FAQ ON SWINE FLU (H1N1)

The H1N1 flu currently affecting humans is a new influenza virus. This virus is also being called H1N1 Influenza A H1N1 or H1N1-Origin Influenza. It is usually a respiratory disease of pigs. People do not normally get H1N1 flu, but human infections can happen. We are now seeing it transmitted from person to person and causing a respiratory illness that is very similar to regular seasonal influenza.

The symptoms of H1N1 flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, achiness, lack of energy, lack of appetite and coughing. Some people with H1N1 flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea.

Since the symptoms for H1N1 flu are similar to the symptoms for seasonal flu, the only way to know for sure that you have H1N1 flu is for your doctor to take a swab from you and send the sample to a laboratory for confirmation. However, your case may be presumed to be H1N1 flu if: 1. You have the symptoms listed for H1N1 Flu; AND 2. have had close contact within the last seven (7) days with a person who has a laboratory confirmed case of H1N1 Flu; OR 3. have traveled with the last seven (7) days to a community either within the United States or internationally where there are one or more laboratory confirmed cases of H1N1 Flu; OR 4. Reside in a community where there are one or more laboratory confirmed H1N1 Flu cases.

The severity of cases in the current H1N1 flu outbreak has varied widely. In Mexico, there have been deaths and other severe cases. The virus itself could change, either becoming more or less dangerous. Scientists are watching closely to see how severe the new H1N1 flu virus will be—but health experts warn that it can be hard to predict how flu viruses can change.

Public Health recommends that you use the same precautions to prevent H1N1 flu as you would for seasonal flu: • Wash your hands frequently or use an alcohol hand rub; • Don’t touch your hands, mouth and eyes because that’s how viruses get into your body; • Stay about six feet away from someone who has a respiratory infection when possible; and • Practice a healthy lifestyle—get enough sleep and eat healthy

Public Health recommends that you use the same precautions to prevent others from getting H1N1 flu as you would for seasonal flu: • Cover your cough, either with a tissue or cough into your sleeve; • Sneeze into a tissue or your sleeve; and • Stay home from work or school if you are sick.

Call a health care provider if you cannot take care for yourself or a loved one at home, or if you or a family member has a high fever with shaking chills, coughing that produces thick mucous, shortness of breath or trouble breathing or a worsening of an existing medical condition.

The new H1N1 flu virus apparently spreads just like regular flu. You could pick up germs directly from an infected person, or by touching an object they recently touched, and then touching your eyes, mouth, or nose, putting germs into your body. That’s why you should make washing your hands a habit, even when you’re not ill. Infected people can start spreading flu germs up to a day before symptoms start, and for up to seven days after getting sick, according to the Centers For Disease Control and Prevention. The H1N1 flu virus can become airborne if you cough or sneeze without covering your nose and mouth, sending germs into the air.

Yes, you could still catch H1N1 flu or Influenza A H1N1. It is a new virus so the current vaccine does not protect against it.

Yes, you could still catch H1N1 flu or Influenza A H1N1. It is a new virus that no one has immunity for.

No. But, if you are sick with the flu, whether it is the seasonal flu, or is suspected as the H1N1 Flu, you should stay at home to prevent exposing others to your illness. Public Health officials and your doctor may ask you to stay at home until your symptoms have disappeared, for at least 24 hours. Your family members who have been exposed to you should avoid contact with others.

Every year the seasonal flu kills people, usually those who are most vulnerable such as young children, the elderly or those with medical conditions. According to the World Health Organization and the Centers for Disease Control and Prevention, the virus called the H1N1 Flu currently has a very low death rate of less than 0.1 percent in the United States. In other countries, this rate may be higher due to many factors (including access to medical care, how early a person is identified with illness, etc)

No. H1N1 influenza viruses are not transmitted by food.

The high risk groups include: pregnant women, people with underlying medical conditions (most notably chronic lung disease – including asthma), cardiovascular disease, cancer, diabetes, and those with weak immune systems. The WHO reports that some preliminary studies suggest that obesity, and especially extreme obesity, may also be a risk factor for more severe disease.

Hundreds of thousands of people die every year from seasonal flu epidemics, and the new influenza A(H1N1) virus will be no different. Most cases of death generally occur as a result of complications or an opportunistic (secondary) infection, like pneumonia. There are certain factors that put some groups at increased risk of severe or fatal illness.

The incubation period between infection and appearance of symptoms is not kown with total certainty at this stage, but it is assumed to be between two and five days.

People are most infectious from one day before they develop symptoms to up to seven days after they get sick, although they continue to shed the virus (for example, in coughs and sneezes) for up to five days (seven days in children). People become less infectious as their symptoms subside, and once their symptoms are gone they are no longer considered infectious to others. Children, especially younger children, might potentially be contagious for longer periods. It is therefore important for people to stay at home for at least seven days when they have symptoms to reduce spread to other people.

Contact your doctor or healthcare provider immediately if your child has any of the following symptoms: • tiredness • headache • runny nose and sneezing • sore throat • shortness of breath • loss of appetite • vomiting and diarrhoea • aching muscles, limb and joint pain • temperature of 38°C or above • feverish, feels hot or is having convulsions (seizures)

Adults should seek urgent medical attention if they have:

•Difficulty breathing or shortness of breath

•Pain or pressure in the chest or abdomen

•Sudden dizziness

•Confusion

•Severe or persistent vomiting

•Flu-like symptoms that improve, but then come back with worsening fever or cough

A. Yes. The H1N1 vaccine became available in early October, 2009. It is expected that by the end of October, 40 million doses will be available. The federal government has purchased and will distribute about 250 million doses in total.

A. The H1N1 vaccine is available as a shot or as a nasal spray. The injection consists of dead viral cells, while the spray contains living but weakened cells, called an “attenuated live virus.” As a result, the spray is more effective at building immunity but may be more dangerous for some patients. Therefore, it is only recommended for people between 2 and 49 years of age, who are not pregnant. All others should get the shot.

A. Everyone can and should seek the vaccination if possible. Although specific distribution decisions are made at the local level, the CDC recommends priority be given to those in the following high-risk groups:

• Pregnant women

• People who live with or care for children younger than 6 months of age

• Healthcare and emergency medical services personnel

• Persons between the ages of 6 months and 24 years

• People 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems

Once demand in those groups has been satisfied, the next highest priority group is healthy adults between 25 and 64.

A. People ages 10 and older will need only one dose of the vaccine. Children between 6 months and 9 years of age will need two doses. The second dose should be administered about four weeks after the first. Children younger than 6 months should not be vaccinated.

A. It should take about seven or eight days for your body to be immunized. For children, who need two doses, it will take until a week after the second dose – approximately five weeks from the first.

A. Yes, with one proviso. Pregnant women should only get the injection, and not the nasal spray.

Q. Can breastfeeding mothers get a swine flu shot?

A. Yes. In fact, it may even help pass the antibodies on to her baby.

Q. I’ve heard that the swine flu vaccine contains mercury. Is that true?

A. Some forms of the vaccine contain a mercury-based preservative. Although it has not been shown to be harmful to pregnant women or children, there is a mercury-free alternative available. Ask your doctor.

Q. Does the H1N1 vaccine also protect against the seasonal flu?

A. No. People should also still receive their usual annual flu shot, particularly those in high-risk groups: the elderly, the very young, and those with underlying health conditions. In fact, based on reported cases so far, young kids are more susceptible to the seasonal flu than to swine flu, so it’s important to stay up to date on vaccinations.

Q. Can I be vaccinated for the H1N1 and seasonal flu at the same time?

A. It depends what type of vaccine you take. Generally, the shots can be administered at the same time. However, nasal spray doses should be administered at least two weeks apart, so that your immune system has adequate time to develop antibodies for each strain of the virus. Ask your doctor for more specific guidelines that take into account your family’s ages and health conditions.

Q. Are there any side effects to the vaccine?

A. For the most part, you can expect similar side effects to those from the seasonal flu vaccine: soreness at the site of the injection, headache, muscle aches, nausea, or fever. Most side effects will abate within one to two days. If you have severe allergies of any kind, especially egg allergies, inform your doctor before getting the shot.

Q. How do I know this vaccine is safe? Wasn’t it rushed to market?

A. The H1N1 vaccine was developed using the same processes that drug companies use to make the seasonal flu vaccine every year, and in a comparable timeframe. The New York Times quotes CDC director Dr. Thomas R. Frieden as saying, “We have cut no corners. This flu vaccine is made as flu vaccine is made each year, by the same companies, in the same production facilities with the same procedures, with the same safety safeguards.”

Q. Should I skip a vaccination if I’ve already had the swine flu this year?

A. Only if you have laboratory proof that you did, indeed, have the H1N1 virus. Otherwise there’s no way to be sure, and you should get vaccinated. Additionally, if you have had the swine flu already this year, it’s still a good idea to get protected against the seasonal flu. Immunity to one does not protect against the other.

Q. What else can I do to avoid catching the H1N1 virus, or helping it spread?

A. Use common-sense precautions. Avoid coughing or sneezing into your hands – do so into your arm, instead. Wash your hands often, especially after coughing and sneezing (soap and water are preferable, but alcohol-based hand sanitizers are also acceptable). If you do get sick, stay home from work or school until you’ve recovered.

Is it safe to eat pork meat and pork products?

Yes. Swine influenza has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. The swine influenza virus is killed by cooking temperatures of 160 degrees Farenheit or 70 degrees Celcius, corresponding to the general guidance for the preparation of pork and other meat.

Which countries have been affected by outbreaks in pigs?

Swine influenza is not notifiable to international animal health authorities (OIE, www.oie.int), therefore its international distribution in animals is not well known. The disease is considered endemic in the United States. Outbreaks in pigs are also known to have occurred in North America, South America, Europe (including Britain, Sweden, and Italy), Africa (Kenya), and in parts of eastern Asia including China and Japan.

What drugs are available for treatment?

Antiviral drugs for seasonal influenza are available in some countries and effectively prevent and treat the illness. There are two classes of such medicines, 1) adamantanes (amantadine and remantadine), and 2) inhibitors of influenza neuraminidase (oseltamivir and zanamivir).

What can I do to protect myself from catching influenza A(H1N1)?

The main route of transmission of the new influenza A(H1N1) virus seems to be similar to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing. You can prevent getting infected by avoiding close contact with people who show influenza-like symptoms (trying to maintain a distance of about 1 metre if possible) and taking the following measures:

• avoid touching your mouth and nose;

• clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);

• avoid close contact with people who might be ill;

• reduce the time spent in crowded settings if possible;

• improve airflow in your living space by opening windows;

• practise good health habits including adequate sleep, eating nutritious food, and keeping physically active.