Bonus post for the week, published now due to timeliness.

by James Hubbard, MD, MPH

The flu is in full swing, and this year, H1N1 is back. The virus previously known as swine flu, which caused the 2009 pandemic, is causing most of the infections in 2014 too.

H1N1 is a particularly bad strain, and people are hearing all sorts of things about it—and have all sorts of questions. So I asked via Facebook and Twitter what you want to know. You responded with a lot of great questions. In this video, I answer many of the ones specifically about H1N1. For even more answers about the flu, scroll down. (If the answer to your question isn’t here, I apologize. I addressed as many as I could.)

The Big Flu Q&A List

Here’s a pretty representative list of some of the questions you asked, with where to find my answers. (Some questions have have been lightly edited.)

H1N1: The Survival Doctor Answers Your Flu QuestionsH1N1 Vs. Other Flu Strains

Answered in the video: What’s the difference between H1N1 and other flu strains? Why is H1N1 called “swine flu”? Can you can get it from animals?

Other questions:

Q: What age group is most at risk [this year]? —Holly
A: All age groups are at risk for getting the flu. People at particular risk of complications include those with chronic illnesses and who are elderly or very young. The age cutoffs seem to be around 2 years or younger and 65 or older, but in reality, I don’t think there’s a magic number. I think the risks just go up or down with age. (This year, young adults also seem to be getting hit harder than they usually are.)

Q: If you get [the flu this year] do you need to go to hospital immediately or wait a day or two? —Holly
A: That’s an individual choice. Unless they’re really sick, most people don’t have to go to the hospital immediately. However, calling your regular doctor’s office when you start feeling symptoms and getting individual advice is a good idea. Also see this post: “How NOT to Die From the Flu (and Signs You Could).”

Prevention / Immunity

Answered in the video: Are you immune to H1N1 once you’ve had it?

Other questions:

Q: What can I do to minimize my risk [of getting the flu]? My kids’ risk? —Kelli
A: Frequently wash your hands, and teach your children to do that. You could consider keeping them home from school when the flu is hitting its peak. Rest and good nutrition is very important. And of course you can always consider the flu shot. This post lists some home prevention remedies for colds that have good evidence behind them. They may work for the flu also. Vitamin D supplements may help prevent the flu as well (400 to 2,000 IU a day for adults; for children, see labels). For any medication or supplement, always read up on safety precautions, side effects, medication interactions, etc.

Q: How long does the virus live on items or in the air? —Carol
A: The flu can live on hard surfaces for two to eight hours, according to the Centers for Disease Control and Prevention. How long it lives in the air in a form that could make you sick is debatable. It could be seconds to hours.

Q: Can you have a natural immunity to such things? I’ve never had the flu in 35 years and I used to run a pharmacy. Currently several of my clients are ill and I have no hint of anything. —Karen
A: First remember that the flu only affects 5 to 20 percent of people per year. I’m sure some people have a stronger immune system in general. Maybe that’s your case, or maybe it’s pure luck. In any case, congratulations. I hope the trend continues.

Q: Once you get the flu can you get it again? How long does the immunity last? —Joanna
A: Immunity should last a lifetime for that specific variant of the flu. However, there are multiple variants every year, and you’re still susceptible to those.

Flu Shot

Answered in the video: How effective is this year’s flu shot? Is it too late to get vaccinated? Can you still get the flu if you get the shot? Who shouldn’t get vaccinated? Does the flu shot cause symptoms?

Other questions:

Q: With all the anti-immunization fears out there … what’s your view on getting the shot? —LaMona
A: I gave my take on the flu shot controversies here.

Q: When immunized with the swine flu version of the flu shot, how long does the immunity typically last? Is the immunity valid for other strains? —Lime Green Medic
A: It probably lasts different lengths for different people. Some immunity lingers for a long time. But you really can’t count on it for more than about a year. The immunity isn’t valid for other strains unless the other strains were included in the shot.

General Flu Symptoms and Treatment

Answered in the video: What are some of the danger signs you need to go to the hospital?

Other questions:

Q: What are signs that you are not dealing with just a bad cold? —Jami
A: Please see “Is It a Cold or the Flu? How to Tell the Difference.”

Q: Are there any other effective treatments [besides an antiviral like Tamiflu] for H1N1 or any other influenza strains that could prevent more deaths after infection? —Lime Green Medic
A: Here’s my post about other things you can do if you get the flu.

Q: How effective are things like vitamins B & D and things like elderberry syrup in flu cases? —Johanna
A: Vitamin D supplements may help prevent the flu (400 to 2,000 IU a day for adults; for children, see labels). For treatment, vitamin D could be worth a try, though I don’t know of much concrete evidence backing it up. Also for flu treatment, there is some evidence that elderberry helps. (With any medication or supplement, always read up on safety precautions, side effects, medication interactions, etc.) For information on more home remedies, please see these two posts, which are about colds but may also be applicable to the flu since both are viral: “The Natural Remedies Proven to Work on the Common Cold” and “Surprise: 4 Common Cold Treatments That Don’t Work.”

Flu Dangers and Complications

Answered in the video: What do people actually die of when they die of “the flu”? Are people with certain diseases or who are pregnant especially at risk? Can you can get a bacterial infection if you’re on an antiviral like Tamiflu?

Other questions:

Q: I just got out of the hospital a few days ago. Had H1N1 complicated by pneumonia. I am weaker than a kitten, shortness of breath, using a rescue inhaler. Any idea how long before my lungs clear? —Kathy
A: I always tell people it’ll take a minimum of a month to get back to normal with pneumonia. It took me about six months to get over my pneumonia completely. You can read more about that here: “What to Do for Walking Pneumonia.”

Q: How often should you get a pneumonia shot? Is it good for life? —Donald
A: Depends on the person. Some need a booster after five years; some don’t. Check with your doctor.

Long-Term Survival

Answered in the video: If there’s an epidemic or pandemic, how long will the virus maintain its potency; how long should we stay out of crowds? What if there is no hospital to go to?