FRIDAY, Feb. 10 -- It was just about three years ago that a strange new strain of flu first appeared in Mexico, then spread across the border to the United States and eventually much of the globe.

The H1N1 "swine" flu strain didn't behave like a "normal" flu, because it proved particularly dangerous to children and younger adults -- the very groups of people who usually have the strongest defenses against seasonal flu.

After a quiet couple of years, more cases of the pandemic H1N1 flu are circulating again where it all began -- in Mexico.

But infectious disease experts says Americans shouldn't be overly concerned.

In January, there were 1,623 cases of flu reported in Mexico, and 90 percent of those cases were H1N1 flu. There were also 32 flu-related deaths, all but three caused by the H1N1 strain, the Associated Press reported.

"It appears that H1N1 in Mexico is circulating at a higher level than in the United States," said Tom Skinner, a spokesman for the U.S. Centers for Disease Control and Prevention. "We have seen some H1N1 here in the U.S.," he added, but the more familiar H3N2 strain is predominating here this winter.

The flu season in the United States has also gotten off to a slow start, Skinner said, but it's expected to pick up in the coming weeks. "Our season usually peaks sometime in February and it's not too late to get a flu shot," he said.

The flu shot for this year -- and last year -- includes protection against the H1N1 strain, Skinner noted.

Infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University, doesn't think there's much for Americans to worry about, given the situation in Mexico.

"First of all it [the H1N1 virus] turned out to be a very mild virus," he said.

"One of the reasons Mexico saw a severe outbreak compared with us in 2009 is that initially you see more lethality and more morbidity. Then, as the virus spreads, it usually becomes less severe -- that's traditional," Siegel added.

Also, flu pandemics tend to follow a pattern like the one taking place now. They come in "waves" and there are always additional "waves" in the second and third year after flu strain's initial appearance, he said.

"It just becomes one of the circulating viruses," Siegel said.

It's unlikely that another severe outbreak of H1N1 would occur in the United States, he said.

"We have developed a 'herd immunity' through previous exposure to the virus and vaccination, so it slows the spread," he said.

According to the CDC, one reason that children and young adults were more vulnerable to the H1N1 strain back in 2009 is that this strain hadn't circulated widely since the early half of the 20th century. As a result, CDC studies found that no children and very few adults younger than 60 had existing antibodies to the 2009 H1N1 flu virus. Curiously, about one-third of adults 60 and older are thought may have antibodies that may help protect against the virus.

SOURCES:Tom Skinner, spokesman, U.S. Centers for Disease Control and Prevention, Atlanta; Marc Siegel, M.D., associate professor, medicine, New York University, New York City; Feb. 8, 2012, Associated Press

3 Bacteria and 1 Virus Cause Almost 60% of Hospital-Associated Outbreaks, Survey Shows

By Cari Nierenberg
WebMD Health News

Reviewed by Laura J. Martin, MD

Feb. 2, 2012 -- Norovirus is the leading cause of infection outbreaks in hospitals throughout the country, a new study reveals.

The virus, which causes a "stomach flu" known as gastroenteritis, was the culprit in some 18% of all outbreaks in U.S. hospitals during a two-year period. It also was responsible for 65% of unit closures in health care facilities.

Norovirus has also been associated with outbreaks on cruise ships.

Symptoms of norovirus infection include nausea, vomiting, diarrhea, and stomach cramps. In a hospital setting, this rapidly spreading infection can be transmitted from person to person by having direct contact with someone who has the virus, by touching contaminated objects or surfaces, or from eating contaminated food or water.

The virus is found in the vomit or stool of infected people.

For this study, researchers sent out more than 5,000 online surveys to professionals involved in controlling and preventing hospital infections. They were asked to describe the type and number of infectious outbreaks at their facilities between 2008 and 2009. They were also asked if these outbreaks were investigated within the hospital or with help from a state health department.

Of the 822 U.S. institutions responding to the survey, 289 of them, or 35%, had investigated at least one infectious outbreak during the two-year period.

"It is clear that outbreaks of health care associated infections occur with some frequency in hospitals as well as non-acute settings," the researchers write.

Investigating Hospital Outbreaks

The study, which was published in the American Journal of Infection Control, found that four types of organisms were responsible for nearly 60% of the outbreaks reported.

Norovirus was the leading cause of outbreaks. It caused a little more than 18% of infectious outbreaks investigated by the hospitals participating in the survey. Not far behind was Staphylococcus aureus, a bacterium commonly found on the skin or in the nose, which caused 17% of outbreaks.

The third leading cause of hospital outbreaks was Acinetobacterspp, a bacterial infection commonly seen in very ill patients in intensive care units. It caused almost 14% of infectious outbreaks in the health care settings. Fourth was Clostridium difficile, a bacterial infection often linked to the use of certain antibiotics. It caused slightly more than 10% of outbreaks.

Norovirus outbreaks resulted in the highest number of hospital unit closures. They also affected the most people, with more than 12 patients falling ill on average during each hospital outbreak reported.

The norovirus outbreaks occurred most often in behavioral health residential units, as well as in rehabilitation or long-term care units, an unexpected finding. And the outbreaks typically lasted about 17 days.

The survey included a broad mix of health care settings, from teaching and community hospitals to small rural facilities. Slightly more than half of the infectious outbreaks were reported to an outside agency.

SOURCES: Rhinehart, E. American Journal of Infection Control, February 2012.News release, Association for Professionals in Infection Control and Epidemiology.CDC: "Norovirus in Healthcare Settings."CDC: "Diseases and Organisms in Healthcare Settings."

TUESDAY, Jan. 31 -- Concerns that research into a genetically mutated form of bird flu could escape from labs or fall into the hands of bioterrorists led U.S. scientific advisers to ask two prominent journals to withhold key details of the groundbreaking research, the advisers explained Tuesday.

So far, so-called H5N1 bird -- or avian -- flu strains have rarely been transmitted from birds to humans since it was first identified in Asia in 1997. But the genetically modified virus created by scientists in the United States and Holland has been shown to be more transmissible in animal experiments, and the fear is that it could also be highly contagious among people, potentially setting the stage for a deadly pandemic.

The U.S. National Science Advisory Board for Biosecurity (NSABB) acknowledged on Tuesday that research into the potential threat of the modified H5N1 bird flu strain "could lead to greater preparedness and potential development of novel strategies for disease control," particularly if the virus were to mutate naturally.

But, releasing the complete research and results of two scientific papers in full in the journals Nature and Science could expose the United States and other nations to harm, the NSABB said, explaining its request to withhold some data from the public.

Researchers at the University of Wisconsin, Madison and Erasmus University in the Netherlands were able to genetically alter the H5N1 bird flu virus, making it far more transmissible among ferrets, which are often used as research animals because they transmit viruses much the same way humans do.

The NSABB's main concern about the research "is that publishing these experiments in detail would provide information that could help some person, organization or government to develop similar mammal-adapted influenza A/H5N1 viruses for harmful purposes," the advisers said in a statement Tuesday.

Such research that could be used for good or bad purposes is called "dual-use research," the NSABB advisers explained. "We are now confronted by a potent, real-world example," they said.

"By recommending that the basic result [of the research] be communicated without methods or details, we believe that the benefits to society are maximized and the risks minimized," the advisers said. "Although scientists pride themselves on the creation of scientific literature that defines careful methodology that would allow other scientists to replicate experiments, we do not believe that widespread dissemination of the methodology in this case is a responsible action."

The debate came to light in December when the NSABB asked the editors of the two journals to publish the bird flu research in "redacted" form, meaning with key elements blocked out.

The NSABB was created by the federal government after anthrax-laced letters killed five people in 2001 and infected more than a dozen other people.

The scientists behind the bird flu studies agreed earlier this month to a 60-day moratorium on their research. Although they believe their work has a public health benefit, they acknowledge the fear of some governments and others that the genetically altered virus could escape from labs and infect people or fall into the hands of bioterrorists.

This fear has caused a highly unusual debate among governments and scientists over the benefits and risks of the research.

Some scientists and biosecurity experts worry that such a mutated virus could trigger a human pandemic that might rival the Spanish flu outbreak of 1918-19 that killed an estimated 20 million to 40 million people worldwide.

In a letter appearing Jan. 20 in the journals Nature and Science, the bird flu researchers, including Yoshihiro Kawaoka from the University of Wisconsin, Madison, and Ron Fouchier, from Erasmus University in the Netherlands, explained that their work with ferrets has already shown that the H5N1 virus can be genetically manipulated to make it easier to transmit among mammals. No research has been done with humans because it would be unethical.

"No experiments with live H5N1 or H5HA reassortant viruses already shown to be transmissible in ferrets will be conducted during this time," the scientists said on Jan. 20. "We will continue to assess the transmissibility of H5N1 influenza viruses that emerge in nature and pose a continuing threat to human health."

The research was being temporarily stopped, the scientists said, because they needed additional time to share with the scientific community the research's benefits to governments and public health organizations should the virus mutate naturally.

Infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University, told HealthDay earlier this month that the bird flu research was important because it could help health authorities better prepare for an outbreak if the virus were to mutate naturally. But he did not see the need to share the research with the general public.

"Manipulating flu in the laboratory to figure out how it is transmitted is valuable," Siegel said, adding it could lead to a clearer understanding of the virus and possibly new vaccines.

"But that doesn't mean that even if you know those [genetic] combinations that they are going to lead to the next killer pandemic," he said. In fact, as a new flu strain spreads it usually weakens, he noted.

Also, the results of the experiments with ferrets don't mean this virus can be passed on to humans, he said.

"I do believe that restricting information on these genetic manipulations is of value. You should be able to publish this data, but I don't see the value of making it readily available to the general public," Siegel said. "It should be exchangeable among scientists, but you have to be very careful."

However, Siegel doesn't see the need for a moratorium on the research. "This research has got to be done and it should not be restricted. I don't believe there should be any moratoriums on science," he said.

SOURCES: Feb. 9, 2012, Nature; Jan. 20, 2012, Nature and Science; Marc Siegel, M.D., associate professor of medicine, New York University, New York City

TUESDAY, Jan. 24 -- Only about one in five American adults aged 36 to 39 got a flu shot during the H1N1 swine flu epidemic of 2009-2010, even though about 65 percent were at least moderately concerned about the disease and nearly 60 percent claimed to follow the issue moderately or very closely.

That's the finding of a University of Michigan report detailing how this age group monitored the epidemic and what they did to protect themselves and their families.

The analysis of data collected from almost 3,000 young adults during the outbreak also showed that those with young children at home were most concerned and most likely to follow the news about the epidemic.

Overall, young adults were most likely to get information about the epidemic from friends, co-workers and family members. But their most-trusted sources of information were doctors, followed by the U.S. National Institutes of Health, pharmacists at local drug stores, and nurses from county health departments.

YouTube videos, drug company commercials and Wikipedia articles were the least-trusted sources.

The findings appear in "The Generation X Report." Generation X refers to people born between the early 1960s and the early 1980s.

"These results suggest that young adults in Generation X did reasonably well in their first encounter with a major epidemic," report author Jon D. Miller said in a university news release. "Those with minor children at home were at the greatest risk, and they responded accordingly, with higher levels of awareness and concern."

Analyzing how members of Generation X reacted to the swine flu epidemic may help public health officials deal more effectively with future epidemics, according to Miller, director of the Longitudinal Study of American Youth at the U-M Institute for Social Research.

"In the decades ahead, the young adults in Generation X will encounter numerous other crises -- some biomedical, some environmental and others yet to be imagined," Miller said. "They will have to acquire, organize and make sense of emerging scientific and technical information, and the experience of coping with the swine flu epidemic suggests how they will meet that challenge."

-- Robert Preidt

SOURCE: University of Michigan, news release, Jan. 19, 2012

-- If you're plagued with a cold or another respiratory illness that's causing a cough, there are things you can do to help tame the beast.

The National Heart Lung and Blood Institute offers these suggestions to help calm a cough:

• Quit smoking.
• Steer clear of substances that can irritate the lungs and worsen a cough, such as air pollution, tobacco smoke, allergens and strong odors.
• Take all medications as prescribed by your doctor.
• Follow your doctor's treatment plan.
• Take cough medicine, if recommended by your doctor.
• Run a cool-mist humidifier or steam vaporizer.