How do people get the Swine Flu?

How does the flu spread?

The H1N1 influenza virus spreads the same way that seasonal flu spreads--from person to person through coughing or sneezing of people with influenza.

People may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. This means that people can pass on the flu to someone else before knowing they are sick as well as passing on the flu while they are sick.



People are being advised to avoid close contact with sick people and stay at least six feet away from people who are sick.

Why all of the face masks?

One of the images associated with the H1N1 Flu is that of people wearing masks over their faces. It appears that the real value of wearing a mask is to keep those who have the virus from spreading it to others.

People are currently advised to avoid close contact with anyone showing symptoms of the flu and to stay at least 6 feet away.

The CDC has helpful information for those who need to take care of a sick person in the home. If one must have close contact with a sick person like when holding a sick infant, the CDC advises spending the least amount of time possible in close contact and wear a surgical mask or N95 disposable respirator.

How do people get the Swine Flu?

Swine flu is an acute respiratory disease of pigs caused by a tiny spheroid virus that belongs to the Influenza A virus group. It is also know as swine influenza, or this variant by the name of the virus H1N1.

Symptoms of swine flu in swine herds include fever, inactivity, nasal discharge, labored breathing, mouth breathing, and paroxysmal coughing when the pigs are moved.

Usually swine flu does not infect people. In the past few human cases that have occurred have been with people who have had direct contact with pigs.

The current swine flu outbreak is different. It has been caused by a new swine flu virus that has spread from person to person, which allows the virus to be transmitted among people who have not had any contact with pigs.

Pigs and People

How Viruses May Be Transmitted By Different Species

Possible mechanisms for the introduction of novel influenza A viruses into the human population including direct transmission of entire bird or swine viruses or transmission of reassortant viruses.

Source: Carolyn Buxton Bridges, MD, Influenza Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia: "Human influenza viruses and the potential for inter-species transmission."

What should I do if I get sick?

The CDC recommends if you get sick with the Swine Flu:

Stay home from work or school.
Limit contact with others to keep from infecting them.
Watch for concerning symptoms.

In addition you should follow public health advice regarding school closures, avoiding crowds and other social distancing measures.

Image: Modified Microsoft Image.

What should I do if I think it's the flu?

The two things to do if you think it's the flu:

1. Take care of yourself (or child).
2. Monitor yourself (or child) for worsening of symptoms.

Managing the flu means being sure to provide relieve of symptoms (like fever) being sure to keep the sick person well-hydrated.

The caregiver will want to make sure that the sick person is drinking enough water and taking food as tolerated.

The CDC advises using anti-pyretic (fever reducing) medications to relieve fever such as acetaminophen or non steroidal anti-inflammatory drugs. Any Aspirin or aspirin-containing products (e.g. bismuth subsalicylate - Pepto Bismol) *should not be* administered to any confirmed or suspected ill case of novel influenza A (H1N1) virus infection.


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Symptoms of Swine Flu

Dr. Joe Bresee, with CDC's Influenza Division, describes the symptoms of swine flu and warning signs to look for that indicate the need for urgent medical attention.

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How to Protect Yourself From H1N1 Swine Flu ?

As the swine flu sweeps the world we are all concerned with protecting ourselves and our families from contracting this virus. There are many ways that we can be pro-active and protect ourselves and families. First we must understand how the virus is spread. Whenever a person who has the virus coughs, sneezes, spits, blows their nose or even talks and laughs the virus escapes their body in their respiratory secretions. It is spread by droplet infection. That means that the tiny droplets of moisture from their mouth and nose escape and carry the virus with them. These droplets in the air are then breathed in by others or land on surfaces and the virus is there, waiting for a victim. Once the virus enters another person's system it must fight that person's immune system to cause illness. Since this is a new virus strain, people do not have immunity to it and our immune systems frequently fight a losing battle and the the newly infected person becomes ill. There is currently no vaccine in the world that can be taken to prevent contracting this virus once it has entered your body. It will take several months to develop a vaccine. To avoid contracting the illness, we must break the chain of infection and contamination. So, what can we do to break that chain. Here are some simple steps we can all take to keep that virus away.

Instructions

1. Step 1

   Remember the six foot rule. If you are within six feet of a person who is infected you are at risk. Since you do not know who is infected and they may not know that they are infected it makes sense to take precautions when you will be in close proximity to others. One precaution you can take is to wear a mask. A mask will stop and catch the droplets in the air and prevent you from inhaling the viral particles. However, it is important to remember that a mask will only be effective for about 15 minutes before the vapor from your breath saturates it and it then becomes a moist conduit for the virus. It is also imperative that you remember that a used mask is contaminated and should be disposed of properly. Do not stick it in your pocket and save it for later. Throw it away.

2. Step 2

   Next lets look at what happens to those droplets in the air if they are not inhaled by another person. Being heavier than air they sink and settle wherever they land and there they wait. If you touch the surface where they are waiting the virus will happily jump on your hand. If you touch your face with that hand the virus will then be on your face, waiting for the opportunity to enter your eyes, your mouth or your nose. It is therefore important to keep your hands off your face and out of your mouth, eyes or nose.

3. Step 3

   You will be touching surfaces that other people have touched. Think about it. Door knobs, doors, shopping carts, ATM machines, merchandise, money, produce and other groceries, are all things you touch everyday. Some of them are even moist. They are wonderful incubators for the virus. One of the most important things you can do is to wash your hands frequently and use an alcohol gel based hand sanitizer frequently throughout the day. This can not be emphasized enough. This is probably the most important thing you can do to break the chain. Some people will choose to wear gloves when in an environment where they will be touching many things. That is ok. Just throw the gloves away and wash up or use hand sanitizer when you remove them.

4. Step 4

   Remember not to touch your face while wearing your contaminated gloves or after touching non sanitized or public surfaces.

5. Step 5

   Lets talk about public restrooms. Imagine for a moment that you have bright red sticky paint on your hands and that it will leave a red mark on everything you touch while you are in the restroom. Now trace your path in the restroom. Is there a door you must open to get in? There is the stall door and lock. The hand rail in the stall. The flushing mechanism. Many people use their foot to flush. But then you have to unlock the stall door to get out of the stall. But you think you will be washing your hands so it is ok. You go to the sink and turn on the water, wash your hands using soap from the dispenser which you also touch and turn off the water. But wait. The handle to turn off the water is red. If you touch it with your now clean hand your hand will be red again. How can you turn off the water without contaminating your hand? Actually, the one item with the highest germ count in the entire bathroom is the handle on the sink. Use a paper towel to protect your hand while you turn off the water.

6. Step 6

   When you have exited the restroom, use your hand sanitizer to clean your hands.

7. Step 7

   Consider not shaking hands with others, or giving those little hugs and kisses. Use hand sanitizer or wash your hands if you must shake hands with people.

8. Step 8

   Remember those little droplets full of viral particles? They are heavier than air and they settle on surfaces. And what surface ultimately catches the most? The floor. Every particle that does not stick somewhere will eventually settle out of the air onto the floor and you walk on the floor and pick up those particles on your shoes. That means your shoes frequently carry a heavy viral load. There are several ways to deal with this. You can spray your shoes with a disinfectant before you enter your car or home. Another method is to keep clean shoes and remove and bag your contaminated shoes before entering your home. Then, of course, you must disinfect your shoes. The important thing is to think about it and don't just leave your contaminated shoes laying around anywhere for children to touch or where them on the floor where children crawl or play. And remember that the floor in public places is contaminated.... and so is anything that falls on it.

9. Step 9

   Now that you know how this virus gets around, think about the things you do and consider where you go and what you touch. Teach your children and other family members. You can seriously reduce your chances of catching this disease.

10. Step 10

    If you do develop symptoms of the flu contact your health care provider immediately. There are medications that can help your body fight the virus. These medications must be taken during the first 48 hours of infection.

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Symptoms of Swine Flu?

Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.

It is important to realize that many people who have Swine Flu are better in a couple of days.

The human symptoms of swine flu are similar to the symptoms of seasonal influenza. The symptoms may include:

1. Fever (greater than 100°F or 37.8°C)
2. Sore throat
3. Cough
4. Stuffy nose
5. Chills
6. Headache and body aches
7. Fatigue
8. Some people have reported diarrhea.
9. Some have reported vomiting.

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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.

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