A day of many questions

It was a crazy day dealing with many issues related to swine flu—reviewing contingency plans, inventories of masks and Tamiflu, and considering the logistics of how we could see a rapid influx of patients, both the sick and worried well. And answering many questions throughout the course of the day: “I’m scheduled to go to Mexico in two weeks. Should I cancel my trip?” “I’m returning home from Mexico City tomorrow. Should I take Tamiflu prophylactically and should I wear a mask around my family members?” “Should we do anything differently at our church services to reduce risk of transmission?” Unfortunately, there are few good answers. This is primarily due to the fact that we’re not entirely sure how this infection is transmitted, as Dan noted earlier. It’s likely transmitted by droplets produced with coughing, talking or sneezing, and this requires that the distance between the infected and susceptible persons is 3 feet or less. But could transmission also occur via the airborne route, in which case the virus is capable of traveling longer distances? Lastly, since this influenza virus is somewhat unique in that some of the patients have had GI symptoms such as diarrhea, does this mean that the virus is being shed in the stool? If so, this may provide another route for spread. Eventually the answers to these questions will be known, but for now at least, we’re all flying by the seat of our pants.