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Issue No. 003/09 |
20
November2009
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Main Topic:
H1N1 FLU
(SWINEFLU)
THE
2009 H1N1 PANDEMIC DISEASE
2009
H1N1 Flu (Swine Flu) and You
August 5, 2009 5:00 PM ET
On this Page
2009 H1N1 Flu
What
is 2009 H1N1 (swine flu)?
2009 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 States
in April 2009. This virus is spreading from person-to-person worldwide,
probably in much the same way that regular seasonal influenza viruses
spread. On June 11, 2009, the World Health Organization
(WHO) signaled that a pandemic of 2009 H1N1 flu was underway.
 Why is 2009 H1N1 virus sometimes called “swine
flu”?
This virus was originally referred to as “swine flu” because laboratory
testing showed that many of the genes in this new virus were very similar
to influenza viruses that normally occur in pigs (swine) in North
America. But further study has shown that this new virus is
very different from what normally circulates in North American pigs. It
has two genes from flu viruses that normally circulate in pigs in Europe
and Asia and bird (avian) genes and human genes. Scientists
call this a "quadruple reassortant" virus.
2009 H1N1 Flu in Humans
Are
there human infections with 2009 H1N1 virus in the U.S.?
Yes. Human infections with the new H1N1
virus are ongoing in the United
States. Most people who have become ill
with this new virus have recovered without requiring medical treatment.
CDC routinely works with states to collect, compile and analyze information
about influenza, and has done the same for the new H1N1 virus since the
beginning of the outbreak. This information is presented in a weekly report,
called FluView.
Is
2009 H1N1 virus contagious?
CDC has determined that 2009 H1N1 virus is contagious and is spreading
from human to human.
How
does 2009 H1N1 virus spread?
Spread of 2009 H1N1 virus is thought to occur in the same way that seasonal
flu spreads. Flu viruses are spread mainly from person to person through
coughing or sneezing by people with influenza. Sometimes people may become
infected by touching something – such as a surface or object – with flu
viruses on it and then touching their mouth or nose.
 What are the signs and symptoms of this virus
in people?
The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore
throat, runny or stuffy nose, body aches, headache, chills and fatigue.
A significant number of people who have been infected with this virus
also have reported diarrhea and vomiting. Severe illnesses and death has
occurred as a result of illness associated with this virus.
How
severe is illness associated with 2009 H1N1 flu virus?
Illness with the new H1N1 virus has ranged from mild to severe. While
most people who have been sick have recovered without needing medical
treatment, hospitalizations and deaths from infection with this virus
have occurred.
In
seasonal flu, certain people are at “high risk” of serious complications.
This includes people 65 years and older, children younger than five years
old, pregnant women, and people of any age with certain chronic medical
conditions. About 70 percent of people who have been hospitalized with
this 2009 H1N1 virus have had one or more medical conditions previously
recognized as placing people at “high risk” of serious seasonal flu-related
complications. This includes pregnancy, diabetes, heart disease, asthma
and kidney disease.
One
thing that appears to be different from seasonal influenza is that adults
older than 64 years do not yet appear to be at increased risk of 2009
H1N1-related complications thus far. CDC laboratory studies have shown
that no children and very few adults younger than 60 years old have existing
antibody to 2009 H1N1 flu virus; however, about one-third of adults older
than 60 may have antibodies against this virus. It is unknown how much,
if any, protection may be afforded against 2009 H1N1 flu by any existing
antibody.
How
does 2009 H1N1 flu compare to seasonal flu in terms of its severity and
infection rates?
With seasonal flu, we know that seasons vary in terms of timing, duration
and severity. Seasonal influenza can cause mild to severe illness, and
at times can lead to death. Each year, in the United States, on average 36,000 people
die from flu-related complications and more than 200,000 people are hospitalized
from flu-related causes. Of those hospitalized, 20,000 are children younger
than 5 years old. Over 90% of deaths and about 60 percent of hospitalization
occur in people older than 65.
When
the 2009 H1N1 outbreak was first detected in mid-April 2009, CDC began
working with states to collect, compile and analyze information regarding
the 2009 H1N1 flu outbreak, including the numbers of confirmed and probable
cases and the ages of these people. The information analyzed by CDC supports
the conclusion that 2009 H1N1 flu has caused greater disease burden in
people younger than 25 years of age than older people. At this time, there
are few cases and few deaths reported in people older than 64 years old,
which is unusual when compared with seasonal flu. However, pregnancy
and other previously recognized high risk medical conditions from seasonal
influenza appear to be associated with increased risk of complications
from this 2009 H1N1. These underlying conditions include asthma, diabetes,
suppressed immune systems, heart disease, kidney disease, neurocognitive and neuromuscular disorders and pregnancy.
How
long can an infected person spread this virus to others?
People infected with seasonal and 2009 H1N1 flu shed virus and may be
able to infect others from 1 day before getting sick to 5 to 7 days after.
This can be longer in some people, especially children and people with
weakened immune systems and in people infected with the new H1N1 virus.
Prevention & Treatment
What
can I do to protect myself from getting sick?
There is no vaccine available right now to protect against 2009 H1N1 virus.
However, a 2009 H1N1 vaccine is currently in production and may
be ready for the public in the fall. As always, a vaccine will be available
to protect against seasonal
influenza
There are everyday actions that can help prevent
the spread of germs that cause respiratory illnesses like influenza.
Take
these everyday steps to protect your health:
- Cover your nose and mouth with a tissue when
you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially
after you cough or sneeze. Alcohol-based
hand cleaners* are also effective.
- Avoid touching your eyes, nose or mouth. Germs
spread this way.
- Try to avoid close contact with sick people.
- If you are sick with flu-like illness, CDC recommends that
you stay home for at least 24 hours after your fever is gone except
to get medical care or for other necessities. (Your fever should be
gone without the use of a fever-reducing medicine.) Keep away from others
as much as possible to keep from making others sick.
Other
important actions that you can take are:
- Follow public health advice regarding school
closures, avoiding crowds and other social distancing measures.
- Be prepared in case you get sick and need to
stay home for a week or so; a supply of over-the-counter medicines,
alcohol-based
hand rubs,* tissues and other related items might could be useful
and help avoid the need to make trips out in public while you are sick
and contagious
 What is the best way to keep from spreading
the virus through coughing or sneezing?
If you are sick with flu-like illness, CDC recommends that you
stay home for at least 24 hours after your fever is gone except to
get medical care or for other necessities. (Your fever should be gone
without the use of a fever-reducing medicine.)
Keep away from others as much as possible. Cover your mouth and nose with
a tissue when coughing or sneezing. Put your used tissue in the waste
basket. Then, clean your hands, and do so every time you cough or sneeze.
If
I have a family member at home who is sick with 2009 H1N1 flu, should
I go to work?
Employees who are well but who have an ill family member at home with
2009 H1N1 flu can go to work as usual. These employees should monitor
their health every day, and take everyday precautions including washing
their hands often with soap and water, especially after they cough or
sneeze. Alcohol-based hand cleaners are also effective.* If they become
ill, they should notify their supervisor and stay home. Employees who
have an underlying medical condition or who are pregnant should call their
health care provider for advice, because they might need to receive influenza
antiviral drugs to prevent illness. For more information please see General Business and
Workplace Guidance for the Prevention of Novel Influenza A
(H1N1) Flu in Workers.
What
is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap
and water or clean with alcohol-based
hand cleaner*. CDC recommends that when you wash your hands -- with
soap and warm water -- that you wash for 15 to 20 seconds. When soap and
water are not available, alcohol-based disposable hand wipes or gel sanitizers
may be used. You can find them in most supermarkets and drugstores. If
using gel, rub your hands until the gel is dry. The gel doesn't need water
to work; the alcohol in it kills the germs on your hands.
What
should I do if I get sick?
If you live in areas where people have been identified with 2009 H1N1
flu and become ill with influenza-like symptoms, including fever, body
aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea,
you should stay home and avoid contact with other people. CDC recommends that
you stay home for at least 24 hours after your fever is gone except
to get medical care or for other necessities. (Your fever should be gone
without the use of a fever-reducing medicine.) Stay away from others as
much as possible to keep from making others sick.Staying
at home means that you should not leave your home except to seek medical
care. This means avoiding normal activities, including work, school, travel,
shopping, social events, and public gatherings.
If
you have severe illness or you are at high risk for flu complications,
contact your health care provider or seek medical care. Your health care
provider will determine whether flu testing or treatment is needed.
If
you become ill and experience any of the following warning signs, seek
emergency medical care.
In
children, emergency warning signs that need urgent medical attention include:
- Fast breathing or trouble breathing
- Bluish or gray skin color
- Not drinking enough fluids
- Severe or persistent vomiting
- Not waking up or not interacting
- Being so irritable that the child does not want
to be held
- Flu-like symptoms improve but then return with
fever and worse cough
In
adults, emergency warning signs that need urgent medical attention include:
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness
- Confusion
- Severe or persistent vomiting
- Flu-like symptoms improve but then return with
fever and worse cough
Are
there medicines to treat 2009 H1N1 infection?
Yes. CDC recommends the use of oseltamivir or
zanamivir for the treatment and/or prevention of infection
with 2009 H1N1 flu virus. Antiviral drugs are prescription medicines (pills,
liquid or an inhaled powder) that fight against the flu by keeping flu
viruses from reproducing in your body. If you get sick, antiviral drugs
can make your illness milder and make you feel better faster. They may
also prevent serious flu complications. During the current pandemic, the
priority use for influenza antiviral drugs
is to treat severe influenza illness (for example hospitalized patients)
and people who are sick who have a condition that places them at high
risk for serious flu-related complications.
What
is CDC’s recommendation regarding "swine flu parties"?
"Swine flu parties" are gatherings during which people have
close contact with a person who has 2009 H1N1 flu in order to become infected
with the virus. The intent of these parties is for a person to become
infected with what for many people has been a mild disease, in the hope
of having natural immunity 2009 H1N1 flu virus that might circulate later
and cause more severe disease.
CDC
does not recommend "swine flu parties" as a way to protect against
2009 H1N1 flu in the future. While the disease seen in the current 2009
H1N1 flu outbreak has been mild for many people, it has been severe and
even fatal for others. There is no way to predict with certainty what
the outcome will be for an individual or, equally important, for others
to whom the intentionally infected person may spread the virus.
CDC
recommends that people with 2009 H1N1 flu avoid contact with others as
much as possible. If you are sick with flu-like illness, CDC recommends that you
stay home for at least 24 hours after your fever is gone except to
get medical care or for other necessities. (Your fever should be gone
without the use of a fever-reducing medicine.) Stay away from others as
much as possible to keep from making others sick.
Contamination & Cleaning
 How long can influenza virus remain viable
on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces
and can infect a person for 2 to 8 hours after being deposited on the
surface.
What
kills influenza virus?
Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition,
several chemical germicides, including chlorine, hydrogen peroxide, detergents
(soap), iodophors (iodine-based antiseptics),
and alcohols are effective against human influenza viruses if used in
proper concentration for a sufficient length of time. For example, wipes
or gels with alcohol in them can be used to clean hands. The gels should
be rubbed into hands until they are dry.
*What if soap and water are not available and alcohol-based products are not
allowed in my facility?
Though the scientific evidence is not as extensive as that on hand washing
and alcohol-based sanitizers, other hand sanitizers that do not contain
alcohol may be useful for killing flu germs on hands.
What
surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated
with germs and then touches his or her eyes, nose, or mouth. Droplets
from a cough or sneeze of an infected person move through the air. Germs
can be spread when a person touches respiratory droplets from another
person on a surface like a desk, for example, and then touches their own
eyes, mouth or nose before washing their hands.
How
should waste disposal be handled to prevent the spread of influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues
and other disposable items used by an infected person be thrown in the
trash. Additionally, persons should wash their hands with soap and water
after touching used tissues and similar waste.
 What household cleaning should be done to
prevent the spread of influenza virus?
To prevent the spread of influenza virus it is important to keep surfaces
(especially bedside tables, surfaces in the bathroom, kitchen counters
and toys for children) clean by wiping them down with a household disinfectant
according to directions on the product label.
How
should linens, eating utensils and dishes of persons infected with influenza
virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do
not need to be cleaned separately, but importantly these items should
not be shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using household
laundry soap and tumbled dry on a hot setting. Individuals should avoid
“hugging” laundry prior to washing it to prevent contaminating themselves.
Individuals should wash their hands with soap and water or alcohol-based
hand rub immediately after handling dirty laundry.
Eating
utensils should be washed either in a dishwasher or by hand with water
and soap.
Exposures Not Thought to Spread 2009
H1N1 Flu
Can
I get infected with 2009 H1N1 virus from eating or preparing pork?
No. 2009 H1N1 viruses are not spread by food. You cannot get infected
with novel HIN1 virus from eating pork or pork products. Eating properly
handled and cooked pork products is safe.
Is
there a risk from drinking water?
Tap water that has been treated by conventional disinfection processes
does not likely pose a risk for transmission of influenza viruses. Current
drinking water treatment regulations provide a high degree of protection
from viruses. No research has been completed on the susceptibility of
2009 H1N1 flu virus to conventional drinking water treatment processes.
However, recent studies have demonstrated that free chlorine levels typically
used in drinking water treatment are adequate to inactivate highly pathogenic
H5N1 avian influenza. It is likely that other influenza viruses such as
2009 H1N1 would also be similarly inactivated by chlorination. To date,
there have been no documented human cases of influenza caused by exposure
to influenza-contaminated drinking water.
Can
2009 H1N1 flu virus be spread through water in swimming pools, spas, water
parks, interactive fountains, and other treated recreational water venues?
Influenza viruses infect the human upper respiratory tract. There has
never been a documented case of influenza virus infection associated with
water exposure. Recreational water that has been treated at CDC recommended
disinfectant levels does not likely pose a risk for transmission
of influenza viruses. No research has been completed on the susceptibility
of 2009 H1N1 influenza virus to chlorine and other disinfectants used
in swimming pools, spas, water parks, interactive fountains, and other
treated recreational venues. However, recent studies have demonstrated
that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm
for spas) are adequate to disinfect avian influenza A (H5N1) virus. It
is likely that other influenza viruses such as
2009 H1N1 virus would also be similarly disinfected by chlorine.
Can
2009 H1N1 influenza virus be spread at recreational water venues outside
of the water?
Yes,
recreational water venues are no different than any other group setting.
The spread of this 2009 H1N1 flu is thought to be happening in the same
way that seasonal flu spreads. Flu viruses are spread mainly from person
to person through coughing or sneezing of people with influenza. Sometimes
people may become infected by touching something with flu viruses on it
and then touching their mouth or nose.
Note:
Much of the information in this document is based on studies and past
experience with seasonal (human) influenza. CDC believes the information
applies to 2009 H1N1 (swine) viruses as well, but studies on this virus
are ongoing to learn more about its characteristics. This document will
be updated as new information becomes available.
| IOMS
Newsletter - 20 November 2009 |
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Issue
No. 003/09
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