Important Information on H1N1 Swine Flue

Current situation

Following the outbreak of the novel influenza A(H1N1) virus around the globe, public health authorities set up surveillance activities to learn more about the virus and its spread. Measures have been adjusted in keeping with the increase in the number of world cases, the mildness of the symptoms of the influenza A(H1N1) observed in Québec and the knowledge gained in recent investigations into the virus.

As of May 15, 2009, Québec's public health authorities no longer systematically study suspected or probable cases of influenza A(H1N1) in the community. Only cases requiring hospitalization are now investigated.

On June 11, the World Health Organization (WHO) announced an increase to a level 6 alert, which signals that a global pandemic is under way. That decision was expected, as the virus was already circulating in a large number of countries, including Canada, and was transmitting among humans.

Québec's public health authorities and health and social services institutions went into action as soon as the first cases appeared. Vigilance is being maintained and the necessary steps taken in terms of both prevention and the provision of care, in accordance with the Québec Pandemic Influenza Plan.

Influenza A(H1N1)

What is an influenza pandemic?

An influenza pandemic is declared when a novel influenza virus emerges and circulates in a number of regions around the world through sustained and efficient transmission among human beings. Influenza A(H1N1) is thus the first pandemic of the 21st century. World health authorities currently consider the pandemic to be moderate. In the majority of cases, the symptoms of influenza A(H1N1) resemble those of seasonal flu.

Is the influenza A(H1N1) virus the same as the seasonal A(H1N1) virus?

No. Antigenically speaking, the novel influenza A(H1N1) virus that emerged at the end of April is very different to the seasonal A(H1N1) flu viruses that circulate every year. Because of this, seasonal flu shots would probably not protect us against the new virus.

Since the influenza A(H1N1) virus was initially associated with pigs, should contact with pigs be avoided?

As influenza viruses can be transmitted in both directions between pigs and humans, anyone with flu symptoms should avoid contact with pigs. That said, few cases of human-to-pig or pig-to-human transmission of the A(H1N1) virus have been reported to date.

Can the influenza A(H1N1) virus be contracted by eating pork?

No. Cooking destroys the virus. Pork and pork products that have been handled and cooked properly are entirely safe.

Symptoms, transmission, treatment and diagnosis of influenza A(H1N1)

What are the symptoms of influenza A(H1N1)?

The symptoms of influenza A(H1N1) are comparable to those of seasonal flu: fever, cough, fatigue, reduced appetite, headache and muscle pain. Certain individuals infected by the A(H1N1) virus will also experience a runny nose, sore throat, nausea, vomiting and diarrhea. Symptoms can vary from one person to the next and, as with seasonal flu, the existence of an underlying chronic illness may lead to complications.

How is influenza A(H1N1) transmitted?

The flu virus is very easily transmitted through droplets from the nose or mouth of an infected person.

You can catch the flu if you are in contact with a contaminated surface or an infected person and you then touch your nose, mouth or eyes. Symptoms develop one to seven days after infection. It should be noted that an infected person may be contagious 24 hours before and up to seven days after the onset of symptoms.

The flu virus prefers cool, dry places and spreads with close contact between people. Contact readily occurs in individuals who live under the same roof, care for someone who is ill, use public transportation or go to public events or gatherings (shows, sports events, etc.).

How long can the A(H1N1) virus survive outside the body?

The virus can live for a certain time on hard surfaces. However, it is easily destroyed by washing one's hands in lukewarm water with soap or by using a hand disinfectant or sanitizer. Household disinfectants destroy the virus on surfaces.

What are the incubation period and the contagious period for influenza A(H1N1)?

Symptoms of influenza A(H1N1) develop between one and seven days after infection. An infected person may be contagious 24 hours before and up to seven days after the onset of symptoms.

What should I do if I have flu symptoms?

Healthy people usually get better on their own. If you have influenza A(H1N1), you should stay at home insofar as possible and rest until your symptoms are gone. The flu does not usually require medication, but over-the-counter remedies can be used to relieve symptoms. To avoid infecting others, it is important to have as little contact as possible with family and friends until symptoms disappear.

The usual respiratory hygiene measures should also be applied by people who are ill:

• If you have to sneeze or cough, cover your mouth and nose with a tissue.
• Dispose of soiled tissues in the trash.
• If you do not have a tissue, turn your face into your shoulder or the bend of your elbow to sneeze or cough.
• Wash your hands often. If soap and water are not available, use an antiseptic product.

If I have the flu, should I see a health professional?

As a rule, persons who have flu symptoms that include fever should see a health professional if they:

• are at risk of developing complications because of age (less than 2 years old or more than 65) or an underlying chronic illness;
• are experiencing pain or having difficulty breathing;
• have been vomiting for more than four hours;
• are confused or are having convulsions.

To help you make the right decision for yourself or someone close to you, see the Decision Chart and the folder Influenza A(H1N1): What you need to know, what you need to do: Protecting yourself, protecting others.

What should I do if my child has flu symptoms?

As with the rest of the population, children whose health is generally good get over the flu easily. Children's symptoms may differ from those of adults, however, and should be watched.

It is important to call Info-Santé 8-1-1or see a physician if you suspect influenza A(H1N1) in a child who

• is less than 2 years old and has a fever of more than 38oC (100.4oF);
• has a chronic disease or immunodepressed condition and a fever of more than 38oC (100.4oF);
• appears to be very ill, with no energy, and is hard to waken.

It is important to ensure the comfort of a sick child and to administer appropriate medications according to the child's weight and the manufacturer's instructions.

Are there medications that treat influenza A(H1N1)?

Antivirals can be used for prevention and early treatment of influenza. If taken within 48 hours after the onset of illness, antivirals can reduce symptoms, shorten the length of illness and possibly prevent complications. As antivirals are not vaccinations, they do not immunize against the virus.

How can I obtain antivirals?

Antivirals are not indicated for everyone with influenza. Your physician determines who requires antiviral treatment and which antiviral should be administered.

How long will it take to develop a vaccine?

The production of a vaccine against the virus strain that causes influenza A(H1N1) is already under way, and the vaccine will probably become available in the fall. Enough vaccine will be produced for the entire population of Canada.

Preventive measures

How can I avoid becoming infected by the flu virus?

To avoid spreading the virus, apply the following simple hygiene and preventive measures at all times, wherever you go: Wash your hands often with soap and water. Cough into a tissue or into your upper arm or the bend of your elbow. Do not cough into your hands.

Should I still be vaccinated with Québec's seasonal vaccine?

Systematic flu vaccination of residents is no longer necessary in Québec, since the seasonal flu period is almost over. As well, there are no data currently available on the effectiveness of seasonal vaccines against the novel influenza A(H1N1) virus.

To avoid contracting influenza A(H1N1), should I take extra precautions, such as wearing a surgical mask?

Canadian government authorities do not currently recommend that the public at large wear masks as protection against influenza A(H1N1). To date, this measure has not been considered effective in preventing the transmission of influenza. People often wear their mask incorrectly, or contaminate it when putting it on or removing it—thereby increasing the risk of infection. Only those who are ill should wear a mask, to avoid infecting people around them.

Travel information

What measures are applied by government authorities with incoming travellers to Canada who may be infected with the influenza A(H1N1) virus currently circulating in Québec?

All international travellers arriving in Canada (whether by air, road, rail or water) are visually screened, specifically in terms of health. This measure is not specific to influenza A(H1N1).

Do directives still apply to travellers and workers going to Mexico?

Given that the most recent information from Mexico points to a reduction in the risk of contracting the H1N1 virus there, and that almost all cases reported in Canada and the U.S. have been benign, the Public Health Agency of Canada (PHAC) no longer recommends that Canadians postpone non-essential trips to Mexico. This has been the case since May 18, 2009.

Should I get the seasonal flu shot if I am going to Mexico?

No. But before travelling to Mexico or around the globe, you should go to a travel health clinic to find out whether seasonal flu is still present at your destination.

How can I find a physician if I get sick abroad?

If emergency care is required, the best solution is often the nearest hospital. In other circumstances, the main tourist hotels usually have a physician who can provide medical care. Hotels can also obtain appointments with local doctors.