Symptoms of Swine Flu

Novel influenza A (Swine Flu) is a new flu virus of swine origin that was first detected in April, 2009. The virus is infecting people and is spreading from person-to-person, sparking a growing outbreak of illness in the United States. An increasing number of cases are being reported internationally as well.

It’s thought that novel influenza A (Swine Flu) flu spreads in the same way that regular seasonal influenza viruses spread; mainly through the coughs and sneezes of people who are sick with the virus.

It’s uncertain at this time how severe this swine flu outbreak will be in terms of illness and death compared with other influenza viruses. Because this is a new virus, most people will not have immunity to it, and illness may be more severe and widespread as a result. In addition, currently there is no vaccine to protect against this swine flu virus. CDC anticipates that there will be more cases, more hospitalizations and more deaths associated with this new virus in the coming days and weeks.

Novel influenza A (swine flu) activity is now being detected through CDC’s routine influenza surveillance systems and reported weekly in FluView. CDC tracks U.S. influenza activity through multiple systems across five categories. The fact that swine flu activity is now detected through seasonal surveillance systems is an indication that there are higher levels of influenza-like illness in the United States than is normal for this time of year. About half of all influenza viruses being detected are swine flu viruses.

cdc, swine flu cdc, swine flu

Background

The novel H1N1 flu virus is causing illness in infected persons in the United States and countries around the world. CDC expects that illnesses may continue for some time. As a result, you or people around you may become ill. If so, you need to recognize the symptoms and know what to do.

Symptoms

Common symptoms include fever, headache, tiredness, cough, sore throat, runny nose, body aches, diarrhea, and vomiting. The high risk groups for novel H1N1 flu are not known at this time but it’s possible that they may be the same as for seasonal influenza. People at higher risk of serious complications from seasonal flu include people age 65 years and older, children younger than 5 years old, pregnant women, people of any age with chronic medical conditions (such as asthma, diabetes, or heart disease), and people who are immunosuppressed (e.g., taking immunosuppressive medications, infected with HIV).

Avoid Contact With Others

If you are sick, you may be ill for a week or longer. You should stay home and avoid contact with other persons, except to seek medical care. If you leave the house to seek medical care, wear a mask or cover your coughs and sneezes with a tissue. In general you should avoid contact with other people as much as possible to keep from spreading your illness. At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods.

Treatment is Available for Those Who Are Seriously III

It is expected that most people will recover without needing medical care.

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed. Be aware that if the flu becomes wide spread, there will be little need to continue testing people, so your health care provider may decide not to test for the flu virus.

Antiviral drugs can be given to treat those who become severely ill with influenza. These antiviral drugs are prescription medicines (pills, liquid or an inhaler) with activity against influenza viruses, including H1N1 flu virus. These medications must be prescribed by a health care professional.

There are two influenza antiviral medications that are recommended for use against H1N1 flu. The drugs that are used for treating H1N1 flu are called oseltamivir (trade name Tamiflu ®) and zanamivir (Relenza ®). As the H1N1 flu spreads, these antiviral drugs may become in short supply. Therefore, the drugs will be given first to those people who have been hospitalized or are at high risk of complications. The drugs work best if given within 2 days of becoming ill, but may be given later if illness is severe or for those at a high risk for complications.

Emergency Warning Signs

If you become ill and experience any of the following warning signs, seek emergency 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

Protect Yourself, Your Family, and Community

• Stay informed. Health officials will provide additional information as it becomes available. Visit the CDC H1N1 Flu website.
• 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 a flu-like illness, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. Keep away from other household members as much as possible. This is to keep you from infecting others and spreading the virus further.
• Learn more about how to take care of someone who is ill in “Taking Care of a Sick Person in Your Home“
• Follow public health advice regarding school closures, avoiding crowds, and other social distancing measures.
• If you don’t have one yet, consider developing a family emergency plan as a precaution. This should include storing a supply of extra food, medicines, and other essential supplies. Further information can be found in the “Flu Planning Checklist”

cdc, swine flu cdc, swine flu

The U.N. World Health Organization and U.S. Centers for Disease Control and Prevention have been collecting samples of the new H1N1 swine flu virus to make a new vaccine in case it is needed.

Following are some facts about influenza vaccines.

* The WHO and CDC prepare samples of virus to give to industrial makers.

* These samples must be grown in specially produced chicken eggs. The virus is then purified and made into vaccines, a process that takes months.

* At least 20 companies make flu vaccines including Sanofi Pasteur, Australia’s CSL Ltd, GlaxoSmithKline Plc, Novartis AG, Baxter and nasal spray maker MedImmune, acquired by AstraZeneca Plc.

* Experts agree the current process for making vaccines is clumsy and outdated, but new and more efficient technologies are still a few years away.

* WHO and CDC experts are trying to decide if a new vaccine for the H1N1 swine flu strain is needed, or perhaps if a fourth element could be added to the seasonal flu vaccine mix for next September.

* The health agencies also had been considering adding some vaccines against H5N1 avian influenza, which occasionally infects people and is also considered a major pandemic threat.

* Tests show the H1N1 component of the current seasonal flu vaccine does not protect against the new strain.

* Consulting firm Oliver Wyman found that drug companies would need four years to meet global demand for vaccines if a pandemic broke out today, but new technology could significantly boost production by 2014.

* Currently, drug makers could make up to 2.5 billion doses of pandemic vaccines in one year, meaning it would take four years to meet global demand, Oliver Wyman found. In a best-case scenario, they could make 7.7 billion doses in 1.5 years.

* Compounds called adjuvants can be used to boost a vaccine’s effectiveness, so it could be diluted and used in more people.

* Current global demand for seasonal influenza vaccine is about 500 million doses a year.

* The CDC recommends that 261 million Americans — 85 percent of the population — should be vaccinated against flu. A RAND Corp. study in December showed that only about a third of those who should have did get the vaccine.

cdc, swine flu, who

Based on new information on circulation of a new influenza A (H1N1) virus among people in the US and Mexico first detected in April, 2009, this document provides updated interim planning guidance for State, territorial, tribal, and local communities.  This guidance includes recommendations on school dismissal for K – 12 schools and closure of childcare programs and facilitiesand updates previously issued guidance on community mitigation interventions for this disease (April 28, 2009,http://www.cdc.gov/swineflu/mitigation.htm).  School dismissal and childcare closures are an important part of a comprehensive, layered mitigation approach aimed at reducing disease transmission and associated morbidity and mortality during the 2009 H1N1 virus outbreak in the US. 

The goals of these strategies are to slow the spread of the disease in a community to 1) delay the peak of the disease in order to “buy time” for the production and distribution of a vaccine against this new virus, 2) decrease the number of people who get sick from this virus in a given community, thus reducing the “surge” on healthcare systems, and 3) reduce the total number of people who get sick or die.

It is prudent for communities to act based on available information to protect their citizens. These community mitigation interventions are scalable and flexible so that local public health authorities, working with their partners in a given State or community can use these tools based on the local situation. As public health officials in the United States learn more about this emerging virus, CDC will be reviewing these findings on a daily basis and updated guidance will be issued in conjunction with our State, local, tribal and territorial partners.

Schools play a critical role in protecting the health of their students, staff, and the community from contagious diseases such as H1N1 influenza.  Children are very susceptible to getting this new virus and schools may serve as amplification point for spread of this new virus in a community. The reason for closing schools during this H1N1 outbreak is to try to reduce the spread of the virus.  However, little information is available on what the effectiveness of a school closure might be in preventing further community spread of this new virus.  In addition, the risk of severe illness from this virus is not yet clear.

The authority for decisions regarding school dismissal and childcare closure may vary and resides in different sectors of State and local government including School Superintendents, Mayors, Governors, emergency management officials, and public health officials.

cdc, swine flu cdc, swine flu

CDC recommends that affected communities with laboratory-confirmed cases of influenza A (H1N1) virus infection consider activating school dismissal and childcare closure interventions according to the guidelines below.  “Affected communities” may include a U.S. State or proximate epidemiological region (e.g., a metropolitan area that spans more than one State’s boundary).  These guidelines address a flexible and scalable approach that States and local jurisdictions can use based on the situation in their communities (e.g. number of cases, severity of illness, affected groups).

Recommend Scalable and Incremental School Dismissal and Childcare Facility Closure in Affected Communities:

School districts must work closely and directly with their local and State public health officials to make sound decisions and implement strategies in a coordinated manner keeping in mind:

1.    Decisions to dismiss students and close childcare facilities and subsequent implementation of those measures should be made based on the extent and severity of illness;
2. That local authorities decide whether or not to dismiss schools or close childcare facilities; and;
3. That authority for decision-making may reside in multiple sectors of State and local government; these entities must be well coordinated.

Interim Recommendations

• Sick people (students, faculty and staff) should stay home unless they need to seek medical care and stay away from schools regardless of whether schools and childcare facilities are operating normally or have dismissed students or closed, respectively.
• Dismissal of students in a school and closure of childcare facilities should be considered in schools with one or more laboratory-confirmed or non-subtypable influenza A case among students, faculty or staff in order to decrease the spread of illness in the community.
• Dismissal of students from schools and closure of childcare facilities should be considered for a school district or part of a school district (e.g., a feeder school network or a geographic area) if more than 1 school in that district has confirmed or non-subtypable influenza A cases among their students, faculty or staff.  This would include pre-emptively dismissing students from schools in that district, including schools without current laboratory-confirmed cases.
• Neighboring school districts to those that dismiss students should also consider pre-emptively dismissing students from schools without current laboratory-confirmed cases. Issues to consider include geographic proximity and extent of mixing of student populations across district lines.  
• If a school dismisses students or a childcare facility closes, school or childcare related gatherings should also be cancelled.  Parents and students should be encouraged to avoid congregating in large numbers outside of the school setting.

If a school dismisses students or a childcare facility closes, schools and childcare facilities should dismiss students for a minimum of 14 days. Schools, in consultation with local and State public health officials, should evaluate daily the need for possible extension of the dismissal/closure based on local influenza surveillance information, and the occurrence of new infections and severity of illness in the community from this virus. This length of time is recommended because children are likely to be infectious for about 7 – 10 days after the onset of illness

To reiterate an important point, decisions regarding school dismissal within these communities are being left to the appropriate authorities but must involve consultation with local and State public health officials, taking into account the extent and severity of H1N1 disease in the community. Schools (K – 12) and childcare facilities should also consult with their local or State health departments for guidance on re-opening schools. When schools re-open, keep commonly touched surfaces such as stairway railings, elevator buttons and door handles clean by wiping them down with detergent-based cleaners or EPA registered disinfectants that are usually used in the school setting.  These products should be used according to directions on the product label.  Additional, extensive cleaning of schools by wiping down floors and walls prior to reopening is not necessary as it is unknown whether this would be helpful in decrease the spread of influenza.   

If students are dismissed from schools, they should be encouraged not to re-congregate outside of school in large numbers. If childcare facilities close and there is a need for childcare, families could plan to work together with two to three other families to supervise and provide care (using the same caregivers each day) for a small and consistent group of infants and young children while their parents are at work (studies suggest that childcare group size of five or fewer children may be associated with fewer respiratory infections). 

Schools and childcare facilities in unaffected areas should begin to prepare for the possibility of school dismissal or childcare facility closure. This includes asking teachers, parents and officials in charge of critical school-associated programs (such as meal services) to make contingency plans. Parents should plan for caring for children who may be dismissed from schools, as these decisions may be made very quickly based on emerging disease in the community.

For more information see: http://www.cdc.gov/h1n1/

cdc, swine flu cdc, swine flu

cdc, swine flu cdc, swine flu