Swain Flu.finaLdoc

8/14/2019 Swain Flu.finaLdoc

1/57

SWAIN FLU SUSANTA ROUT--1

Know the Difference between Cold and Swine Flu Symptoms

Symptom Cold Swine Flu

Fever Fever is rare with a cold.

Fever is usually present with theflu in up to 80% of all flu cases.

A temperature of 100F orhigher for 3 to 4 days isassociated with the flu.

Coughing

A hacing! productive"mucus# producing$ coughis often present with acold.

A non#productive "non#mucusproducing$ cough is usuallypresent with the flu "sometimesreferred to as dry cough$.

Acheslight &ody aches and

pains can &e part of a cold.

evere aches and pains are

common with the flu.

Stuffy Nose

tuffy nose is commonlypresent with a cold andtypically resolvesspontaneously within awee.

tuffy nose is not commonlypresent with the flu.

Chills'hills are uncommon witha cold.

(0% of people who have the flue)perience chills.

Tiredness *iredness is fairly mild witha cold.

*iredness is moderate to severewith the flu.

Sneezingnee+ing is commonlypresent with a cold.

nee+ing is not common withthe flu.

SuddenSymptoms

'old symptoms tend todevelop over a few days.

*he flu has a rapid onset within3#( hours. *he flu hits hard andincludes sudden symptoms liehigh fever! aches and pains.

eadacheA headache is fairlyuncommon with a cold.

A headache is very common withthe flu! present in 80% of flucases.

Sore Throatore throat is commonlypresent with a cold.

ore throat is not commonlypresent with the flu.

ChestDiscomfort

'hest discomfort is mild tomoderate with a cold.

'hest discomfort is often severewith the flu.


2/57


Swine influenza

.

,00- flu pandemic"wine flu$ irus

Avian influen+a

Swine influenza

Flu season

/esearch

accine

*reatment

A21 su&type

A11 su&type

wine influen+a is endemic in pigs
http://en.wikipedia.org/wiki/2009_flu_pandemichttp://en.wikipedia.org/wiki/Orthomyxoviridaehttp://en.wikipedia.org/wiki/Avian_influenzahttp://en.wikipedia.org/wiki/Flu_seasonhttp://en.wikipedia.org/wiki/Influenza_researchhttp://en.wikipedia.org/wiki/Influenza_vaccinehttp://en.wikipedia.org/wiki/Influenza_treatmenthttp://en.wikipedia.org/wiki/H5N1http://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1http://en.wikipedia.org/wiki/File:Sow_with_piglet.jpghttp://en.wikipedia.org/wiki/File:Sow_with_piglet.jpghttp://en.wikipedia.org/wiki/File:Flu_und_legende_color_c.jpghttp://en.wikipedia.org/wiki/Orthomyxoviridaehttp://en.wikipedia.org/wiki/Avian_influenzahttp://en.wikipedia.org/wiki/Flu_seasonhttp://en.wikipedia.org/wiki/Influenza_researchhttp://en.wikipedia.org/wiki/Influenza_vaccinehttp://en.wikipedia.org/wiki/Influenza_treatmenthttp://en.wikipedia.org/wiki/H5N1http://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1http://en.wikipedia.org/wiki/2009_flu_pandemic


3/57


lectron microscopeimage of the reassorted11 influen+a virusphotographed at the '5' 6nfluen+a 7a&oratory. *he viruses are 801,0 nanometresin diameter.91:

Swine influenza"also called swine flu! hog flu! and pig flu$ is aninfection &y any one of several types of swine influen+a virus. Swineinfluenza virus"S!"$ is any strain of the influen+a family of virusesthatis endemicin pigs.9,:As of ,00-! the nown 6 strains include influen+a'and the su&types of influen+a Anown as 11! 1,! 31! 3,!and ,3.

wine influen+a virus is common throughout pig populations worldwide.

*ransmission of the virus from pigs to humans is not common and doesnot always lead to human influen+a! often resulting only in the productionof anti&odiesin the &lood. 6f transmission does cause human influen+a! itis called +oonoticswine flu. ;eople with regular e)posure to pigs are atincreased ris of swine flu infection. *he meat of an infected animal posesno ris of infection when properly cooed.

5uring the mid#,0th century! identification of influen+a su&types &ecamepossi&le! allowing accurate diagnosis of transmission to humans. ince

then! only 20 such transmissions have &een confirmed. *hese strains ofswine flu rarely pass from human to human. ymptoms of +oonotic swineflu in humans are similar to those of influen+aand of influen+a#lie illnessin general! namely chills! fever! sore throat! muscle pains! severeheadache! coughing! weanessand general discomfort.

Contents

1 'lassificationo 1.1 6nfluen+a '

o 1., 6nfluen+a A
http://en.wikipedia.org/wiki/Electron_microscopehttp://en.wikipedia.org/wiki/Reassortmenthttp://en.wikipedia.org/wiki/Nanometrehttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-0http://en.wikipedia.org/wiki/Virushttp://en.wikipedia.org/wiki/Orthomyxoviridaehttp://en.wikipedia.org/wiki/Endemismhttp://en.wikipedia.org/wiki/Pighttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-Merck-1http://en.wikipedia.org/wiki/Influenzavirus_Chttp://en.wikipedia.org/wiki/Influenzavirus_Chttp://en.wikipedia.org/wiki/Influenza_A_Virushttp://en.wikipedia.org/wiki/H1N1http://en.wikipedia.org/wiki/H1N2http://en.wikipedia.org/wiki/H3N1http://en.wikipedia.org/wiki/H3N2http://en.wikipedia.org/wiki/H2N3http://en.wikipedia.org/wiki/Human_influenzahttp://en.wikipedia.org/wiki/Antibodyhttp://en.wikipedia.org/wiki/Zoonosishttp://en.wikipedia.org/wiki/Influenzahttp://en.wikipedia.org/wiki/Influenza-like_illnesshttp://en.wikipedia.org/wiki/Chillshttp://en.wikipedia.org/wiki/Feverhttp://en.wikipedia.org/wiki/Pharyngitishttp://en.wikipedia.org/wiki/Myalgiahttp://en.wikipedia.org/wiki/Headachehttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Fatigue_(medical)http://en.wikipedia.org/wiki/Malaisehttp://en.wikipedia.org/wiki/Malaisehttp://en.wikipedia.org/wiki/Swine_influenza#Classificationhttp://en.wikipedia.org/wiki/Swine_influenza#Influenza_Chttp://en.wikipedia.org/wiki/Swine_influenza#Influenza_Ahttp://en.wikipedia.org/wiki/File:H1N1_influenza_virus.jpghttp://en.wikipedia.org/wiki/File:H1N1_influenza_virus.jpghttp://en.wikipedia.org/wiki/Electron_microscopehttp://en.wikipedia.org/wiki/Reassortmenthttp://en.wikipedia.org/wiki/Nanometrehttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-0http://en.wikipedia.org/wiki/Virushttp://en.wikipedia.org/wiki/Orthomyxoviridaehttp://en.wikipedia.org/wiki/Endemismhttp://en.wikipedia.org/wiki/Pighttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-Merck-1http://en.wikipedia.org/wiki/Influenzavirus_Chttp://en.wikipedia.org/wiki/Influenzavirus_Chttp://en.wikipedia.org/wiki/Influenza_A_Virushttp://en.wikipedia.org/wiki/H1N1http://en.wikipedia.org/wiki/H1N2http://en.wikipedia.org/wiki/H3N1http://en.wikipedia.org/wiki/H3N2http://en.wikipedia.org/wiki/H2N3http://en.wikipedia.org/wiki/Human_influenzahttp://en.wikipedia.org/wiki/Antibodyhttp://en.wikipedia.org/wiki/Zoonosishttp://en.wikipedia.org/wiki/Influenzahttp://en.wikipedia.org/wiki/Influenza-like_illnesshttp://en.wikipedia.org/wiki/Chillshttp://en.wikipedia.org/wiki/Feverhttp://en.wikipedia.org/wiki/Pharyngitishttp://en.wikipedia.org/wiki/Myalgiahttp://en.wikipedia.org/wiki/Headachehttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Fatigue_(medical)http://en.wikipedia.org/wiki/Malaisehttp://en.wikipedia.org/wiki/Swine_influenza#Classificationhttp://en.wikipedia.org/wiki/Swine_influenza#Influenza_Chttp://en.wikipedia.org/wiki/Swine_influenza#Influenza_A


4/57


o 1.3 urveillance

, istory

o ,.1 1-18 pandemic in humans

o ,., 1-


5/57


>f the three generaof influen+a viruses that cause human flu! two alsocause influen+a in pigs! with influen+a A&eing common in pigs andinfluen+a '&eing rare.93:6nfluen+a ?has not &een reported in pigs.@ithin influen+a A and influen+a '! the strains found in pigs and humansare largely distinct! although due to reassortmentthere have &een

transfers of genes among strains crossing swine! avian! and humanspecies &oundaries.

!nfluenza C

6nfluen+a ' viruses infect &oth humans and pigs! &ut do not infect &irds.94:

*ransmission &etween pigs and humans have occurred in the past.92:Fore)ample! influen+a ' caused small out&reas of a mild form of influen+aamongst children in apan9(:and 'alifornia.9(:5ue to its limited host range

and the lac of genetic diversity in influen+a '! this form of influen+a doesnot cause pandemics in humans.9


6/57


wine influen+a was first proposed to &e a disease related to humaninfluen+a during the 1-18 flu pandemic! when pigs &ecame sic at thesame time as humans.91(:*he first identification of an influen+a virus as acause of disease in pigs occurred a&out ten years later! in 1-30.91


7/57


strain remains elusive.9,4:6t is estimated that anywhere from 20 to100 million people were illed worldwide.91-:9,2:

#$&' ()S) outbrea*

Main article: 1976 swine flu outbreak

>n Fe&ruary 2! 1-cto&er 1! 1-


8/57


influen+a vaccines! with an incidence of a&out one case per millionvaccinations.930:As a result! 5i usto writes that Ithe pu&lic refused totrust a government#operated health program that illed old people andcrippled young people.I 6n total! 48!1(1!01- Americans! or Dust over ,,%of the population! had &een immuni+ed &y the time the ational 6nfluen+a

6mmuni+ation ;rogram"66;$ was effectively halted on 5ecem&er 1(!1-verall! there were 10-8 cases of Guillain#?arrJ yndrome "G?$recorded nationwide &y '5' surveillance! 23, of which were lined to the66; vaccination! resulting in death from severe pulmonary complicationsfor ,2 people! which! according to 5r. ;. a&er! were pro&a&ly caused &yan immunopathological reaction to the 1-ther influen+avaccines have not &een lined to G?! though caution is advised for

certain individuals! particularly those with a history of G?. 933:934:932:till!as o&served &y a participant in the immuni+ation program! the vaccineilled more Americans than the disease did.93(:

#$%% zoonosis

6n eptem&er 1-88! a swine flu virus illed one woman and infectedothers. 3,#year old ?ar&ara Ann @ieners was eight months pregnantwhen she and her hus&and! d! &ecame ill after visiting the hog &arn at a

county fair in @alworth 'ounty! @isconsin. ?ar&ara died eight days later!after developing pneumonia.93


9/57


+,,& -hilippine outbrea* in swine

>n August ,0! ,00< 5epartment of Agriculture officers investigated theout&rea "epi+ootic$ of swine flu in ueva ciDaand 'entral 7u+on!;hilippines. *he mortality rate is less than 10% for swine flu! unless there

are complications lie hog cholera. >n uly ,
http://en.wikipedia.org/wiki/Epizootichttp://en.wikipedia.org/wiki/Nueva_Ecijahttp://en.wikipedia.org/wiki/Luzonhttp://en.wikipedia.org/wiki/Hog_cholerahttp://en.wikipedia.org/wiki/Metro_Manilahttp://en.wikipedia.org/wiki/Bulacanhttp://en.wikipedia.org/wiki/Pampangahttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-43http://en.wikipedia.org/wiki/Swine_influenza#cite_note-44http://en.wikipedia.org/wiki/H1N1http://en.wikipedia.org/wiki/Strain_(biology)http://en.wikipedia.org/wiki/2009_flu_pandemichttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-NewSci-20090424-pandemic-45http://en.wikipedia.org/wiki/WHOhttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-CDCdispatch-46http://en.wikipedia.org/wiki/Swine_influenza#cite_note-KahnHysteria-47http://en.wikipedia.org/wiki/Albertahttp://en.wikipedia.org/wiki/2009_swine_flu_outbreak_in_Mexicohttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-48http://en.wikipedia.org/wiki/Reassortmenthttp://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1http://en.wikipedia.org/wiki/Human_influenzahttp://en.wikipedia.org/wiki/Avian_influenzahttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-NewSci-20090424-pandemic-45http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Trifonov.2B2009-49http://en.wikipedia.org/wiki/Zoonosishttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-50http://en.wikipedia.org/wiki/Swine_influenza#cite_note-51http://en.wikipedia.org/wiki/Swine_influenza#cite_note-52http://en.wikipedia.org/wiki/Epizootichttp://en.wikipedia.org/wiki/Nueva_Ecijahttp://en.wikipedia.org/wiki/Luzonhttp://en.wikipedia.org/wiki/Hog_cholerahttp://en.wikipedia.org/wiki/Metro_Manilahttp://en.wikipedia.org/wiki/Bulacanhttp://en.wikipedia.org/wiki/Pampangahttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-43http://en.wikipedia.org/wiki/Swine_influenza#cite_note-44http://en.wikipedia.org/wiki/H1N1http://en.wikipedia.org/wiki/Strain_(biology)http://en.wikipedia.org/wiki/2009_flu_pandemichttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-NewSci-20090424-pandemic-45http://en.wikipedia.org/wiki/WHOhttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-CDCdispatch-46http://en.wikipedia.org/wiki/Swine_influenza#cite_note-KahnHysteria-47http://en.wikipedia.org/wiki/Albertahttp://en.wikipedia.org/wiki/2009_swine_flu_outbreak_in_Mexicohttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-48http://en.wikipedia.org/wiki/Reassortmenthttp://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1http://en.wikipedia.org/wiki/Human_influenzahttp://en.wikipedia.org/wiki/Avian_influenzahttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-NewSci-20090424-pandemic-45http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Trifonov.2B2009-49http://en.wikipedia.org/wiki/Zoonosishttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-50http://en.wikipedia.org/wiki/Swine_influenza#cite_note-51http://en.wikipedia.org/wiki/Swine_influenza#cite_note-52


10/57


Transmission

Transmission between pigs

6nfluen+a is Luite common in pigs! with a&out half of &reeding pigs having

&een e)posed to the virus in the =.924:

Anti&odies to the virus are alsocommon in pigs in other countries.924:

*he main route of transmission is through direct contact &etween infectedand uninfected animals.911:*hese close contacts are particularly commonduring animal transport. 6ntensive farmingmay also increase the ris oftransmission! as the pigs are raised in very close pro)imity to each other.922:92(:*he direct transfer of the virus pro&a&ly occurs either &y pigstouching noses! or through dried mucus. Air&orne transmission through

the aerosols produced &y pigs coughing or snee+ing are also an importantmeans of infection.911:*he virus usually spreads Luicly through a herd!infecting all the pigs within Dust a few days.9,:*ransmission may alsooccur through wild animals! such as wild &oar! which can spread thedisease &etween farms.92ther professions at particular ris of infection are veterinarians andmeat processing worers! although the ris of infection for &oth of thesegroups is lower than that of farm worers.9(1:

!nteraction with avian .N# in pigs

;igs are unusual as they can &e infected with influen+a strains thatusually infect three different species pigs! &irds and humans. 9(,:*his

maes pigs a host where influen+a viruses might e)change genes!producing new and dangerous strains.9(,:Avian influen+a virus 3,isendemicin pigsin 'hina and has &een detected in pigs in ietnam!increasing fears of the emergence of new variant strains.9(3:3,evolved
http://en.wikipedia.org/wiki/Swine_influenza#cite_note-cfsph-53http://en.wikipedia.org/wiki/Swine_influenza#cite_note-cfsph-53http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Kothalawala-10http://en.wikipedia.org/wiki/Intensive_farminghttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-54http://en.wikipedia.org/wiki/Swine_influenza#cite_note-55http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Kothalawala-10http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Merck-1http://en.wikipedia.org/wiki/Wild_boarhttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-56http://en.wikipedia.org/wiki/Zoonosishttp://en.wikipedia.org/wiki/Zoonosishttp://en.wikipedia.org/wiki/Reassortmenthttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-pmid19276439-57http://en.wikipedia.org/wiki/Swine_influenza#cite_note-58http://en.wikipedia.org/wiki/Swine_influenza#cite_note-pmid18258038-59http://en.wikipedia.org/wiki/Swine_influenza#cite_note-pmid19276439-57http://en.wikipedia.org/wiki/Swine_influenza#cite_note-60http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Thacker-61http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Thacker-61http://en.wikipedia.org/wiki/H3N2http://en.wikipedia.org/wiki/Endemic_(epidemiology)http://en.wikipedia.org/wiki/Pighttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-62http://en.wikipedia.org/wiki/H3N2http://en.wikipedia.org/wiki/Swine_influenza#cite_note-cfsph-53http://en.wikipedia.org/wiki/Swine_influenza#cite_note-cfsph-53http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Kothalawala-10http://en.wikipedia.org/wiki/Intensive_farminghttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-54http://en.wikipedia.org/wiki/Swine_influenza#cite_note-55http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Kothalawala-10http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Merck-1http://en.wikipedia.org/wiki/Wild_boarhttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-56http://en.wikipedia.org/wiki/Zoonosishttp://en.wikipedia.org/wiki/Zoonosishttp://en.wikipedia.org/wiki/Reassortmenthttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-pmid19276439-57http://en.wikipedia.org/wiki/Swine_influenza#cite_note-58http://en.wikipedia.org/wiki/Swine_influenza#cite_note-pmid18258038-59http://en.wikipedia.org/wiki/Swine_influenza#cite_note-pmid19276439-57http://en.wikipedia.org/wiki/Swine_influenza#cite_note-60http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Thacker-61http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Thacker-61http://en.wikipedia.org/wiki/H3N2http://en.wikipedia.org/wiki/Endemic_(epidemiology)http://en.wikipedia.org/wiki/Pighttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-62http://en.wikipedia.org/wiki/H3N2


11/57


from ,,&y antigenic shift.9(4:6n August ,004! researchers in 'hinafound 21in pigs.9(2:

Cain symptoms of swine flu in swine.9,:

*hese 21 infections may &e Luite common in a survey of 10apparently healthy pigs housed near poultry farms in @est ava! where

avian flu had &roen out! five of the pig samples contained the 21virus. *he 6ndonesian government has since found similar results in thesame region. Additional tests of 120 pigs outside the area were negative.9((:9(


12/57


Cain symptoms of swine flu in humans9(8:

5irect transmission of a swine flu virus from pigs to humans isoccasionally possi&le "called +oonoticswine flu$. 6n all! 20 cases arenown to have occurred since the first report in medical literature in

1-28! which have resulted in a total of si) deaths.9(-:

>f these si) people!one was pregnant! one had leuemia! one had odgin diseaseand twowere nown to &e previously healthy.9(-:5espite these apparently lownum&ers of infections! the true rate of infection may &e higher! sincemost cases only cause a very mild disease! and will pro&a&ly never &ereported or diagnosed.9(-:

6n this video! 5r. oe ?resee! with '5'Ks 6nfluen+a 5ivision! descri&es thesymptoms of swine flu and warning signs to loo for that indicate theneed for urgent medical attention.

ee also ee this video with su&titles on Mou*u&e 9,:

According to the 'enters for 5isease 'ontrol and ;revention"'5'$! inhumans the symptoms of the ,00- Iswine fluI 11 virus are similar tothose of influen+aand of influen+a#lie illnessin general. ymptomsinclude fever! cough! sore throat! &ody aches! headache! chillsandfatigue. *he ,00- out&rea has shown an increased percentage ofpatients reporting diarrheaand vomiting.9


13/57


confir$edswine flu reLuires la&oratory testing of a respiratory sample "asimple nose and throat swa&$.9ther causes ofdeath are pneumonia"leading to sepsis$9


14/57


enough to have significant cross#protection! and custom "autogenous$vaccines made from the specific viruses isolated are created and used inthe more difficult cases.9


15/57


wine can &e infected &y &oth avian and human influen+a strains ofinfluen+a! and therefore are hosts where the antigenic shiftscan occurthat create new influen+a strains.

*he transmission from swine to human is &elieved to occur mainly inswine farms where farmers are in close contact with live pigs. Althoughstrains of swine influen+a are usually not a&le to infect humans this mayoccasionally happen! so farmers and veterinarians are encouraged to usea face maswhen dealing with infected animals. *he use of vaccines onswine to prevent their infection is a maDor method of limiting swine tohuman transmission. /is factors that may contri&ute to swine#to#humantransmission include smoing and not wearing gloves when woring with

sic animals.9


16/57


/ecommendations to prevent spread of the virus among humans includeusing standard infection control against influen+a. *his includes freLuentwashing of hands with soap and water or with alcohol#&ased handsaniti+ers! especially after &eing out in pu&lic.98,:'hance of transmissionis also reduced &y disinfecting household surfaces! which can &e done

effectively with a diluted chlorine &leach solution.983:

)perts agree that hand#washing can help prevent viral infections!including ordinary influen+a and the swine flu virus. Also avoidingtouching eyes! nose and mouth with hands prevents flu. 93:6nfluen+a canspread in coughs or snee+es! &ut an increasing &ody of evidence showssmall droplets containing the virus can linger on ta&letops! telephonesand other surfaces and &e transferred via the fingers to the mouth! noseor eyes. Alcohol#&ased gel or foam hand saniti+erswor well to destroy

viruses and &acteria. Anyone with flu#lie symptoms such as a suddenfever! cough or muscle aches should stay away from wor or pu&lictransportation and should contact a doctor for advice.

ocial distancingis another tactic. 6t means staying away from otherpeople who might &e infected and can include avoiding large gatherings!spreading out a little at wor! or perhaps staying home and lying low if aninfection is spreading in a community. ;u&lic healthand other responsi&leauthorities have action plans which may reLuest or reLuire social

distancing actions depending on the severity of the out&rea.

accination

accinesare availa&le for different inds of swine flu. Although thecurrent trivalent influen+a vaccine is unliely to provide protection againstthe new ,00- 11 strain!984:vaccines against the new strain are &eingdeveloped and could &e ready as early as ovem&er ,00-.982:

Treatment

!n swine

As swine influen+a is rarely fatal to pigs! little treatment &eyond rest andsupportive care is reLuired.924:6nstead veterinary efforts are focused onpreventing the spread of the virus throughout the farm! or to otherfarms.911:accination and animal management techniLues are mostimportant in these efforts. Anti&iotics are also used to treat this disease!

which although they have no effect against the influen+a virus! do helpprevent &acterial pneumoniaand other secondary infectionsin influen+a#weaened herds.924:
http://en.wikipedia.org/wiki/Influenza#Infection_controlhttp://en.wikipedia.org/wiki/Hand_sanitizerhttp://en.wikipedia.org/wiki/Hand_sanitizerhttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-81http://en.wikipedia.org/wiki/Swine_influenza#cite_note-82http://www.cdc.gov/H1N1flu/qa.htmhttp://en.wikipedia.org/wiki/Hand_sanitizerhttp://en.wikipedia.org/wiki/Social_distancinghttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Vaccinehttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-83http://en.wikipedia.org/wiki/Swine_influenza#cite_note-84http://en.wikipedia.org/wiki/Swine_influenza#cite_note-cfsph-53http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Kothalawala-10http://en.wikipedia.org/wiki/Pneumoniahttp://en.wikipedia.org/wiki/Secondary_infectionhttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-cfsph-53http://en.wikipedia.org/wiki/Influenza#Infection_controlhttp://en.wikipedia.org/wiki/Hand_sanitizerhttp://en.wikipedia.org/wiki/Hand_sanitizerhttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-81http://en.wikipedia.org/wiki/Swine_influenza#cite_note-82http://www.cdc.gov/H1N1flu/qa.htmhttp://en.wikipedia.org/wiki/Hand_sanitizerhttp://en.wikipedia.org/wiki/Social_distancinghttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Vaccinehttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-83http://en.wikipedia.org/wiki/Swine_influenza#cite_note-84http://en.wikipedia.org/wiki/Swine_influenza#cite_note-cfsph-53http://en.wikipedia.org/wiki/Swine_influenza#cite_note-Kothalawala-10http://en.wikipedia.org/wiki/Pneumoniahttp://en.wikipedia.org/wiki/Secondary_infectionhttp://en.wikipedia.org/wiki/Swine_influenza#cite_note-cfsph-53


17/57


!n humans

6f a person &ecomes sic with swine flu! antiviral drugs can mae theillness milder and mae the patient feel &etter faster. *hey may alsoprevent serious flu complications. For treatment! antiviral drugs wor

&est if started soon after getting sic "within , days of symptoms$. ?esideantivirals! supportive care at home or in hospital! focuses on controllingfevers! relieving pain and maintaining fluid &alance! as well as identifyingand treating any secondary infections or other medical pro&lems. *he=.. 'enters for 5isease 'ontrol and ;reventionrecommends the use of*amiflu "oseltamivir$ or /elen+a "+anamivir$ for the treatment andorprevention of infection with swine influen+a virusesB however! themaDority of people infected with the virus mae a full recovery withoutreLuiring medical attention or antiviral drugs.98(:*he virus isolates in the

,00- out&rea have &een found resistant to amantadineand rimantadine.98


18/57


3. /einen ;; "12 eptem&er ,003$. Iwine influen+a a +oonosisI.&eterinary Sciences %o$orrow. 612(-#0830.httpwww.vetscite.orgpu&lisharticles000041print.html.I6nfluen+a ? and ' viruses are almost e)clusively isolated from man!although influen+a ' virus has also &een isolated from pigs and

influen+a ? has recently &een isolated from seals.I.

4. /?ouvier C! ;alese ; "eptem&er ,008$. I*he &iology of influen+avirusesI. &accine+' Suppl 0 54-23. ;C65 1-,301(0.

2. /Rimura ! A&io '! ;eng G! et al"April 1--


19/57


20/57


,,. /Ray /C! 5one ! ;aton 5 "August 1--4$. Iffect ofseLuential porcine reproductive and respiratory syndrome and swineinfluen+a on the growth and performance of finishing pigsI. &et.'ec.#1."-$ 1--,04. ;C65


21/57


httpaDe.o)fordDournals.orgcgicontenta&stract1113,


22/57


41. /tephanie 5esmon "April ,8! ,00-$. I)pert wine flu virusmore comple) than typically seenI. 8alti$ore Sun.httpwww.&altimoresun.comnewshealth&al#swine#flu#strain04,8!0!31(24(


23/57


httpwww.eurosurveillance.orgimagesdynamic141


24/57


(0. /Gray G'! Cc'arthy *! 'apuano A@! etterLuist F! >lsen'@! AlavanDa C' "5ecem&er ,00cto&er ,004$. IGenetic analysis of human ,, and early 3,influen+a viruses! 1-2cto&er ,002$. I21 avianinfluen+a timelineI ";5F$.httpwww.who.intcsrdiseaseavianWinfluen+a*imelineW,8W10a.pdf.

((. /I6ndonesian pigs have avian flu virusB &ird cases dou&le in'hinaI. =niversity of Cinnesota 'enter for 6nfectious 5isease/esearch T ;olicy. ,< Cay ,002.httpwww.cidrap.umn.educidrapcontentinfluen+aavianflunewsmay,


25/57


26/57


http://en.wikipedia.org/wiki/Swine_influenza#cite_ref-78http://www.cdc.gov/ncidod/eid/vol12no06/05-1576.htmhttp://www.cdc.gov/ncidod/eid/vol12no06/05-1576.htmhttp://www.ncbi.nlm.nih.gov/pubmed/16707061http://www.ncbi.nlm.nih.gov/pubmed/16707061http://en.wikipedia.org/wiki/PubMed_Centralhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1673213http://www.cdc.gov/ncidod/eid/vol12no06/05-1576.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-CDCspread_79-0http://en.wikipedia.org/wiki/Swine_influenza#cite_ref-CDCspread_79-1http://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-80http://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-81http://cdc.gov/swineflu/investigation.htmhttp://cdc.gov/swineflu/investigation.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-82http://www.waterandhealth.org/newsletter/new/winter_2005/chlorine_bleach.htmlhttp://www.waterandhealth.org/newsletter/new/winter_2005/chlorine_bleach.htmlhttp://www.waterandhealth.org/newsletter/new/winter_2005/chlorine_bleach.htmlhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-83http://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-84http://www.nbcconnecticut.com/news/local/CT-Company-Making-Swine-Flu-Vaccine.htmlhttp://www.nbcconnecticut.com/news/local/CT-Company-Making-Swine-Flu-Vaccine.htmlhttp://www.nbcconnecticut.com/news/local/CT-Company-Making-Swine-Flu-Vaccine.htmlhttp://www.nbcconnecticut.com/news/local/CT-Company-Making-Swine-Flu-Vaccine.htmlhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-85http://www.who.int/csr/disease/swineflu/faq/en/index.htmlhttp://www.who.int/csr/disease/swineflu/faq/en/index.htmlhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-86http://www.cdc.gov/swineflu/antiviral_swine.htmhttp://www.cdc.gov/swineflu/antiviral_swine.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-87http://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.htmlhttp://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.htmlhttp://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.htmlhttp://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.htmlhttp://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.htmlhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-78http://www.cdc.gov/ncidod/eid/vol12no06/05-1576.htmhttp://www.cdc.gov/ncidod/eid/vol12no06/05-1576.htmhttp://www.ncbi.nlm.nih.gov/pubmed/16707061http://www.ncbi.nlm.nih.gov/pubmed/16707061http://en.wikipedia.org/wiki/PubMed_Centralhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1673213http://www.cdc.gov/ncidod/eid/vol12no06/05-1576.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-CDCspread_79-0http://en.wikipedia.org/wiki/Swine_influenza#cite_ref-CDCspread_79-1http://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-80http://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-81http://cdc.gov/swineflu/investigation.htmhttp://cdc.gov/swineflu/investigation.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-82http://www.waterandhealth.org/newsletter/new/winter_2005/chlorine_bleach.htmlhttp://www.waterandhealth.org/newsletter/new/winter_2005/chlorine_bleach.htmlhttp://www.waterandhealth.org/newsletter/new/winter_2005/chlorine_bleach.htmlhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-83http://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://www.cdc.gov/swineflu/key_facts.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-84http://www.nbcconnecticut.com/news/local/CT-Company-Making-Swine-Flu-Vaccine.htmlhttp://www.nbcconnecticut.com/news/local/CT-Company-Making-Swine-Flu-Vaccine.htmlhttp://www.nbcconnecticut.com/news/local/CT-Company-Making-Swine-Flu-Vaccine.htmlhttp://www.nbcconnecticut.com/news/local/CT-Company-Making-Swine-Flu-Vaccine.htmlhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-85http://www.who.int/csr/disease/swineflu/faq/en/index.htmlhttp://www.who.int/csr/disease/swineflu/faq/en/index.htmlhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-86http://www.cdc.gov/swineflu/antiviral_swine.htmhttp://www.cdc.gov/swineflu/antiviral_swine.htmhttp://en.wikipedia.org/wiki/Swine_influenza#cite_ref-87http://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.htmlhttp://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.htmlhttp://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.htmlhttp://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.html


27/57


8-. ituation =pdate-0. ach wee '5' analy+es information a&out

influen+a disease activity in the =nited tates and

pu&lishes findings of ey flu indicators in a report

called Fluiew. 5uring the wee of August 1(#,,!

,00-! a review of these ey indictors found that influen+a activity is

either sta&le! or is increasing in some areas. Activity appears to &e

increasing in the outheast &ased on influen+a#lie illness data

reported &y health care providers. ?elow is a summary of the most

recent ey indicators

Novel #N# Flu 2Swine Flu3 and 4ou

August 2! ,00- 200 ;C *

On this Page

ovel 11 Flu ovel 11 Flu in umans

;revention T *reatment

'ontamination T 'leaning

)posures ot *hought to pread ovel 11 Flu

Novel #N# Flu

5hat is novel #N# 2swine flu36ovel 11 "referred to as [swine flu\ early on$ is a new influen+a virus

causing illness in people. *his new virus was first detected in people inthe =nited tates in April ,00-. *his virus is spreading from person#to#person worldwide! pro&a&ly in much the same way that regular seasonalinfluen+a viruses spread. >n une 11! ,00-! the @orld ealth>rgani+ation"@>$ signaled that a pandemic of novel 11 flu wasunderway.

5hy is novel #N# virus sometimes called7swine flu86

*his virus was originally referred to as [swine flu\&ecause la&oratory testing showed that many ofthe genes in this new virus were very similar toinfluen+a viruses that normally occur in pigs
http://www.cdc.gov/flu/weekly/http://www.cdc.gov/h1n1flu/qa.htm#ahttp://www.cdc.gov/h1n1flu/qa.htm#bhttp://www.cdc.gov/h1n1flu/qa.htm#dhttp://www.cdc.gov/h1n1flu/qa.htm#ehttp://www.cdc.gov/h1n1flu/qa.htm#chttp://www.who.int/csr/disease/swineflu/en/index.htmlhttp://www.who.int/csr/disease/swineflu/en/index.htmlhttp://www.cdc.gov/h1n1flu/update.htmhttp://www.cdc.gov/flu/weekly/http://www.cdc.gov/h1n1flu/qa.htm#ahttp://www.cdc.gov/h1n1flu/qa.htm#bhttp://www.cdc.gov/h1n1flu/qa.htm#dhttp://www.cdc.gov/h1n1flu/qa.htm#ehttp://www.cdc.gov/h1n1flu/qa.htm#chttp://www.who.int/csr/disease/swineflu/en/index.htmlhttp://www.who.int/csr/disease/swineflu/en/index.html


28/57


29/57


treatment! hospitali+ations and deaths from infection with this virus haveoccurred.

6n seasonal flu! certain people are at [high ris\ of serious complications.*his includes people (2 years and older! children younger than five years

old! pregnant women! and people of any age with certain chronic medicalconditions. A&out ne thing that appears to &e different from seasonal influen+a is thatadults older than (4 years do not yet appear to &e at increased ris of

novel 11#related complications thus far. '5' la&oratory studies haveshown that no children and very few adults younger than (0 years oldhave e)isting anti&ody to novel 11 flu virusB however! a&out one#thirdof adults older than (0 may have anti&odies against this virus. 6t isunnown how much! if any! protection may &e afforded against novel11 flu &y any e)isting anti&ody.

ow does novel #N# flu compare to seasonal flu in terms of itsseverity and infection rates6

@ith seasonal flu! we now that seasons vary in terms of timing! durationand severity. easonal influen+a can cause mild to severe illness! and attimes can lead to death. ach year! in the =nited tates! on average3(!000 people die from flu#related complications and more than ,00!000people are hospitali+ed from flu#related causes. >f those hospitali+ed!,0!000 are children younger than 2 years old. >ver -0% of deaths anda&out (0 percent of hospitali+ation occur in people older than (2.

@hen the novel 11 out&rea was first detected in mid#April ,00-! '5'

&egan woring with states to collect! compile and analy+e informationregarding the novel 11 flu out&rea! including the num&ers ofconfirmed and pro&a&le cases and the ages of these people. *heinformation analy+ed &y '5' supports the conclusion that novel 11 fluhas caused greater disease &urden in people younger than ,2 years ofage than older people. At this time! there are few cases and few deathsreported in people older than (4 years old! which is unusual whencompared with seasonal flu. owever! pregnancy and other previouslyrecogni+ed high ris medical conditions from seasonal influen+a appear to&e associated with increased ris of complications from this novel 11.*hese underlying conditions include asthma! dia&etes! suppressed


30/57


immune systems! heart disease! idney disease! neurocognitive andneuromuscular disorders and pregnancy.

ow long can an infected person spread this virus to others6;eople infected with seasonal and novel 11 flu shed virus and may &e

a&le to infect others from 1 day &efore getting sic to 2 to < days after.*his can &e longer in some people! especially children and people withweaened immune systems and in people infected with the new 11virus.

-revention 9 Treatment

5hat can ! do to protect myself from getting sic*6*here is no vaccine availa&le right now to protect against novel 11virus. owever! a novel 11 vaccine is currently in production and may&e ready for the pu&lic in the fall. As always! a vaccine will &e availa&le toprotect against seasonal influen+a*here are everyday actions that can help prevent the spread of germsthat cause respiratory illnesses lie influen+a.

Ta*e these everyday steps to protect your health:

'over your nose and mouth with a tissue when you cough orsnee+e. *hrow the tissue in the trash after you use it.

@ash your hands often with soap and water! especially after youcough or snee+e. Alcohol#&ased hand cleaners]are also effective.

Avoid touching your eyes! nose or mouth. Germs spread this way.

*ry to avoid close contact with sic people.

6f you are sic with flu#lie illness! '5' recommends that you stayhome for at least ,4 hours after your fever is gonee)cept to getmedical care or for other necessities. "Mour fever should &e gonewithout the use of a fever#reducing medicine.$ Reep away fromothers as much as possi&le to eep from maing others sic.

;ther important actions that you can ta*e are:

Follow pu&lic health advice regarding school closures! avoidingcrowds and other social distancing measures.

?e prepared in case you get sic and need to stay home for a weeor soB a supply of over#the#counter medicines! alcohol#&ased handru&s!]tissues and other related items might could &e useful and
http://www.cdc.gov/flu/protect/keyfacts.htmhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/flu/protect/keyfacts.htmhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterial


31/57


help avoid the need to mae trips out in pu&lic while you are sicand contagious

5hat is the best way to *eep from spreadingthe virus through coughing or sneezing6

6f you are sic with flu#lie illness! '5'recommends that you stay home for at least ,4hours after your fever is gonee)cept to getmedical care or for other necessities. "Mour fevershould &e gone without the use of a fever#reducing

medicine.$Reep away from others as much as possi&le. 'over your mouth and nosewith a tissue when coughing or snee+ing. ;ut your used tissue in thewaste &aset. *hen! clean your hands! and do so every time you cough or

snee+e.

!f ! have a family member at home who is sic* with novel #N#flu< should ! go to wor*6mployees who are well &ut who have an ill family mem&er at home withnovel 11 flu can go to wor as usual. *hese employees should monitortheir health every day! and tae everyday precautions including washingtheir hands often with soap and water! especially after they cough orsnee+e. Alcohol#&ased hand cleaners are also effective.] 6f they &ecome

ill! they should notify their supervisor and stay home. mployees whohave an underlying medical condition or who are pregnant should calltheir health care provider for advice! &ecause they might need to receiveinfluen+a antiviral drugs to prevent illness. For more information pleasesee General ?usiness and @orplace Guidance for the ;revention of ovel6nfluen+a A "11$ Flu in @orers.

5hat is the best techni=ue for washing my hands to avoid gettingthe flu6

@ashing your hands often will help protect you from germs. @ash withsoap and water or clean with alcohol#&ased hand cleaner]. '5'recommends that when you wash your hands ## with soap and warmwater ## that you wash for 12 to ,0 seconds. @hen soap and water arenot availa&le! alcohol#&ased disposa&le hand wipes or gel saniti+ers may&e used. Mou can find them in most supermarets and drugstores. 6fusing gel! ru& your hands until the gel is dry. *he gel doesnKt need waterto worB the alcohol in it ills the germs on your hands.

5hat should ! do if ! get sic*66f you live in areas where people have &een identified with novel 11 fluand &ecome ill with influen+a#lie symptoms! including fever! &ody aches!
http://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/workplace.htmhttp://www.cdc.gov/h1n1flu/guidance/workplace.htmhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/workplace.htmhttp://www.cdc.gov/h1n1flu/guidance/workplace.htmhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterial


32/57


runny or stuffy nose! sore throat! nausea! or vomiting or diarrhea! youshould stay home and avoid contact with other people.'5' recommendsthat you stay home for at least ,4 hours after your fever is gonee)ceptto get medical care or for other necessities. "Mour fever should &e gonewithout the use of a fever#reducing medicine.$ tay away from others as

much as possi&le to eep from maing others sic.taying at homemeans that you should not leave your home e)cept to see medical care.*his means avoiding normal activities! including wor! school! travel!shopping! social events! and pu&lic gatherings.

6f you have severe illness or you are at high ris for flu complications!contact your health care provider or see medical care. Mour health careprovider will determine whether flu testing or treatment is needed.

6f you &ecome ill and e)perience any of the following warning signs! seeemergency medical care.

!n children< emergency warning signs that need urgent medicalattention include:

Fast &reathing or trou&le &reathing ?luish or gray sin color

ot drining enough fluids

evere or persistent vomiting

ot waing up or not interacting

?eing so irrita&le that the child does not want to &e held

Flu#lie symptoms improve &ut then return with fever and worsecough

!n adults< emergency warning signs that need urgent medicalattention include:

5ifficulty &reathing or shortness of &reath ;ain or pressure in the chest or a&domen

udden di++iness

'onfusion

evere or persistent vomiting Flu#lie symptoms improve &ut then return with fever and worse

cough
http://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htm


33/57


Are there medicines to treat novel #N# infection6Mes. '5' recommends the use of oseltamivir or +anamivir for thetreatment andor prevention of infection with novel 11 flu virus.Antiviral drugs are prescription medicines "pills! liLuid or an inhaledpowder$ that fight against the flu &y eeping flu viruses from reproducing

in your &ody. 6f you get sic! antiviral drugs can mae your illness milderand mae you feel &etter faster. *hey may also prevent serious flucomplications. 5uring the current pandemic! the priority use for influen+aantiviral drugsis to treat severe influen+a illness "for e)amplehospitali+ed patients$ and people who are sic who have a condition thatplaces them at high ris for serious flu#related complications.

5hat is CDC>s recommendation regarding ?swine flu parties?6Iwine flu partiesI are gatherings during which people have close contact

with a person who has novel 11 flu in order to &ecome infected withthe virus. *he intent of these parties is for a person to &ecome infectedwith what for many people has &een a mild disease! in the hope of havingnatural immunity novel 11 flu virus that might circulate later andcause more severe disease.

'5' does not recommend Iswine flu partiesI as a way to protect againstnovel 11 flu in the future. @hile the disease seen in the current novel11 flu out&rea has &een mild for many people! it has &een severe and

even fatal for others. *here is no way to predict with certainty what theoutcome will &e for an individual or! eLually important! for others towhom the intentionally infected person may spread the virus.

'5' recommends that people with novel 11 flu avoid contact withothers as much as possi&le. 6f you are sic with flu#lie illness! '5'recommends that you stay home for at least ,4 hours after your fever isgonee)cept to get medical care or for other necessities. "Mour fevershould &e gone without the use of a fever#reducing medicine.$ tay away

from others as much as possi&le to eep from maing others sic.

Contamination 9 Cleaning

ow long can influenza virus remain viable on

ob@ects 2such as boo*s and door*nobs36tudies have shown that influen+a virus can survive
http://www.cdc.gov/h1n1flu/recommendations.htmhttp://www.cdc.gov/h1n1flu/recommendations.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/recommendations.htmhttp://www.cdc.gov/h1n1flu/recommendations.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htm


34/57


on environmental surfaces and can infect a person for , to 8 hours after&eing deposited on the surface.

5hat *ills influenza virus66nfluen+a virus is destroyed &y heat "1(


35/57


need to &e cleaned separately! &ut importantly these items should not &eshared without washing thoroughly first.7inens "such as &ed sheets and towels$ should &e washed &y usinghousehold laundry soap and tum&led dry on a hot setting. 6ndividualsshould avoid [hugging\ laundry prior to washing it to prevent

contaminating themselves. 6ndividuals should wash their hands with soapand water or alcohol#&ased hand ru& immediately after handling dirtylaundry.

ating utensils should &e washed either in a dishwasher or &y hand withwater and soap.

posures Not Thought to Spread Novel #N# Flu

Can ! get infected with novel #N# virus from eating or preparingpor*6o. ovel 11 viruses are not spread &y food. Mou cannot get infectedwith novel 61 virus from eating por or por products. ating properlyhandled and cooed por products is safe.

!s there a ris* from drin*ing water6

*ap water that has &een treated &y conventional disinfection processesdoes not liely pose a ris for transmission of influen+a viruses. 'urrentdrining water treatment regulations provide a high degree of protectionfrom viruses. o research has &een completed on the suscepti&ility ofnovel 11 flu virus to conventional drining water treatment processes.owever! recent studies have demonstrated that free chlorine levelstypically used in drining water treatment are adeLuate to inactivatehighly pathogenic 21 avian influen+a. 6t is liely that other influen+aviruses such as novel 11 would also &e similarly inactivated &y

chlorination. *o date! there have &een no documented human cases ofinfluen+a caused &y e)posure to influen+a#contaminated drining water.

Can novel #N# flu virus be spread through water in swimmingpools< spas< water par*s< interactive fountains< and other treatedrecreational water venues66nfluen+a viruses infect the human upper respiratory tract. *here hasnever &een a documented case of influen+a virus infection associated withwater e)posure. /ecreational water that has &een treated at '5'

recommended disinfectant levels does not liely pose a ris fortransmission of influen+a viruses. o research has &een completed on thesuscepti&ility of novel 11 influen+a virus to chlorine and otherdisinfectants used in swimming pools! spas! water pars! interactive


36/57


fountains! and other treated recreational venues. owever! recent studieshave demonstrated that free chlorine levels recommended &y '5' "13parts per million 9ppm or mg7: for pools and ,2 ppm for spas$ areadeLuate to disinfect avian influen+a A "21$ virus. 6t is liely that otherinfluen+a viruses such as novel 11 virus would also &e similarly

disinfected &y chlorine.

Can novel #N# influenza virus be spread at recreational watervenues outside of the water6

Mes! recreational water venues are no different than any other groupsetting. *he spread of this novel 11 flu is thought to &e happening inthe same way that seasonal flu spreads. Flu viruses are spread mainlyfrom person to person through coughing or snee+ing of people with

influen+a. ometimes people may &ecome infected &y touchingsomething with flu viruses on it and then touching their mouth or nose.

ote: Much of the infor$ation in this docu$ent is based on studies andpast e>perience with seasonal +hu$an, influen3a. )*) believes theinfor$ation applies to novel 11 +swine, viruses as well but studies onthis virus are on!oin! to learn $ore about its characteristics. %his

docu$ent will be updated as new infor$ation beco$es available.

!nterim Euidance for Novel #N# Flu 2Swine Flu3: Ta*ing

Care of a Sic* -erson in 4our ome

August 2! ,00- 200 ;C *

On this Page

ow Flu preads Cedications to elp 7essen ymptoms of the Flu

teps to 7essen the pread of Flu in the ome

ousehold 'leaning! 7aundry! and @aste 5isposal

%his docu$ent has been updated in accordance with the )*)'eco$$endations for the /$ount of %i$e -ersons with 2nfluen3a?@ike2llness Should be /way fro$ =thers. %his docu$ent provides interi$

!uidance and will be updated as needed.

ovel 11 flu virus infection "formerly nown as swine flu$ can cause awide range of symptoms! including fever! cough! sore throat! &ody aches!
http://www.cdc.gov/h1n1flu/guidance_homecare.htm#ahttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#bhttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#chttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#dhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#ahttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#bhttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#chttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#dhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htmhttp://www.cdc.gov/h1n1flu/guidance/exclusion.htm


37/57


headache! chills and fatigue. ome people have reported diarrhea andvomiting associated with novel 11 flu. 7ie seasonal flu! novel 11 fluin humans can vary in severity from mild to severe. evere disease withpneumonia! respiratory failure and even death is possi&le with novel11 flu infection. 'ertain groups might &e more liely to develop a

severe illness from novel 11 flu infection! such as pregnant womenand persons with chronic medical conditions. ometimes &acterialinfections may occur at the same time as or after infection with influen+aviruses and lead to pneumonias! ear infections! or sinus infections.

*he following information can help you provide safer care at home forsic persons during a flu out&rea or flu pandemic.

ow Flu Spreads

*he main way that influen+a viruses are thought tospread is from person to person in respiratorydroplets of coughs and snee+es. *his can happenwhen droplets from a cough or snee+e of aninfected person are propelled through the air anddeposited on the mouth or nose of people near&y.6nfluen+a viruses may also &e spread when a

person touches respiratory droplets on another person or an o&Dect andthen touches their own mouth or nose "or someone elseXs mouth or nose$&efore washing their hands.

;eople with novel 11 flu who are cared for at home should

chec with their health care provider a&out any special care theymight need if they are pregnant or have a health condition such asdia&etes! heart disease! asthma! or emphysema

chec with their health care provider a&out whether they should

tae antiviral medications eep away from others as much as possi&le. *his is to eep from

maing others sic. 5o not go to wor or school while ill

stay home for at least ,4 hours after fever is gone! e)cept to seemedical care or for other necessities. "Fever should &e gone withoutthe use of a fever#reducing medicine.$

get plenty of rest

drin clear fluids "such as water! &roth! sports drins! electrolyte&everages for infants$ to eep from &eing dehydrated


38/57


cover coughs and snee+es. 'lean hands with soap and water or analcohol#&ased hand ru& often and especially after using tissues andafter coughing or snee+ing into hands

wear a facemas if availa&le and tolera&le when sharing

common spaces with other household mem&ers to help preventspreading the virus to others. *his is especially important if otherhousehold mem&ers are at high ris for complications frominfluen+a. For more information! see the 6nterim /ecommendationsfor Facemas and /espirator =se

&e watchful for emergency warning signs "see &elow$ that mightindicate you need to see medical attention.

*e+"a,$!s ($ el& Lesse! Sm&($ms $% (he Fl/

Chec* with your healthcare provider or pharmacist for correct< safe

use of medications

Antiviral medications can sometimes help lessen influen+a symptoms! &utreLuire a prescription. Cost people do not need these antiviral drugs tofully recover from the flu. owever! persons at higher ris for severe flu

complications! or those with severe flu illness who reLuire hospitali+ation!might &enefit from antiviral medications. Antiviral medications areavaila&le for persons 1 year of age and older. As your health careprovider whether you need antiviral medication.

6nfluen+a infections can lead to or occur with &acterial infections.*herefore! some people will also need to tae anti&iotics. Core severe orprolonged illness or illness that seems to get &etter! &ut then gets worseagain may &e an indication that a person has a &acterial infection. 'hec

with your health care provider if you have concerns.

5arning5o notgive aspirin "acetylsalicylic acid$ to children or teenagerswho have the fluB this can cause a rare &ut serious illness called /eyeXssyndrome. For more information a&out /eyeXs syndrome! visit the ational6nstitute of ealth we&site .

'hec ingredient la&els on over#the#counter cold and flu medicationsto see if they contain aspirin.

'hildren 2 years of age and older and teenagers with the flu can taemedicines withoutaspirin! such as acetaminophen "*ylenol^$ andi&uprofen "Advil^! Cotrin^! uprin^$! to relieve symptoms.
http://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htmhttp://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htmhttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#tophttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htmhttp://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htm


39/57


'hildren younger than 4 years of age should N;T&e given over#the#counter cold medications without first speaing with a health careprovider.

*he safest care for flu symptoms in children younger than , years of

age is using a cool#mist humidifier and a suction &ul& to help clearaway mucus.

Fe'ers a!+ ahes a! e (rea(e+ "(h ae(am"!$&he! Tle!$l $r "/&r$%e! A+'"l *$(r"! N/&r"! $r

!$!s(er$"+al a!,-"!amma($r +r/#s NSAIS. am&les $% (hese :"!+s $% me+"a,$!s "!l/+e;

Eeneric Name Grand Name2s3

Acetaminophen*ylenol^

6&uprofen Advil^! Cotrin^! uprin^

apro)en Aleve

>ver#the#counter cold and flu medications used according to thepacage instructions may help lessen some symptoms such as coughand congestion. 6mportantly! these medications will not lessen how

infectious a person is. 'hec the ingredients on the pacage la&el to see if the medication

already contains acetaminophen or i&uprofen &efore taing additionaldoses of these medicationsHdonXt dou&le dose_ ;atients with idneydisease or stomach pro&lems should chec with their health careprovider &efore taing any A65.

'hec with your health care provider or pharmacist if you are taing other

over#the#counter or prescription medications not related to the flu. For

more information on products for treating flu symptoms! see the F5A

we&site.

5hen to See* mergency Hedical Care

Get medical care right away if the sic person at home

has difficulty &reathing or chest pain has purple or &lue discoloration of the lips

is vomiting and una&le to eep liLuids down

has signs of dehydration such as di++iness when standing! a&sence of
http://www.fda.gov/fdac/features/2005/105_buy.htmlhttp://www.fda.gov/fdac/features/2005/105_buy.htmlhttp://www.fda.gov/fdac/features/2005/105_buy.htmlhttp://www.fda.gov/fdac/features/2005/105_buy.html


40/57


urination! or in infants! a lac of tears when they cry

has sei+ures "for e)ample! uncontrolled convulsions$

is less responsive than normal or &ecomes confused

Steps to Iessen the Spread of Flu in the ome

@hen providing care to a household mem&er who is sic with influen+a!the most important ways to protect yourself and others who are not sicare to

eep the sic person away from other people

as much as possi&le "see [placement of thesic person\$ especially others who are at highris for complications from influen+a

remind the sic person to cover their coughs!and clean their hands with soap and water oran alcohol#&ased hand ru& often! especiallyafter coughing andor snee+ing

have everyone in the household clean their hands often! using soap

and water or an alcohol#&ased hand ru&. 'hildren may needreminders or help eeping their hands clean

as your health care provider if household contacts of the sicpersonHparticularly those contacts who may &e pregnant or havechronic health conditionsHshould tae antiviral medications such asoseltamivir "*amiflu^$ or +anamivir "/elen+a^$ to prevent the flu

6f you are in a high ris group for complications from influen+a! youshould attempt to avoid close contact "within ( feet$ with householdmem&ers who are sic with influen+a. 6f close contact with a sicindividual is unavoida&le! consider wearing a facemas or respirator!if availa&le and tolera&le. 6nfants should not &e cared for &y sicfamily mem&ers. For more information! see the 6nterim/ecommendations for Facemas and /espirator =se

-lacement of the sic* person

Reep the sic person in a room separate from the common areas of

the house. "For e)ample! a spare &edroom with its own &athroom! ifthatXs possi&le.$ Reep the sicroom door closed.

=nless necessary for medical care or other necessities! people whoare sic with an influen+a#lie#illness should stay home and eep
http://www.cdc.gov/flu/about/disease/symptoms.htmhttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#tophttp://www.cdc.gov/flu/about/disease/symptoms.htmhttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/masks.htm


41/57


42/57


=se paper towels for drying hands after hand washing or dedicatecloth towels to each person in the household. For e)ample! havedifferent colored towels for each person.

6f possi&le! consideration should &e given to maintaining good

ventilation in shared household areas "e.g.! eeping windows openin restrooms! itchen! &athroom! etc.$.

Antiviral medications can &e used to prevent the flu! so chec withyour health care provider to see if some persons in the home shoulduse antiviral medications.

!f you are the caregiver

Avoid &eing face#to#face with the sic person.

@hen holding small children who are sic! place their chin on yourshoulder so that they will not cough in your face.

'lean your hands with soap and water or use an alcohol#&ased handru&]after you touch the sic person or handle used tissues! orlaundry.

*al to your health care provider a&out taing antiviral medication toprevent the caregiver from getting the flu.

6f you are at high ris of influen+a associated complications! youshould not &e the designated caretaer! if possi&le.

6f you are in a high ris group for complications from influen+a! youshould attempt to avoid close contact "within ( feet$ with householdmem&ers who are sic with influen+a. 5esignate a person who is notat high ris of flu associated complications as the primary caretaerof household mem&ers who are sic with influen+a! if at all possi&le.6f close contact with a sic individual is unavoida&le! considerwearing a facemas or respirator! if availa&le and tolera&le. Formore information! see the 6nterim /ecommendations for Facemasand /espirator =se

Honitor yourself and household members for flu symptomsand contact a telephone hotline or health care provider ifsymptoms occur)

(sing Facemas*s or Jespirators

Avoid close contact "less than a&out ( feetaway$ with the sic person as much aspossi&le.
http://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/masks.htm


43/57


6f you must have close contact with the sic person "for e)ample!hold a sic infant$! spend the least amount of time possi&le in closecontact and try to wear a facemas "for e)ample! surgical mas$ or-2 disposa&le respirator.

An -2 respirator that fits snugly on your face can filter out smallparticles that can &e inhaled around the edges of a facemas! &utcompared with a facemas it is harder to &reathe through an -2mas for long periods of time. Core information on facemass andrespirators can &e found at 11 Flu "wine Flu$we&site.

Facemass and respirators may &e purchased at a pharmacy!&uilding supply or hardware store.

@ear an -2 respirator if you help a sic person with respiratory

treatments using a ne&uli+er or inhaler! as directed &y their doctor./espiratory treatments should &e performed in a separate roomaway from common areas of the house when at all possi&le.

=sed facemass and -2 respirators should &e taen off and placedimmediately in the regular trash so they donXt touch anything else.

Avoid re#using disposa&le facemass and -2 respirators! ifpossi&le. 6f a reusa&le fa&ric facemas is used! it should &elaundered with normal laundry detergent and tum&le#dried in a hotdryer.

After you tae off a facemas or -2 respirator! clean your handswith soap and water or an alcohol#&ased hand saniti+er.

For more information! see the 6nterim /ecommendations forFacemas and /espirator =se

ousehold Cleaning< Iaundry< and 5aste Disposal

*hrow away tissues and other disposa&leitems used &y the sic person in the trash.@ash your hands after touching used tissuesand similar waste.

Reep surfaces "especially &edside ta&les!surfaces in the &athroom! and toys forchildren$ clean &y wiping them down with ahousehold disinfectant according to directions on the product la&el.
http://www.cdc.gov/h1n1flu/http://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/guidance_homecare.htm#tophttp://www.cdc.gov/h1n1flu/http://www.cdc.gov/h1n1flu/masks.htmhttp://www.cdc.gov/h1n1flu/masks.htm


44/57


7inens! eating utensils! and dishes &elonging to those who are sicdo not need to &e cleaned separately! &ut importantly these itemsshould not &e shared without washing thoroughly first.

@ash linens "such as &ed sheets and towels$ &y using household

laundry soap and tum&le dry on a hot setting. Avoid [hugging\laundry prior to washing it to prevent contaminating yourself. 'leanyour hands with soap and water or alcohol#&ased hand ru& rightafter handling dirty laundry.

ating utensils should &e washed either in a dishwasher or &y handwith water and soap.

Novel #N# !nfluenza "accine

August ,8! ,00-! 230 ;C *

What are the plans for developing novel H1N1 vaccine?

accines are the most powerful pu&lic health tool for control of influen+a!and the =.. government is woring closely with manufacturers to taesteps in the process to manufacture a novel 11 vaccine. @oringtogether with scientists in the pu&lic and private sector! '5' has isolated

the new 11 virus and modified the virus so that it can &e used to maehundreds of millions of doses of vaccine. accine manufacturers are nowusing these materials to &egin vaccine production. Caing vaccine is amulti#step process which taes several months to complete. 'andidatevaccines will &e tested in clinical trials over the few months.

When is it expected that the novel H1N1 vaccine will be

available?

*he novel 11 vaccine is e)pected to &e availa&le in the fall. Corespecific dates cannot &e provided at this time as vaccine availa&ilitydepends on several factors including manufacturing time and time neededto conduct clinical trials

Will the seasonal flu vaccine also protect against the novel

H1N1 flu?

*he seasonal flu vaccine is not e)pected to protect against the novel11 flu.


45/57


Can the seasonal vaccine and the novel H1N1 vaccine be

given at the same time?

6t is anticipated that seasonal flu and novel 11 vaccines may &eadministered on the same day. owever! we e)pect the seasonal vaccine

to &e availa&le earlier than the 11 vaccine. *he usual seasonalinfluen+a viruses are still e)pected to cause illness this fall and winter.6ndividuals are encouraged to get their seasonal flu vaccine as soon as itis availa&le.

Who will be recommended to receive the 2! H1N1

vaccine?

'5'Xs Advisory 'ommittee on 6mmuni+ation ;ractices "A'6;$ hasrecommended that certain groups of the population receive the novel11 vaccine when it first &ecomes availa&le. *hese target groupsinclude pregnant women! people who live with or care for childrenyounger than ( months of age! healthcare and emergency medicalservices personnel! persons &etween the ages of ( months and ,4 yearsold! and people ages of ,2 through (4 years of age who are at higher risfor novel 11 &ecause of chronic health disorders or compromisedimmune systems.

@e do not e)pect that there will &e a shortage of ,00- 11 vaccine! &utavaila&ility and demand can &e unpredicta&le. *here is some possi&ilitythat initially the vaccine will &e availa&le in limited Luantities. 6n thissetting! the committee recommended that the following groups receivethe vaccine &efore others pregnant women! people who live with or carefor children younger than ( months of age! health care and emergencymedical services personnel with direct patient contact! children ( monthsthrough 4 years of age! and children 2 through 18 years of age who have

chronic medical conditions.

*he committee recogni+ed the need to assess supply and demand issuesat the local level. *he committee further recommended that once thedemand for vaccine for these target groups has &een met at the locallevel! programs and providers should &egin vaccinating everyone fromages ,2 through (4 years. 'urrent studies indicate the ris for infectionamong persons age (2 or older is less than the ris for younger agegroups. *herefore! as vaccine supply and demand for vaccine among

younger age groups is &eing met! programs and providers should offervaccination to people over the age of (2.


46/57


"o those that have been previousl# vaccinated against the

1!$% swine influen&a need to get vaccinated against the 2

! H1N1 influen&a?

*he 1-


47/57


and mae you feel &etter faster. *hey may also prevent serious flucomplications. *his fall! antivirals may &e prioriti+ed for persons withsevere illness or those at higher ris for flu complications.

!nterim Jecommendations for Facemas* and Jespirator (se

to Jeduce Novel !nfluenza A 2#N#3 "irus Transmission

August 2! ,00- 200 ;C *

%his docu$ent has been updated in accordance with the '5'/ecommendations for the Amount of *ime ;ersons with 6nfluen+a#7ie6llness hould &e Away from >thers. %his docu$ent provides interi$!uidance and will be updated as needed

%his docu$ent provides updated interi$ !uidance on the use offace$asks and respirators for decreasin! the e>posure to novel influen3a

/ +11, virus. %his !uidance replaces other )*) !uidance on $askandAor respirator use that $ay be included in other )*) docu$ents inre!ards to the outbreak of novel 11 virus. o chan!e has been $adeto !uidance on the use of face$asks and respirators for health caresettin!s. %his docu$ent includes !uidance on face$ask and respiratoruse for a wider ran!e of settin!s than was included in previous

docu$ents and includes reco$$endations for those who are at increasedrisk of severe illness fro$ infection with the novel 11 virus co$paredwith those who are at lower risk of severe illness fro$ influen3ainfection.


48/57


influen+a A "11$ virus transmission in these settings. 6n the a&sence ofclear scientific data! the interim recommendations &elow have &eendeveloped on the &asis of pu&lic health Dudgment! the historical use offacemass and respirators in other settings for preventing transmission ofinfluen+a and other respiratory viruses! and on current information on the

spread and severity of the novel influen+a A "11$ virus.

6n areas with confirmed human cases of novel influen+a A "11$ virusinfection! the ris for infection can &e reduced through a com&ination ofactions. o single action will provide complete protection! &ut anapproach com&ining the following steps can help decrease the lielihoodof transmission. *hese recommended actions are

@ash hands freLuently with soap and water or use alcohol#&ased

hand cleaner]when soap and water are not availa&le. 'over your mouth and nose with a tissue when coughing or

snee+ing.

Avoid touching your eyes! nose and mouth

;eople who are sic with an influen+a#lie illness "676$ "fever plus atleast cough or sore throat and possi&ly other symptoms lie runnynose! &ody aches! headaches! chills! fatigue! vomiting and diarrhea$should stay home and eep away from others as much as possi&le!including avoiding travel! for at least ,4 hours after fever is gonee)cept to get medical care or for other necessities. "Fever should &egone without the use of fever#reducing medicine$.

Avoid close contact "i.e. &eing within a&out ( feet$ with persons with676.

6n addition! influen+a antiviral medications are an important tool for thetreatment and prevention of influen+a! including novel 11. Also see

Guidance on the use of antiviral medications.

Facemas*s and Jespirators

/ecommendations for the uses of facemass andor respirators are listedin *a&le 1&elow for different settings where a person may &e e)posed tonovel 11 virus. *hese recommendations also differ &ased on whetherthe person e)posed to novel 11 is in a group at increased ris forsevere illness from influen+a infection. Core information on preventinginfluen+a transmission in health care settings can &e found in the 6nterimGuidance for 6nfection 'ontrol for 'are of ;atients with 'onfirmed or
http://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/recommendations.htmhttp://www.cdc.gov/h1n1flu/masks.htm#table1http://www.cdc.gov/h1n1flu/guidelines_infection_control.htmhttp://www.cdc.gov/h1n1flu/guidelines_infection_control.htmhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/qa.htm#antibacterialhttp://www.cdc.gov/h1n1flu/recommendations.htmhttp://www.cdc.gov/h1n1flu/masks.htm#table1http://www.cdc.gov/h1n1flu/guidelines_infection_control.htmhttp://www.cdc.gov/h1n1flu/guidelines_infection_control.htm


49/57


uspected ovel 6nfluen+a A "11$ irus 6nfection in a ealthcareetting.

6n community and home settings! the use of facemass and respiratorsgenerally are not recommended. owever! for certain circumstances as

descri&ed in *a&le 1! a facemas or respirator may &e considered!specifically for persons at increased ris of severe illness from influen+a.

=se of -2 respirators or facemass generally is not recommended forworers in non#healthcare occupational settings for general woractivities. For specific wor activities that involve contact with peoplewho have 676! such as escorting a person with 676! interviewing a personwith 676! providing assistance to an individual with 676! the following arerecommended

worers should try to maintain a distance of ( feet or more from theperson with 676B

worers should eep their interactions with ill persons as &rief aspossi&leB

the ill person should &e ased to follow good cough etiLuette andhand hygiene and to wear a facemas! if a&le! and one is availa&leB

worers at increased ris of severe illness from influen+a infection

"see footnote D of table 1$ should avoid people with 676 "possi&ly &ytemporary reassignment$B and!

where worers cannot avoid close contact with persons with 676!some worers may choose to wear a facemas or -2 respirator ona voluntary &asis.

6n the occupational healthcare setting! respiratory protection isrecommended. ?ecause infection control precautions! including

respiratory protection! are imperfect! worers who are at increased ris ofsevere illness from influen+a! and who are caring for a patient withnown! pro&a&le! or suspected novel 11 or 676! may considertemporary reassignment to avoid e)posure.

Additional recommendations for use of facemass &y people who have 676that may &e due to novel 11 infection are included in *a&le ,.

*here are important differences &etween facemass and respirators.

Facemass do not seal tightly to the face and are used to &loc largedroplets from coming into contact with the wearerXs mouth or nose. Costrespirators "e.g. -2$ are designed to seal tightly to the wearerXs faceand filter out very small particles that can &e &reathed in &y the user. For
http://www.cdc.gov/h1n1flu/guidelines_infection_control.htmhttp://www.cdc.gov/h1n1flu/guidelines_infection_control.htmhttp://www.cdc.gov/h1n1flu/masks.htm#table1http://www.cdc.gov/h1n1flu/masks.htm#table1http://www.cdc.gov/h1n1flu/masks.htm#table2http://www.cdc.gov/h1n1flu/guidelines_infection_control.htmhttp://www.cdc.gov/h1n1flu/guidelines_infection_control.htmhttp://www.cdc.gov/h1n1flu/masks.htm#table1http://www.cdc.gov/h1n1flu/masks.htm#table1http://www.cdc.gov/h1n1flu/masks.htm#table2


50/57


&oth facemass and respirators! however! limited data is availa&le ontheir effectiveness in preventing transmission of 11 "or seasonalinfluen+a$ in various settings. owever! the use of a facemas orrespirator is liely to &e of most &enefit if used as early as possi&le whene)posed to an ill person and when the facemas or respirator is used

consistently. "/ef. 1. Cac6ntyre '/! et al. 65 ,00-B12,33#41. ,.'owling ?! et al. on#pharmaceutical interventions to prevent householdtransmission of influen+a. *he 8th Asia ;acific 'ongress of Cedicalirology! ong Rong! ,(#,8 Fe&ruary ,00-.$

(acemas)s* =nless otherwise specified! the term \facemass\ refers todisposa&le facemass cleared &y the =.. Food and 5rug Administration"F5A$ for use as medical devices. *his includes facemass la&eled assurgical! dental! medical procedure! isolation! or laser mass. uch

facemass have several designs. >ne type is affi)ed to the head with twoties! conforms to the face with the aid of a fle)i&le adDustment for thenose &ridge! and may &e flatpleated or duc#&illed in shape. Anothertype of facemas is pre#molded! adheres to the head with a single elastic&and! and has a fle)i&le adDustment for the nose &ridge. A third type isflatpleated and affi)es to the head with ear loops. Facemass cleared &ythe F5A for use as medical devices have &een determined to have specificlevels of protection from penetration of &lood and &ody fluids. Facemasshelp stop droplets from &eing spread &y the person wearing them. *heyalso eep splashes or sprays from reaching the mouth and nose of theperson wearing the facemas. *hey are not designed to protect against&reathing in very small particle aerosols that may contain viruses.Facemass should &e used once and then thrown away in the trash.

+espirators:=nless otherwise specified! IrespiratorI refers to an -2 orhigher filtering face piece respirator certified &y the '5'ational6nstitute for >ccupational afety and ealth "6>$. A respirator isdesigned to protect the person wearing the respirator against &reathing invery small particle aerosols that may contain viruses. A respirator thatfits snugly on the face can filter out virus#containing small particleaerosols that can &e generated &y an infected person! &ut compared witha facemas it is harder to &reathe through a respirator for long periods oftime. /espirators are not recommended for children or people who havefacial hair.

@here respirators are used in a non#occupational setting! fit testing!

medical evaluation and training are recommended for optimaleffectiveness.


51/57


@hen respiratory protection is reLuired in an occupational setting!respirators must &e used in the conte)t of a comprehensive respiratoryprotection program as reLuired under >AXs /espiratory ;rotectionstandard ",- 'F/ 1-10.134$. *his includes fit testing! medical evaluationand training of the worer. @hen reLuired in the occupational setting!

tight#fitting respirators cannot &e used &y people with facial hair thatinterferes with the face seal.

@hen respirators are used on a voluntary &asis in an occupationalsetting! reLuirements for voluntary use of respirators in wor sites can &efound on the >A we&site.

mployers should continue to evaluate worplace ha+ards related to thenovel 11 influen+a A situation in accordance with '5' and >A

guidance. Candatory use of respiratory protection may &e reLuired whenwor activities in occupational settings confer ris that is tasfunction&ased! and ris analyses conducted &y the employer could identifyha+ardous wor activities. For e)ample! performing activities whichgenerate large amounts of aerosols reLuire respiratory protectionregardless of the setting in which it is performed "i.e. in a hospital! anoutpatient setting! a prison$.

For additional information on facemass and respirators! see the

'5'6> we&site! the Food and 5rug Administration we&site! and the>ccupational afety and ealth Administration we&site.

Eroups at igher Jis* for Severe !llness from Novel

!nfluenza A 2#N#3 !nfection

Groups of people at higher ris for severe illness from novel influen+a A"11$ infection are thought to &e the same as those people at higherris for severe illness from seasonal influen+a. *hese groups include

'hildren younger than 2 years old ;ersons aged (2 years or older

'hildren and adolescents "younger than 18 years$ who are receivinglong#term aspirin therapy and who might &e at ris for e)periencing/eye syndrome after influen+a virus infection

;regnant women

Adults and children who have asthma! chronic pulmonary!cardiovascular! hepatic! hematological! neurologic! neuromuscular!or meta&olic disorders such as dia&etesB
http://www.osha.gov/SLTC/etools/respiratory/voluntaryuses.htmlhttp://www.cdc.gov/niosh/npptl/topics/respirators/http://www.fda.gov/cdrh/ppe/masksrespirators.htmlhttps://www.osha.gov/Publications/respirators-vs-surgicalmasks-factsheet.htmlhttp://www.osha.gov/SLTC/etools/respiratory/voluntaryuses.htmlhttp://www.cdc.gov/niosh/npptl/topics/respirators/http://www.fda.gov/cdrh/ppe/masksrespirators.htmlhttps://www.osha.gov/Publications/respirators-vs-surgicalmasks-factsheet.html


52/57


Adults and children who have immunosuppression "includingimmunosuppression caused &y medications or &y 6$

Res"+e!(s $% !/rs"!# h$mes a!+ $(her hr$!"-are %a"l",es.

*a&le 1. '5' 6nterim /ecommendations for Facemas and /espirator =se

for ome! 'ommunity! and >ccupational ettings for on#6ll ;ersons to

;revent 6nfection with ovel 11 1,

Setting -ersons not at

increased ris* of severe

illness from influenza

2NonBhigh ris* persons3

-ersons at increased

ris* of severe illness

from influenza 2ighB

Jis* -ersons3 1

Community

o novel 11 in

community

Facemasrespirator not

recommended


recommended

ovel 11 in

community not

crowded setting


recommended


recommended
http://www.cdc.gov/h1n1flu/masks.htm#footnote1http://www.cdc.gov/h1n1flu/masks.htm#footnote2http://www.cdc.gov/h1n1flu/masks.htm#footnote3http://www.cdc.gov/h1n1flu/masks.htm#footnote1http://www.cdc.gov/h1n1flu/masks.htm#footnote2http://www.cdc.gov/h1n1flu/masks.htm#footnote3


53/57


ovel 11 in

community

crowded setting


recommended

Avoid setting.

6f unavoida&le! consider

facemas or respirator4

2

ome

'aregiver to

person with

influen+a#lie

illness


recommended

Avoid &eing caregiver. 6f

unavoida&le! use facemas

or respirator 42

>ther household

mem&ers in home


recommended


recommended

;ccupational 2nonBhealth care3

o novel 11 in

community


Documents

Swain Flu.finaLdoc