H1N1 Flu FAQs: The Basics

Concerned about the H1N1 flu? We've addressed here some of the most common questions related to the virus.

Symptoms

What are the symptoms of H1N1 flu?
The symptoms of H1N1 flu, also known as swine flu, in people are similar to the symptoms of regular human flu (this is human flu, but a new strain) and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with H1N1 flu.

The CDC provides additional guidance on symptoms and treatments in its document "What To Do If You Get Sick: 2009 H1N1 and Seasonal Flu."

How does one get the flu?
Watch this excellent video/animation from NPR.org for more than you'd ever want to know about virus reproduction and infection.

Who is most at risk?
Pandemic H1N1, in contrast to seasonal influenza, continues to spare--relatively--the elderly, while children and young adults are at greatest risk, and are at greatest risk for severe complications of the flu. This pattern, also seen in the 1918 influenza pandemic, appears to be the result of past exposure to related viruses in those 60 years of age and older, almost one-third of whom possesses neutralizing antibodies to the pandemic H1N1 virus. The most severe disease occurs in those with underlying medical conditions and those who are pregnant.

When should I go to the hospital?
If you have the symptoms above--and especially if you have those symptoms and have a fever of 100 degrees Farenheit or higher--call your doctor or medical provider first for instructions. Your doctor may have you come in for an appointment and test you for influenza. If you do not have a doctor, you can use our Find a Doctor resource.

Do not go to your doctor's office before you call, and do not go to the hospital unless you experience trouble breathing, pain in your chest or abdomen, sudden dizziness, confusion, or severe or persistent vomiting. For children, be on the lookout for additional symptoms, including blueish skin color, not responding or waking up, or a fever with a rash. The CDC has additional guidance on evaluating symptoms.

If your doctor instructs you to go to the hospital, go directly to the emergency department. When you enter the emergency department, you may be asked to wear a mask, for your protection and for the protection of others. Visitors may also be asked to wear masks. It is important to remember wearing a mask does not have a negative connotation, but is a socially acceptable way to protect others, especially if they have respiratory symptoms, such as a cough, sneezing, or sniffles.

If you're sick, stay away from work or school; it's important to limit contact with other people, so you don't spread germs to others.

What do I do if I don't have health insurance?
If you're experiencing flu symptoms and you don't have insurance, you can contact the RotaCare Free Clinic at El Camino Hospital to get more information or to make an appointment. Contact a clinic representative by sending an e-mail to mv_rotacare@elcaminohospital.org or by calling 650-988-7632. Please call or e-mail before you visit the clinic.

Vaccination

Who should get vaccinated?
H1N1 vaccination is recommended for (not in order of priority):

• Individuals aged 6 months--24 years
• Individuals aged 25--64 years with medical conditions putting them at higher risk
• Individuals who live with or provide care for infants aged 6 months or younger (e.g., parents, siblings, and daycare providers)
• Pregnant women
• Health-care and emergency medical services personnel

The California Department of Public Health has recommended that children, young adults and pregnant woman receive first priority for vaccination, especially children under the age of 5 and individuals living with infants aged 6 months or younger.

Seasonal influenza vaccination is recommended for:

• Children 6 months through 18 years of age
• Pregnant women
• Individuals >50 years of age
• Individuals with comorbidities that put them at risk for severe influenza
• Residents of nursing homes and other long-term care facilities
• Individuals who live with or care for those at high risk of complications from influenza, including:
  
  • Health care workers
  • Household contacts of persons at high risk of influenza complications
  • Household contacts and out-of-home caregivers of children aged 6 months or younger

While most persons will receive the inactivated vaccine via injection, the live attenuated nasal vaccine may be used in individuals 2 to 49 years of age who do not have medical conditions--for example, egg allergies--that make it inadvisable to receive that form of the vaccine.

I want to get vaccinated. Where can I go?
Your doctor's office should be your first option, but some clinics, drugstores, and other locations are offering vaccinations. Please note that El Camino Hospital does not have the vaccine for public distribution.

Because the federal government is picking up the cost of vaccinating the public, H1N1 vaccinations should cost nothing. Seasonal vaccinations, however, may require payment.

Google launched an online tool for tracking vaccination availability and locations for H1N1 and seasonal influenza in the U.S. Enter your zip code, and the site will show you where you can get vaccinated. The flu-shot finder service is live on Google now and will soon be available at flu.gov and websites of the American Lung Association.

I got a seasonal flu shot; am I protected?
Most people will not gain immunity from the seasonal flu shot, because H1N1 flu is a new strain. Fortunately, the H1N1 flu vaccine is becoming more available.

Prevention

I've been around someone who might have had the flu. Should I call my doctor?
Only if you have symptoms of influenza (or any other illness, for that matter). In other words, call your doctor only if you would have normally.

Wash my hands--but for how long?
We tell our kids to go wash their hands…and they return from the sink ten seconds later. "All done!" Experts say it takes at least 20 seconds of scrubbing--with soap!--or about the length of time it takes to sing the A-B-C song.

Still having trouble getting kids to wash their hands? Try showing them the National Sanitation Foundation's Scrub Club website, which has games that are fun for kids (10 years old or younger, most likely) to play and that will teach them the importance of hand-washing and other hygiene maintenance.

What else can I do to prevent contracting the H1N1 flu?
Use a hand sanitizer when you can't get to a sink to wash your hands; sanitizing gels or liquids with an alcohol content of at least 60 percent are effective against the flu. It's a good idea to keep your distance from anyone who's coughing or sneezing more than usual--but that's a good idea at any time. And as always, cough or sneeze into a tissue (and then wash your hands), or into the fold of your elbow, without using your hands.

What's the difference between "suspected," "probable" and "confirmed" cases of H1N1 flu?
"Suspected" means only that a person has the usual flu-type symptoms; "probable" means that the person has been tested and has been determined to have Influenza A (not Influenza B). "Confirmed" means that an additional test has been performed, and that that test has come back positive for H1N1 flu. See the NPR story on the topic.

Can I get Tamiflu to protect me or my family?
The Centers for Disease Control recently updated its recommendations for who should take Tamiflu or Relenza (another antiviral drug that is effective against H1N1 flu) and when. It advises that Tamiflu should be given to people who have contracted H1N1 flu, starting within 48 hours of the onset of symptoms. Tamiflu can be effective in moderating the length and severity of an influenza infection, if given within 48 hours of infection; that's why it's important to contact your doctor if you do have flu symptoms. Only your doctor can prescribe Tamiflu or Relenza.

The CDC does allow that certain people who have a higher risk of complications from the H1N1 flu may be given Tamiflu, but only if they have been exposed to H1N1 flu or could potentially be exposed to it--for example, in a nursing home. People who have a higher risk of complications include people over age 65, children under 5 years old (and especially children under 2 years old), and other groups; see the CDC's list.

If you have neither contracted H1N1 flu nor been exposed to it, you shouldn't take Tamiflu or Relenza, for several reasons. If the flu spreads, the drugs may be needed by people who have been infected or exposed. Furthermore, taking drugs to suppress infection does not give you immunity to future infections. The virus may morph over time--and potentially become stronger--at which point Tamiflu and Relenza may not be effective.