu, all reporting countries reported either low or medium influenza activity in Week 10. In 37 out of 47 reporting countries, influenza-like illness (ILI) activity peaked in recent weeks and is now declining. During Week 10, 42% of sentinel specimens (specimens routinely collected from designated health care facilities for surveillance purposes) tested positive for the influenza virus. Forty-six percent of those positive samples were influenza A (mainly 2009 H1N1) and 54% were influenza B.


According to WHO's Influenza Collaborating Center in China, influenza activity in China decreased sharply from peaks in Week 5 (northern China) and Week 4 (southern China). In Week 9, 17% of specimens tested in both regions were influenza-positive. The most common influenza subtypes in China were 2009 H1N1 and influenza B. In Mongolia, Japan and the Republic of Korea, influenza-like illness activity decreased.

UPDATE on the week ending November 6, 2010 from WHO:2010-2011 Influenza Season Week 44 ending November 6, 2010

All data are preliminary and may change as more reports are received.


During week 44 (October 31-November 6, 2010), influenza activity remained low in the United States.

* Of 2,704 specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division, 185 (6.8%) were positive for influenza.

* Two human infections with novel influenza A viruses were reported.

* The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.

* One influenza-associated pediatric death was reported and was associated with an influenza A virus for which the subtype was undetermined.

* The proportion of outpatient visits for influenza-like illness (ILI), 1.3%, was below the national baseline, 2.5%. All 10 regions reported ILI below region-specific baseline levels; one state experienced low ILI activity, 49 states experienced minimal ILI activity.

* Geographic spread of influenza in three states was reported as local; the District of Columbia, Puerto Rico, and 34 states reported sporadic activity; Guam and 13 states reported no influenza activity, and the U.S. Virgin Islands did not report.

From the CDC November 2010

Influenza-Associated Pediatric Mortality in the US 2009 - Oct. 2010

One influenza-associated pediatric death was reported to CDC during week 44 (Texas). This death was associated with an influenza A virus for which the subtype was not determined. The death reported during week 44 occurred between October 24 and October 30, 2010.

In the US in the 2009 - 2010 Pandemic and flu season there have been a total of 282 deaths of children. In the 2010-2011 flu season in the US there has been only one pediatric death from influenza through October 2010.

July_2010">July_2010">July_2010">July 2010Estimation of unreported cases based upon reported cases:

Updated Estimates from April 2009 - January 16, 2010:

On February 12, 2010, CDC updated the estimates to include the time period from April 2009 through January 16, 2010.

CDC estimates that between about 8,330 and 17,160 2009 H1N1-related deaths occurred between April 2009 and January 16, 2010. The mid-level in this range is about 11,690 2009 H1N1-related deaths."

7/15/2010 Situation UpdateAccording to the final FluView for the 2009-2010 influenza season (May 16-22, 2010), flu activity in the United States declined again from the previous week and is about the same as what is normally seen during the summer in the United States. Only a small number of influenza viruses are being reported, most of which are 2009 H1N1. Flu is unpredictable, but sporadic cases of flu, caused by either 2009 H1N1 or seasonal flu viruses, will likely continue to occur throughout the summer in the United States.

Internationally, 2009 H1N1 viruses are still circulating, including in the Southern Hemisphere, which is entering its flu season

7/9/2010 Situation Update from WHO2009 H1N1 continues to actively circulate in certain areas of the tropics, including the Caribbean, West Africa, and South and Southeast Asia. In the Southern Hemisphere, influenza A (H3N2) viruses are currently co-circulating with 2009 H1N1. In the Northern Hemisphere, the number of influenza B viruses detected has exceeded reports of influenza A.

Influenza type B and A (H3N2) viruses have been detected in South Africa at an increasing rate. Low levels of influenza-like illness (ILI) have been reported from several Southern Hemisphere countries, including Australia, New Zealand, Chile and Argentina. 2009 H1N1 and A (H3N2) viruses are currently co-circulating in certain Caribbean, Central America, and Southeast Asia countries. 2009 H1N1 is actively circulating in Southern and Western regions of India and Western regions of Africa. In Bangladesh, the seasonal influenza activity is shifting from 2009 H1N1 to influenza type B. Influenza type B continues to actively circulate in central and southern regions of Africa.

2/12/10 Estimated number of cases and deaths in the US from CDC:Cases: 57 million Deaths: 11,690

*Cumulative from April 2009 to January 16, 2010, plus CDC estimates of unreported cases based upon a calculated formula for *Cumulative from April 2009 to January 16, 2010, plus CDC estimates of unreported cases based upon a calculated formula for estimation of unreported/untested cases based on reported cases.

June 17, 2010

Online Pharmacy Fraud, mislabeled drug TM-FLU sold as generic Tamiflu.

FDA Announces Internet Scam

A drug called TM-FLU from the online pharmacy called TRYDRUGS PHARMACEUTICALS PVT. LTD., at M.G. Road, Ahmedabad, Gujarat, does not contain Oseltamivir, which is the active ingredient of the well known brand of antiviral medicines, Tamiflu. This drug contains a different prescription medicine and should not be used as an OTC (Over the Counter) drug, it requires physician monitoring during its use.

On June 17, 2010 the US FDA (Food and Drug Administration) declared that this "generic Tamiflu" called TM-FLU is fraudulent and does not contain Oseltamivir. It will not be effective for influenza. There is no FDA approved generic Tamiflu product. Worse, it does contain Cloxacillin (one of the antibiotics of the penicillin group). This can cause deadly allergic reactions in some people, and antibiotics are not effective against the viruses that cause influenza.

The following advice is given in the FDA announcement (see link):

Health care professionals and consumers are encouraged to report adverse events that may be related to the use of these fraudulent products to the FDA's MedWatch Program by phone at 800-FDA-1088, by fax at 800-FDA-0178, or by mail at: MedWatch, HF-2, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787.

You should not use this drug from this online pharmacy. You should discard any remaining quantity in the proper way for your location. This pharmaceutical company is fake and they are doing fraudulent business.

See the links below for more information.

June 3, 2010

Although the H1N1/09 Swine Flu Pandemic is still in effect, it is believed to have now passed the peak.

There are still enough cases of the pandemic virus widespread across the world, that it is still considered a pandemic, but the peak seems to have passed and it is anticipated that the gradual shift to fewer and fewer cases will continue.

From the CDC April 23, 2010

During the week of April 11 - 17, 2010, according to the CDC, most key indicators declined from the prior week.

  • Visits to doctors for influenza-like illness (ILI) declined from last week and are low nationally, with all 10 U.S. regions reporting ILI below region-specific baseline levels.
  • Laboratory-confirmed hospitalizations rates have leveled off and very few hospitalizations were reported by states during the week ending April 17.
  • The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report increased over last week, but in general, are not higher than expected. Also, this indicator can lag behind the others. No pediatric deaths were reported this week. Since April 2009, CDC has received reports of 337 laboratory-confirmed pediatric deaths: 281 due to 2009 H1N1, 53 pediatric deaths that were laboratory confirmed as influenza A, but the flu virus subtype was not determined, and three pediatric deaths that were associated with seasonal influenza viruses. (Laboratory-confirmed deaths are thought to represent an undercount of the actual number. CDC has provided estimates about the number of 2009 H1N1 cases and related hospitalizations and deaths).
  • No states reported widespread or regional influenza activity. This is the first week since the week ending December 13, 2008 that no states are reporting widespread or regional flu activity.
  • The majority of the influenza viruses identified so far continue to be 2009 H1N1 influenza A viruses. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception.

3/5/10 From the World Health Organization (WHO):

5 March 2010 -- As of 28 February 2010, worldwide more than 213 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 16455 deaths.

Summary: In the temperate zone of the northern hemisphere, transmission of virus persists in some areas of Europe and Asia but influenza activity is declining and at low level in the most areas. The most active areas of transmission are currently observed in parts of Southeast Asia and East and South-eastern Europe. Recently, influenza type B is increasingly reported in Asia.

2/12/10 Estimated number of cases and deaths in the US*:

Cases: 57 million Deaths: 11,690

*Cumulative from April 2009 to January 16, 2010, plus CDC estimates of unreported cases based upon a calculated formula for estimation of unreported/untested cases based on reported cases.

Updated Estimates from April 2009 - January 16, 2010

On February 12, 2010, CDC updated the estimates to include the time period from April 2009 through January 16, 2010.

  • "CDC estimates that between 41 million and 84 million cases of 2009 H1N1 occurred between April 2009 and January 16, 2010. The mid-level in this range is about 57 million people infected with 2009 H1N1.
  • CDC estimates that between about 183,000 and 378,000 H1N1-related hospitalizations occurred between April 2009 and January 16, 2010. The mid-level in this range is about 257,000 2009 H1N1-related hospitalizations.
  • CDC estimates that between about 8,330 and 17,160 2009 H1N1-related deaths occurred between April 2009 and January 16, 2010. The mid-level in this range is about 11,690 2009 H1N1-related deaths."

Mortality Rates:UPDATE 03/07/10

The US Centers for Disease Control and Prevention (CDC) has estimated that, as of 2/12/10, since the beginning of the pandemic, the US has had approximately 57 million cases of A-H1N1/09 Pandemic Swine Flu and approximately 11,690 resulting deaths. Based upon this, an estimate of the mortality rate in the US from the pandemic is 0.02%.

In comparison, the CDC and World Health Organization (WHO) have estimated that with seasonal flu, "we see over 30 million cases in the United States. We see 200,000 hospitalizations and, on average, 36,000 deaths." (During the entire fall and winter flu season.) Based upon this, the average mortality rate of seasonal flu in the US would be 0.12 %.

The statistics of this mortality rate variation and other information gathered during the pandemic are under study by epidemiologists. It may be attributable to the fact that the especially vulnerable demographic group of the elderly (age 65 and older) suffers the majority of the cases and deaths from seasonal flu (because their weakened immune systems are unable to fight it off before their frail bodies must attempt to deal with the symptoms caused by another new strain of virus). In contrast, the majority of cases of the pandemic swine flu are among the younger and healthier demographic groups, so that, except for the very young and those with underlying medical conditions, most are able to survive the disease. It is not fully understood yet why the elderly do not contract this virus subtype as easily as the typical seasonal viruses, but speculation is that they may have acquired immunity through prior exposure to a similar virus strain.

*All data are preliminary and may change as more reports are received.


Total................................Cases.......1562049.........Deaths......16665As of 1/05/10*




The Norwegian Institute of Public Health has informed WHO of a mutation detected in three H1N1 viruses. The viruses were isolated from the first two fatal cases of pandemic influenza in the country and one patient with severe illness. So far on additional testing, no further cases with this mutation have been found. WHO believes this suggests that the mutation is not widespread in Norway.

All of the mutated H1N1 viruses still respond to Tamiflu and Relenza (oseltamivir and zanamivir, respectively), and the pandemic swine flu (A-H1N1/09) vaccines are still effectively providing immunization against these virus mutations as well.

Although further investigation is under way, no evidence currently suggests that these mutations are leading to an unusual increase in the number of H1N1 infections or a greater number of severe or fatal cases.

Laboratories in the WHO Global Influenza Surveillance Network closely monitor influenza viruses worldwide and will remain vigilant for any further changes in the virus that may have public health significance."



Five patients on the same unit of a University Hospital in Wales appear to have contracted the A-H1N1/09 "Swine Flu" infection when it spread among the patients on their unit. The unit they shared treats those with underlying severe health conditions, which would have made them at higher risk of getting the disease. The hospital is keeping them isolated, and health officials say there is no risk to others.

The strain has been found to be resistant to Tamiflu, one of the anti-viral medicines used to treat the swine flu. Although mutations that are resistant to Tamiflu have been found in a small number of cases (several dozen) around the globe during the pandemic, until now, those strains were evaluated and had not been able to spread from person to person.

See BBC report [see link below]


UPDATE 12/31/09

The first dog to be found to have Swine Flu (which was caught from the owner) was diagnosed in New York on 12/21/09 by veterinarians. The dog had shown signs of coughing, not eating, and lethargy accompanied with a fever when the owners took it to the vet. The elderly (13 year old dog) was given two days of IVs and antibiotics before being allowed to go home and is now recovering.

There is currently no vaccine for pets for H1N1/09 influenza, just for seasonal flu, but the safeguards of proper cough and sneeze etiquette and hand washing that you would take with a human child should also be taken to prevent the spread to your pets, according to the American Veterinary Medical Association (AVMA). So far, there have been very few cases among pet animals, but in all cases, the animal had been in close proximity to a person in the household with the H1N1/09 virus.

The American Veterinary Medical Association (AVMA) has said if you are sick or a pet is sick with flu symptoms:

"...isolate yourselves from each other, which we realize is only possible to some degree," said AVMA spokesman Michael San Filippo.

An Animal Medical Center in New York representative recommends, "Don't play kissyface with your dog or your cat or your ferret. You wouldn't with your kids if you were sick, so don't do it with your pet."

Unconfirmed cases of swine flu in a few dogs in China were reported on December 1, 2009, but the diagnosis had not yet been verified by lab results.


The first dog to be found to have Swine Flu (which was caught from the owner) was diagnosed in New York on 12/21/09 by veterinarians. The dog had shown signs of coughing, not eating, and lethargy accompanied with a fever when the owners took it to the vet. The elderly (13 year old dog) was given two days of IVs and antibiotics before being allowed to go home and is now recovering.

There have been several reported and confirmed cases of pet ferrets having contracted H1N1/09 pandemic swine flu from their owners. There is no evidence that the reverse has occurred (that a person got it from a ferret or any other pet).

Also, there is now a case of a domestic house cat also with confirmed H1N1/09. It was in very close contact with the owner while the owner had the pandemic swine flu. It is suggested by the American Veterinary Medical Association that caution be taken with pets when anyone in the household has the flu. (The cat recovered fully from the flu).

So far, no pot bellied pigs have been shown to have contracted the virus. Dogs do have their own strain of flu virus that is currently circulating and only a veterinarian can determine which type of flu they have, so watch your dog carefully for any signs of respiratory disease or distress.

Keep your pets safe from the flu if a member of the household has the virus the same way you would protect other people by isolating the sick person as much as possible, avoid close contact with family and pets, and use good cough and sneeze etiquette and thorough frequent handwashing.

If any pets show signs of the flu (respiratory cold-like symptoms), check with your veterinarian for advice. See more below at the related link for the American Veterinary Medical Association.


As of a December 30, 2009 report of the Vaccine Adverse Event Reporting System (VAERS), 32 cases have been reported of serious adverse effects of the A-H1N1/09 vaccine resulting in, or related to, deaths of those 32 people.

See the related links section for a link to that full report.



A second round of recall of H1N1/09 Swine Flu vaccine occurred 12/23/09 when MedImmune, the maker of the US approved live vaccine for intra-nasal administration, recalled just under 5 million doses of the vaccine. The recall was like the first vaccine recall earlier in the month, it was not a safety recall, it is because the vaccine had been tested to have a slight decrease in the potency. (See Vaccine section below for more details on the first recall.)

The US Federal Drug Administration (FDA) stated that it was not unusual for vaccines to lose strength over time. This type of vaccine usually has a shelf-life of around 4 months. The FDA also does not recommend re-vaccination of those who had a vaccination using the recalled lots since the vaccines were potent enough when given in the prior months. The maker of the vaccine, a subsidiary of AstraZeneca, has also said that the potency of vaccines already given would be well above the necessary strength to provide protection without any need to revaccinate.

The loss of strength was measured during routine quality testing which is ongoing.


The CDC and FDA have issued a summary of the Adverse Events that have been reported through the Vaccine Adverse Event Reporting System about the H1N1/09 vaccine. See also above at the first of this answer and the related link section below for more information.

The summary was developed based upon the information gathered by the FDA and CDC through the Vaccine Adverse Event Reporting System. This summary from the CDC is as of Dec 30, 2009, shows a possible link between 32 people's deaths and the vaccine. Almost 100 million doses have been distributed for use in the US alone.

VAERS Summary:

As of December 30, 2009, 99.3 million doses of 2009 H1N1 vaccine had been shipped to vaccination providers in the United States, although the precise number of vaccines administered is unknown.

  • As of December 30, 2009, VAERS had received 7326 adverse event reports following 2009 monovalent H1N1 vaccination.
  • The vast majority (94%) of adverse events reported to VAERS after receiving the 2009 monovalent H1N1 vaccine are classified as "non-serious" (e.g., soreness at the vaccine injection site).
  • Of the 7326 reports, 440 (6%) were reports that were classified as "serious" health events (defined as life threatening or resulting in death, major disability, abnormal conditions at birth, hospitalization, or extension of an existing hospitalization)*.
  • The percentage of reports involving what would be considered serious health events is not different between 2009 H1N1 and seasonal influenza vaccines. Additionally, no new or unusual events or pattern of adverse events have emerged.
  • VAERS reports continue to be monitored as more vaccine is administered.
  • Among the 440 reports of serious health events, there were 32 reports of death.
  • As with all reports of serious adverse events and deaths, the 32 VAERS reports that involve deaths are under review by CDC, FDA and the states where the reported deaths occurred. Preliminary findings do not indicate a common cause or pattern (such as similarities in age, gender, geographic location, illness surrounding death, or underlying medical conditions) to suggest that these deaths were associated with the vaccine. These cases are under further review pending additional medical records (e.g., autopsy reports, medical files).


A Centers for Disease Control and Prevention (CDC) official, Dr. Anne Schuchat, estimated that 60 million Americans have now taken the vaccines with at least one dose. and said intense monitoring for side effects has not turned up any safety concerns

As of today over 111 million doses of the four vaccines approved for distribution in the U.S. have been released for use.

SECOND VACCINE RECALL 12/23/09 (also a non-safety recall)

A second round of recall of H1N1/09 Swine Flu vaccine occurred 12/23/09 when MedImmune, the maker of the US approved live vaccine for intra-nasal administration, recalled just under 5 million doses of the vaccine. The recall was like the first vaccine recall earlier in the month, it was not a safety recall, it is because the vaccine had been tested to have a slight decrease in the potency. (See Vaccine section below for more details on the first recall.)


The US Food and Drug Administration (FDA) announced the non-safety recall of certain lots of the H1N1/09 vaccine, totaling 1.2 million doses, on December 15, 2009. They determined that the vaccine in a particular lot of pre-filled syringes did not meet the range of potency (strength) that was specified by the FDA and the division of Merck and Company, Inc. for use in the US.

Merck, whose division, Sanofi Pasteur, produced the vaccine, has confirmed that the recall affects 1.2 million doses.

According to the Centers for Disease Control and Prevention (CDC) this non-safety issue has prompted the recall of swine flu vaccine that was prepared in single dose syringes for children under age three. These reports indicate that there is no safety issue and those who have already had the vaccination using these particular lots of vaccine do not need to have additional vaccine administered since the strength level is only slightly below what was required in the original approval by FDA.

Only certain lots of the vaccine are included in the recall of December 15, 2009. In the manufacture of most medicines and vaccines, the recommended dose is based on a specified strength range that will be effective for the general population. Because a larger person may need slightly more and a smaller person slightly less, the exact measure of the recommended dose is adjusted based on clinical trials. These trials are used to determine the parameters of the dosage that can be effective for larger sized people, but still safe and not too much for the smaller sized people. In some types of medicines this dose must be more exact and then it is often based on the size of person, such as doses specified as so many milligrams or units per kg of weight.

The doses of vaccines do not need to be as specific. But when the FDA has approved and expected delivery of a specific dose that will be safe and effective for the general population, instead of one which needs to be more finely adjusted by individual measurements, they will require the recall and expect the company to provide the drug exactly as stated in the approval documents.

This is an indication that the ongoing monitoring of the H1N1/09 vaccine by the FDA is being carried out well and the watch is especially close. The recall is a reassuring indicator to medical professionals.

The following statements were made by CDC:

Should infants and children who received vaccines from these lots be re-vaccinated?

No. The vaccine potency is only slightly below the "specified" range. The vaccine in these lots is still expected to be effective in stimulating a protective response despite this slight reduction in the concentration of antigen. There is no need to re-administer a dose to those who received vaccine from these lots. However, as is recommended for all 2009 H1N1 vaccines, all children less than 10 years old should get the recommended two doses of H1N1 vaccine approximately a month apart for the optimal immune response. Therefore, children less than 10 years old who have only received one dose of vaccine thus far should still receive a second dose of 2009 H1N1 vaccine.

What action(s) should parents of children who have received vaccine from the recalled lots take?

Parents of children who received vaccine from the recalled lots do not need to take any action, other than to complete the two-dose immunization series if not already completed.

CDC has indicated that the following lots are included in the recall:

0.25 ml pre-filled syringes, 10-packs (NDC # 49281-650-25, sometimes coded as 49281-0650-25):




0.25 ml pre-filled syringes, 25-packs (NDC # 49281-650-70, sometimes coded as 49281-0650-70):



Some states (such as Texas) are now allowing access to the A-H1N1/09 vaccine by the general public. The prioritization for high risk persons is no longer employed to determine eligibility for immunizations since production has caught up with the demand in those states.

About 45 million doses have been released in the first round of vaccine distribution in the US according to the CDC and now the vaccine will be produced at a rate of approximately 20 million doses per week.

The vaccines approved so far by the FDA for use in the US are those produced by Novartis, Sanofi, and CSL (who have produced the inactivated vaccines for injection), and MedImmune who has produced an attenuated (weakened) vaccine for administration in nasal spray for ages 2-49.

The vaccines for Europe approved by EMEA, are two vaccines that are inactivated ("dead") and adjuvanted ("strengthened" so smaller doses can produce the same immunization to enable more doses). They are Focetria by Novartis and Pandemrix by GlaxoSmithKline and both are for administration by injection. Approval awaits for a third vaccine.



New studies, on how long a person remains contagious, back up the previously reported CDC guidelines that one should be suspected to be capable of still spreading the Novel Swine Flu for one full week after the symptoms start, or until 24 hours after the fever subsides [while taking no fever reducers] which ever is longer, rather than the most recent CDC guidelines that waiting for 24 hours after fever subsides without taking fever reducers is long enough.

The studies show that in some cases the virus remains in the nasal passages of patients for up to 16 days after symptoms begin. Below are some excerpts from the report:

Swine flu also appears to be contagious longer than ordinary seasonal flu, several experts said.

When the coughing stops is probably a better sign of when a swine flu patient is no longer contagious, experts said after seeing new research that suggests the virus can still spread many days after a fever goes away.

Using a very sensitive test to detect virus in the nose or throat, [the study] found that 80 percent had it five days after symptoms began, and 40 percent seven days after. Some still harbored virus as long as 16 days later. How soon they started on antiviral medicines such as Tamiflu made a difference in how much virus was found, but not whether virus was present at all. . .

Doctors know that people can spread ordinary seasonal flu for a couple of days before and after symptoms start by studying virus that patients shed in mucus. The first such studies of swine flu are just coming out now, and they imply a longer contagious period for the novel bug.

A-H1N1/09 Has 0.01% Mortality Rate According to recent studiesUntil now, it has been difficult to come up with an estimate of the mortality rates of Swine Flu (novel H1N1/09), since the case numbers were being drawn from known cases from hospitalized patients or other laboratory confirmed cases, which were known to be just a fraction of the total number of infections (because those figures excluded the unknown number of mild cases treated at home, untested, and unreported.)

Very rough estimates of the mortality rate of the pandemic A-H1N1/09 influenza have now been calculated from statistics gathered by a French study in late August 2009 and reported in the Public Library of Science (PLOS). Based on their findings, it is estimated that Novel Swine Flu is 100 times more virulent than seasonal flu.

The main cause of death with A-H1N1/09 is viral pneumonia with resulting ARDS (Adult Respiratory Distress Syndrome). Even though treated in a hospital ICU, approximately 50% of ARDS cases result in death. In the French study, the number of ARDS cases was found to be one in every 5000 cases, giving the estimate of ARDS deaths as 1 in 10,000 cases of infection.

The number of deaths from ARDS in seasonal flu cases, based on empirical evidence in France, is calculated to be between 5 and 10 each year out of an average annual number of seasonal flu cases of 6 million infections. Until better counts of cases are available, that gives a rough estimate of the deaths due to ARDS resulting from seasonal influenza of one out of a million infected patients.

The 1 death in 10,000 cases from A-H1N1/09 compared to 1 in 1,000,000 from seasonal flu strains gives the prior mentioned indications of A-H1N1/09 being 100 times more virulent than seasonal flu.

(For the full article about the study, see the related links section below.)

US Officials predicted in August 2009that there is a potential for 40% to 50 % of the US population to have had the A-H1N1/09 Virus over the course of the next two years.

December 12, 2009 CDC UPDATE:

Ongoing monitoring has continued to lead the CDC to conclusions that this virus is much different than the seasonal flu in the age of those affected. Those age 65 and older are much less at risk from 2009 H1N1 than with seasonal flu:

"... this disease primarily affects people younger than 65 year old, with the number of cases, hospitalizations and deaths overwhelmingly occurring in people 64 years and younger. The risk of illness, hospitalization and death related to 2009 H1N1 is very age specific and very different from seasonal influenza. With seasonal influenza, about 60 percent of seasonal flu-related hospitalizations and 90 percent of flu-related deaths occur in people 65 years and older. The proportion of younger people being impacted by 2009 H1N1 is much greater than what occurs during seasonal flu and their risk of serious illness, including hospitalization and death from 2009 H1N1 is much greater than that for seasonal flu. People 65 and older are much less affected by this virus than what routinely occurs with seasonal influenza and therefore the risk of serious illness, hospitalization and death from 2009 H1N1 in people in this age group is much less than that posed by seasonal flu."

See case and fatality numbers by US state below.


Totals: more than..........Cases......1562049.........Deaths......16665As of 1/05/10*

*Cumulative. (Given that countries are no longer required to test and report individual cases, the number of cases reported actually understates the real number of cases, according to WHO).


From WHO 11/13/09 ""In the temperate region of the southern hemisphere, little pandemic influenza activity has been reported in recent weeks. Of note, a cluster of pandemic influenza cases been reported in Argentina in the capital area. "

WHO: Pandemic Phase (6) is still in effect.

It is important to note that this does not indicate an increase in the severity, just that the criteria for Phase 6 regarding the spread of the Novel H1N1 Influenza have been met.

10/25/09The President Barack Obama has declared a US National Emergency due to the increase in cases of H1N1/09 and concern about a potential over-burdening of the national health care infrastructure in the US. Update 12/13/09The CDC is allocating doses of the vaccine to each state as the vaccine is produced and released by the drug companies. The allocation process is explained by them as:

"The number of doses "allocated" for ordering is the amount that is at the distribution depots and ready for states to order. The quantity of vaccine allocated is based on the project area's population size. As an example, if 6 million doses total (3 million doses of nasal spray vaccine AND 3 million doses of injectable vaccine) are ready for ordering nationally and a state has 10% of the US population, then their allocation for today is 600,000 doses total (300,000 doses of the nasal spray vaccine and 300,000 doses of injectable vaccine)."

Distribution at the point of service in some locations is still being made on a priority basis to those at highest risk first: pregnant women; individuals who live with or care for children under 6 months old; healthcare and emergency service workers; individuals between 6 months to 24 years old; and then adults 25 to 64 with chronic health conditions.

There is a single injection for adults and children over 9 years old. Children under 10 will need two vaccinations, a second one approximately a month after the first one will provide the needed protection for these with immature immune systems. In adults fully immunity is usually developed within 8 to 10 days of the vaccination. In children who require two doses of vaccine, full immunity takes slightly longer after the second vaccination, approximately two weeks.

The CDC and WHO recommend that people also get the seasonal flu shot as usual. It will have no protection against A-H1N1/09, and the swine flu shot will have no protection against the seasonal flu strains that are expected to be in the Northern Hemisphere this fall and winter as usual. The seasonal and H1N1 vaccines could be given on the same date, however, you should not wait to get the seasonal flu shot until the swine flu shot is available to your risk group. As soon as you have an opportunity to get the seasonal flu shot you should go ahead and get that done as soon as possible.

The H1N1/09 vaccine is made from the pandemic strain of swine flu, but otherwise it is being made the same wayand with the same preservatives, and medium for injection as has been used for decades now for seasonal flu shots. So there is no expectation of problems with getting the vaccination than that which would be normal for the seasonal flu injections. Over the decades of use of this type of vaccine, problems have been very low.

There have been very few reactions or problems with this method of vaccine development and delivery and there is no scientific data to support the concerns that some have voiced about the preservative thimerosal. There is no cause and effect data linking autism to the thimerosal in scientific studies, or other problems. The minuscule amount of mercury in the preservative's compound ingredients is no more than would be obtained through a meal of fish.

Some manufacturers have been developing single doses of vaccine that will not contain the thimerosal which may be available to those who have this concern. The larger 10cc vials will have to have the preservative added, but single dose vials and single dose pre-loaded syringes may be an option for some. Discuss this with your health care professional in advance of presenting for the vaccination if you have concerns.

Vaccinations Are Voluntary In the US*

August 21, 2009 excerpts from the press briefing by CDC:

"The whole vaccination program is voluntary, whether or not a person receives vaccine and at the national level, there are no mandates for vaccination." *

*Exception: In some states, such as NY, health care workers are required by law to get the vaccination if they work in a clinical practice with patients in their care.

". . . the protective effects of influenza vaccine or for the most part, almost any vaccine, are not immediate. The body has to take its time to generate some antibody, that usually occurs over a couple week period. So even with a very effective vaccine and even where only one dose is required, people should not presume that the minute they're immunized they're protected. Also, again, in the viewpoint of being very clear about influenza vaccines they are generally not like the other vaccines, polio or measles vaccine, many which are 95% plus effective in preventing disease if you're exposed to it, and influenza vaccines in healthy, young adults are not quite that protective. There's various estimates of protection, depending on the match of the strain, but, for example, with a well-matched strain in healthy, young adults, protection level is in the area of 70%, 80%, might be typical. . . "

"That has important implications, even if you're vaccinated, wash those hands, cover those coughs, stay home if you're sick."

August 21, 2009 excerpts from the press briefing about vaccine production by the Food and Drug Administration (FDA):

". . . with respect to safety, these are the studies of licensed vaccines from licensed manufacturers, where what's been changed is just the use of this particular H1 strain as opposed to other H1 strains we use in seasonal vaccines so there is a long, accumulated safety database about these products. . . "

ManufacturersThe manufacturers who were contracted and licensed by the US Health and Human Services to produce the H1N1/09 Vaccine are the same ones used by the US for seasonal flu since 2004: Novartis, GlaxoSmithKline, Sanofi Pasteur, CSL Biotherapies, and MedImmune. Taking precautions is a responsibility we all share.

Protect yourself and others by getting a vaccination and by using proper hygiene.

Visit to learn how you can help promote public awareness.



Cluster of Tamiflu Resistant A-H1N1/09 virus reported 11/20/09 found in the US in a North Carolina hospital:

Duke University Medical Center of Durham, NC has reported Tamiflu-resistant strains of A-H1N1/09 Swine Flu now found to have infected a few patients in the hospital. It is thought that the infections originated at the University hospital. Hospital officials say that they do not believe this indicates increased risks for the general population, since all four patients were extremely ill cancer patients, and on the same unit in the hospital. The reports of the Tamiflu resistant strains in the US came on the same day as similar reports from Norway and Wales, on Friday, 11/20/09 [for more information on the UK and Norway, see below and related links at the bottom of the page].

About 15 other situations with resistant mutated strains have been reported around the world since April, including four in the United States. Some cases proved fatal, but others caused only mild illnesses according to the CDC.

According to the CDC 12/13/09:

"To prevent the spread of antiviral resistant virus strains, CDC reminds clinicians and the public of the need to continue hand and cough hygiene measures for the duration of any symptoms of influenza, even while taking antiviral medications."

Drug Resistant Strains of H1N1/09

Close to 1000 pandemic H1N1 viruses have been evaluated by the laboratories in the Global Influenza Surveillance Network for antiviral drug resistance. All other viruses have been shown sensitive to both oseltamivir and zanamivir. WHO and its partners will continue to conduct ongoing monitoring of influenza viruses for antiviral drug resistance.

Therefore, based on current information, these instances of drug resistance appear to represent sporadic cases of resistance. At this time, there is no evidence to indicate the development of widespread antiviral resistance among pandemic H1N1 viruses. Based on this risk assessment, there are no changes in WHO's clinical treatment guidance. Antiviral drugs remain a key component of the public health response when used as recommended.

Tamiflu Side Effects in Children 7/31/09According to research from the European Programme for Intervention Epidemiology Training and colleagues from the Health Protection Agency (HPA) in London, which was published in Eurosurveillance, the peer-reviewed journal of the European Centre for Disease Prevention and Control, children are having neuropsychiatric side effects from Tamiflu such as nightmares, inability to concentrate, insomnia, and slight confusion.

The article at the NHS web site (link is provided to the full article in the related links section below), states:

". . . more than half of children taking Tamiflu to combat swine flu suffer side effects such as nausea, insomnia and nightmares," said The Daily Telegraph. It also said the study suggests that one in five children who took part reported having a neuropsychiatric side effect."

These were almost all in Japan and none so far have been reported in the US.

% of High Risk Cases

About 70% of individuals that are hospitalized with complications from A-H1N1/09 influenza have some kind of underlying disease. The most predominant of that is asthma. The second is diabetes. Other common underlying conditions believed to have contributed to the complications requiring hospitalization include Immunocompromised status, either through cancer chemotherapy or other compromising conditions (about 13%) and chronic underlying heart disease.

Guidance Documents from the US Centers for Disease Control and Prevention (CDC)

See related links section for links to the full CDC guidance documentation.


See the links below in the related links section for links to the following Guidance Papers:

Guidance for Responses to Influenza for Institutions of Higher Education During the 2009 - 2010 Academic Year.This covers recommendations divided into two groups:

Recommendations to use now, during this academic year, assuming a similar severity to the spring/summer H1N1 flu outbreak, and recommendations to consider adding if the flu begins to cause more severe disease.

Preparing for the Flu: A communication Toolkit for Institutions of Higher Education.

Includes Posters, Fact Sheets, Q&A Information, Templates for letters and announcements, and other communication resources.

Technical Report on CDC Guidance for Responses to Influenza for Institutions of Higher Education during the 2009 - 2010 Academic Year.

Includes detailed explanations of the strategies presented in the CDC Guidance for Responses to Influenza for Institutions of Higher Education during the 2009- 2010 Academic Year and suggestions on how to use them. The guidance is designed

to decrease exposure to regular seasonal flu and 2009 H1N1 flu while limiting the

disruption of day-to-day activities and the vital academic activities that go on in Institutions of Higher Education.

Portions of this guidance pertaining to dormitories and residence halls may be useful for residential (boarding) schools providing primary and secondary education, with adaptations as needed for their younger population.


(See related links section for a link to this information at the CDC web site.)

GUIDANCE FOR BUSINESSES AND EMPLOYERS FROM CDC 8/19/09Arrange for close regular monitoring of media health information and state and local updates to stay alert to changes in the community.

CDC also provides Preparing for the Flu a Communication Toolkit for Businesses and Employers , see link to this information in related links section below.


Guidance Documents on other topics from the US Centers for Disease Control and Prevention (CDC) and WHO are available at their web sites, see links below.

For an alphabetical listing of the WHO Guidance Document topics see the link below.

Changes in A-H1N1/09 Activity Reports from CDC and WHO

CDC follows suit with WHO, stops reports of numbers of cases of Novel H1N1, continues hospitalization and death counts and monitoring. They are now using a new methodology for estimating quantitative figures. See link below for methods.

The statistics in the answer to this WikiAnswers question will have to be modified as availability of reliable data changes. Updates based on available data will continue.

World Case Counts and Fatality Numbers By CountryThis section is no longer being updated~Last updates 1/5/10


Cumulative totals (lab verified cases only*)

*This will make totals vary from the estimated totals reported elsewhere in this Q&A

-As of 1/05/10

World Case Counts and Fatality Numbers By Country

Country Cases Deaths Afghanistan 853 17 Akrotiri & Dhekelia 88 0 Albania 350 6 Algeria 633 39 Andorra 1 0 Angola 37 0 Anguilla 14 0 Antigua and Barbuda 4 0 Argentina 142,592 617 Armenia 101 2 Aruba 13 0 Australia 37,642 191 Austria 964 5 Azerbaijan 14 2 Bahamas 29 4 Bahrain 1,346 7 Bangladesh 802 6 Barbados 154 3 Belarus 102 20 Belgium 76,973 17 Belize 42 0 Bermuda, UKOT 10 0 Bhutan 6 0 Bolivia 2,310 58 Bosnia & Herzegovina 558 7 Botswana 31 0 Brazil 58,178 2,105 Brit.Virgin Islands, UKOT 19 0 Brunei 971 1 Bulgaria 766 35 Cambodia 531 6 Cameroon 4 0 Canada 25,828 401 Cape Verde 62 0 Cayman Islands, UKOT 112 1 Chile 12,258 150 China* (Hong Kong) 33,109 50 China* (Mainland) 115,208 501 Colombia 3,288 193 Cook Islands 106 1 Costa Rica 1,596 47 Cote d'Ivoire 3 0 Croatia 526 22 Cuba 794 41 Cyprus 297 3 Czech Republic 1,207 48 Democratic Republic of Congo 78 0 Denmark 651 21 Djibouti 9 0 Dominica 36 0 Dominican Republic 491 23 Ecuador 2,251 96 Egypt 10,056 120 El Salvador 834 31 Estonia 628 7 Ethiopia 6 0 Falkland Islands 7 1 Faroe Islands 44 0 Fiji 234 0 Finland 6,122 36 France 5,000 221 France, New Caledonia, FOC 27 6 French Polynesia, FOC 4 0 French Guiana 126 2 Gabon 1 0 Georgia 759 6 Germany 209,885 132 Ghana 54 1 Gibraltar 35 0 Greece 8,768 60 Greenland 1 0 Grenada 20 0 Guadaloupe, FOC 2 0 Guam 269 2 Guatemala 1,170 18 Guernsey 17 0 Guyana 73 0 Haiti 91 0 Honduras 560 18 Hungary 283 37 Iceland 8,650 2 India 25,572 898 Indonesia 1,097 10 Iran, Islamic Republic 3,672 147 Iraq 2,868 40 Ireland 3,189 22 Isle Of Man 75 0 Israel 4,330 75 Italy 3,593 188 Jamaica 149 6 Japan 11,636 108 Jersey 234 0 Jordan 3,033 16 Kazakhstan 17 0 Kenya 417 0 Kiribati 4 0 Korea, North 50 47 Republic of Korea (South) 108,234 170 Kosovo 98 10 Kuwait 8622 27 Kyrgyzstan 61 1 Laos 242 2 Latvia 57 24 Lebanon 1838 5 Lesotho 65 0 Libya 223 1 Liechtenstein 13 0 Lithuania 68 14 Luxembourg 333 2 Macau 2,625 2 Macedonia 2600 14 Madagascar 877 3 Malawi 4 0 Malaysia 12,210 77 Maldives 25 1 Malta 718 5 Marshall Islands 115 1 Martinique, FOC 3 0 Mauritius 69 8 Mexico 67,982 823 Micronesia 79 0 Moldova 1,024 17 Monaco 36 0 Mongolia 1,073 26 Montenegro 119 2 Montserrat 21 0 Morocco 2,775 38 Mozambique 101 2 Myanmar 68 0 N. Mariana Islands 6 0 Namibia 72 1 Nauru 8 0 Nepal 112 1 Netherlands 1,473 51 Neth. Antilles, Curacao** 8 0 Neth. Antilles, Sint Maarten 2 0 New Caledonia, FOC 12 0 New Zealand 3,198 22 Nicaragua 2,172 11 Nigeria 2 0 Norway*** 12,654 29 Oman 6,029 30 Pakistan 121 10 Palau 46 0 Palestinian Territories 1,582 22 Panama 787 11 Papua New Guinea 12 0 Paraguay 855 52 Peru 9,003 205 Philippines 5,212 30 Poland 2,024 116 Portugal 166,922 58 Puerto Rico 908 49 Qatar 550 8 Republic of the Congo 21 0 Romania 5,421 42 Russia 24,299 580 Rwanda 331 0 Saint Kitts 6 2 Saint Lucia 55 1 Saint Maarten 2 0 Saint Vincent 17 0 Samoa 138 2 San Marino 5 0 Sao Tome & Principe 41 2 Saudi Arabia 14,532 97 Serbia 520 47 Seychelles 33 0 Singapore 1,217 19 Slovakia 955 25 Slovenia 990 13 Solomon Islands 4 1 Somalia 2 0 South Africa 12,642 93 Spain 22,379 256 Sri Lanka 422 23 Sudan 24 1 Suriname 138 2 Swaziland 5 0 Sweden 2,130 20 Switzerland 11,210 9 Syria 432 127 Taiwan 5,474 35 Tajikistan 16 0 Tanzania 677 1 Thailand 29,886 191 Timor-Leste 6 0 Tonga 20 1 Trinidad & Tobago 211 5 Tunisia 1200 15 Turkey 12,316 507 Turks & Caicos 44 0 Tuvalu 23 0 Uganda 251 0 Ukraine 57,862 213 United Arab Emirates 125 6 United Kingdom 27,826 303 United States of America 111,324 4,869 Uruguay 550 33 Vanuatu 3 0 Venezuela 1,973 121 Viet Nam 11,083 52 Virgin Islands (US) 80 1 West Bank & Gaza Strip ? ? Yemen 5,038 25 Zambia 726 0 Zimbabwe 1,318 0 Total 1,562,049 16,665 -As of 1/05/10

Cumulative figures are subject to revision


UKOT: United Kingdom Overseas Territory

FOC: French Overseas Collectivity

OT: Overseas Territory

Netherlands Antilles, Curaçao **: 3 confirmed cases: The three confirmed cases are crew members of a cruise ship. They did not leave the boat during their illness nor during the 24 hours preceding the onset of symptoms.

Norway***: 7 confirmed cases are cruise ship crew and passengers. None left the ship during the illness nor 24 hours before the onset of symptoms.

CHANGES IN THE CDC REPORTING OF NOVEL H1N1 (A-H1N1/09) CASES 7/24/09From CDC: "Because only a small proportion of persons with respiratory illness are tested for novel H1N1, at this time, confirmed and probable case counts represent a significant underestimation of the true number of novel H1N1 flu cases in the U.S., so the true benefit of reporting these numbers to track the course of the epidemic is questionable. In addition, because of the extensive spread of novel H1N1 flu within the United States, it has become extremely resource-intensive for states to count individual cases.

Instead of reporting confirmed and probable novel H1N1 flu cases, CDC has transitioned to using its traditional flu surveillance systems to track the progress of both the novel H1N1 flu pandemic and seasonal influenza. These systems work to determine when and where flu activity is occurring, track flu-related illness, determine what flu viruses are circulating, detect changes in flu viruses and measure the impact of flu on hospitalizations and deaths in the U.S.""

US Case Counts and fatality numbers by stateThis is being reported from various available sources, since the CDC is no longer publishing cases and deaths by state on a weekly basis. The timing of information about one state may be off slightly from that of another, the date at the top of the list will be applicable to most entries but beside each state there may be a different date, in which case, it will be the date of that particular state's information that is provided. 1/14/10 Estimated number of cases and deaths in the US*:Cases: 115431 Deaths:10837

*Cumulative, plus CDC estimates of unreported cases

This section is no longer being updated~Last updates 1/14/10

US Case Counts and fatality numbers by state - State Cases Deaths Alabama 2,453 39 Alaska 460 12 Arizona 8,545 140 Arkansas 154 20 California 10,031 470 Colorado 1,550 59 Connecticut 5,194 30 Delaware 381 6 District of Columbia 54 1 Florida 3,636 187 Georgia 886 41 Guam 338 2 Hawaii 2,221 11 Idaho 1,165 22 Illinois 4,416 86 Indiana 317 37 Iowa 739 40 Kansas 1,201 26 Kentucky 2,042 37 Louisiana 1,876 41 Maine 2,220 18 Maryland 1,284 41 Massachusetts 1,912 29 Michigan 3,166 76 Minnesota 2,174 60 Mississippi 1,279 14 Missouri 1515 11 Montana 949 19 Nebraska 430 14 Nevada 2,437 36 New Hampshire 722 9 New Jersey 1,414 40 New Mexico 308 50 New York 2,738 157 North Carolina 638 81 North Dakota 650 3 Ohio 227 33 Oklahoma 237 40 Oregon 1,105 75 Pennsylvania 10,934 75 Puerto Rico 908 49 Rhode Island 203 13 Samoa, American 85 1 South Carolina 1,634 41 South Dakota 2,081 23 Tennessee 1,163 50 Texas 11,403 203 Utah 988 44 Vermont 404 3 Virgin Islands 80 1 Virginia 327 35 Washington 658 91 West Virginia 1,214 20 Wisconsin 9,555 50 Wyoming 725 10 Total 115,431 10,837 -As of 1/14/10

*Numbers are likely under reported, see information above about CDC's new estimates.

Travel Advice The CDC has recommended that anyone with flu like symptoms should not travel for 7 days following the beginning of the first symptoms or until there have been no symptoms for at least 24 hours [including no fever, without fever reducing drugs], whichever is longer.

Some countries are screening incoming flights for people with symptoms of the flu (and especially those coming from the US) and putting those with possible H1N1 in quarantine or requiring other precautionary steps to be taken. See the related question link below for the following question for additional details of travel information and advice from the US Department of State and the CDC:

See additional information in the related questions below for virus prevention techniques. See the CDC link below for state by state information from each state's health department.

For a weekly report from the CDC with charts and graphs and lots of interesting data, see the related link below in related link section.A link to the CDC Novel H1N1 Influenza Information in Spanish is provided in links below as well as a link to a full listing of the other languages in which the CDC information is available.

Cold and Flu
Drug Interactions

Can you get the flu shot while taking Flagyl?

There is no drug interaction problem between the flu vaccine and Flagyl. But whether you get the vaccination while still taking the antibiotic may depend on why you are taking antibiotics. If you have a current infection, it is usually better to wait until that is cleared up before taking vaccines. But, each situation can be different, and this is a question that the doctor who prescribed the antibiotics should be asked to know what is right in your case.

Unless there is a specific reason your doctor wants you to wait, usually the only reason not to get a flu shot while taking antibiotics would be if you have an active infection with a high fever over 101 F. Get your flu shot unless you have a high fever, or the doctor recommends delaying the immunization due to your specific condition.

Cold and Flu

How are colds and flu spread?

They are both spread the way many common viruses are spread, especially those affecting the upper respiratory system like colds and flu. For specifics:

Spread of the common cold:

You are most likely to get a cold if someone sneezes or coughs over you or near you. To avoid the spread this way, you need to stay at least a 6 foot diameter distance from the person. Cold viruses are in the air on respiratory droplets for a short time after a cough or sneeze. Although they can travel in the air for only a matter of seconds and for only about a six foot diameter around the person who coughed or sneezed before they drop out of the air onto surrounding surfaces, that is still one of the most common ways to catch a cold. So, being in a crowded public area where you can not stay at least six feet away from others is one of the most likely ways to catch a cold, besides direct contact with the person who has a cold (shaking hands, touching their skin, sharing eating utensils or kissing) or contact with things they have just contaminated.

You can also catch a cold from someone else by touching their mucous membranes or picking up respiratory droplets on your hands that have been ejected with a cough or sneeze and then touching your own nose, eyes or mouth, even hours later. Keep your hands washed frequently and avoid touching your face, especially the mucous membranes of the eyes, nose and mouth, and you will likely stay cold-free.

More detail:

You can also pick up viruses by touching somewhere a sneeze or cough has touched, e.g., a sick person's hands or used tissues or a nearby counter top or phone. Colds are spread when the viruses enter the body through mucous membranes, typically of the eyes, nose, and mouth. Any transfer of body fluids between an infected person and a healthy person (e.g. a sneeze, a kiss, a shared beverage) can spread a cold. Also, a person with a cold can contaminate a surface such as a table, phone or doorknob with her hands. If a healthy person touches that contaminated doorknob and then rubs her eyes or nose or eats with her hands, she can get the cold. For this reason, regular and thorough hand washing is recommended especially during cold and flu seasons, see the related question below on how to properly wash your hands to remove germs.

You can spread a cold by going to school or work or out in public when sick. It is best to stay home and rest to get well, rather than take the virus in public and make others sick, too.

Spread of the flu:

It goes from person to person through close contact and direct touch, indirect touch, or respiratory droplets in the air carrying the virus short distances from person to person or from person to environmental surfaces through coughs and sneezes. If you touch where a person with flu touches, you will most likely pick up the virus and get the flu, too. That is how it spreads indirectly. Stay a minimum of six feet away from someone with a known infection and avoid close contact from being in crowded places.

You get direct spreading when you have skin to skin contact or direct person to person contact with an infected individual, such as shaking hands, kissing, or caring for a child or other infected person with hands-on care. You could be infected by getting too close to someone who has it. Do not hug people who have the flu. Wait for them to recover, then hug them (a lot).

Do not share drinking glasses or eating utensils with someone, this can also spread the disease. There is some evidence to suggest that it can be spread through gastrointestinal means, such as saliva, emesis (vomit), and feces (stool).

The importance of hand washing before and after eating, using the restroom, or providing personal care to an infected individual can not be over stressed. Avoid putting your hands in your mouth and nose or rubbing your eyes before washing your hands. Teach your family proper hand washing technique. (See related question for this information).

Flu viruses enter the body through the mucous membranes - the eyes, the nose or the mouth. They go from person to person through close contact and direct touch, indirect touch, or respiratory droplets containing the virus being ejected through coughs and sneezes from person to person or from person to environmental surfaces.

If you touch where a person with flu touches, you will most likely pick up the virus and get the flu. That is how it spreads indirectly. Stay a minimum of six feet away from someone with a known infection, avoid close contact from crowded places. The six foot guideline is based on how far respiratory droplets can go before falling to the floor or other surfaces. They do not actually float in the air to be an airborne pathogen. The respiratory droplets that carry the virus particles come from a sneeze or cough of an infected person.

Flu viruses can also be spread by handling money soon after an infected person touched it.

Flu is not spread through swimming in chlorinated pools, or by being in the water at recreational water parks that regularly treat the water. It is not spread in fountains that use purified water or in spas. There is some risk of catching it at beaches, or at recreational water theme parks from people among the crowds and not in the treated water, just as in any other crowded public place.

Protect yourself and others by getting your flu vaccination, it is the most important and most effective way to stay well and to avoid spreading the flu to your family, coworkers, and in public. Flu vaccines, as currently made, have been proven to be safe and effective over decades of use.

Another very important method of prevention is proper and frequent hand washing and regular hygiene. To help prevent the flu, wash your hands frequently with soap and warm water, and avoid touching your face, eyes, nose, and mouth. When you have the virus on your hands and touch the tissues in those places, that is how the virus enters your body.

How Long Can You Spread It When Infected?

There are still studies in progress to determine the best answer to this question. A commonly accepted guideline stipulates that one should be suspected to be capable of still spreading the flu until 24 hours after the fever subsides [while taking no fever reducers]. This is the guideline suggested by the CDC and WHO.

Testing of swine flu in one study using a very sensitive test to detect virus in the nose or throat found that 80 percent had it five days after symptoms began, and 40 percent seven days after. Some still harbored virus as long as 16 days later. How soon they started on antiviral medicines such as Tamiflu made a difference in how much virus was found, but not whether virus was present at all. For best results Tamiflu and other antiviral medicines should be started within 40 hours of the first symptoms, according to the most recent findings.

Doctors know that people can spread ordinary seasonal flu for a couple of days before and after symptoms start by studying viruses that patients shed in mucus. The first such studies of swine flu imply a longer contagious period.

Conditions and Diseases
Cold and Flu
Swine Flu (H1N1/09)
The Difference Between
Viruses (biological)

What is the difference between a cold and the flu?

They are caused by different viruses and have slightly different symptoms.

See related question below for the symptoms of the A-H1N1/09 "Swine Flu".

The symptoms of the cold and flu can be hard to differentiate, sometimes not even possible without a specific laboratory test to determine which virus is causing your symptoms. See the related link below for more information on this from US Flu website,

The primary differences are:

  • The flu usually causes a high fever and a cold doesn't cause a fever except in rare circumstance.
  • General aches and pains with the flu are usually present and can be severe, with a cold they are mild.
  • You may feel very fatigued from the flu and this is unusual with a cold.
  • Headaches are much more common with the flu.
  • The usual cold symptoms of stuffy or runny nose, sneezing, and sore throat are only sometimes seen with the flu.
  • A severe cough comes with the flu but is not as severe with a cold.

Colds typically begin with a sore throat. Sometimes a mild fever, cough, and/or a stuffy nose are present. It is important to note the difference between a cold and an allergy because of the different treatments associated with each. Cold symptoms can usually be controlled through the use of a decongestant and anti-inflammatory medicine (e.g. Ibuprofen). Fever is not as common in colds as in the flu. Those with colds almost always have fevers under 101 degrees Fahrenheit.

There are a few basic kinds of flu viruses but hundreds of cold viruses. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations, whereas this is possible with an infection with a flu virus.


LIKELY (>50% chance of these symptoms)

  • fever 102 deg. F (39 deg. C) or higher (can reach up to 107 deg. F (42 deg. C) in extreme cases)
  • dry hacking cough
  • severe runny nose
  • stuffiness
  • chills (happen during fevers when body adjusts thermostat to raise it's set point)
  • headache

POSSIBLE (30-50% chance)

  • sore throat

RARE (< 30% chance)

  • diarrhea
  • vomiting


LIKELY (>50% chance)

  • runny nose
  • stuffiness
  • coughing frequently

POSSIBLE (30-50% chance)

  • fever 99 deg. F to 101 deg. F (37.2 deg C to 38.3 deg C.)
  • chills
  • sore throat

RARE (<30% chance)

  • gastrointestinal symptoms like diarrhea and vomiting

The 'flu - an abbreviation for "influenza" - is a viral infection of the respiratory passages causing fever, severe aching, and catarrh, and often occurring in epidemics.

A cold, on the other hand, a common viral infection in which the mucous membrane of the nose and throat becomes inflamed.
Influenza (the flu) is usually a more severe illness than the common cold, which is caused by other respiratory viruses. The 'flu typically showcases symptoms including headaches, chills and cough followed rapidly by a fever, appetite loss, muscle aches and tiredness. Cold symptoms are limited to the upper respiratory tract with runny nose, sneezing, watery eyes, and throat irritation.

Conditions and Diseases
Cold and Flu
Infectious Diseases

How is the common cold spread?

You are most likely to get a cold if someone sneezes or coughs over you or near you. To avoid the spread this way, you need to stay at least a 6 foot diameter distance from the person. Cold viruses are in the air on respiratory droplets for a short time after a cough or sneeze. Although they can travel in the air for only a matter of seconds and for only about a six foot diameter around the person who coughed or sneezed before they drop out of the air onto surrounding surfaces, that is still one of the most common ways to catch a cold.

So, being in a crowded public area where you can not stay at least six feet away from others is one of the most likely ways to catch a cold, besides direct contact with the person who has a cold (shaking hands, touching their skin, sharing eating utensils or kissing) or contact with things they have just contaminated.

You can also catch a cold from someone else by touching their mucous membranes or picking up respiratory droplets on your hands that have been ejected with a cough or sneeze and then touching your own nose, eyes or mouth, even hours later. Keep your hands washed frequently and avoid touching your face, especially the mucous membranes of the eyes, nose and mouth, and you will more likely stay cold-free.

More detail:

You can also pick up viruses by touching somewhere a sneeze or cough has touched, e.g., a sick person's hands or used tissues or a nearby counter top or phone. Colds are spread when the viruses enter the body through mucous membranes, typically of the eyes, nose, and mouth. Any transfer of body fluids between an infected person and a healthy person (e.g. a sneeze, a kiss, a shared beverage) can spread a cold. Also, a person with a cold can contaminate a surface such as a table, phone or doorknob with her hands. If a healthy person touches that contaminated doorknob and then rubs her eyes or nose or eats with her hands, she can get the cold. For this reason, regular and thorough hand washing is recommended especially during cold and flu seasons, see the related question below on how to properly wash your hands to remove germs.

You can spread a cold by going to school or work or out in public when sick. It is best to stay home and rest to get well, rather than take the virus in public and make others sick, too.

For even more detail, see the related questions below.

Pregnancy Symptoms
Cold and Flu

What are the symptoms of the flu?

Some symptoms of the flu are elevated fever, continual cough, fatigue, vomiting, chills/sweating. these may be symptoms of other diseases or viruses but they are common in the flu and the cold.

Cold and Flu

How long after being exposed to the flu can you get sick?

Symptoms of the flu usually develop suddenly, about three days after being exposed to the virus. They include fever, chills, cough, sore throat, runny nose, and soreness and aching in the back, arms and legs

Conditions and Diseases
Cold and Flu
Oral Health and Dental Care
Infectious Diseases

Why does your teeth hurt when you have a common cold?

The very tips of the roots of your top teeth sit very close to and sometimes in your sinus cavity. When you have a cold and your sinuses are blocked and inflammed it put pressure on the teeth which can be very sore. It does not cause any long term damage to the teeth but it can feel just like a tooth ache.

Conditions and Diseases
Cold and Flu
Infectious Diseases

How many people in the US died of the spanish flu?

Thought to have started in the trenches of the end of WWI the Spanish flu reached pandemic status in the summer of 1918 & within 8 months was almost over.

The 1918 flu pandemic (January 1918 - December 1920) was an unusually deadly Pandemic which infected 500 million people across the world, including remote Pacific islands and the Arctic, and killed 20 to 50 million of them-1 to 3 percent of the world's population at the time-making it one of the deadliest In human history far more died in the Spanish flue Pandemic that from the Black plague in europe 500 years earlier.

To be very specific, most did not die from the Flu Virus, Most died from getting Pnuemonia caused by the flu.By the end of 1918

Cold and Flu

Who did the Spanish flu affect?

It was a pandemic, so it affected the entire world and all age groups, including the young and healthy. Because it hit during World War 1, many soldiers were sick with the disease and also helped to spread it around the world, as they came and went from home and battlefield.

Cold and Flu
Famous Quotations

Should you feed a fever or starve a cold?

First, this is an idiom that is no longer considered good medicine. It comes from a culture from long ago before we understood pathogens, disease, and our immune systems.

When you are ill with a cold, other upper respiratory infection, and/or fever, eat sensibly when you are hungry and stop when you are satisfied. Drink plenty of liquids. Rest in bed. You can treat the symptoms with over-the-counter medicines. Ask your pharmacist for product recommendations for your specific symptoms. See more in the related question for how to treat a cold.

Don't rely on this old saying as medical advice.

About the origin of this common traditional saying:

The phrase is from Chaucer in "The Canterbury Tales." In Middle English, the phrase was "Fede a cold and starb ob feber" translated as "feed a cold and DIE of fever." It wasn't medical advice, it was a cautionary statement: If you eat when you're sick, you'll die of fever.

Because so many people didn't eat when they were sick and they died, "starb" became "starve" and the definition was changed from just "die" to "die from lack of food." Considering that people at that time believed bathing caused illness (hence the wearing of perfumed pomanders to hold at your nose to ward of the stench of the person you were talking to), and that they believed many myths about health, such as that Jews were the cause of the Black Plague, and that drinking your urine could cure the plague. Even if they meant it as medical advice, it's not something we should be taking seriously today!

There are other stories about the original phrasing and origin of the idiom that have been handed down over the generations, here are some of those provided by contributors:

  • The adage is "Starve a fever, feed a cold." It was based on beliefs that don't hold true in today's medical knowlege. Some of those beliefs that led to the idiom were that fighting the flu took a lot of metabolic activity, and that digestion is a demanding task. They reasoned that as a fever is usually short lived (1-3 days), not eating may be a better way of allowing your body to contribute the maximum amount of metabolic activity to recovery. But, if the fever lasted longer, then maintaining adequate available energy to support the immune system may become a problem if not eating your normal amounts and quality of foods. Doctors who practice "Natural" medicine, and many allopathic doctors, too, continue to recommend diluted vegetable juice (preferred) or fruit juice (unsweetened) for energy during an illness. (This is not suggested for a long term or normal diet.)
  • The original phrase, back before it was misquoted, was - "Feed a cold, STAVE a fever" - as in "stave off" or "keep away" a fever.
  • I'll preface this by saying I am a licensed naturopathic physician and acupuncture physician. Feed a cold: As others have pointed out the common cold tends to last 7-10 days. It is hard/and or dangerous to fast for that long. Avoid sugars/starches, since eating mainly simple carbohydrates like breads, potatoes, and sugars can result in nutritional deficiencies and over production of insulin that is difficult for your body to deal with, especially if you have a concurrent cold. But, do eat healthy nutritional foods from all food groups if you can.

    Starve a fever: Digestion does take a lot of energy. As the temperature increases, metabolism can become less efficient. You may feel bloated if you eat too much at a time. As for keeping your temperature up when you are sick: that is correct, to a point. Your body increases its temperature to fight infection by creating a hostile environment for the pathogens. You can help your immune system do its normal job by not taking medicines that lower the temperature too soon or too often. In an otherwise healthy adult, short bouts of 102-103 degrees F. are acceptable, but if the fever increases or lasts more than a day at that temp, it should be addressed with contact with your health care provider. Depending on the age of a child, it may or may not be a good to let the temperature rise that high and you should consult the pediatrician for advice about fevers in children the age of yours. In all cases the person must keep well hydrated and temperatures checked frequently, because fever is only a part of what is happening.

  • Actually, a fever is one of the ways your body fights an infection. The reason you get a fever is because your body is trying to render the biological processes inside the infectious bacteria useless. The proteins inside the bacteria only function within certain temperature ranges, i.e., the normal human body temperature range of 97.5 degrees to 99.5 degrees. When the temperature rises beyond this, the proteins lose their ability to function; they've been denatured. Without these proteins working properly, or at all, the bacteria either dies or is severely weakened enough for your immune system to easily finish it off.
  • Unless the fever lasts longer than a week, or isn't too high (higher than 103 degrees in adults can become dangerous), you shouldn't try to lower your body temperature. Your doctor will tell you if that's necessary. Otherwise just bundle up and insulate yourself so that your body can keep up the higher temperature without having to expend a lot of energy. Eat healthy foods and don't physically stress your body too much.
  • Eating doesn't really matter. Just drink lots of fluids.
  • As I have always understood, this adage applies to temperature. "Feed a fever" means bundle up and sweat it out. "Starve a cold" means bundle up and warm up. (This is not the current understanding, we now know that being cold does not cause or exacerbate a cold.)
  • It would seem that both are wrong. Most doctors will tell you that it is important to reduce stresses on your body when sick. Both starving and overeating produce unwanted stress. So, unless you have a stomach disorder, eat moderately to maintain your strength in either case. The saying is not intended to be current medical advice.
  • (From Cecil Adam's "Straight Dope") Your version of the proverb is the traditional one, but you can find citations in the literature that have it the other way around. The idea, if not the exact wording, dates back to 1574, when a dictionary maker named Withals wrote, "Fasting is a great remedie of feuer."
  • Doctors have been trying to stamp out the above piece of folklore for years. Current medical thinking is that you want to keep an even strain when you're sick with either a cold or a fever, and you certainly don't want to stress your system by stuffing or starving yourself.
  • Nobody's sure where the notion of feeding colds and so on arose. (It surely didn't originate with Withals.) One somewhat dubious explanation has it that the proverb really means "If you feed a cold now, you'll have to starve a fever later." A more plausible interpretation is that the feed-a-cold idea arose out of a folk understanding of the disease process, namely that there were two kinds of illnesses, those caused by low temperatures (colds and chills) and those caused by high temperatures (fever). If you had a chill, you wanted to stoke the interior fires, so you pigged. If you had a fever, you didn't want things to overheat, so you slacked off on the fuel.
  • When I had sniffles as a kid the feed-a-cold thing was usually good for a few extra Twinkies. So you'll just have to forgive me if, in the delirium of a 99-degree temperature, I used to imagine it was feed a fever too.
  • The way it was explained to me was that if you have a cold you usually didn't want to or couldn't eat and needed to, so you "fed" a cold, basically not binging, but simply remembering to eat. However, if you have a fever, you may crave a lot more food, and may need to back off and need more moderation, so you would need to "starve" a fever so as not to make yourself more sick - keep those hunger pangs in check. And that came from a very, very wise old wife, so it must be true!
  • The point is when you have fever your body is working to fight something in your system. You should eat light since the body needs energy to digest and it is better to let the body focus on the "fight at hand" and just eat light until the fever breaks. With a cold, your immune system is involved for up to 10 days, and you need to keep those guys fueled (antibody production). So you eat things that encourage their production, such as vitamin C-rich foods and fruit, and soups, and teas, because they add needed fluid, and because warm fluid helps to thin the mucous associated with colds.
  • Your body needs energy to fight whatever viral or bacterial infection it has to, so "starving" is not a good idea. Though your body initially uses energy to digest, the digestion process returns more energy than it uses. If you feel cold at night, get up and eat a piece of cheese or some nuts (the oils and proteins will slowly fuel your body and keep you warm while you sleep). Most importantly, stay hydrated and take no fluids that are diuretics (like caffeine in soft drinks, coffee and tea, beer and other alcohol)!
  • The way I remember it is feed a cold but starve a flu ("stomach flu"). Gastrointestinal infections cause nausea, vomiting and diarrhea and your digestive tract needs rest with consumption of plenty of fluids. You need energy to get over a cold, so eat soup, hot foods, and cold liquids.
  • I've always found that if you freeze a fever and heat a cold, as in very warm or cool showers, it works out pretty well. If I'm sick with a cold I'll stand in a hot shower and take in the steam. It really clears the the nasal cavity. And as for fevers, a lukewarm bath always helps me.
  • Regardless of medical reasons, the adage "Feed a cold and starve a fever" was lexically designed to help remember the proposed eating pattern for each sickness...d in feed-cold and v in starve-fever.
  • I agree with the furnace analogy and if you want to test this, try this: After a meal (2-3 hours) get a sugar-filled cookie of your choice (probably most anything with simple sugar will work), locate yourself in a comfortable room and in a relaxed position, take your temperature with a digital thermometer, and also just feel (sense) what your body and temperature are like. Now eat that sugar-filled cookie. You should begin to feel your temperature rise within the first few minutes; you might even break a slight sweat. Measure your temperature each minute for the next 10 minutes... I think you will find that your body quickly goes to work converting this cookie into energy and that process slightly raises your temperature... if not measurable at least in some part you may sense the rise. Now it just seems logical that at a time that we are trying to reduce our temperature taking cold showers and baths, and medications that reduce fever... stoking the body's furnace with simple sugars is not very smart. I go with starve a fever. Of course I do not mean to not eat at all, but understanding the concept you might better choose what you eat to minimize the effect.
  • For the record, high glucose (sugar) intake could not possibly raise your temperature in 10 minutes for two reasons, 1) your body temperature does not flux based on what foods you eat, and 2) It takes about 30 minutes for your body to begin effectively absorbing anything taken by mouth, this includes meds and food. And your immune system works at its own pace, you can assist it slightly by working with your body, but getting yourself "close to heat stroke" and putting hydrogen peroxide in your ears cannot make your immune system work 10 times faster, the only thing it is likely to do is make you very uncomfortable and annoy any stray harmless bacteria in your ears.
  • "Feed a cold, starve a fever" is right on if you are an active fighter, but dead wrong if you are a passive waiter. With a cold, if you are a fighter, eat all of those favorite foods that make your mouth water when you think of them. You need lots of fuel for the fight. The bugs can't handle the fever temperature. [The following advice is controversial today, suddenly changing anything else while you are ill is usually not good medical advice:]

    So, stop eating suddenly, forcing the body to switch to using stored fat. That is very potent fuel! When the fever comes up, supplement it with a hot toddy (heated lemon juice, honey, medicinal brandy or rum), get into a hot bath. Get into bed and sweat. By morning the nasty 14 day head cold will be gone.

  • It must be pointed out that contributors to this answer are probably NOT doctors. Taking some of the advice given above may harm your health. If you are thinking of trying any of the less-orthodox ideas above, you should probably seek the advice of your doctor first.
  • When you have a fever your body uses certain strategies like altering your metabolism and binding iron to slow the pathogens down. That said, although I wrote this after the disclaimer, I'm not a doctor either :)
  • Admittedly, I'm not a doctor either, but I am a working nurse and some of these suggestions alarmed me. For minor illnesses you should maintain moderate intake. Gorging or starving yourself for several days will only put added stress on the body. The most common recommendations for oral intake with a fever is to take in plenty of fluids, eat when you're hungry, and try to keep as comfortable as possible. If it's a high-grade fever (above 102 or 103 in adults) you can take whichever NSAID (tylenol, motrin, alleve etc.) you prefer to bring the fever down, since high-grade fevers can be damaging to your own tissues. (Be sure that you do not take any OTC medicines differently than the package directions say. Many cold preparations contain Tylenol and other fever reducers so if you take more than one that does, you risk getting too much acetaminaphen which can be very dangerous and damaging to the liver. Children under 16 should not take aspirin due to the risk of Reyes' syndrome.)
  • Feed a cold and starve a fever. This was from the olden days of yore when we did not know much about medicine - when people contracted some bad fevers, they usually died with a few weeks. The general consensus at that time was to not waste good food on a person that was going to die. Of course this is no longer true today... Our knowledge of medicine is far greater and keeps improving almost every week.
  • This is definitely not a good idea in either case. You need more fluids than usual when you have the flu AND a cold. Drink plenty of water and juice, eat enough food to satisfy your appetite, and drink hot fluids to ease your cough and sore throat.
  • Neither, actually: It's "Feed a cold & STAVE a fever." - as in "stave away" or "stave off."
  • You should feed a cold to keep a fever away. If you have a fever you should feed that too, although you are unlikely to feel like eating.
  • Firstly, do NOT medicate to lower fevers unless medically necessary (and the target temperature for that in adults varies from source to source - I use 103-104 F as my range, but mostly gear it on how you feel. For infants and children the point at which fever becomes dangerous is dependent on their age and general health status, you should ask your pediatrician in advance what the maximum temperature of your infant or child should be and when to contact the provider for care). You will feel uncomfortable letting your temperature rise above normal, but the goal is not to suppress the body's ability to fight the invader (it was mentioned above about the body's heat). Whether to provide food to the body for a fever/flu can vary depending upon your life-style. If you are prone to eating unhealthy foods or are a regular-heavy drinker/drug user, your body is already lacking in many of the elements that are necessary to fight infection. Nonetheless, my studies have led me to believe that it is warranted to consume nutritional foods while with a fever. However, the best intake would be that of warm fluids such as vegetable (preferred) or fruit juice. I usually drink about 4oz. low-sodium, organic vegetable juice when I 'feel' the need - which tends to be about once per hour. Drink much water, particularly if you have diarrhea. Although typically mentioned, water consumption is so easily neglected, yet has profound effects on the body, both healthy and ill. The same applies to a cold. The bottom line is that providing heavy foods or unhealthy foods will tax your system unnecessarily while not yielding much in the way of nutrients. Eliminating toxins (caffeine, nicotine, alcohol, etc.) and adding substantive [liquid] foods will aid your body in doing its job.
  • No, you should be getting proper nutrition and hydration all the time regardless if you are sick. When you starve a fever you are basically denying your body what it needs to get better.
  • I disagree with most of the information above. I was brought up to believe it's "starve a cold and feed a fever" which refers to medication when tackling an illness. There is no medication to cure the common cold, only to suppress it or make you more comfortabe while your immune system works, so it's best to let a normal common cold run its course without medication. However, in case of a fever, medication can be taken upon medical advice in order to lower the temperature. This is true and makes more since. It has nothing to do with food. Of course you should encourage food and liquid as much as tolerated in any case.
Cold and Flu
Dieting and Weight Loss

Is it bad to lose 6 lbs in one day when sick?

Yes, you should contact your doctor. It can depend on what you are sick with, but whatever it is, you should consult your primary health care professional. It can be very bad for some people and not good for others. It likely does represent a loss of a lot of water weight because fat does not burn away that quickly. You are probably either dehydrated or at risk of serious dehydration from that. Loss of fluids in that amount from your body could come from profuse sweating with fever, vomiting, diarrhea or overuse of diuretics.

Conditions and Diseases
Cold and Flu
Viruses (biological)

What is the causative organism of seasonal influenza?

The human seasonal flu, as well as other types of human influenza, are caused by three types of viruses: influenza Types A, B, and C. Swine flu is caused by an influenza type A influenzavirus, for example. Type A flu viruses have been the causes of all influenza pandemics to date.

Within each type there are mutations and countless numbers of strains and subtypes. The influenza viruses are RNA viruses that come from the family Orthomyxoviridae.


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