H1N1 Swine Flu 2009 - 2010 Frequently

Asked Questions
What Is Swine Flu and How Can You Protect Yourself?

Protect yourself from swine flu.

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With so much in the news about swine flu, also called 2009 pandemic novel
influenza A H1N1, it's wise to know what it is, what you can expect, and how to
protect yourself and your loved ones. Empowered patients can use this knowledge to
reduce their fear of swine flu.

What is H1N1 swine flu?

The swine flu is a strain of virus that shares genes with flu viruses that affect pigs.
The swine flu of interest in 2009 is the novel H1N1 strain, which was passed from
pigs to human beings. It is causing illness in humans, and as of June 2009, was
declared pandemic by the World Health Organization. In October 2009, President
Barack Obama declared an H1N1 swine flu national emergency in the United States.

What does H1N1 Influenza A mean?

The official, scientific name for swine flu, its serologic classification, is Novel H1N1
Influenza A. "Novel" just means that it is a new strain. The H means hemagglutinin
and the N means neuraminidase and the "1"s refer to their antibody type. Influenza A
is a genus of the Orthomyxoviridae family of viruses, and refers to the fact that the
virus is first identified in an animal, usually a pig or a bird. When put together, they
describe the 2009-2010 swine flu virus.

Why is this flu different from other flus?

There are thousands of different kinds of viruses that can cause the flu. New strains
develop frequently and each one is different from the one before it. The seasonal flu is
actually comprised of several different strains of flu. Swine flu is a new, different
strain of virus.

What are the swine flu stages I keep hearing about?

The World Health Organization, WHO, developed a plan to respond to health
emergencies, like swine flu, which have the potential to become pandemic. Each stage
represents a different level of response. For example, Stage 4 means that the disease
can no longer be contained inside any specific country, therefore governments must
take steps to handle community spread of the disease. As of late spring 2009, H1N1
swine flu was labeled pandemic by WHO, meaning it had reached Stage 5. (You can
follow WHO swine flu staging for changes and updates.)

What exactly is a pandemic?

WHO defines a pandemic along those stages mentioned above. They describe the
prevalence of the disease, across populations and countries. There is a difference
between a pandemic and an epidemic.

Why did President Obama declare a "state of emergency" in the United States?

The state of emergency declaration in October 2009 was a reaction to the fact that
more than 1,000 Americans (including almost 100 children) had died as a result of
H1N1 swine flu.

The declaration is less about the actual spread of the flu, and more about taking down
barriers to quick and more effective reaction on the part of providers, including
physicians, hospitals, local health departments and others. In an official state-of-
emergency, these groups have more control over how they handle their reactions and
less government red tape to deal with.

I keep hearing "swine flu" and "avian flu" in the same sentence.
What's that all about?

Avian flu is another name for bird flu. This pairing is heard as "swine, avian, human"
and refers to the fact that the H1N1 pandemic flu strain seems to be a combination of
all three.

How is the swine flu transmitted?

The swine flu is transmitted just the way any viral disease is transmitted through
person-to-person contact. One person touches something someone with a virus has
already touched, or droplets in the air which came from a sneeze or a cough of a
person who has the swine flu spread to another person.

What are the symptoms of swine flu?

Symptoms of swine flu are the same as typical flu symptoms. Fever, cough, sore
throat, body aches, headache, chills and fatigue are the most prevalent symptoms.
Some patients report diarrhea and vomiting, too.
Do people die from swine flu?

People can die, but most do not.

Is there a swine flu vaccine like seasonal flu vaccine?

A vaccine was developed similarly to the way seasonal flu is developed. Specific
groups of people will be inoculated first, according to the plans suggested by the
CDC.

In the early stages of H1N1 swine flu innoculation, there are severe shortages of
vaccine. To determine whether you are at risk, and therefore need to be vaccinated,
you'll want to stay up with progress in the development and dissemination of the
H1N1 swine flu vaccine.

There are many spam emails circulating that claim a vaccine is available for purchase
on the Internet. Don't be fooled! The vaccine cannot be purchased by individuals, so
anything you might purchase on the web would likely be counterfeit.

Is it possible to track swine flu outbreaks?

Yes. There are a number of ways to track incidents of swine flu across the world.

You and Swine Flu

I never come into contact with pigs. Am I safe from swine flu?

No. This is a myth. Transmission of the virus doesn't require you to come into contact
with pigs. It can pass from one human to another. According to the CDC, there is
some evidence that people who do come into contact regularly with pigs may be
immune to the swine flu.

I got a flu shot. Am I protected?

Health officials say that a seasonal flu shot (which addresses different strains of flu)
will not protect us from the swine flu. The seasonal flu shot was developed to combat
strains that are not related to the swine flu strain, H1N1. If you get a flu shot in 2009,
be sure to ask clearly which vaccine(s) you are receiving -- swine flu or seasonal flu.
Infectious diseases experts tell us we will be need both shots to benefit from the most
protection.

Is there any way to prepare in case I (or my loved one) gets the H1N1 Swine Flu?

Absolutely. The World Health Organization believes no matter how much we try to
prevent it, at least one-third of us will get the swine flu. It makes sense to follow these
steps to prepare for the swine flu.
Protect Yourself and Your Family:

If I think I have the swine flu, what should I do?

If you find yourself with flu-like symptoms, contact your doctor's office immediately and
stay home from work or school. It may be the swine flu, or it could be seasonal flu, or any
upper respiratory problem. Let your doctor figure that out for you.

Don't just show up at your doctor's office. Call first, to make an appointment. If others
have symptoms, you don't want to be in the waiting room with them and your doctor will
know how to be sure the illness can't pass in the waiting room.

There are some prescription drugs that your doctor may recommend that can make the
illness easier to tolerate, and may help you avoid complications. Those drugs must be
started within 48 hours of symptoms onset to be effective.

Make sure you cover your mouth and nose if you cough or sneeze using a tissue or your
sleeve -- not your hands. You don't want to transmit it to others.

If I get the swine flu, how long will it last, or how long will I be contagious?

The length of illness will depend on the severity of your case of flu. You will be contagious
from one day before the onset of symptoms until five to seven days later. Children may be
contagious even longer. The CDC recommends you stay home until 24 hours after your
fever is gone.

How can I tell if I have the H1N1 swine flu or the seasonal flu - or even just a
lousy cold? What's the difference?

The only real way to tell whether you specifically have the H1N1 swine flu vs the seasonal
flu or a cold is to be tested. Your doctor can run a test and tell you whether you really
have the flu and if so, which kind it is.

However, the CDC warns that the flu tests aren't always accurate. In fact, they may be
inaccurate from 10 to 70% of the time.

Should I travel during this time?

There is no simple answer. As incidents of flu spread, there will be more and more hot
spots around the world to be concerned with.

You can find travel warnings at the CDC website. Or ask your doctor or your local public
health officials for their advice about travel to these areas.

Who Is Most at Risk for Catching Swine Flu?

Like any contagious disease, babies or anyone with a compromised immune system are
vulnerable. Older Americans, those born before 1960, seem to have some immunity,
perhaps because they exposed to a similar pathogen when they were young children.
However, what it is unusual about swine flu and is that healthy people may be at a similar
level of risk. Health professionals theorize that a stronger immune system may cause the
body to develop highly vigorous antibodies to attack that virus, and those antibodies
inflame the lung cells, making healthy people even sicker.

People who have died from swine flu were mostly older than age 3 and younger than age
60.

I heard that older people may be immune to swine flu. Is that really true?

One study of blood draws taken from a group of people of all ages showed that 1/3 of
those who were age 60 and older had a pre-existing immunity. Scientists theorize those
people were exposed to some sort of similar virus when they were children, and they built
up the antibodies needed to fight that virus, which may protect them from this one.

If that is true, however, the patient would need to be tested to see if he/she is immune. If
so, the CDC believes they will need only one shot of the vaccine instead of two.

What about my pets? Can my cat or dog get swine flu?

As of early November 2009, the first report was made of a cat that had been tested
positively for H1N1 swine flu. Previous reports have been made of a pet ferret that was
and found to have H1N1 swine flu.

So far no reports have been made of swine flu in dogs. If you have a pot-bellied pig as a
pet, you'll want to check with your veterinarian.

Should You Fear H1N1 Swine Flu?

With little control over the advancement of H1N1 swine flu, we have to wonder: should we
really fear the swine flu?

No. Fear is unnecessary. But a healthy respect is definitely called for.

A "Public Health Emergency"

It does sound frightening -- those words -- "Public Health Emergency." And calling swine
flu a public health emergency most definitely gets our attention.

Behind those words, though, is the fact that the actual declaration is really a vehicle for
making money available and suggesting that local governments begin using their
predetermined plans for managing public health problems. It doesn't mean there is a
crisis.

Let those words remind you to take precautions yourself. But don't be afraid of them.

Flu is Flu

H1N1 swine flu is one more strain of flu. It sounds scary because it originally came from
pigs, and that creates some mystery.
But it behaves like other flus. We catch it the same way, and we can protect ourselves the
same ways. We can make choices to protect ourselves and our families.

Do you fear the seasonal flu? Probably not. And this flu is really no more frightening than
seasonal flu. Seasonal flu takes tens of thousands of lives each year. Deaths from H1N1
swine flu have not approached those of seasonal flu.

Pandemic Describes Geography Only

We hear the word "pandemic" used by the media and that reminds us of history class in
high school. It sounds like it means millions of people might die. But that's not what it
means at all!

Pandemic simply means it is found large groups of people in many countries around the
world. Pan comes from Latin and Greek meaning across or around. Demos means
populations or people. Pan-demic. Geography and demographics. Not deaths.

Learn more about the definition of pandemic and how it could affect you in the 21st
Century.

What About Those Face Masks?

When I see those masks on the people on TV, it reminds me of SARS and bird flu in China
a few years ago. Again, that was scary because so many of the people who contracted
those diseases did die.

Masks just keep the wearers from inhaling the water droplets that might be breathed out
by someone who has the flu bug. Or when worn by someone who has any upper
respiratory disease, they may contain some of the spread of that illness. They aren't a bad
idea, but they don't indicate that the flu is any more dangerous than any normal flu.

Thousands of people die of seasonal flu each year, but we don't all wear masks.

Why Does It Seem Like We are Unprepared?

Another reason some fear the swine flu is because, unlike seasonal flu, we seem
unprepared to stop its spread.

We do have two drugs available to help with symptoms, which the CDC tells us is in
plentiful supply. Relenza and Tamiflu, both of which are used during seasonal flu seasons
each year, are also useful for helping swine flu patients, too.

H1N1 Swine Flu vaccine has been developed and as of October 2009, is available for
distribution. Stay up to date on its availability.

Put Your Fear Energy Into Protection Efforts Instead

Fear takes a lot of energy. It makes much more sense to put our efforts into protecting
ourselves and our loved ones, and protection is not difficult.

Begin by developing a plan in case someone in your family gets the swine flu. From storing
food and water, to filling your medicine cabinet with the right drugs, to defining sleeping
spaces for the sick family member, by being prepared, you will be less stressed.
There are travel considerations, and prevention steps like hand washing -- listed in H1N1
Swine Flu FAQs.

If you have upper-respiratory symptoms like coughing or congestion, stay home from work
or school so you won't pass the germs to someone else. They may not even be flu! But
there is no sense in taking chances, plus rest is an important way to fight those germs.

Most of all, like any empowered patient, informing yourself about the facts is the best way
to protect yourself and your loved ones. Here is more information to keep that fear at bay:

Frequently Asked Questions About Swine Flu Vaccines

and Vaccinations”:

The World Health Organization has declared the H1N1 swine flu, also being called Novel
H1N1 swine flu, to be pandemic.

A vaccine is now available to the public to inoculate us against H1N1 swine flu. It has been
tested for effectiveness and safety and is being distributed throughout the United States to
medical practices and state and local health departments. (Please note, if you find any
claim that you can purchase swine flu vaccine, online or anywhere else, know that this
claim is bogus.)

How Is the H1N1 Swine Flu Vaccine Developed?

The H1N1 swine flu vaccine was developed like any flu vaccine is developed. According to
the FDA (pdf), "seed" virus, in this case the H1N1 swine flu virus, is injected into fertilized
eggs where it grows into the agent needed to vaccinate human beings. Once the material
has grown in the eggs, it gets distributed to manufacturers who use it to develop individual
doses of either an injectable or a nasal vaccine. From there it is distributed to the
organizations who make it available to the public - medical practices, government health
organizations and others.

Why Is There a Shortage of H1N1 Swine Flu Vaccine?

In the United States, the federal government approved the swine flu vaccine for production
in April 2009. Based on the growth patterns in previous years of seasonal flu seed vaccine,
then vaccination doses, it estimated that 120 million doses of swine flu vaccine would be
ready for the public by mid-October. What was not anticipated was the slower growth of
the virus during the egg stages of development, meaning, the remaining aspects of
production were delayed. As of late October 2009, only about 10% of the expected doses
were ready for injection.

Additional delays are chalked up to capacity. The manufacturers that produce vaccines
were already running full throttle developing seasonal flu vaccines. Decisions had to be
made about whether to repurpose their manufacturing lines to swine flu vaccine
production, replace those lines all together, or exactly how to handle this additional load of
manufacturing.

A further drain on the supply occurred when officials decided that many children would
need two doses instead of just one to protect them completely. That means that twice as
many doses will be needed for many children, increasing the demand by possibly 30%.
The revised estimate for H1N1 swine flu vaccine dose delivery is 150 million doses by the
end of 2009. It remains to be seen whether that will happen, or what further problems
may crop up.

Who Should Get the H1N1 Swine Flu Vaccine?

The World Health Organization (WHO) met in Geneva, Switzerland to discuss the reach of
pandemic Novel H1N1 swine flu across the globe, and to discuss progress in the
development of the vaccine and the approach countries should take to assure vaccination
of its citizens.

American public health officials reviewed the WHO recommendations, then developed their
priority list of who should receive H1N1 vaccinations.

According to the CDC, citizens should be vaccinated in this order:

• pregnant women
• caregivers and adults who live with or care for children younger than six months of
age(parents, daycare providers, teachers and others)
• healthcare workers and emergency personnel
• children and young adults, ages 6 months to 24 years
• people age 25 to 64 who suffer from chronic health problems or have compromised
immune systems
• adults age 65 and older

Note: children under age six months are too young to get the vaccine.

Information about vaccination or precautions for specific groups of people such as

pregnant women, schools and daycare centers, businesses, people who suffer from specific
medical conditions, even people who work with pigs, can be found at the CDC's website.

How Many Doses of the H1N1 Swine Flu Vaccine Do I Need to Get?

Make sure you understand that in late 2009, there are two vaccines officials believe we will
need to develop the most protection from flu. One vaccine is intended to prevent catching
the H1N1 swine flu and a second vaccine is needed to protect against the seasonal flu, the
flu that comes around once a year.

As of October 2009, the CDC is recommending:

• Children age nine and under may need two doses of the swine flu vaccine, at least
21 days apart. The second dose is a booster for the first.
• Children and adults 10 years of age and older may need one dose of the swine flu
vaccine.
• The seasonal flu vaccine has its own requirements, separate from the swine flu
vaccine.
• Check with your own doctor or your child's pediatrician and follow his or her
guidance to be sure you are as protected as possible.

Can I Get Both the Seasonal and the H1N1 Swine Flu Vaccine at the Same Time?

Whether or not you can get doses of both vaccines at the same time depends on the type
of administration (shots vs. mist, or killed vs live) that you will be receiving. Your safest
bet is to ask your doctor what he or she recommends.
If I was vaccinated in 1976 against swine flu, do I need to get the 2009 vaccine?

According to the CDC, it is unlikely the vaccine given in 1976 will protect you from this
more current strain of influenza.

I'm having trouble finding flu vaccine supplies. How can I find a place to get my
flu shots?

There are several websites that offer locators for flu clinics:

• The first place to check is your doctor's office. Even if they have no supply of
vaccine, they may know where you can go.
• The American Lung Association has a Flu Clinic Locator.
• Your state's health department may provide flu clinic information.
• Or check your local newspaper or TV station websites which may list clinics near
you.

If I Decide Not to Get the H1N1 Vaccine, or If I Am Unable to Get It, What Can I
Do to Protect Myself?

The best defense against any flu or any infection, whether or not you have been
vaccinated, is to practice good hygiene such as frequent handwashing. If you do get sick,
stay home from school or work to prevent spreading it to others.

Sometimes the defense is a good offense, too. The World Health Organization
estimates one third of us will get H1N1 swine flu regardless of what we do to prevent
it. A smart patient prepares ahead of time by developing a swine flu plan for when a
family member gets swine flu.

How can I protect myself and my family from the swine flu?

Follow some common sense protections emphasized for any flu, including seasonal flu:

• Keep your hands washed and sanitized.

If you touch something that may carry the infection, then avoid touching your eyes,
nose or mouth.

If you can't wash your hands frequently, then use hand sanitizers to keep the germs at
bay.

• Avoid being near others who might be sick to avoid breathing droplets they have
sneezed or coughed, or touching something they have touched.

• When you greet others, consider not shaking their hands or hugging or kissing
them during this time. Those are generally courtesies. You might even explain that you
are doing them a favor! They'll respect you for it.

• If you have travel plans, do some due diligence and consider changing plans if you
will be traveling to an area where cases of swine flu, even possible cases of swine flu,
have been identified. The CDC issues travel advisories.
 • Plan ahead. Plan for the possibility that you or your children (meaning, you, too)
might get the swine flu, including the fact that you may need to stay home from work
or school. If it seems like people at work or school have an upper respiratory illness,
even if they have not identified it as swine flu, you may want to consider staying home,
too.

• A vaccine became available in Fall 2009, although is in short supply until later in
the year.

Can I get the swine flu from eating pork?

No. The swine flu virus is not contained in pork meat. This is another myth.

Why do I see people on the TV news wearing masks over their nose and mouth?

In areas where any virus is running rampant, they hope to protect themselves from
breathing any droplets of virus that might be left in the air from someone who sneezed or
coughed. Health officials are not sure whether those masks are helpful or not, but they
certainly can't hurt.

Should I be afraid of swine flu?

Fear is not called for. A healthy respect is. Learn about reasons not to fear swine flu, and
Swine Flu Myths.