H1N1 Frequently Asked Questions

Influenza (also known as the flu) is a contagious respiratory illness caused by flu viruses. Seasonal flu and H1N1 flu are both influenza viruses that can cause mild to severe illness. Influenza usually comes on suddenly and typically includes fever and/or chills, cough or sore throat. Other symptoms may include headache, extreme tiredness, runny or stuffy nose, or muscle aches. Nausea, vomiting, and diarrhea are other flu symptoms and are more common in children than adults.

H1N1 is a new (novel) type of influenza virus that was first detected in the United States in April 2009. It was originally called "swine flu" because tests showed some of the genes in the virus were similar to flu viruses that can occur in pigs.

Influenza is and has always been a serious disease. On average, each year in the U.S. there are an estimated 36,000 deaths due to influenza related causes. Because H1N1 is a new influenza virus, people will not have any immunity against this strain of influenza. 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.

Since the H1N1 virus appears to cause similar symptoms as regular seasonal influenza, there is no way to know just from a person's signs and symptoms which strain they have. Most patients with clinical illness consistent with uncomplicated influenza do not require diagnostic influenza testing. Current data shows that most recent influenza strains that are circulating are novel H1N1 influenza.

The symptoms of 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. Most people who have become ill with the H1N1 influenza virus have recovered without requiring medical treatment. Children and adults who are ill and at high risk for flu complications and people with more severe flu symptoms should consult their healthcare provider.

Because children and young adults are more likely to gather in groups, at schools and colleges, they are more vulnerable to catching all types of flu. The disease does not appear to be more severe than seasonal flu but will affect a disproportionate number of young people who will probably get it with some more likely to have complications.

Like any other influenza virus, H1N1 influenza can spread easily from person-to-person. Person-to-person transmission mainly occurs when an infected person coughs or sneezes and another person is exposed to droplets from the infected person which contain the virus. People also may become infected by touching something that has influenza viruses on it, and then touching their mouth, nose, or eyes. The H1N1 flu virus is not transmitted by eating pork or through other food.

As with other seasonal influenza viruses, it is thought that a person can spread H1N1 flu virus before symptoms begin. A person may infect another person one day before symptoms start, and up to seven or more days after becoming sick. People with H1N1 infection should be considered contagious for as long as they show symptoms. Children, especially younger children, may be contagious for longer periods of time.

In most cases, germs will only survive a couple of hours on surfaces such as handrails, door handles, etc. However, if the circumstances are just right (e.g. warm moist conditions as may be found in soiled linens or clothing), influenza germs can survive on surfaces for much longer periods of time. Studies have shown that typically, influenza viruses may survive for 2-8 hours on environmental surfaces.

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. Household disinfectants are sufficient to clean surfaces that have been contaminated with the flu virus.

Linens, eating utensils, and dishes used by those who are sick do not need to be cleaned separately. But these items should not be reused by another person until they have been washed thoroughly. 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 sanitizer immediately after handling dirty laundry. Eating utensils should be washed either in a dishwasher, or by hand with water and soap.

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.

The H1N1 flu virus is not spread by food. You cannot get infected from eating pork or pork products. Eating properly handled and cooked pork products is safe.

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 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 H1N1 virus also would be similarly disinfected by chlorine.

It is most important to use the same precautions that you would take to prevent regular seasonal influenza:

• Avoid close contact with people who are sick.
• Stay home when you are sick and stay home until 24 hours after symptoms go away.
• Avoid school, work, and large crowds when you are sick, if possible.
• Cover your mouth and nose with a tissue when you cough or sneeze and properly discard the tissue.
• If you don't have a tissue and need to cough or sneeze, do so into your elbow. Wash your hands after you cough or sneeze.
• Wash your hands often with soap and water, or use an alcohol-based hand sanitizer when hand washing is not possible.
• Avoid touching your eyes, nose or mouth, as germs can more easily gain entrance into your body through those areas.
• Clean countertops, doorknobs and bedding more often (use normal household cleaners).
• An H1N1 flu vaccination is the best way to prevent H1N1 influenza infection and its complications.

The H1N1 flu virus is spread much the same way as regular seasonal influenza. If you develop influenza-like symptoms, you should stay home and avoid contact with others as much as possible until 24 hours after your symptoms go away. If you leave the house to seek medical care, wear a mask, or cover your coughs and sneezes with a tissue, and then properly dispose of that tissue once it is used.

To limit the spread of the virus, use of a face mask is recommended for sick individuals who require limited time in public (such as a doctors visit) and around well caregivers and family members. If used correctly, facemasks and respirators may help reduce the risk of spreading influenza, but will not eliminate the risk of disease or illness. They should be used along with other preventive measures such as: social distancing (keeping 6 feet away from other individuals), frequent hand washing, covering your mouth and nose when coughing or sneezing, and limiting contact with ill people. As with many other respiratory illnesses, time spent with ill people should be as short as possible to prevent the illness from spreading. For CDC's Recommendations for Facemask and Respirator Use to Reduce 2009 Influenza A (H1N1) Virus Transmission, click here.

If your child is sick with influenza symptoms, you should keep the child home until 24 hours after symptoms resolve or go away. Additionally, as part of any good prevention measure, reinforce with your children the message to: wash their hands frequently; avoid touching their hands to their eyes, mouth, or nose; avoid close contact with others who are sick, and to cover their own mouth and nose when coughing or sneezing. If you know that your child has been exposed to a confirmed or suspected case of the H1N1 flu virus, contact your healthcare provider for specific guidance.

No. If you are sick with influenza symptoms, stay home and do not attend public events or social gatherings until 24 hours after symptoms resolve. If you know that you have been exposed to a confirmed or suspected case of the H1N1 flu virus, contact your healthcare provider for specific guidance.

Antiviral medications 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. They also may prevent serious flu complications.

During the current H1N1 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. A physician should make this determination.

CDC recommends the use of Oseltamivir (Tamiflu) or Zanamivir (Relenza) for the treatment and/or prevention of infection with 2009 H1N1 flu virus. To be most effective at reducing the severity of flu symptoms, these medications should be taken within the first 48 hours of becoming ill. Antibiotics will not work on a viral infection like the flu.

Aspirin should not be given to children or teenagers who have the flu.

Priority groups include:

• Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
• Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants younger than 6 months old might help protect infants by "cocooning" them from the virus;
• Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
• All people from 6 months through 24 years of age: Children from 6 months through 18 years of age because cases of 2009 H1N1 influenza have been seen in children who are in close contact with each other in school and day care settings, which increases the likelihood of disease spread. Also, young adults 19 through 24 years of age because many cases of 2009 H1N1 influenza have been seen in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) closely monitor the safety of influenza and other vaccines used in the United States.

• Licensed 2009 H1N1 vaccines are produced using the same manufacturing process as seasonal influenza vaccines.
• All seasonal influenza vaccines licensed in the United States are produced in eggs and they do not contain adjuvants.
• When seasonal influenza vaccines are administered according to licensed indication and usage information, they are safe. However, vaccines, like any medical product, carry some risks. It is anticipated that the safety profile of licensed 2009 H1N1 vaccines will be similar to seasonal influenza vaccines. Serious adverse events after vaccination are uncommon.

No.

Current studies indicate that the risk for H1N1 flu infection among persons age 65 or older is less than the risk for younger age groups. One possible explanation is that some adults in this age group have had previous exposure to an influenza A (H1N1) virus that is more closely related to the novel influenza A (H1N1) virus. Laboratory studies have shown that some older adults have antibodies against the virus. Initially the H1N1 vaccine will be available in limited quantities. Since older people have some immunity, it is recommended that younger at-risk groups of the population receive the H1N1 vaccine when it first becomes available.

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

Seasonal flu and H1N1 vaccines may be administered on the same day.

A limited supply of the H1N1 vaccine is now available through the Davis County Health Department. As more shipments and types of H1N1 vaccine arrive each week, vaccination clinics will be opened. Call the Flu Information Line at 801-451-3333 for H1N1 vaccine availability and the latest information on times, dates, and locations of these clinics. For more information about H1N1 vaccinations, click here.

Even if you plan on receiving the H1N1 flu vaccine, it is recommended that individuals also receive the seasonal flu vaccine. The usual seasonal influenza viruses are still expected to cause illness this fall and winter. Individuals are encouraged to get their seasonal flu vaccine while supplies last.

The most up-to-date information for Utah is reported on the Situation Report available at http://health.utah.gov/epi/h1n1flu/. The most current U.S. data is available on the CDC web site at www.cdc.gov/h1n1flu.

Novel H1N1 flu has been detected in every county in Utah. The most current data on novel H1N1 activity in Utah is updated each Wednesday and can be found at http://health.utah.gov/epi/h1n1flu/ in the Situational Report. For more information about the flu situation in Davis County, click here .

A Phase 6 designation reflects the fact that there are now ongoing community-level outbreaks in multiple parts of the world. The decision to raise the alert level was due to the spread of virus not due to the severity of the illness.

Domestic Travel – There have been no recommendations issued by CDC for people to avoid domestic travel. However, if you are planning to travel to affected areas within the U.S., check out the CDC's recommendations.

International Travel – CDC has not issued any recent restricted travel recommendations. They did announce possible novel H1N1 flu screening for international travelers. Some countries are screening arriving passengers for flu-like illness. For more information, click here.

On 5/1/09, the World Health Organization (WHO) issued a "no rationale for travel restrictions" statement.

Visit CDC's Traveler's Health webpage for the latest information on travel.