What Is NDM-1?

NDM-1, which stands for New Delhi metallo-ß-lactamase-1, the name of an gene which apparently can make many different strains of bacteria highly drug resistant.  It was first isolated in New Delhi, India, hence the name and has now spread to the UK and Canada

Why Is NDM-1 Dangerous?

What makes it a particular concern is that it easily spreads from bacteria to bacteria, so it is like a super solider formula for bacteria: It can change common bacteria that are currently easily controlled by antibiotics into super virus – highly resistant to most antibiotics.

That means that this new “Indian super bug” could be a health issue that makes other recent world health issues such as H1N1 and SARS pale in comparison, because it could conceivably turn every virus into a super virus.

Symptoms of NDM-1?

Potentially any  bacteria could be infected by the NDM-1, but currently the primary concern is with two types of bacterium: E.coli, the often serious infection of the digestive tract, and Klebsiella pneumonia.

So, clearly if you find yourself suffering from a serious digestive infection or pneumonia it is worth at least mentioning NDM-1 to your physician, because these infections can be fatal.

However, potentially NDM-1 supercharge all bacterium – that’s the fear.

Spread of NDM-1

Researchers believe that the gene already infects three or four percent of patients in India.  NDM-1 numerous cases have been reported in the UK and cases have already been identified in the United States, Canada, Sweden, Australia, and the Netherlands, and given the large volume of international travel from South Asia it is all but certain that NDM-1 will quickly become widespread in the rest of the world.

Treatments for NDM-1?

The best treatment for NDM-1 is not to become infected with bacteria carrying the gene.  That means paying more attention to basic public health practices, as hand washing, and health professionals will need to be even more aware of their efforts to encounter the spread of infections within hospitals and clinics.

There are a few antibiotics that still have some effect against NDM-1, but the most powerful family of antibiotics are now ineffective.

This is a commercial web site. That means that we generally make something, often just a few cents, when you click on one of the Google ads, and sometimes a little more if you actually make a purchase at the site you visit.

You probably realize that this is the same model as most web sites on the internet and none of the banners or links should in any way be interpreted as guarantees or endorsements of the products or services offered. You should do your own research before you make any purchases.

We take this very seriously, because H1N1 is a very serious problem. We are not medical professionals, but we have tried to take the best information available from the CDC and other government sources and put it into easy to understand language. However, nothing on this site should be interpreted as medical advice.

If you believe that you or someone you care about might be suffering from H1N1, please seek IMMEDIATE medical attention.

H1N1 and Health Insurance

The health insurance angle to the swine flu pandemic in the United States is amazing.

Very few average people are considering their health insurance, because it is not as interesting or exciting as the issues around the symptoms and treatment of the illness.

However, medical insurance is an issue that many public health officials and journalists are concerned about. The National Association of Insurance Commissioners is encouraging consumers to review their health care plans as they relate to the so-called Swine Flu.

Many state health agencies are urging people to check their insurance, and, in fact, the information on this page is largely drawn from health insurance checklists drawn up by the states of Ohio and Michigan.

Kathy Kristoff of CBS Moneywatch notes that, “Those who do have insurance are finding that their coverage varies widely, with some companies covering the treatment in full and others demanding large co-payments.”

According to another recent report California insurance companies deny an average of 21% of all claims, so you need to know your coverage.

Understand Your Health Insurance coverage

It’s always important to understand just what you health insurance policy covers, but with the potential for an increased demand for health care services, you need to be even more aware of your specific plan details. Read your policy carefully and consider the following questions:

• Do you have a cost-sharing responsibility for flu vaccinations? Many health insurance policies have co-payments for seasonal flu vaccinations.
• Ask your insurance company if you will have a co-pay for the seasonal flu vaccine and what the cost will be.
• Is the vaccination covered by your insurance? The seasonal flu vaccine and the H1N1 flu vaccine are normally administered separately. The U.S. government is covering the cost of the H1N1 vaccine, but you may be charged its administration. Check with your insurance company to see if your coverage includes the seasonal flu vaccine and extends to the administration of the H1N1 vaccine.
• What is your co-payment for the most common H1N1 treatments? The two drugs doctors can prescribe to treat H1N1 flu are Tamiflu and Relenza.
• In addition, you should know of any limitations on the number of doses covered by your policy – per prescription or per year.
• Is your coverage accepted at walk-in care facilities? If your area is heavily affected by the spread of the H1N1 flu outbreak, your regular physician might not be able to see you in a timely manner.
• What is your out-of-network co-payment? If you must go to an out-of-network provider, be aware you will likely pay a higher co-payment for your office visit and any tests run during the visit.
• Check with your insurance company to determine if you have coverage for vaccines received at drug stores, employers’ offices and schools. Some health plans, including Medicare Advantage plans, only provide coverage for vaccines received from designated providers.

Be prepared in case you or a family member do become infected:

• Have your health insurance ID card readily available.
• Review your health insurance policy provisions. Know which doctors and hospitals are in your network.
• Make note of your co-payments. Know how much a doctor’s office visit will cost.
• Keep handy a list of pharmacies and medications covered under your policy.
• If you have plans to travel, make sure you check to see if there are any doctors or medical facilities in-network where you will be visiting.
• Ask your employer or insurance company for any and all applicable health insurance information that might be available to you in a simple-to-reference format.
• Post this information where it can easily be accessed by everyone.

Best Bets For H1N1 Coverage

However, some insurance companies are taking action positive action. Tim Bireley, VP, Guardian Group Medical, the health insurance division of the Gaurdian Group Life Insurance Company of America said, “Guardian decided to cover the costs associated with administering the vaccine…” That’s a very good sign if you are covered by the Guardian, but you are still only covered for actual treatments if you become ill with Swine Flu under the specific provisions of your individual plan.”

Aetna, United Health Care, and several other companies have also made similar decisions, but you should definitely review your policy.

Here’s a report from the state of Texas on what H1N1 related expenses insurance companies in that state are covering: Texas Health Insurance Companies

Short Term Insurance

You might also consider a short term plan if you are uninsured or short term additional coverage if you are already insured, particularly from one of the companies that have said the y will cover H1N1 expenses.

If you fill out a short application eHealthInsurance can give you a free quote.  They examine the rates from dozens of companies, so it can save you a lot of effort.  More, importantly it can give you a little peace of mind about your coverage.

You will get a lot of quotes back, but compare them with the companies on the document from the Texas Department of Insurance.  Then you should have some security about what you are actually buying.

H1n1 In The News

• Nature publishes details of bird flu strain that could spread among people - Publication of bird flu study was delayed after warnings that the information could be exploited by terroristsControversial research on a hybrid strain of bird flu that could potentially spread between humans was published on Wednesday in Nature after security restrictions on the work were lifted.Scientists created the virus by merging a mutated strain of bird flu with the "swine flu" virus that sparked a human pandemic in 2009. The hybrid strain spread easily between ferrets – the best proxy that flu researchers have for people – but was not lethal and could be controlled with antiviral drugs and bird flu vaccines.The work by Yoshihiro Kawaoka at the University of Wisconsin-Madison was submitted last year to the journal, but was delayed after the US government's biosecurity advisers s...

  MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

• [A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University]. - Conclusion: It is an important task to protect oncohematological and organ transplant patients. Orv. Hetil., 2012, 153, 649-654. PMID: 22543220 [PubMed - in process] (Source: Orvosi Hetilap)
• Human Infections with Novel Reassortant Influenza A(H3N2)v Viruses, United States, 2011. - Authors: Lindstrom S, Garten R, Balish A, Shu B, Emery S, Berman L, Barnes N, Sleeman K, Gubareva L, Villanueva J, Klimov A Abstract During July-December 2011, a variant virus, influenza A(H3N2)v, caused 12 human cases of influenza. The virus contained genes originating from swine, avian, and human viruses, including the M gene from influenza A(H1N1)pdm09 virus. Influenza A(H3N2)v viruses were antigenically distinct from seasonal influenza viruses and similar to proposed vaccine virus A/Minnesota/11/2010. PMID: 22516540 [PubMed - in process] (Source: Emerging Infectious Diseases)
• Differentiated swine airway epithelial cell cultures for the investigation of influenza A virus infection and replication - Conclusions  Retinoic acid promoted ciliogenesis, whereas epidermal growth factor controlled the thickness of the pseudoepithelium. The optimal concentrations for differentiated swine cell cultures were 1·5 ng/ml epidermal growth factor and 100 nm retinoic acid. Influenza A viruses infected and productively replicated in these cultures in the absence of exogenous trypsin, suggesting that the cultures express a protease capable of activating influenza virus hemagglutinin. Differences in virus infection and replication characteristics found previously in pigs in vivo were recapitulated in the swine cultures. This system could be a useful tool for a range of applications, including investigating influenza virus species specificity, defining cell tropism of influenza viruses in the swin...
• Biosecurity aspects and pathogen inactivation in acidified high risk animal by-products. - Authors: Vinnerås B, Samuelson A, Emmoth E, Nyberg KA, Albihn A Abstract The aim of the study was to investigate the effects of formic acid addition to ground high risk animal by-products (ABP 1) in terms of stabilization and pathogen inactivation and to evaluate the biosecurity risk connected with the ABP 1 based combustion fuel Biomal. Laboratory studies were performed on the persistence of Salmonella Typhimurium, Bacillus cereus spores, porcine herpes virus, avian influenza virus, bovine viral diarrhea virus, equine rhinitis A virus and porcine parvovirus in Biomal at different storage times. It was shown that Salmonella and enveloped viruses were inactivated within 1 day (24 h). Bacillus cereus spores were not reduced during 147 days and the non-enveloped virus porcine parvovi...

US Government Feed

• FDA Approves First Quadrivalent Vaccine to Prevent Seasonal Influenza - FluMist Quadrivalent, a vaccine to prevent seasonal influenza in people ages 2 years through 49 years, has been approved today by the U.S. Food and Drug Administration. FluMist Quadrivalent is the first influenza vaccine to contain four strains of the influenza virus, two influenza A strains and two influenza B strains.
• First U.S. Cell-based Flu Vaccine Plant Set for Dedication - The first U.S. facility to use a faster and more flexible technology to make influenza vaccine was dedicated today, as part of an initiative that could provide vaccine supplies sooner in an influenza pandemic. The plant in Holly Springs, N.C., can create vaccine using cultured animal cells instead of the conventional process of using fertilized eggs.
• CDC Confirms Two Human Infections with Novel Influenza Viruses - CDC has confirmed two cases of human infection with two different novel influenza A viruses in different states. Both patients have fully recovered.
• FDA Updated Communication on Use of Jet Injectors with Inactivated Influenza Vaccines - The Food and Drug Administration (FDA) is recommending that health care professionals use a sterile needle and syringe to administer inactivated influenza vaccines.
• CDC Issues Initial 2011-2012 Seasonal “FluView” Report: Current Activity is Low; Outlook for Vaccine is Good - The Centers for Disease Control and Prevention released the initial “FluView” report for the U.S. 2011–2012 flu season with the message that flu activity is currently low, making this the perfect time to get vaccinated. There should be lots of vaccine available, because the supply is projected to set a U.S. record.

UN Feed

• Influenza update - 03 June 2011
• Influenza update - 20 May 2011
• Influenza update - 06 May 2011
• Influenza update - 21 April 2011
• Influenza update - 08 April 2011

Medical News

• Washington State Faces Pertussis Epidemic - Pertussis infections have reached epidemic proportions in the state of Washington, officials there said, with more than 10 times as many cases this year as were counted by early May in 2011.
• Oral Zinc May Cut Cold's Length - The duration of adult cold symptoms appears to be shortened with the use of oral zinc formulations, but mild adverse effects are common, according to a meta-analysis.
• Clinical Notes: Eat to Live or Live to Eat? - Eating for pleasure has different effects in the body than eating for sustenance, a new study found. Also this week: the suicide toll grows among former pro football players.
• Study Shows How Bird Flu Could Jump to Humans - A hotly debated study identifies four mutations in a key gene in the highly pathogenic H5N1 avian flu that allow it to adapt to mammals.
• Clinical Notes: U.S. Workers Short on Shuteye - Some 41 million members of the labor force do not get enough sleep, and not only because of rotating shifts, a CDC report indicated. Also this week: staph and flu infections can be a deadly mix.

Preventing H1N1

Prevention of H1N1 is actually easy for most people to understand, because, like all flu viruses, H1N1 spreads from person to person, mainly through the coughing or sneezing of a sick person. H1N1 may also spread when a person touches something that is contaminated with the virus and then touches his or her eyes, nose, or mouth.

The H1N1 vaccine is under development and should begin to be available in large numbers in several months, but currently simple public health measures offer the best protection against H1N1.

• Wash your hands frequently with soap and warm water. Hand washing seems simple, but, remember, medical students actually are taught how to wash their hands, so make a real effort, because it’s a cheap, simple, and a highly effective way to prevent yourself from becoming infected with the H1N1 virus.
• Be careful touching your eyes, nose or mouth, because the H1N1 virus is often spread when a person touches a contaminated object and then touches his or her eyes, nose or mouth. Be particularly aware of door handles and computer keyboards, because these surfaces are almost impossible to keep free of a tough virus like H1N1.
• If possible avoid the company of people who are sick, especially if they are already suffering H1N1 Flu symptoms.
  However, if you are a care-giver be doubly vigilant about washing your hands and protecting yourself from infection.
• Cover your mouth and nose with a facial tissue when sneezing or coughing, or “sneeze in your elbow.”  
If you are sick, stay home from work, school, church, or other public places, because you will help prevent others from catching H1N1.  Essentially, be polite.
• If you live in a community where H1N1 has occurred, stay away from shopping malls, movie theaters, or other places where there are large groups of people.   Although, exercise is great for you overall,  gyms are perfect breeding grounds for viruses like H1N1 and you should probably avoid them if there is an ongoing outbreak of H1N1 Flu in your area.

Dr. Margret Chan, Director, World Health Organization

That is what Dr. Chan said on June 11, 2009, and fortunately she was WRONG.  Today we know that there are  things that you can do to lower the risks to yourself and your family.  Old fashioned personal hygiene and good public health measures have worked so far, but some scientist believe that the Swine Flu virus might reemerge in the Spring.

H1N1 News Tracker

Stay current on the latest news on the spread of the virus and possible treatments.  Our H1N1 News Tracker has the very latest H1n1 news from the CDC, WHO, and other scientific and medical journals.

This is where you will see the H1N1 news before it is the news, because these are the sources that mainstream journalists use for their stories.

Symptoms of H1N1

The symptoms of H1N1 are similar to the symptoms of common seasonal flu.  The common Swine Flu symptoms include:

• Fever – particularly a fever of over 100 degrees
• Sore throat
• Cough
• Chills and fatigue
• Body aches
• Headache
• Occasionally, vomiting and diarrhea

Persons who experience flu-like symptoms should contact their physician immediately, but, remember, Swine Flu is an extremely contagious disease and anyone who believe they are infected with H1N1 should avoid going out in public unless absolutely necessary.  So, call first.

Swine Flu Warning Signs

Anyone at higher risk of serious complications from seasonal flu,  including people over the age 65, and  children younger than 5 years old, pregnant women, people of any age with chronic medical conditions (such as diabetes, or heart disease), and people who are infected with HIV should be extra vigilant in looking for the symptoms of H1N1.

However, anyone with asthma or other respiratory illness, and perhaps even heavy smokers should be extra vigilant, because what makes severe cases of H1N1 more severe than regular flu is the way that it attacks the respiratory system. Seasonal flu is largely an upper respiratory illness, but in severe cases H1N1 moves deeper into the lungs and causes viral pneumonia. It is the complications from the pneumonia that has caused the vast majority of Swine Flu deaths.

Because young children often cannot clearly explain how they are feeling it critically important to keep an eye out for children who are having difficulty breathing.

If any person, but particularly small children and others in high risk groups, exhibit any of the following serious warning signs, seek immediate emergency medical care:

• Trouble breathing, including rapid breathing.
• Gray or bluish skin color
• Not drinking enough fluids
• Sleeping constantly and not interacting when awake
• Being especially irritable
• Not urinating or no tears when crying
• The symptoms improve but then return with fever and worse cough

H1N1 Symptoms: Summary

The symptoms of H1N1 are nearly identical to the traditional flu, but you should also look for the beginning of pneumonia type symptoms, particularly among anyone has a pre-existing respiratory illness.

In simple layman’s terms the severe cases of Swine Flu are basically the seasonal flu and viral pneumonia. Most cases are NOT severe, but the worse cases can be fatal, usually because of respiratory complications.

What worries public health professionals is that the vaccine for H1N1 is not widely available yet, though one is being manufactured, and the vaccine for the regular flu will not be effective against this newly discovered strain.

Also, that means, if the vaccines are available, you will need two flu shots to be fully protected from both H1N1 and the normal seasonal variety of the flu.

Finally, the simple fact that the H1N1 virus is new is a real concern, because there is concern that it might mutate into something more deadly. Remember, the regular seasonal flu strain kills hundreds of thousands of people around the world each year, and, so, even if H1N1 turns out to be no more virulent than the regular flu that is still an awful disaster on the grandest scale.

At this point it is hard to know what the ultimate out come of the H1N1 pandemic will be.  Be prepared, but don’t panic.

Products For Preventing and Treating H1N1

There has been a flood of products to the market designed to prevent or treat H1N1.  Some of these treatment may be great, but very few of them have the scientific research behind them to truly prove their effectiveness.

Consumers need to be VERY wary of products that make extraordinary claims.  The H1N1 pandemic has brought out all sorts of kooks and con men offering instant cures.

In the United States the Federal Trade Commission and the Food and Drug Administration have teamed up to crack down on business making unsubstantiated medical claims.  Download a PDF list of business and products censured by the FDA.

Many advocates of alternative medicine have railed against the FDA for being overly aggressive, because the FDA requires expensive, time-consuming peer-reviewed scientific studies before they will approve a product for use.

Though, it is easy to understand the frustration of people who want to make their own decisions about their personal health care, but the FDA is trying to protect the public from potentially deadly frauds. However, consumers still should carefully research any product and come to their own conclusion before making a purchase.

Finally, most of the advertisements on this website are automatically posted.  Hopefully, they are doing proper due diligence, but if you believe that a fraudulent product is being advertised, please contact us and we will investigate the matter.

With that disclaimer in mind, here are the products and services that most well educated consumers should probably consider.

Air Purifiers

Air purifiers are used in scientific laboratories to control airborne infections, but the FDA does NOT recommend air purifiers to prevent the spread of the Swine Flu virus, apparently because they know that most people do not live in a sterile laboratories.  Also, they do not want to give people a false sense of protection, because the best protection is still good personal hygiene practices and sound public health measures.

Frankly, it makes a lot of sense.

Furthermore, they have reprimanded several air purifier manufactures for making unverified claims, but CleanAir4Life.com offers a variety of air purifiers that they assert eliminate viruses, including the H1N1 virus.   They make some very strong claims, but they also offer a lot of compelling evidence, particularly for the Airfree models.  Regardless, air purifiers are no substitute for good personal hygiene and public health measures.

However, you should remember that even a perfect air purifier is worthless if you do not follow good standards of hygiene and public health.

Health Insurance

If you live in the United States this is probably a very good time to check out your health insurance coverage.

eHealthInsurance is a service that compares rates from a variety of companies to find one right for you. They offer plans for small businesses, individuals, and families, but they also offer short term health insurance for a maximum duration of six months that is even cheaper.

Remember, H1N1 is not a pre-existing condition and if you are otherwise healthy you could probably easily buy a short term additional coverage. Then when the threat has lessened you simply let the coverage lapse.

Costs vary depending on your age, smoking habits, and where you live. In a recent test for short term rates for single thirty-year-old non-smoking male living in the greater Los Angeles area were as cheap as $68.00 a month and only $41.00 a month if that person lived in rural Missouri.

Even if you already have health insurance eHealthInsurance might be able to offer you better coverage at the same price you are already paying or provide you with low cost additional coverage.

However, remember there is more to health insurance than the cost, so be sure to check on deductibles, coverage, co-pays, and the other details. Also, with most companies you will have to provide information on you general health and any preexisting conditions before they allow you to enroll.

Medical Supplies

There are also a lot of choices for medical supplies, such as masks, disinfectants, and hand cleaners.   Frankly, you can probably buy most items you might need at your local pharmacy or supermarket, but if you believe you need hospital quality medical supplies you should price them at iMed.com

Medical masks are probably the most common item that you might want to order from a medical supply company, because if you are going to the effort to wear a mask you probably want to go ahead and buy form fitting hospital quality masks, known as N95 respirators, which might not be easily available in your local drugstore.

However, you should note that the experts are not sure how effective even the N95 masks are at preventing the spread of H1N1.

Medication

The FDA has approved the prescription antiviral drugs Tamiflu and Relenza for the treatment of H1N1 Flu.  You probably want to purchase these and other prescription medication from your local pharmacy.

H1N1 Treatment

None of the statements on this site should be viewed as medical advice. If you believe you or a family member is suffering from Swine Flu symptoms, contact your doctor. DON’T TAKE CHANCES!