Swine Flu Curbing

Key Facts About Seasonal Influenza (Flu)

What is Influenza (Also Called Flu)?

The flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. The best way to prevent the flu is by getting a flu vaccination each year.

Every year in the United States, on average:

• 5% to 20% of the population gets the flu;
  
• more than 200,000 people are hospitalized from flu-related complications; and
  
• about 36,000 people die from flu-related causes.
  

Some people, such as older people, young children, and people with certain health conditions (such as asthma, diabetes, or heart disease), are at high risk for serious flu complications.

Symptoms of Flu

Symptoms of flu include:

• fever (usually high)
  
• headache (headaches)
  
• extreme tiredness
  
• dry cough
  
• sore throat
  
• runny or stuffy nose
  
• muscle aches
  
• Stomach symptoms, such as nausea, vomiting, and diarrhea, also can occur but are more common in children than adults
  

Complications of Flu

Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

How Flu Spreads

Flu viruses are thought to spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

Preventing Seasonal Flu: Get Vaccinated

The single best way to prevent the flu is to get a flu vaccination each year. There are two types of vaccines:

• The "flu shot" – an inactivated vaccine (containing killed virus) that is given with a needle. The flu shot is approved for use in people 6 months of age and older, including healthy people and people with chronic medical conditions.
  
• The nasal-spray flu vaccine – a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “Live Attenuated Influenza Vaccine”). LAIV is approved for use in healthy* people 2-49 years of age who are not pregnant.
  

About two weeks after vaccination, antibodies develop that protect against influenza virus infection. Flu vaccines will not protect against flu-like illnesses caused by non-influenza viruses.

When to Get Vaccinated

Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later.

Who Should Get Vaccinated?

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, certain people should get vaccinated each year either because they are at high risk of having serious flu-related complications or because they live with or care for high risk persons. During flu seasons when vaccine supplies are limited or delayed, the Advisory Committee on Immunization Practices (ACIP) makes recommendations regarding priority groups for vaccination.

People who should get vaccinated each year are:

1. Children aged 6 months up to their 19th birthday
   
2. Pregnant women
   
3. People 50 years of age and older
   
4. People of any age with certain chronic medical conditions
   
5. People who live in nursing homes and other long-term care facilities
   
6. People who live with or care for those at high risk for complications from flu, including:
   

a. Health care workers
b. Household contacts of persons at high risk for complications from the flu
c. Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Use of the Nasal Spray Flu Vaccine

Vaccination with the nasal-spray flu vaccine is an option for healthy* people 2-49 years of age who are not pregnant, even healthy persons who live with or care for those in a high risk group. The one exception is healthy persons who care for persons with severely weakened immune systems who require a protected environment; these healthy persons should get the inactivated vaccine.
Who Should Not Be Vaccinated

Some people should not be vaccinated without first consulting a physician. They include:

• People who have a severe allergy to chicken eggs.
  
• People who have had a severe reaction to an influenza vaccination in the past.
  
• People who developed Guillian-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine previously.
  
• Children less than 6 months of age (influenza vaccine is not approved for use in this age group).
  
• People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.
  

If you have questions about whether you should get a flu vaccine, consult your health-care provider.

For more about preventing the flu, see the following:

• Key Facts About Seasonal Flu Vaccine
  
• Influenza Antiviral Drugs
  
• Good Health Habits for Prevention
  
• The Flu: A Guide for Parents
  

* "Healthy" indicates persons who do not have an underlying medical condition that predisposes them to influenza complications.

• Page last updated March 12, 2009
  
• Content Source: Coordinating Center for Infectious Diseases (CCID)
  
• National Center for Immunization and Respiratory Diseases (NCIRD)

What to Do If You Get Flu-Like Symptoms

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
The symptoms of novel H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with novel H1N1 flu virus also have reported 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. Unless necessary for medical care, you should stay home and minimize contact with others, including avoiding travel and not going to work or school, for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. If you leave the house to seek medical care, wear a facemask, if available and tolerable, and 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, especially people at increased risk of severe illness from influenza. With seasonal flu, 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. People infected with the novel H1N1 are likely to have similar patterns of infectiousness as with seasonal flu.

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 widespread, less testing will be needed, 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 novel 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 novel H1N1 flu. The drugs that are used for treating novel H1N1 flu are called oseltamivir (trade name Tamiflu ®) and zanamivir (Relenza ®). As the novel H1N1 flu spreads, these antiviral drugs may become in short supply. Therefore, the drugs may be given first to those people who have been hospitalized or are at high risk of severe illness from flu. 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.

Aspirin or aspirin-containing products (e.g., bismuth subsalicylate – Pepto Bismol) should not be administered to any confirmed or suspected ill case of novel influenza A (H1N1) virus infection aged 18 years old and younger due to the risk of Reye’s syndrome. For relief of fever, other anti-pyretic medications are recommended such as acetaminophen or non steroidal anti-inflammatory drugs. For more information about Reye’s syndrome, visit the National Institute of Health website.

• Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.
  
• Children 5 years of age and older and teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.
  
• Children younger than 4 years of age should NOT be given over-the-counter cold medications without first speaking with a health care provider.

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 and 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, except to seek medical care or for other necessities. Keep away from other household members as much as possible. This is to keep you from infecting others and spreading the virus further.
  
• If you are sick and sharing a common space with other household members in your home, wear a facemask, if available and tolerable, to help prevent spreading the virus to others. For more information, see the Interim Recommendations for Facemask and Respirator Use.
  
• 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"
  

Page last reviewed July 8, 2009 4:30 PM ET
Page last updated July 8, 2009 4:30 PM ET
Content source: Centers for Disease Control and Prevention

This document has been updated in accordance with the Guidance on Facemask and Respirator Use.

Use of antiviral drugs against influenza A(H1N1)

For what purposes can antiviral drugs be used against influenza A(H1N1)?

So far most people who have contracted the new A (H1N1) virus have experienced influenza-like symptoms (such as sore throat, cough, runny nose, fever, malaise, headache, joint/muscle pain) and recovered without antiviral treatment.

Antiviral drugs may reduce the symptoms and duration of illness, just as they do for seasonal influenza. They also may contribute to preventing severe disease and death. Influenza A (H1N1) is a new virus and only a small number of people with the infection have been treated for it with antiviral drugs. WHO is in touch with public health authorities and clinicians in affected countries and is gathering information about how effective the drugs are.

To which antiviral drugs does this influenza virus respond?

There are two classes of antiviral drugs for influenza: inhibitors of neuraminidase such as oseltamivir and zanamivir; and adamantanes, such as amantadine and rimantadine. Tests on viruses obtained from patients in Mexico and the United States have indicated that current new H1N1 viruses are sensitive to neuraminidase inhibitors, but that the viruses are resistant to the other class, the adamantanes.

Could the virus become resistant to oseltamivir and zanamivir?

Resistance can develop to antiviral drugs used for influenza. Therefore, WHO and its partners are monitoring antiviral drug resistance.

Under what circumstances should antiviral drugs be administered?

Antiviral drugs are to be used according to national pandemic influenza preparedness plans. Public health authorities in some countries have decided to treat patients likely to have this disease as a part of public health measures.

Where antiviral drugs are available for treatment, clinicians should make decisions based on assessment of the individual patient's risk. Risks versus benefits should also be evaluated on a case by case basis.

Should I take an antiviral now just in case I catch the new virus?

No. You should only take an antiviral, such as oseltamivir or zanamivir, if your health care provider advises you to do so. Individuals should not buy medicines to prevent or fight this new influenza without a prescription, and they should exercise caution in buying antivirals over the internet.

Warning on purchase of antivirals without a prescription, including via the Internet [pdf 35kb]

What is WHO doing about getting antiviral drugs to countries as preparation for a pandemic?

WHO’s first priority is to provide an emergency stock of antiviral drugs to countries that have no or insufficient stock of the drugs and lack the capacity to procure these drugs themselves.

WHO is also working with Member States, donors and other groups that have stockpiles and are willing to share these with WHO for distribution to countries in need.

Which drug will be provided, and how much of it does WHO have available?

WHO had a global stockpile of approximately 5 million adult treatment courses of oseltamivir. Part of this stockpile has already been distributed through the WHO Regional Offices, which are handling allocation and distribution. WHO is currently distributing the remaining 3 million adult treatment courses of this stockpile to developing countries in need.

WHO continues to assess needs and to work with manufacturers to secure more donations of antivirals. More antiviral drugs will be distributed once these donations are received.

Which countries will receive the drug, and how will they be selected?

WHO has arranged the first deployment of antiviral drugs from the WHO stockpile to 72 countries. Priority was given to vulnerable countries, taking into consideration national manufacturing and procurement capacity. As necessary, other countries will be supported through regional office stockpiles.

What if the initial emergency deployment turns out to be inadequate?

WHO is in discussion with manufacturers regarding the potential need for scaling up production. It is WHO’s understanding that manufacturers have plans for producing large numbers of treatments quickly.

WHO will work on behalf of its Member States to secure further antivirals as needed, either through donations or purchase at the lowest possible price.

Information source :: http://www.who.int/csr/disease/swineflu/frequently_asked_questions/swineflu_faq_antivirals/en/index.html