Swine Flu and You: A downloadable booklet for Touro employees.

What is H1N1 Influenza?

H1N1 influenza (swine flu) is caused by a new virus that recently emerged in Mexico and the United States, and has spread throughout the world. H1N1 flu can cause severe illness and death in some people. Most of the recent cases in the United States have been of moderate severity.

How is the H1N1 influenza virus spread?

Like any flu virus, H1N1 is spread mainly through respiratory droplets that are released when an infected person coughs or sneezes. People in close proximity to the infected person (about 3 feet) can become infected if these droplets contact the mouth or nose. Influenza viruses may also spread when a person touches respiratory droplets on another person or object, and then touches his/her own mouth or nose.

How long is a person with H1N1 flu contagious?

The contagious period varies, but it is thought to be 3-5 days. The NYC Department of Health advises people with flu-like illness to stay home until their symptoms and fever have completely resolved and they have not had fever for 24 hours without the use of fever reducing medications. This process usually takes 7-10 days.

Who is at greater risk for complications of H1N1 influenza?

Infants, toddlers, seniors and pregnant women are at increased risk of severe illness or complications from influenza. So are people with certain underlying health conditions. If you or a family member meet one of these criteria, and you develop flu-like illness (fever accompanied by cough or sore throat), please call your doctor to discuss treatment with antiviral medicine. In addition to the people listed above those at higher risk of flu complications include:

• People with chronic lung problems such as asthma or emphysema
• People with chronic heart, kidney, liver or blood disorders
• People with neurological disorders that can cause breathing problems
• People with diabetes
• People whose immune systems are weakened due to illness or medication
• People under 18 years of age who are on long-term aspirin therapy

How can I protect myself from H1N1 influenza?

The precautions are the same as seasonal flu and many other respiratory infections:

• Avoid close contact with people who have an influenza-like illness.
• If you need to have close contact with someone who has an influenza-like illness...
  Wash your hands often with soap and warm water. If your hands are not visibly soiled, you can use a hand cleaner containing 60% to 95% alcohol. Avoid touching your nose, mouth or eyes and wash your hands thoroughly before doing so.
• If your age or health status increases your risk of complications from flu, and you have been in close contact with someone who has flu-like illness, call your doctor to see if you should take medication to prevent influenza.

Should people at risk of complications take medicine to prevent H1N1 flu?

Antiviral medicine can help prevent H1N1 infection in people at high risk of developing severe illness. The NYC Department of Health does not recommend preventive treatment except for those people who have known risk factors (see above) and who are in close contact with people who have flu-like illness.

What should I do if I develop flu-like illness?

If you develop a fever accompanied by cough or sore throat, you can take steps to protect yourself and avoid spreading illness to others.

• If you have severe or worsening symptoms, such as difficulty breathing, go immediately to a hospital emergency room. If you do not have severe illness, there is no need to go to a hospital, and nothing will be gained from it.
• If you are at risk of complications, call your doctor to discuss treatment with antiviral medicine.
• Rest, drink plenty of fluids and take the medications you would normally take to treat your symptoms. People under 18 years old should not take aspirin or products containing aspirin, since aspirin can cause a rare but serious illness called Reyes Syndrome in young people with flu.
• Avoid spreading the flu to others by covering your nose and mouth with a tissue when you cough or sneeze, and washing your hands frequently.

How can I help prevent the spread of H1N1 influenza?

• Stay at home until your symptoms resolve. Do not return to work or school until you have been well for 24 hours without the use of fever reducing medication.
• Cover your mouth and nose with a tissue whenever you cough or sneeze. If you do not have a tissue, use your sleeve instead of your bare hand. Throw the used tissue into the wastebasket. Do not accumulate tissues around you.
• Wash your hands often with soap and warm water. If your hands are not visibly soiled, you can use an alcohol based hand cleaner. Don't touch phones, doorknobs or other shared items before washing your hands. Use your own towel or disposable towels to dry your hands.
• Stay in a separate room and limit your contact with others in your home. Consider wearing a surgical mask when other people are nearby. A surgical mask can prevent germs from spreading.
• Don't share food, drink or toothbrushes with others in your home.
• Don't share dishes, glasses or eating utensils until they have been washed.

Who should go to the emergency room?

Anyone with severe or worsening illness should go to the emergency room. If you go to the emergency room, travel by private car or taxi, not by bus or subway. In adults the signs of severe or worsening illness include:

• Rapid breathing, difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Bluish skin color
• Dizziness or confusion
• Increasing fever
• Severe or persistent vomiting

In children, the signs of severe or worsening illness include:

• Increased fever
• Rash
• Rapid or difficult breathing
• Bluish skin color
• Irritability
• Lack of responsiveness (not waking up or not interacting)
• Not drinking enough fluids

If you call 911 for emergency medical assistance, tell the operator that you have symptoms of influenza. You should also tell the ambulance crew and the nurse in the emergency room when you arrive. You may be asked to sit in a separate area and wear a mask while waiting to be seen.

Who should not go to the emergency room?

• Do not go to the emergency room for mild flu-like illness if you have no underlying medical condition.
• If you develop mild flu-like illness and you also have an underlying medical condition, call your doctor to discuss treatment. If appropriate, the doctor can call a pharmacy with your prescription.

What should I do if someone in my home has the flu?

If you are not caring for the person who is sick, limit your contact as much as possible. If you are taking care of the person:

• Make sure the person has plenty of tissues and a wastebasket for disposal.
• Make sure soap and warm water are available for hand-washing.
• Encourage the person to remain in his/her room while sick. The person should avoid touching others until 24 hours after the symptoms resolve without the use of fever reducing medications.
• If possible, choose one person to be the primary caregiver and have that person bring meals and other necessities into the person's room. Encourage the person to wear a surgical mask when around others.
• Wear a mask yourself when you are within 3 feet of the person, for example when helping adjust the person's position in bed or helping with feeding or personal hygiene. Masks can be washed with normal laundry detergent and tumble-dried in a hot dryer.
• If you handle the sick person's laundry, wash it with household laundry detergent and tumble dry it on a hot setting. Avoid holding dirty laundry near your face, and clean your hands after handling it. It is not necessary to separate a sick person's laundry from other household laundry.

What other precautions are needed in a home where someone has the flu?

• Limit visitors if possible. Tell friends and family members that someone is sick, and ask that they delay visiting until the person has recovered.
• Household members should monitor themselves closely for flu-like symptoms. If they get sick with fever and cough, they should stay at home and take the precautions listed above to avoid infecting others: cover coughs and sneezes with a tissue, wash hands frequently, and limit direct contact with others.

If I live with someone who has flu-like illness, can I go to work or school?

Yes, but anyone who starts to feel ill at work or school should return home right away, and follow the precautions described above for people with fever and cough.

Is there a vaccine for H1N1 flu?

There is currently no vaccine against H1N1 flu, and vaccination against seasonal flu does not prevent H1N1 flu. This makes it very important to take precautions such as covering coughs and washing hands, which can help prevent any kind of flu.

Source: NYC Department of Health and Mental Hygiene
Additional Information: www.nyc.gov/health, www.flu.gov