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2009 Novel Influenza A (H1N1) Frequently Asked Questions

General information

What are the signs and symptoms of H1N1 influenza?
Symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Diarrhea and vomiting may also be experienced. Severe illnesses and death has occurred as a result of illness associated with this virus.

 

How is H1N1 influenza spread?

The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands. Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick.

 

How severe is illness associated with 2009 H1N1 flu virus?
Illness has ranged from mild to severe. While most people have recovered without needing medical treatment, hospitalizations and deaths from infection with this virus have occurred. About 70 percent of people who have been hospitalized with the 2009 H1N1 virus have had one or more previous medical conditions (pregnancy, diabetes, heart disease, asthma and kidney disease).

 

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.

 

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.

 

Can I get infected with 2009 H1N1 virus from eating or preparing pork?
No. You cannot get infected with novel HIN1 virus from eating pork or pork products. Eating properly handled and cooked pork products is safe.

 

Can you get flu from drinking water or swimming pools?

Chlorinated tap water and swimming pool water does not put you at risk for flu.  To date, we don’t know of anyone who has acquired flu from drinking water or from a swimming pool.

 

H1N1 vaccine

How many doses of the H1N1 vaccine will I need?

Healthy adults and children 10 and older will need only one dose of vaccine. Those age 9 and under will need two doses 21-28 days apart. It’s also fine to get the seasonal flu shot and the H1N1 shot at the same time.  It is true that if you get the nasal spray form of the vaccine, you need to wait three to four weeks before getting another nasal spray vaccine.

 

Can I get the seasonal shot and the H1N1 shot at the same time?

It is fine to get the seasonal flu shot and the H1N1 shot at the same time.  It is true that if you get the nasal spray form of the vaccine, you need to wait three to four weeks before getting another nasal spray vaccine.

 

Will the seasonal flu vaccine also protect me against H1N1?

The seasonal flu vaccine is not expected to protect against the H1N1 flu.

 

Will I be able to get the H1N1 vaccine if I can’t afford it?

The federal government has purchased the H1N1 vaccine and is providing it to the states free of charge.  This is different in many places from the seasonal flu vaccine. Public vaccination clinics (sponsored by local health departments at schools or other places) will offer vaccine at no charge.  Some private providers may charge a small fee to administer the vaccine, but cost should not be a barrier to getting immunized.  Many, many people and businesses have stepped up to the public health challenge we all face and are working together for the overall public good to make this vaccine free – or at least affordable – for all those who want it.

 

Is the H1N1 vaccine safe?

Clinical trials conducted by the National Institutes of Health and the vaccine manufacturers have shown that the new H1N1 vaccine is both safe and effective.  The FDA has licensed it.  There have been no safety shortcuts. It is produced exactly the same way the seasonal flu vaccine is produced every year.  It is simply a new virus strain.  In fact, had H1N1 struck this country earlier than this spring, the H1N1 strain probably would have been included as part of this year’s seasonal flu shot. Millions of Americans get the seasonal flu vaccine each year without any problems. Still, understanding that some Americans have concerns about “new” vaccines, the National Institutes of Health and the vaccine manufacturers have conducted more rigorous tests on the H1N1 vaccine than they do on other flu vaccines, and there have been no red flags from these clinical trials. Also, CDC has stepped up surveillance efforts to track the H1N1 vaccine and any possible adverse events.  Since it is so closely related to the seasonal flu vaccine, we do not expect to see serious side effects.  But we are taking all the necessary steps to promote and monitor safety. Our top doctors and scientists believe the risk of the flu, especially for pregnant women, children, and people with underlying health conditions, is higher than any risk that might come from the H1N1 vaccine.

 

Is it safe for children and pregnant women to get a vaccine that contains thimerosal?

It is safe for children and pregnant women to receive a flu vaccine that contains thimerosal. Thimerosal is a very effective preservative that has been used since the 1930s to prevent contamination in some multi-dose vials of vaccines.  There is no convincing evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site. The 2009-H1N1 influenza vaccines that FDA has licensed will be manufactured in several formulations, including pre-filled, single-dose syringes and nasal sprayers along with multi-dose vials.  Only multi-dose vials of seasonal influenza vaccine will contain thimerosal to prevent potential contamination after the vial is opened.  Single-dose units, however, will not require the use of thimerosal as a preservative.  You may request this form of the vaccine if it is available.  In addition, the nasal spray version of the 2009 H1N1 vaccine is produced in single-units and will not contain thimerosal.

 

Prevention

What can I do to protect myself from getting sick?

There are other everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:

  • Get a Novel Influenza A vaccination when it is available.

  • 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 for 24 hours without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.

If I have a family member at home who is sick with 2009 H1N1 flu, should I go to work or school?
Employees or students who are well but who have an ill family member at home with 2009 H1N1 flu can go to work or school as usual. These individuals 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. If they become ill, they should stay home.

 

Will a surgical mask protect me from getting H1N1?

Wearing a surgical mask does not protect you from the H1N1 virus. The purpose of a surgical mask is to protect other people from your germs. If you have access to surgical masks, the best thing to do is to ask people with flu-like symptoms to wear a surgical mask when they need to be in close quarters with other people. The mask will absorb their droplets when they cough or sneeze.

 

Testing for the H1N1 virus

  • Testing for Novel Influenza A virus is limited to:

  • Severely hospitalized patients

  • Severely ill pregnant women

  • Deaths associated with Influenza-Like-Illness

  • Outbreaks in congregate living settings (nursing homes, etc.)

 

Are there medicines to treat H1N1 infection?

Yes. Antiviral drugs are prescription medicines 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. The antiviral drugs oseltamivir (trade name Tamiflu ®) and zanamivir (Relenza ®) can be given to those who are severely ill. These medications must be prescribed by a health care professional and are reserved for:

  • People at greatest risk for complications from influenza (people with chronic illness, neuromuscular diseases, compromised airways)

  • Severely ill pregnant women

  • Those with a high likelihood of exposure to Novel Influenza A who are at high risk for complications if they become ill

What should I do if I get sick?

If you or a member of your family becomes 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, including avoiding travel and not going to work or school, 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 fever-reducing medicine.)  If you leave the house to seek medical care, wear a facemask, if available and tolerable, and cover your coughs and sneezes with a tissue. If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek 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

 

Taking care of a sick person in your home

The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

People with novel H1N1 flu who are cared for at home should:

  • check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema

  • keep away from others as much as possible. Do not go to work or school while ill

  • stay home for at least 24 hours after fever is gone, except to seek medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine.)

  • get plenty of rest

  • drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants)

  • cover coughs and sneezes. Clean hands with soap and water or an alcohol-based hand rub often and especially after using tissues and after coughing or sneezing into hands

  • wear a facemask – if available and tolerable – when sharing common spaces with other household members to help prevent spreading the virus to others. This is especially important if other household members are at high risk for complications from influenza. 

  • be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention.

 

When providing care to a household member who is sick with influenza, the most important ways to protect yourself and others who are not sick are to:

  • keep the sick person away from other people as much as possible (see “placement of the sick person”) especially others who are at high risk for complications from influenza

  • remind the sick person to cover their coughs, and clean their hands with soap and water or an alcohol-based hand rub often, especially after coughing and/or sneezing

  • have everyone in the household clean their hands often, using soap and water or an alcohol-based hand rub. Children may need reminders or help keeping their hands clean

  • ask your health care provider if household contacts of the sick person—particularly those contacts who may be pregnant or have chronic health conditions—should take antiviral medications such as oseltamivir (Tamiflu®) or zanamivir (Relenza®) to prevent the flu

 

If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable.  Infants should not be cared for by sick family members. 

 

Placement of the sick person

  • Keep the sick person in a room separate from the common areas of the house. (For example, a spare bedroom with its own bathroom, if that’s possible.) Keep the sickroom door closed.

  • Unless necessary for medical care or other necessities, people who are sick with an influenza-like-illness should stay home and keep away from others as much as possible, including avoiding travel, for at least 24 hours after fever is gone except to get medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine). Children, especially younger children, might potentially be contagious for longer periods. 

  • If persons with the flu need to leave the home (for example, for medical care), they should wear a facemask, if available and tolerable and cover their nose and mouth when coughing or sneezing

  • Have the sick person wear a facemask – if available and tolerable – if they need to be in a common area of the house near other persons.

  • If possible, sick persons should use a separate bathroom. This bathroom should be cleaned daily with household disinfectant (see below).

 

If you are the caregiver

  • Avoid being face-to-face with the sick person.

  • When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.

  • Clean your hands with soap and water or use an alcohol-based hand rub after you touch the sick person or handle used tissues, or laundry.

  • Talk to your health care provider about taking antiviral medication to prevent the caregiver from getting the flu.

  • If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. Designate a person who is not at high risk of flu associated complications as the primary caretaker of household members who are sick with influenza. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable. For more information, see the Interim Recommendations for Facemask and Respirator Use

 

Household Cleaning

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. Remember to:

  • Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.

  • Keep surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

  • 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.

  • Wash bed sheets and towels by using household laundry soap and tumble dry on a hot setting. Avoid “hugging” laundry prior to washing it to prevent contaminating yourself. Clean your hands with soap and water or alcohol-based hand rub right after handling dirty laundry.

  • Eating utensils should be washed either in a dishwasher or by hand with water and soap.