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Consumer Reports Swine Flu Survival Kit Prepares Consumers for Potentially Tough Flu

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YONKERS, N.Y., Aug. 3 /PRNewswire-USNewswire/ -- As the U.S. prepares for a possible second wave of H1N1 or swine flu, as well as for the annual scourge of seasonal flu and colds, a new report from Consumer Reports helps households prepare for, prevent, and treat cold and flu symptoms safely and effectively, including recommendations for what to pack in an emergency kit for a flu outbreak. The report is available in the September 2009 issue of Consumer Reports and online at www.ConsumerReportsHealth.org.

How to Prepare a Swine Flu Emergency Kit

In case the second wave of swine flu is severe enough to warrant home confinement, consumers should pack an emergency kit in advance. You will need:

A two-week supply of food and water.
Fever reducers, such as acetaminophen, ibuprofen, or naproxen.
Cough and cold medications containing chlorpheniramine, diphenhydramine, oxymetazoline, and pseudoephedrine and lozenges with dyclonine, glycerin, or honey can help ease symptoms.
Electrolyte drinks, such as Gatorade or Powerade, to keep you hydrated.
Hand sanitizer with at least 60 percent alcohol, such as Purell, to kill viruses when
soap and water aren't available.

Surgical masks with an FDA rating of at least N-95 to help prevent spreading the flu. Masks need to be replaced often and disposed of after use.
For all emergencies, Consumer Reports recommends packing at least three days' worth of nonperishable food; at least one gallon of water per person, per day; a first-aid kit that includes any prescription or over-the-counter medications your family might need; as well as antihistamines for allergic reactions, pain relievers, stomach and antidiarrhea remedies, and antacids.

The government is currently preparing a vaccine against the swine flu that will likely be recommended for school-age children and other high-risk individuals, such as pregnant women, those with chronic illness, and those who live or work with infants, preschoolers, or older adults. In the meantime, Consumer Reports recommends that everyone -- but especially high-risk people -- get vaccinated against regular, seasonal flu before December when that infection usually arrives.

"This could be an especially big year for flu, so people need to take every precaution and double their efforts to safeguard their families," says Joel Keehn, senior editor, Consumer Reports. Even when the vaccine doesn't prevent seasonal flu, it often lessens its symptoms. In terms of treatments, certain antiviral drugs can not only ease symptoms of seasonal flu but also shorten its duration and possibly prevent complications as well. Some of those drugs probably help against swine flu too. Antivirals work best if taken early on in the illness, so it's best to take them at the first sign of symptoms.

Brands to Buy and Brands to Skip

Also in this issue, in a side by side comparison, Consumer Reports identifies the Consumer Reports Best Buy Drug choices to treat eight common conditions, including Attention Deficit/ Hyperactivity Disorder (ADHD), heartburn, and insomnia that can save consumers hundreds or even thousands of dollars a year. For example, consumers who need to lower their LDL ("bad") cholesterol by less than 30 percent can save nearly $1,000 a year by taking Lovastatin, a generic statin, instead of taking Lipitor, a more expensive brand-name drug. Launched in December 2004, Consumer Reports Best Buy Drugs is a public health initiative that rates more than 200 prescription drugs using comparative effectiveness research. Best Buy Drugs reports are available for free at www.ConsumerReportsHealth.org/BestBuyDrugs. By opting for Best Buy Drug choices, consumers can realize significant monthly savings while receiving the most effective and safest treatments for their condition.

As the new school year approaches and weed pollen allergen levels peak, Consumer Reports also lists other useful information for treating colds and allergies without medication. For colds, the best remedies are the simplest and can often be found in your kitchen, not a drugstore. For example, you can soothe a sore throat with a saltwater gargle, or try honey or nonmedicated lozenges for a cough. Controlling allergies starts by limiting exposure to the triggers, keeping windows shut when outdoor triggers are high, and using an air conditioner or a dehumidifier to reduce humidity. To treat allergy symptoms with over-the-counter drugs, Consumer Reports recommends using generic versions of Claritin and Zyrtec -- loratadine or cetirizine.

Avoiding Hidden Drugstore Traps

No matter your ailment, consumers need to watch out for the following traps at the drugstore when shopping for remedies:

Brand-name extensions. Drug manufacturers often use brand names to launch related but different products. There are 34 Vicks products and 14 Sudafed products, and countless store brands and generic versions. With so many products to choose from, people might take medications that are inappropriate or even risky.
Recommendation: Choose remedies by active ingredients, not the brand.
"Shotgun" remedies. Many products are loaded with multiple ingredients to blast several symptoms at once. That's a misfire, since some added ingredients can increase risks, and any ingredient that treats a symptom you don't have is unnecessary. Such products can increase the risk of overdoses if you take multiple medications.
Recommendation: Opt for medicines with just one active ingredient.
Prescription drugs that became over the counter (OTC). Direct access to medication can introduce new risks if people turn to them when simpler remedies would suffice or if they treat problems without a doctor's diagnosis.
Recommendation: Before trying a drug that has become available over the counter, talk with your doctor to make sure that it's right for you, that you need it, and that the condition doesn't require medical supervision.

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    Preparing for Swine Flu's Return
    New Wave Expected After Virus Flourished in Southern Hemisphere
    By Rob Stein
    Washington Post Staff Writer
    Monday, August 10, 2009

    As the first influenza pandemic in 41 years has spread during the Southern Hemisphere's winter over the past few months, the United States and other northern countries have been racing to prepare for a second wave of swine flu virus.

    At the same time, international health authorities have become increasingly alarmed about the new virus's arrival in the poorest, least-prepared parts of the world.

    While flu viruses are notoriously capricious, making any firm predictions impossible, a new round could hit the Northern Hemisphere within weeks and lead to major disruptions in schools, workplaces and hospitals, according to U.S. and international health officials.

    "The virus is still around and ready to explode," said William Schaffner, an influenza expert at the Vanderbilt University School of Medicine who advises federal health officials. "We're potentially looking at a very big mess."

    President Obama arrived in Mexico on Sunday for a two-day summit that will include discussions on swine flu, along with Mexico's drug wars, border security, immigration reform and economic recovery.

    "Everyone recognizes that H1N1 is going to be a challenge for all of us, and there are people who are going to be getting sick in the fall and die," said John O. Brennan, the U.S. deputy national security adviser for counterterrorism and homeland security. "The strategy and the effort on the part of the governments is to make sure we . . . collaborate to minimize the impact."

    Since emerging last spring in Mexico, the virus, known as H1N1, has spread to at least 168 countries, causing more than 162,000 confirmed cases and playing a role in at least 1,154 deaths, including 436 in the United States.

    Scientists have been closely monitoring the flu's spread for clues to how much of a threat it might pose this fall. So far, no signs have emerged that the virus has mutated into a more dangerous form. Most people who become infected seem to experience relatively mild illness.

    Still, the virus has caused major outbreaks involving a disproportionate number of younger people in Australia, New Zealand, Argentina and other countries, prompting schools to close, causing theaters to shut down, and straining some emergency rooms and intensive care units, sometimes forcing doctors to postpone other care, such as elective surgeries.

    Swine flu has also begun to spread in South Africa, where at least two deaths have been reported; the national laboratory, meanwhile, was overwhelmed last week with samples that needed testing. In India, a 14-year-old girl became the first person to die from the disease in that densely populated nation.

    In Britain, meanwhile, where anxiety was increasing because of high-profile cases including "Harry Potter" films actor Rupert Grint, health officials were trying to determine the cause of a sharp rise in reported cases in recent weeks.

    "This is something that we could see here soon," said Arnold S. Monto, a University of Michigan infectious-disease expert who advises the World Health Organization, the U.S. Centers for Disease Control and Prevention, and other federal health agencies. He noted that some emergency rooms were overwhelmed by last spring's outbreak in New York City. "We have to be worried about our ability to handle a surge of severe cases."

    Concern about a second wave has prompted a flurry of activity by federal, state and local officials, including intensifying flu virus monitoring and making plans to distribute vaccine and antiviral drugs and other treatments if necessary.

    "There's a lot of moving parts to this," said Joseph S. Bresee, who heads the CDC's influenza epidemiology and prevention branch. "Hopefully we won't have a panic, but instead we'll have the appropriate level of concern and response."

    The Obama administration has been updating recommendations for when to close schools, what parents should do if their children get sick, how doctors should care for patients and how businesses should respond to large-scale absences. Officials are hoping to navigate a fine line, urging precautions to minimize spread, serious illness and deaths while avoiding undue alarm and misinformation.

    "The last time we had anything similar to this was prior to the Internet," said one senior official who spoke on the condition of anonymity last week during one of a series of background briefings for reporters.

    A Gathering Storm
    The virus could cause nothing more than a typical flu season for the Northern Hemisphere this winter. But many experts suspect the second wave could be more severe than an average flu season, which hospitalizes an estimated 200,000 Americans and contributes to 36,000 deaths. Because the virus is new, most people are not immune to it.

    "This epidemic will transmit faster than usual, because the population is more susceptible," said Marc Lipsitch, a professor of epidemiology at the Harvard School of Public Health who has been helping the CDC project the severity of the upcoming wave. "It's fair to say there will be tens of millions of illnesses and hundreds of thousands of hospitalizations, and tens of thousands of deaths. That's not atypical. It just depends on how many tens of thousands."

    Perhaps more important, in every country where the virus has spread, it has continued to affect children and young adults much more commonly than typical flu viruses.

    "In a pandemic where a greater fraction of illness and deaths occur in kids and young adults, that will be clearly noticeable to the public. There will be a sense that this is a greater severity of illness even if fewer people die overall," the CDC's Bresee said.

    Most of those who have developed serious illness and died have had other health problems. But those include many common conditions, such as diabetes, asthma and obesity. Pregnant women appear to be especially at risk. And the virus can cause severe illness and death in otherwise healthy people in perhaps a third of cases.

    The virus continued to simmer in the United States over the summer, causing more than 80 outbreaks in camps in more than 40 states. Officials estimate that more than 1 million Americans have been infected.

    The number of cases could increase rapidly as soon as schools begin to reopen in the next few weeks and could accelerate further as cooler, drier temperatures return, possibly peaking in October.

    That is much earlier than the usual flu season, and it could create confusion. People could start becoming sick with the swine flu before a vaccine is widely available and nonetheless be urged to get the regular seasonal flu vaccine, which will be available first. Because different groups are being given priority for the different vaccines, officials are concerned it could be difficult to make sure the right people get the vaccine at the right time to provide optimal protection. The elderly are a top priority for the seasonal vaccine, but not for the swine flu vaccine.

    The first batches of swine flu vaccine are not expected to become available until mid-October, assuming studies indicate it is safe and effective. And officials have yet to answer many key questions, including how many doses will be needed. If it is two, as many suspect, it could take at least five weeks after the first shot before vaccinated people are fully protected.

    Southern Hemisphere
    In the Southern Hemisphere, which experiences winter during the Northern Hemisphere's summer, the swine flu virus caused a more intense and somewhat earlier flu season in some places. In Argentina, which was hit particularly hard, school breaks were extended and the economy suffered as people avoided restaurants, clubs and other public places.

    "There was panic and I felt it, too," said Cristina Malaga, a maid in Buenos Aires who stayed home for a week in July out of fear. "I was scared. It is three buses to get to work and there were many people on those buses who are coughing."

    At the Guti?rrez Children's Hospital, officials set up a trailer with specially outfitted examination rooms to help deal with the influx of sick people.

    "The system did not collapse, because we prepared special units for outpatients and for inpatients," said Eduardo L?pez, who heads the hospital's medical department.

    Paula Morey, a housewife who lives in an affluent neighborhood in Buenos Aires, said she and friends stopped sharing the national tea, which is served in a communal gourd. Now, she said, they bring their own gourd. Morey also began cleaning her 4-year-old daughter's hands constantly and carrying a tube of disinfectant to dab on the moment she touches anything like a doorknob.

    "She had to learn to take care of herself," Morey said.

    Greater Concerns
    The appearance of the virus in countries such as South Africa and India is raising concern that the pandemic could be devastating if it begins to sicken large numbers of people in places with fewer resources.

    "These are countries with vulnerable populations and fragile health-care systems," said Nikki Shindo, acting head of the WHO's influenza program.

    Indian doctors and health officials were scrambling last week to prepare for a sharp increase in cases. Despite well-run clinics for the wealthy, many of India's government health services are overcrowded, understaffed, chaotic and antiquated.

    "If we start investigating every case of H1N1 virus, I think the government facility will not be able to cope with the rush," said Dharam Prakash, the Indian Medical Association's secretary general.

    In Kenya, white-coated health workers have been passing out questionnaires at the Nairobi airport and putting up glossy posters about the virus on the walls of downtown cafes. False alarms about the virus have spawned a sense of panic in some places. When a health clinic in a Nairobi mall recently suspected a patient of being infected, word leaked out and soon shoppers were sending out text messages across the city warning people to stay away. The clinic was shut down for a day.

    Northern Hemisphere
    In Britain, chief medical officer Liam Donaldson said there were several possible explanations for that country's recent increase in cases, including London's role as an international transport hub. In an effort to relieve intense pressure on doctors, the government recently launched the National Pandemic Flu Service, a phone and Internet hotline that allows patients to diagnose themselves and prescribe their own drugs.

    "It's changing the way people are responding," said Alan Hay, who directs the WHO's World Influenza Centre in London.

    Meanwhile, health officials in Virginia, Maryland, the District and other localities said they have been preparing all summer for the swine flu's return, including making plans to set up special clinics to treat and vaccinate patients if necessary.

    "We're doing a tremendous amount of contingency planning," said Frances Phillips, Maryland's deputy secretary for public health.

    Although strains of the virus have emerged that are resistant to Tamiflu, one of two antiviral drugs effective in treating it, scientists say both drugs generally appear to continue to be effective. The U.S. government shipped 11 million doses of the drugs to states to add to the 23 million they already had on hand and bought an additional 13 million doses to replenish its supplies.

    "There's only so much that can be done to get ready. Flu, like a hurricane, is a force of nature. You can't stop it. You can't make it less severe than it would be otherwise," said Eric Toner of the University of Pittsburgh's Center for Biosecurity. "All you can do is try to be prepared to deal with the consequences."

    The last flu pandemic, the 1968-69 Hong Kong flu, was the mildest of the 20th century, contributing to perhaps 1 million deaths worldwide, including about 34,000 in the United States. After emerging, many flu viruses continue to circulate for years, while others disappear or combine with other viruses.

    Correspondents Juan Forero in Buenos Aires, Emily Wax in Mumbai and Stephanie McCrummen in Nairobi; special correspondent Karla Adam in London; and staff writer Cheryl W. Thompson in Guadalajara, Mexico, contributed to this report.

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