So how do you know if you or your children have H1N1 flu or if your symptoms are severe enough to require medical treatment? The latest way is a free interactive website from The American Medical Association (AMA), built with partners Microsoft and personal health record provider Healthy Circles. The website offers information about seasonal and H1N1 flu and gives advice on when to seek professional help. The site asks a series of questions about a patient’s symptoms and history, and then lets the patient know if they need to see a doctor. But unlike other self-assessment flu sites, this website also allows doctors to communicate with patients and will eventually permit doctors to prescribe routine medications online.

Using information based on the latest CDC flu guidelines, the site helps patients determine the severity of their flu symptoms and, if they choose, share that information with a physician on a forum similar to that of Facebook. Physicians are then able to use tools on the site to monitor their patients’ symptoms, and manage patient flow within their respective practices.

“It’s basically Facebook for health care,” said Dr. James Mault, Chief Executive Officer of Healthy Circles, which developed the Web site. “I think that may help in a small way in reducing the worried well and the worried not-so-sick who are overwhelming our system right now.” And the site complies with medical privacy laws, he said.

Dr. Mary Anne McCaffree, a pediatrician from Oklahoma City and member of the AMA board, says that with both the seasonal flu and the H1N1 virus circulating, doctor’s offices are already seeing much more traffic than normal. “This resource allows patients to access their symptoms and determine when to seek care for themselves or their loved ones,” she said. “To prevent the spread of influenza, this site also helps determine when it is safe for those who have been sick to return to work or school.”

Colorado is the first state to adopt the technology, which will link government health sites in Colorado directly to the AMA site. “As part of Colorado’s dedication to healthcare technology, we are proud to be the first state in the nation to support this new online tool for Colorado families and healthcare professionals,” said Governor Bill Ritter. “This new tool will play a critical role in helping to reduce demands on our healthcare system.”

McCaffree said the site is the first step in a larger AMA initiative that will provide additional online tools for patients and doctors. As those tools are developed, new conditions outside of the flu will be added to a larger “umbrella portal.”

Since first being approved by the U.S. Food and Drug Administration (FDA) in 2006 for use in females, the issue of whether or not to use Gardasil for males has been strongly debated. Advocates for use of Gardasil as a routine immunization among males believe that widespread use of the vaccine may reduce cervical cancer rates, since males commonly transmit HPV to females.

Although in early October the FDA approved the Gardasil vaccine for use among males aged 9 through 26, results of a study conducted in the same month revealed that immunization among males was not cost effective, as costs would outweigh the health benefit of the vaccine. Now, the results of the final vote by the Advisory Committee on Immunization Practices reported to the U.S. Centers for Disease Control and Prevention (CDC) has apparently put this issue to rest. The vaccine will not be approved for boys as part of the childhood immunization schedule.

The pivotal study published in the British Medical Journal made a comparison between a female-only vaccination program and a co-ed vaccination program. Researchers from the Harvard School of Public Health performed the analysis. According to lead researcher Jane Kim, an assistant professor of health decision science, “This study found that while vaccine coverage and efficacy are high in girls, including boys in an HPV vaccination program generally exceeds what the U.S. typically considers good value for money.”

The basis of a good value was deemed as having cost-effectiveness ratios ranging from $50,000 to $100,000 per quality-adjusted life year, or the cost of the vaccine versus the number of added years someone would gain by getting the vaccine. By assuming lifelong protection among 75 percent coverage, the routine vaccination of girls who were 12 years of age was found to be a good value at less than $50,000 per quality adjusted life year. However, by adding boys of the same age, the cost-effectiveness ratio was increased to over $100,000 per quality adjusted life year.

Currently, the CDC recommends Gardasil for girls ages 11 and 12, and for women ages 13 to 26, who have not been vaccinated for the prevention cervical cancer. The disease claims 4,000 female lives annually in the United State alone.

Some of the warning signs are fairly basic, as fever and chills are clearly the body’s way of saying that there are germs in its midst. There are some strains of the flu that do not have those symptoms, though, and grab hold of the body with the basic cough, sore throat, sinus problems, and body aches. But no matter how run-of-the-mill the warning signs may seem, the flu is harsh on the body and should be treated with antibiotics. If medication from a doctor is not an option, there are numerous over-the-counter drugs to help ease the symptoms and prompt a faster healing process.

However, according to the Centers for Disease Control and Prevention (CDC), there are more severe signs of the flu that should be given the proper attention. If there is difficulty breathing or shortness of breath, sudden dizziness, confusion in one’s thoughts, severe or persistent vomiting, or pain or pressure in the chest or abdomen, those are not typical signs of an ordinary flu. These can be signs that the body was not prepared for the flu or that a more severe strain is in play, and a doctor should be contacted immediately. In the case that the symptoms come on quickly and a doctor cannot be reached, one may want to consider the emergency room in order to get treated promptly and prevent the onset of something more severe like pneumonia.

Especially with children, signs of breathing difficulties and confusion should be dealt with immediately by contacting a doctor or visiting an emergency room. Other signs that should alert parents to a more severe form of the flu are a bluish tone to the child’s skin, the refusal of a child to drink enough fluids, irritability that takes the form of a child not wishing to be held, or flu-like symptoms that go away but come back with fever and in a worse form than before. Children can be more highly susceptible to emergency situations if their immune systems have not fully formed or they simply do not complain and inform parents of all of the symptoms before they get to a severe stage.

Anyone with other health complications, such as cancer, heart disease, blood disorders, lung difficulties, or diabetes should pay special attention to their flu symptoms and contact a doctor at their onset. The flu can do special harm to those with other conditions, as well as to the elderly, toddlers, or pregnant women, and no risks should be taken when treating colds or the flu in these cases.

In addition to any prescribed medication, the treatment of the flu should be taken seriously. Reducing contact with others, especially at work or school, is beneficial to the resting and recovery process and will prevent the spread of the disease to others in the community. An abundance of fluids, soothing foods, warmth, and rest are the best ways to treat the symptoms of the flu, and noticeable improvements should be seen in a matter of days.

The government’s H1N1 Flu Self-Evaluation guide is designed to give individuals 18 and older information about what they can do to take care of themselves, prevent the spread of the flu to other members of their families, and identify the warning signs of more serious flu symptoms that require medical attention. The site poses a series of questions about whether you or another person 18 and older are experiencing fever or other flu symptoms or have any other health problems, and then issues recommendations based upon your answers. It might, for example, say that only bed rest and fluids are needed, or that you could be very sick and should call a doctor as soon as possible.

The Microsoft self-assessment tool is based on triage procedures being used at Emory University, which were based on what the CDC has determined are key risks factors for a bad flu outcome. The Microsoft tool also uses a series of questions about symptoms and underlying health to determine the need for medical attention. It is intended for use by people 12 years of age or older and also gives users the option of sharing the information gathered during the self-assessment, including gender, age, symptoms and zip codes, for public health, education and research purposes. “This can help health officials, researchers and others learn more about where symptoms may be occurring in the US,” the Web site states. The site also features links to other content, including H1N1 prevention tips.

A large insurer tested the Microsoft tool against more than 2,500 records of patient visits for flulike symptoms in Colorado, and only two people deemed low-risk were hospitalized within the following two weeks. “It reflects the best available science,” said Emory emergency medicine specialist Dr. Arthur Kellermann.

Both sites are part of an effort to keep people who aren’t sick from filling up already crowded doctor’s offices and emergency rooms. “If current estimates are correct, many emergency departments across the nation could be overwhelmed by two groups of patients—those who have H1N1 and those who believe they have H1N1,” said Angela Gardner, president of the American College of Emergency Physicians. “It is going to be essential that we use every tool and service at our disposal to contain this illness, and online H1N1 self-assessment tools, such as the one offered by Microsoft, can be helpful in providing people with ways to determine whether they should seek emergency care.”

The CDC also posts lists of warning signs to seek emergency flu care at http://www.flu.gov. “One way that we can help relieve some of the burden on the states and local providers this flu season is by helping people understand what the warning signs are when it comes to the flu,” said HHS Secretary Kathleen Sebelius. “In addition to the Self-Evaluation guide, we have also created some handy one-page information sheets called Flu Essentials that people can share with family, friends and neighbors.”