Novel H1N1 Flu

What is novel H1N1 (swine flu)?

Novel H1N1 (referred to as swine flu early on) is a new influenza virus causing illness
in people. This new virus was first detected in people in the United tates in !pril "##$.
This virus is spreading fro% person&to&person worldwide' pro(a(ly in %uch the sa%e
way that regular seasonal influenza viruses spread. )n *une 11' "##$' the +orld Health
)rganization (+H)) signaled that a pande%ic of novel H1N1 flu was underway.
Why is novel H1N1 virus sometimes called swine
flu?
This virus was originally referred to as swine flu
(ecause la(oratory testing showed that %any of the
genes in this new virus were very si%ilar to influenza
viruses that nor%ally occur in pigs (swine) in North
!%erica. ,ut further study has shown that this new
virus is very different fro% what nor%ally circulates in
North !%erican pigs. -t has two genes fro% flu viruses
that nor%ally circulate in pigs in .urope and !sia and (ird (avian) genes and hu%an
genes. cientists call this a /0uadruple reassortant/ virus.
Novel H1N1 Flu in Humans
Are there human infections with novel H1N1 virus in the U!?
1es. Hu%an infections with the new H1N1 virus are ongoing in the United tates. 2ost
people who have (eco%e ill with this new virus have recovered without re0uiring
%edical treat%ent.
343 routinely wor5s with states to collect' co%pile and analyze infor%ation a(out
influenza' and has done the sa%e for the new H1N1 virus since the (eginning of the
out(rea5. This infor%ation is presented in a wee5ly report' called 6lu7iew.
"s novel H1N1 virus conta#ious?
343 has deter%ined that novel H1N1 virus is contagious and is spreading fro% hu%an to
hu%an.
How does novel H1N1 virus s$read?
pread of novel H1N1 virus is thought to occur in the sa%e way that seasonal flu spreads.
6lu viruses are spread %ainly fro% person to person through coughing or sneezing (y
people with influenza. o%eti%es people %ay (eco%e infected (y touching so%ething 8
such as a surface or o(9ect 8 with flu viruses on it and then touching their %outh or nose.
What are the si#ns and sym$toms of this virus in
$eo$le?
The sy%pto%s of novel H1N1 flu virus in people
include fever' cough' sore throat' runny or stuffy nose'
(ody aches' headache' chills and fatigue. ! significant
nu%(er of people who have (een infected with this virus
also have reported diarrhea and vo%iting. evere
illnesses and death has occurred as a result of illness
associated with this virus.
How severe is illness associated with novel H1N1 flu virus?
-llness with the new H1N1 virus has ranged fro% %ild to severe. +hile %ost people who
have (een sic5 have recovered without needing %edical treat%ent' hospitalizations and
deaths fro% infection with this virus have occurred.
-n seasonal flu' certain people are at high ris5 of serious co%plications. This includes
people :; years and older' children younger than five years old' pregnant wo%en' and
people of any age with certain chronic %edical conditions. !(out <# percent of people
who have (een hospitalized with this novel H1N1 virus have had one or %ore %edical
conditions previously recognized as placing people at high ris5 of serious seasonal flu&
related co%plications. This includes pregnancy' dia(etes' heart disease' asth%a and
5idney disease.
)ne thing that appears to (e different fro% seasonal influenza is that adults older than :=
years do not yet appear to (e at increased ris5 of novel H1N1&related co%plications thus
far. 343 la(oratory studies have shown that no children and very few adults younger
than :# years old have e>isting anti(ody to novel H1N1 flu virus? however' a(out one&
third of adults older than :# %ay have anti(odies against this virus. -t is un5nown how
%uch' if any' protection %ay (e afforded against novel H1N1 flu (y any e>isting
anti(ody.
How does novel H1N1 flu com$are to seasonal flu in terms of its severity and
infection rates?
+ith seasonal flu' we 5now that seasons vary in ter%s of ti%ing' duration and severity.
easonal influenza can cause %ild to severe illness' and at ti%es can lead to death. .ach
year' in the United tates' on average @:'### people die fro% flu&related co%plications
and %ore than "##'### people are hospitalized fro% flu&related causes. )f those
hospitalized' "#'### are children younger than ; years old. )ver $#A of deaths and a(out
:# percent of hospitalization occur in people older than :;.
+hen the novel H1N1 out(rea5 was first detected in %id&!pril "##$' 343 (egan
wor5ing with states to collect' co%pile and analyze infor%ation regarding the novel
H1N1 flu out(rea5' including the nu%(ers of confir%ed and pro(a(le cases and the ages
of these people. The infor%ation analyzed (y 343 supports the conclusion that novel
H1N1 flu has caused greater disease (urden in people younger than "; years of age than
older people. !t this ti%e' there are few cases and few deaths reported in people older
than := years old' which is unusual when co%pared with seasonal flu. However'
pregnancy and other previously recognized high ris5 %edical conditions fro% seasonal
influenza appear to (e associated with increased ris5 of co%plications fro% this novel
H1N1. These underlying conditions include asth%a' dia(etes' suppressed i%%une
syste%s' heart disease' 5idney disease' neurocognitive and neuro%uscular disorders and
pregnancy.
How lon# can an infected $erson s$read this virus to others?
Beople infected with seasonal and novel H1N1 flu shed virus and %ay (e a(le to infect
others fro% 1 day (efore getting sic5 to ; to < days after. This can (e longer in so%e
people' especially children and people with wea5ened i%%une syste%s and in people
infected with the new H1N1 virus.
%revention & 'reatment
What can " do to $rotect myself from #ettin# sic(?
There is no vaccine availa(le right now to protect against novel H1N1 virus. However' a
novel H1N1 vaccine is currently in production and %ay (e ready for the pu(lic in the fall.
!s always' a vaccine will (e availa(le to protect against seasonal influenza
There are everyday actions that can help prevent the spread of ger%s that cause
respiratory illnesses li5e influenza.
'a(e these everyday ste$s to $rotect your health)
3over your nose and %outh with a tissue when you cough or sneeze. Throw the
tissue in the trash after you use it.
+ash your hands often with soap and water' especially after you cough or sneeze.
!lcohol&(ased hand cleanersC are also effective.
!void touching your eyes' nose or %outh. Der%s spread this way.
Try to avoid close contact with sic5 people.
-f you are sic5 with flu&li5e illness' 343 reco%%ends that you stay ho%e for at
least "= hours after your fever is gone e>cept to get %edical care or for other
necessities. (1our fever should (e gone without the use of a fever&reducing
%edicine.) Eeep away fro% others as %uch as possi(le to 5eep fro% %a5ing
others sic5.
*ther im$ortant actions that you can ta(e are)
6ollow pu(lic health advice regarding school closures' avoiding crowds and other
social distancing %easures.
,e prepared in case you get sic5 and need to stay ho%e for a wee5 or so? a supply
of over&the&counter %edicines' alcohol&(ased hand ru(s'C tissues and other related
ite%s %ight could (e useful and help avoid the need to %a5e trips out in pu(lic
while you are sic5 and contagious
What is the +est way to (ee$ from s$readin# the
virus throu#h cou#hin# or snee,in#?
-f you are sic5 with flu&li5e illness' 343 reco%%ends
that you stay ho%e for at least "= hours after your fever
is gone e>cept to get %edical care or for other
necessities. (1our fever should (e gone without the use
of a fever&reducing %edicine.)
Eeep away fro% others as %uch as possi(le. 3over your
%outh and nose with a tissue when coughing or
sneezing. But your used tissue in the waste (as5et. Then' clean your hands' and do so
every ti%e you cough or sneeze.
"f " have a family mem+er at home who is sic( with novel H1N1 flu- should " #o to
wor(?
.%ployees who are well (ut who have an ill fa%ily %e%(er at ho%e with novel H1N1
flu can go to wor5 as usual. These e%ployees should %onitor their health every day' and
ta5e everyday precautions including washing their hands often with soap and water'
especially after they cough or sneeze. !lcohol&(ased hand cleaners are also effective.C -f
they (eco%e ill' they should notify their supervisor and stay ho%e. .%ployees who have
an underlying %edical condition or who are pregnant should call their health care
provider for advice' (ecause they %ight need to receive influenza antiviral drugs to
prevent illness. 6or %ore infor%ation please see Deneral ,usiness and +or5place
Duidance for the Brevention of Novel -nfluenza ! (H1N1) 6lu in +or5ers.
What is the +est techni.ue for washin# my hands to avoid #ettin# the flu?
+ashing your hands often will help protect you fro% ger%s. +ash with soap and water or
clean with alcohol&(ased hand cleanerC. 343 reco%%ends that when you wash your
hands && with soap and war% water && that you wash for 1; to "# seconds. +hen soap and
water are not availa(le' alcohol&(ased disposa(le hand wipes or gel sanitizers %ay (e
used. 1ou can find the% in %ost super%ar5ets and drugstores. -f using gel' ru( your
hands until the gel is dry. The gel doesnFt need water to wor5? the alcohol in it 5ills the
ger%s on your hands.
What should " do if " #et sic(?
-f you live in areas where people have (een identified with novel H1N1 flu and (eco%e
ill with influenza&li5e sy%pto%s' including fever' (ody aches' runny or stuffy nose' sore
throat' nausea' or vo%iting or diarrhea' you should stay ho%e and avoid contact with
other people. 343 reco%%ends that you stay ho%e for at least "= hours after your fever
is gone e>cept to get %edical care or for other necessities. (1our fever should (e gone
without the use of a fever&reducing %edicine.) tay away fro% others as %uch as possi(le
to 5eep fro% %a5ing others sic5.taying at ho%e %eans that you should not leave your
ho%e e>cept to see5 %edical care. This %eans avoiding nor%al activities' including
wor5' school' travel' shopping' social events' and pu(lic gatherings.
-f you have severe illness or you are at high ris5 for flu co%plications' contact your
health care provider or see5 %edical care. 1our health care provider will deter%ine
whether flu testing or treat%ent is needed.
-f you (eco%e ill and e>perience any of the following warning signs' see5 e%ergency
%edical care.
"n children- emer#ency warnin# si#ns that need ur#ent medical attention include)
6ast (reathing or trou(le (reathing
,luish or gray s5in color
Not drin5ing enough fluids
evere or persistent vo%iting
Not wa5ing up or not interacting
,eing so irrita(le that the child does not want to (e held
6lu&li5e sy%pto%s i%prove (ut then return with fever and worse cough
"n adults- emer#ency warnin# si#ns that need ur#ent medical attention include)
4ifficulty (reathing or shortness of (reath
Bain or pressure in the chest or a(do%en
udden dizziness
3onfusion
evere or persistent vo%iting
6lu&li5e sy%pto%s i%prove (ut then return with fever and worse cough
Are there medicines to treat novel H1N1 infection?
1es. 343 reco%%ends the use of oselta%ivir or zana%ivir for the treat%ent andGor
prevention of infection with novel H1N1 flu virus. !ntiviral drugs are prescription
%edicines (pills' li0uid or an inhaled powder) that fight against the flu (y 5eeping flu
viruses fro% reproducing in your (ody. -f you get sic5' antiviral drugs can %a5e your
illness %ilder and %a5e you feel (etter faster. They %ay also prevent serious flu
co%plications. 4uring the current pande%ic' the priority use for influenza antiviral drugs
during is to treat severe influenza illness (for e>a%ple hospitalized patients) and people
who are sic5 who have a condition that places the% at high ris5 for serious flu&related
co%plications.
What is /0/1s recommendation re#ardin# 2swine flu $arties2?
/wine flu parties/ are gatherings during which people have close contact with a person
who has novel H1N1 flu in order to (eco%e infected with the virus. The intent of these
parties is for a person to (eco%e infected with what for %any people has (een a %ild
disease' in the hope of having natural i%%unity novel H1N1 flu virus that %ight circulate
later and cause %ore severe disease.
343 does not reco%%end /swine flu parties/ as a way to protect against novel H1N1 flu
in the future. +hile the disease seen in the current novel H1N1 flu out(rea5 has (een
%ild for %any people' it has (een severe and even fatal for others. There is no way to
predict with certainty what the outco%e will (e for an individual or' e0ually i%portant'
for others to who% the intentionally infected person %ay spread the virus.
343 reco%%ends that people with novel H1N1 flu avoid contact with others as %uch as
possi(le. -f you are sic5 with flu&li5e illness' 343 reco%%ends that you stay ho%e for at
least "= hours after your fever is gone e>cept to get %edical care or for other necessities.
(1our fever should (e gone without the use of a fever&reducing %edicine.) tay away
fro% others as %uch as possi(le to 5eep fro% %a5ing others sic5.

/ontamination & /leanin#
How lon# can influen,a virus remain via+le on
o+3ects (such as +oo(s and door(no+s)?
tudies have shown that influenza virus can survive on
environ%ental surfaces and can infect a person for " to H
hours after (eing deposited on the surface.
What (ills influen,a virus?
-nfluenza virus is destroyed (y heat (1:<&"1"I6 J<;&
1##I3K). -n addition' several che%ical ger%icides'
including chlorine' hydrogen pero>ide' detergents (soap)' iodophors (iodine&(ased
antiseptics)' and alcohols are effective against hu%an influenza viruses if used in proper
concentration for a sufficient length of ti%e. 6or e>a%ple' wipes or gels with alcohol in
the% can (e used to clean hands. The gels should (e ru((ed into hands until they are dry.
4What if soa$ and water are not availa+le and alcohol5+ased $roducts are not
allowed in my facility?
Though the scientific evidence is not as e>tensive as that on hand washing and alcohol&
(ased sanitizers' other hand sanitizers that do not contain alcohol %ay (e useful for
5illing flu ger%s on hands.
What surfaces are most li(ely to +e sources of contamination?
Der%s can (e spread when a person touches so%ething that is conta%inated with ger%s
and then touches his or her eyes' nose' or %outh. 4roplets fro% a cough or sneeze of an
infected person %ove through the air. Der%s can (e spread when a person touches
respiratory droplets fro% another person on a surface li5e a des5' for e>a%ple' and then
touches their own eyes' %outh or nose (efore washing their hands.
How should waste dis$osal +e handled to $revent the s$read of influen,a virus?
To prevent the spread of influenza virus' it is reco%%ended that tissues and other
disposa(le ite%s used (y an infected person (e thrown in the trash. !dditionally' persons
should wash their hands with soap and water after touching used tissues and si%ilar
waste.
What household cleanin# should +e done to $revent
the s$read of influen,a virus?
To prevent the spread of influenza virus it is i%portant to
5eep surfaces (especially (edside ta(les' surfaces in the
(athroo%' 5itchen counters and toys for children) clean
(y wiping the% down with a household disinfectant
according to directions on the product la(el.
How should linens- eatin# utensils and dishes of
$ersons infected with influen,a virus +e handled?
Linens' eating utensils' and dishes (elonging to those who are sic5 do not need to (e
cleaned separately' (ut i%portantly these ite%s should not (e shared without washing
thoroughly first.
Linens (such as (ed sheets and towels) should (e washed (y using household laundry
soap and tu%(led dry on a hot setting. -ndividuals should avoid hugging laundry prior
to washing it to prevent conta%inating the%selves. -ndividuals should wash their hands
with soap and water or alcohol&(ased hand ru( i%%ediately after handling dirty laundry.
.ating utensils should (e washed either in a dishwasher or (y hand with water and soap.
67$osures Not 'hou#ht to !$read Novel H1N1 Flu
/an " #et infected with novel H1N1 virus from eatin# or $re$arin# $or(?
No. Novel H1N1 viruses are not spread (y food. 1ou cannot get infected with novel
H-N1 virus fro% eating por5 or por5 products. .ating properly handled and coo5ed por5
products is safe.
"s there a ris( from drin(in# water?
Tap water that has (een treated (y conventional disinfection processes does not li5ely
pose a ris5 for trans%ission of influenza viruses. 3urrent drin5ing water treat%ent
regulations provide a high degree of protection fro% viruses. No research has (een
co%pleted on the suscepti(ility of novel H1N1 flu virus to conventional drin5ing water
treat%ent processes. However' recent studies have de%onstrated that free chlorine levels
typically used in drin5ing water treat%ent are ade0uate to inactivate highly pathogenic
H;N1 avian influenza. -t is li5ely that other influenza viruses such as novel H1N1 would
also (e si%ilarly inactivated (y chlorination. To date' there have (een no docu%ented
hu%an cases of influenza caused (y e>posure to influenza&conta%inated drin5ing water.
/an novel H1N1 flu virus +e s$read throu#h water in swimmin# $ools- s$as- water
$ar(s- interactive fountains- and other treated recreational water venues?
-nfluenza viruses infect the hu%an upper respiratory tract. There has never (een a
docu%ented case of influenza virus infection associated with water e>posure.
Mecreational water that has (een treated at 343 reco%%ended disinfectant levels does
not li5ely pose a ris5 for trans%ission of influenza viruses. No research has (een
co%pleted on the suscepti(ility of novel H1N1 influenza virus to chlorine and other
disinfectants used in swi%%ing pools' spas' water par5s' interactive fountains' and other
treated recreational venues. However' recent studies have de%onstrated that free chlorine
levels reco%%ended (y 343 (18@ parts per %illion Jpp% or %gGLK for pools and "8;
pp% for spas) are ade0uate to disinfect avian influenza ! (H;N1) virus. -t is li5ely that
other influenza viruses such as novel H1N1 virus would also (e si%ilarly disinfected (y
chlorine.
/an novel H1N1 influen,a virus +e s$read at recreational water venues outside of
the water?
1es' recreational water venues are no different than any other group setting. The spread
of this novel H1N1 flu is thought to (e happening in the sa%e way that seasonal flu
spreads. 6lu viruses are spread %ainly fro% person to person through coughing or
sneezing of people with influenza. o%eti%es people %ay (eco%e infected (y touching
so%ething with flu viruses on it and then touching their %outh or nose.