Know The Difference Between Cold and Swine Flu Symptoms Symptom Cold Swine Flu

SWAIN FLU SUSANTA ROUT--1
Know the Difference between Cold and Swine Flu Symptoms
Symptom Cold Swine Flu

Fever is usually present with the
flu in up to 80% of all flu cases.
Fever Fever is rare with a cold. A temperature of 100°F or
higher for 3 to 4 days is
associated with the flu.
A hacking, productive A non-productive (non-mucus
(mucus- producing) cough producing) cough is usually
Coughing
is often present with a present with the flu (sometimes
cold. referred to as dry cough).
Slight body aches and Severe aches and pains are
Aches
pains can be part of a cold. common with the flu.
Stuffy nose is commonly
present with a cold and
Stuffy nose is not commonly
Stuffy Nose typically resolves
present with the flu.
spontaneously within a
week.
Chills are uncommon with 60% of people who have the flu
Chills
a cold. experience chills.
Tiredness is fairly mild with Tiredness is moderate to severe
Tiredness
a cold. with the flu.
Sneezing is commonly Sneezing is not common with
Sneezing
present with a cold. the flu.
The flu has a rapid onset within
Sudden Cold symptoms tend to 3-6 hours. The flu hits hard and
Symptoms develop over a few days. includes sudden symptoms like
high fever, aches and pains.
A headache is very common with
A headache is fairly
Headache the flu, present in 80% of flu
uncommon with a cold.
cases.
Sore throat is commonly Sore throat is not commonly
Sore Throat
present with a cold. present with the flu.
Chest Chest discomfort is mild to Chest discomfort is often severe
Discomfort moderate with a cold. with the flu.
Swine influenza
.
 2009 flu pandemic (Swine flu)
 Virus
 Avian influenza
 Swine influenza
 Flu season
 Research
 Vaccine
 Treatment
 A/H5N1 subtype
A/H1N1 subtype
Swine influenza is endemic in pigs

Electron microscope image of the reassorted H1N1 influenza virus

photographed at the CDC Influenza Laboratory. The viruses are 80–
120 nanometres in diameter.[1]
Swine influenza (also called swine flu, hog flu, and pig flu) is an
infection by any one of several types of swine influenza virus. Swine
influenza virus (SIV) is any strain of the influenza family of viruses that
is endemic in pigs.[2] As of 2009, the known SIV strains include influenza
C and the subtypes of influenza A known as H1N1, H1N2, H3N1, H3N2,
and H2N3.
Swine influenza virus is common throughout pig populations worldwide.

Transmission of the virus from pigs to humans is not common and does
not always lead to human influenza, often resulting only in the production
of antibodies in the blood. If transmission does cause human influenza, it
is called zoonotic swine flu. People with regular exposure to pigs are at
increased risk of swine flu infection. The meat of an infected animal poses
no risk of infection when properly cooked.
During the mid-20th century, identification of influenza subtypes became

possible, allowing accurate diagnosis of transmission to humans. Since
then, only 50 such transmissions have been confirmed. These strains of
swine flu rarely pass from human to human. Symptoms of zoonotic swine
flu in humans are similar to those of influenza and of influenza-like illness
in general, namely chills, fever, sore throat, muscle pains, severe
headache, coughing, weakness and general discomfort.
Contents
 1 Classification
o 1.1 Influenza C
o 1.2 Influenza A
o 1.3 Surveillance
 2 History
o 2.1 1918 pandemic in humans
o 2.2 1976 U.S. outbreak
o 2.3 1988 zoonosis
o 2.4 1998 US outbreak in swine
o 2.5 2007 Philippine outbreak in swine
o 2.6 2009 outbreak in humans
 3 Transmission
o 3.1 Transmission between pigs
o 3.2 Transmission to humans
o 3.3 Interaction with avian H5N1 in pigs
 4 Signs and symptoms
o 4.1 In swine
o 4.2 In humans
o 4.3 Diagnosis
 5 Prevention
o 5.1 Prevention in swine
o 5.2 Prevention in humans
 6 Treatment
o 6.1 In swine
o 6.2 In humans
 7 See also
 8 Notes
 9 Further reading
 10 External links
Classification
Of the three genera of influenza viruses that cause human flu, two also
cause influenza in pigs, with influenza A being common in pigs and
influenza C being rare.[3] Influenza B has not been reported in pigs.
Within influenza A and influenza C, the strains found in pigs and humans
are largely distinct, although due to reassortment there have been
transfers of genes among strains crossing swine, avian, and human
species boundaries.
Influenza C
Influenza C viruses infect both humans and pigs, but do not infect birds. [4]
Transmission between pigs and humans have occurred in the past. [5] For
example, influenza C caused small outbreaks of a mild form of influenza
amongst children in Japan[6] and California.[6] Due to its limited host range
and the lack of genetic diversity in influenza C, this form of influenza does
not cause pandemics in humans.[7]
Influenza A
Swine influenza is known to be caused by influenza A subtypes H1N1,[8]

H1N2,[8] H2N3,[9] H3N1,[10] and H3N2.[8] In pigs, three influenza A virus
subtypes (H1N1, H1N2, and H3N2) are the most common strains
worldwide.[11] In the United States, the H1N1 subtype was exclusively
prevalent among swine populations before 1998; however, since late
August 1998, H3N2 subtypes have been isolated from pigs. As of 2004,
H3N2 virus isolates in US swine and turkey stocks were triple
reassortants, containing genes from human (HA, NA, and PB1), swine
(NS, NP, and M), and avian (PB2 and PA) lineages.[12]
Surveillance
Although there is no formal national surveillance system in the United

States to determine what viruses are circulating in pigs, [13] there is an
informal surveillance network in the United States that is part of a world
surveillance network.
Veterinary medical pathologist, Tracey McNamara, set up a national

disease surveillance system in zoos because the zoos do active disease
surveillance and many of the exotic animals housed there have broad
susceptibilities. Many species fall below the radar of any federal agencies
(including dogs, cats, pet prairie dogs, zoo animals, and urban wildlife),
even though they may be important in the early detection of human
disease outbreaks.[14] [15]
History
Swine influenza was first proposed to be a disease related to human

influenza during the 1918 flu pandemic, when pigs became sick at the
same time as humans.[16] The first identification of an influenza virus as a
cause of disease in pigs occurred about ten years later, in 1930. [17] For
the following 60 years, swine influenza strains were almost exclusively
H1N1. Then, between 1997 and 2002, new strains of three different
subtypes and five different genotypes emerged as causes of influenza
among pigs in North America. In 1997-1998, H3N2 strains emerged.
These strains, which include genes derived by reassortment from human,
swine and avian viruses, have become a major cause of swine influenza
in North America. Reassortment between H1N1 and H3N2 produced
H1N2. In 1999 in Canada, a strain of H4N6 crossed the species barrier
from birds to pigs, but was contained on a single farm.[17]
The H1N1 form of swine flu is one of the descendants of the strain that
caused the 1918 flu pandemic.[18][19] As well as persisting in pigs, the
descendants of the 1918 virus have also circulated in humans through the
20th century, contributing to the normal seasonal epidemics of influenza.
[19]
However, direct transmission from pigs to humans is rare, with only
12 cases in the U.S. since 2005.[20] Nevertheless, the retention of
influenza strains in pigs after these strains have disappeared from the
human population might make pigs a reservoir where influenza viruses
could persist, later emerging to reinfect humans once human immunity to
these strains has waned.[21]
Swine flu has been reported numerous times as a zoonosis in humans,

usually with limited distribution, rarely with a widespread distribution.
Outbreaks in swine are common and cause significant economic losses in
industry, primarily by causing stunting and extended time to market. For
example, this disease costs the British meat industry about £65 million
every year.[22]
1918 pandemic in humans
The 1918 flu pandemic in humans was associated with H1N1 and
influenza appearing in pigs;[19] this may reflect a zoonosis either from
swine to humans, or from humans to swine. Although it is not certain in
which direction the virus was transferred, some evidence suggests that,
in this case, pigs caught the disease from humans.[16] For instance, swine
influenza was only noted as a new disease of pigs in 1918, after the first
large outbreaks of influenza amongst people.[16] Although a recent
phylogenetic analysis of more recent strains of influenza in humans,
birds, and swine suggests that the 1918 outbreak in humans followed a
reassortment event within a mammal,[23] the exact origin of the 1918
strain remains elusive.[24] It is estimated that anywhere from 50 to

100 million people were killed worldwide.[19][25]
1976 U.S. outbreak
Main article: 1976 swine flu outbreak
On February 5, 1976, in the United States an army recruit at Fort Dix said
he felt tired and weak. He died the next day and four of his fellow soldiers
were later hospitalized. Two weeks after his death, health officials
announced that the cause of death was a new strain of swine flu. The
strain, a variant of H1N1, is known as A/New Jersey/1976 (H1N1). It was
detected only from January 19 to February 9 and did not spread beyond
Fort Dix.[26]
President Ford receives swine flu vaccination
This new strain appeared to be closely related to the strain involved in

the 1918 flu pandemic. Moreover, the ensuing increased surveillance
uncovered another strain in circulation in the U.S.: A/Victoria/75 (H3N2)
spread simultaneously, also caused illness, and persisted until March. [26]
Alarmed public-health officials decided action must be taken to head off
another major pandemic, and urged President Gerald Ford that every
person in the U.S. be vaccinated for the disease. [27]
The vaccination program was plagued by delays and public relations

problems.[28] On October 1, 1976, the immunization program began. That
same day, three senior citizens died soon after receiving their swine flu
shots and there was a media outcry linking the deaths to the
immunizations, despite the lack of positive proof. According to science
writer Patrick Di Justo, however, by the time the truth was known—that
the deaths were not proven to be related to the vaccine—it was too late.
"The government had long feared mass panic about swine flu—now they
feared mass panic about the swine flu vaccinations." This became a
strong setback to the program.[29]
There were reports of Guillain-Barré syndrome, a paralyzing

neuromuscular disorder, affecting some people who had received swine
flu immunizations. This syndrome is a rare side-effect of modern
influenza vaccines, with an incidence of about one case per million

vaccinations.[30] As a result, Di Justo writes that "the public refused to
trust a government-operated health program that killed old people and
crippled young people." In total, 48,161,019 Americans, or just over 22%
of the population, had been immunized by the time the National Influenza
Immunization Program (NIIP) was effectively halted on December 16,
1976.[31] [32]
Overall, there were 1098 cases of Guillain-Barré Syndrome (GBS)

recorded nationwide by CDC surveillance, 532 of which were linked to the
NIIP vaccination, resulting in death from severe pulmonary complications
for 25 people, which, according to Dr. P. Haber, were probably caused by
an immunopathological reaction to the 1976 vaccine. Other influenza
vaccines have not been linked to GBS, though caution is advised for
certain individuals, particularly those with a history of GBS. [33] [34][35] Still,
as observed by a participant in the immunization program, the vaccine
killed more Americans than the disease did.[36]
1988 zoonosis
In September 1988, a swine flu virus killed one woman and infected
others. 32-year old Barbara Ann Wieners was eight months pregnant
when she and her husband, Ed, became ill after visiting the hog barn at a
county fair in Walworth County, Wisconsin. Barbara died eight days later,
after developing pneumonia.[37] The only pathogen identified was an H1N1
strain of swine influenza virus.[38] Doctors were able to induce labor and
deliver a healthy daughter before she died. Her husband recovered from
his symptoms.
Influenza-like illness (ILI) was reportedly widespread among the pigs

exhibited at the fair. 76% of 25 swine exhibitors aged 9 to 19 tested
positive for antibody to SIV, but no serious illnesses were detected
among this group. Additional studies suggested between one and three
health care personnel who had contact with the patient developed mild
influenza-like illnesses with antibody evidence of swine flu infection.
However, there was no community outbreak.[39][40]
1998 US outbreak in swine
In 1998, swine flu was found in pigs in four U.S. states. Within a year, it
had spread through pig populations across the United States. Scientists
found that this virus had originated in pigs as a recombinant form of flu
strains from birds and humans. This outbreak confirmed that pigs can
serve as a crucible where novel influenza viruses emerge as a result of
the reassortment of genes from different strains.[41][42][43]
2007 Philippine outbreak in swine
On August 20, 2007 Department of Agriculture officers investigated the

outbreak (epizootic) of swine flu in Nueva Ecija and Central Luzon,
Philippines. The mortality rate is less than 10% for swine flu, unless there
are complications like hog cholera. On July 27, 2007, the Philippine
National Meat Inspection Service (NMIS) raised a hog cholera "red alert"
warning over Metro Manila and 5 regions of Luzon after the disease
spread to backyard pig farms in Bulacan and Pampanga, even if these
tested negative for the swine flu virus.[44][45]
2009 outbreak in humans
The H1N1 viral strain implicated in the 2009 flu pandemic among humans
often is called "swine flu" because initial testing showed many of the
genes in the virus were similar to influenza viruses normally occurring in
North American swine.[46] But further research has shown that the
outbreak is due to a new strain of H1N1 not previously reported in pigs.
In late April, Margaret Chan, the World Health Organization's director-

general, declared a "public health emergency of international concern"
under the rules of the WHO's new International Health Regulations when
the first cases of the H1N1 virus were reported in the United States. [47] [48]
Following the outbreak, on May 2, 2009, it was reported in pigs at a farm
in Alberta, Canada, with a link to the outbreak in Mexico. The pigs are
suspected to have caught this new strain of virus from a farm worker who
recently returned from Mexico, then showed symptoms of an influenza-
like illness.[49] These are probable cases, pending confirmation by
laboratory testing.
The new strain was initially described as an apparent reassortment of at

least four strains of influenza A virus subtype H1N1, including one strain
endemic in humans, one endemic in birds, and two endemic in swine.[46]
Subsequent analysis suggested it was a reassortment of just two strains,
both found in swine.[50] Although initial reports identified the new strain as
swine influenza (i.e., a zoonosis originating in swine), its origin is
unknown. Several countries took precautionary measures to reduce the
chances for a global pandemic of the disease.[51] The 2009 swine flu has
been compared to other similar types of influenza virus in terms of
mortality: "in the US it appears that for every 1000 people who get
infected, about 40 people need admission to hospital and about one
person dies".[52]. There are fears that swine flu will become a major global
pandemic in the winter months, with many countries planning major
vaccination campaigns. [53]
Transmission
Transmission between pigs
Influenza is quite common in pigs, with about half of breeding pigs having
been exposed to the virus in the US.[54] Antibodies to the virus are also
common in pigs in other countries.[54]
The main route of transmission is through direct contact between infected

and uninfected animals.[11] These close contacts are particularly common
during animal transport. Intensive farming may also increase the risk of
transmission, as the pigs are raised in very close proximity to each other.
[55][56]
The direct transfer of the virus probably occurs either by pigs
touching noses, or through dried mucus. Airborne transmission through
the aerosols produced by pigs coughing or sneezing are also an important
means of infection.[11] The virus usually spreads quickly through a herd,
infecting all the pigs within just a few days.[2] Transmission may also
occur through wild animals, such as wild boar, which can spread the
disease between farms.[57]
Transmission to humans
People who work with poultry and swine, especially people with intense
exposures, are at increased risk of zoonotic infection with influenza virus
endemic in these animals, and constitute a population of human hosts in
which zoonosis and reassortment can co-occur.[58] Vaccination of these
workers against influenza and surveillance for new influenza strains
among this population may therefore be an important public health
measure.[59] Transmission of influenza from swine to humans who work
with swine was documented in a small surveillance study performed in
2004 at the University of Iowa.[60] This study among others forms the
basis of a recommendation that people whose jobs involve handling
poultry and swine be the focus of increased public health surveillance. [58]
Other professions at particular risk of infection are veterinarians and
meat processing workers, although the risk of infection for both of these
groups is lower than that of farm workers.[61]
Interaction with avian H5N1 in pigs
Pigs are unusual as they can be infected with influenza strains that
usually infect three different species: pigs, birds and humans. [62] This
makes pigs a host where influenza viruses might exchange genes,
producing new and dangerous strains.[62] Avian influenza virus H3N2 is
endemic in pigs in China and has been detected in pigs in Vietnam,
increasing fears of the emergence of new variant strains.[63] H3N2 evolved
from H2N2 by antigenic shift.[64] In August 2004, researchers in China

found H5N1 in pigs.[65]
Main symptoms of swine flu in swine.[2]
These H5N1 infections may be quite common: in a survey of 10

apparently healthy pigs housed near poultry farms in West Java, where
avian flu had broken out, five of the pig samples contained the H5N1
virus. The Indonesian government has since found similar results in the
same region. Additional tests of 150 pigs outside the area were negative.
[66][67]
Signs and symptoms
In swine
In pigs influenza infection produces fever, lethargy, sneezing, coughing,

difficulty breathing and decreased appetite.[11] In some cases the infection
can cause abortion. Although mortality is usually low (around 1-4%),[2]
the virus can produce weight loss and poor growth, causing economic loss
to farmers.[11] Infected pigs can lose up to 12 pounds of body weight over
a 3 to 4 week period.[11]
In humans
Main symptoms of swine flu in humans[68]
Direct transmission of a swine flu virus from pigs to humans is

occasionally possible (called zoonotic swine flu). In all, 50 cases are
known to have occurred since the first report in medical literature in
1958, which have resulted in a total of six deaths. [69] Of these six people,
one was pregnant, one had leukemia, one had Hodgkin disease and two
were known to be previously healthy.[69] Despite these apparently low
numbers of infections, the true rate of infection may be higher, since
most cases only cause a very mild disease, and will probably never be
reported or diagnosed.[69]
In this video, Dr. Joe Bresee, with CDC's Influenza Division, describes the
symptoms of swine flu and warning signs to look for that indicate the
need for urgent medical attention.
See also: See this video with subtitles on YouTube [2]
According to the Centers for Disease Control and Prevention (CDC), in

humans the symptoms of the 2009 "swine flu" H1N1 virus are similar to
those of influenza and of influenza-like illness in general. Symptoms
include fever, cough, sore throat, body aches, headache, chills and
fatigue. The 2009 outbreak has shown an increased percentage of
patients reporting diarrhea and vomiting.[70] The 2009 H1N1 virus is not
zoonotic swine flu, as it is not transmitted from pigs to humans, but from
person to person.
Because these symptoms are not specific to swine flu, a differential

diagnosis of probable swine flu requires not only symptoms but also a
high likelihood of swine flu due to the person's recent history. For
example, during the 2009 swine flu outbreak in the United States, CDC
advised physicians to "consider swine influenza infection in the differential
diagnosis of patients with acute febrile respiratory illness who have either
been in contact with persons with confirmed swine flu, or who were in
one of the five U.S. states that have reported swine flu cases or in Mexico
during the 7 days preceding their illness onset."[71] A diagnosis of
confirmed swine flu requires laboratory testing of a respiratory sample (a

simple nose and throat swab).[71]
The most common cause of death is respiratory failure. Other causes of

death are pneumonia (leading to sepsis)[72], high fever (leading to
neurological problems), dehydration (from excessive vomiting and
diarrhea) and electrolyte imbalance. Fatalities are more likely in young
children and the elderly.
Diagnosis
Thermal scanning of passengers arriving at Singapore Changi airport.

This section requires expansion.
Different medical kits are available for diagnosis of swine flu.[73]
The two major tests that are being used are the nasopharyngeal (or back
of the throat) swab for viral culture, the gold standard, and the indirect
evidence test by detection of antibodies to novel H1N1 with PCR studies.
Prevention
Prevention of swine influenza has three components: prevention in swine,

prevention of transmission to humans, and prevention of its spread
among humans.
Prevention in swine
Methods of preventing the spread of influenza among swine include

facility management, herd management, and vaccination (ATCvet code:
QI09AA03). Because much of the illness and death associated with swine
flu involves secondary infection by other pathogens, control strategies
that rely on vaccination may be insufficient.
Control of swine influenza by vaccination has become more difficult in

recent decades, as the evolution of the virus has resulted in inconsistent
responses to traditional vaccines. Standard commercial swine flu vaccines
are effective in controlling the infection when the virus strains match
enough to have significant cross-protection, and custom (autogenous)

vaccines made from the specific viruses isolated are created and used in
the more difficult cases.[74][75] Present vaccination strategies for SIV
control and prevention in swine farms typically include the use of one of
several bivalent SIV vaccines commercially available in the United States.
Of the 97 recent H3N2 isolates examined, only 41 isolates had strong
serologic cross-reactions with antiserum to three commercial SIV
vaccines. Since the protective ability of influenza vaccines depends
primarily on the closeness of the match between the vaccine virus and
the epidemic virus, the presence of nonreactive H3N2 SIV variants
suggests that current commercial vaccines might not effectively protect
pigs from infection with a majority of H3N2 viruses.[76][77] The United
States Department of Agriculture researchers say that while pig
vaccination keeps pigs from getting sick, it does not block infection or
shedding of the virus.[78]
Facility management includes using disinfectants and ambient

temperature to control virus in the environment. The virus is unlikely to
survive outside living cells for more than two weeks, except in cold (but
above freezing) conditions, and it is readily inactivated by disinfectants. [2]
Herd management includes not adding pigs carrying influenza to herds
that have not been exposed to the virus. The virus survives in healthy
carrier pigs for up to 3 months and can be recovered from them between
outbreaks. Carrier pigs are usually responsible for the introduction of SIV
into previously uninfected herds and countries, so new animals should be
quarantined.[54] After an outbreak, as immunity in exposed pigs wanes,
new outbreaks of the same strain can occur.[2]
Prevention in humans
Prevention of pig to human transmission

Swine can be infected by both avian and human influenza strains of

influenza, and therefore are hosts where the antigenic shifts can occur
that create new influenza strains.
The transmission from swine to human is believed to occur mainly in

swine farms where farmers are in close contact with live pigs. Although
strains of swine influenza are usually not able to infect humans this may
occasionally happen, so farmers and veterinarians are encouraged to use
a face mask when dealing with infected animals. The use of vaccines on
swine to prevent their infection is a major method of limiting swine to
human transmission. Risk factors that may contribute to swine-to-human
transmission include smoking and not wearing gloves when working with
sick animals.[79]
Prevention of human to human transmission
Influenza spreads between humans through coughing or sneezing and

people touching something with the virus on it and then touching their
own nose or mouth.[80] Swine flu cannot be spread by pork products,
since the virus is not transmitted through food.[80] The swine flu in
humans is most contagious during the first five days of the illness
although some people, most commonly children, can remain contagious
for up to ten days. Diagnosis can be made by sending a specimen,
collected during the first five days for analysis.[81]
Recommendations to prevent spread of the virus among humans include

using standard infection control against influenza. This includes frequent
washing of hands with soap and water or with alcohol-based hand
sanitizers, especially after being out in public.[82] Chance of transmission
is also reduced by disinfecting household surfaces, which can be done
effectively with a diluted chlorine bleach solution.[83]
Experts agree that hand-washing can help prevent viral infections,

including ordinary influenza and the swine flu virus. Also avoiding
touching eyes, nose and mouth with hands prevents flu. [3] Influenza can
spread in coughs or sneezes, but an increasing body of evidence shows
small droplets containing the virus can linger on tabletops, telephones
and other surfaces and be transferred via the fingers to the mouth, nose
or eyes. Alcohol-based gel or foam hand sanitizers work well to destroy
viruses and bacteria. Anyone with flu-like symptoms such as a sudden
fever, cough or muscle aches should stay away from work or public
transportation and should contact a doctor for advice.
Social distancing is another tactic. It means staying away from other

people who might be infected and can include avoiding large gatherings,
spreading out a little at work, or perhaps staying home and lying low if an
infection is spreading in a community. Public health and other responsible
authorities have action plans which may request or require social
distancing actions depending on the severity of the outbreak.
Vaccination
Vaccines are available for different kinds of swine flu. Although the
current trivalent influenza vaccine is unlikely to provide protection against
the new 2009 H1N1 strain,[84] vaccines against the new strain are being
developed and could be ready as early as November 2009.[85]
Treatment
In swine
As swine influenza is rarely fatal to pigs, little treatment beyond rest and
supportive care is required.[54] Instead veterinary efforts are focused on
preventing the spread of the virus throughout the farm, or to other
farms.[11] Vaccination and animal management techniques are most
important in these efforts. Antibiotics are also used to treat this disease,
which although they have no effect against the influenza virus, do help
prevent bacterial pneumonia and other secondary infections in influenza-
weakened herds.[54]
In humans
If a person becomes sick with swine flu, antiviral drugs can make the
illness milder and make the patient feel better faster. They may also
prevent serious flu complications. For treatment, antiviral drugs work
best if started soon after getting sick (within 2 days of symptoms). Beside
antivirals, supportive care at home or in hospital, focuses on controlling
fevers, relieving pain and maintaining fluid balance, as well as identifying
and treating any secondary infections or other medical problems. The
U.S. Centers for Disease Control and Prevention recommends the use of
Tamiflu (oseltamivir) or Relenza (zanamivir) for the treatment and/or
prevention of infection with swine influenza viruses; however, the
majority of people infected with the virus make a full recovery without
requiring medical attention or antiviral drugs.[86] The virus isolates in the
2009 outbreak have been found resistant to amantadine and rimantadine.
[87]
In the U.S., on April 27, 2009, the Food and Drug Administration (FDA)
issued Emergency Use Authorizations to make available Relenza and
Tamiflu antiviral drugs to treat the swine influenza virus in cases for
which they are currently unapproved. The agency issued these EUAs to
allow treatment of patients younger than the current approval allows and
to allow the widespread distribution of the drugs, including by non-
licensed volunteers.[88]
 Virus
 Bird flu
 Dog flu
 Horse flu
 Infectious disease
 List of epidemics
Notes
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Virus Database, version 4: Influenza A".
http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/00.046.0.01.htm.
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http://www.merckvetmanual.com/mvm/index.jsp?
cfile=htm/bc/121407.htm. Retrieved April 30, 2009.
3. ^ Heinen PP (15 September 2003). "Swine influenza: a zoonosis".

Veterinary Sciences Tomorrow. ISSN 1569-0830.
http://www.vetscite.org/publish/articles/000041/print.html.
"Influenza B and C viruses are almost exclusively isolated from man,
although influenza C virus has also been isolated from pigs and
influenza B has recently been isolated from seals.".
4. ^ Bouvier NM, Palese P (September 2008). "The biology of influenza
viruses". Vaccine 26 Suppl 4: D49–53. PMID 19230160.
5. ^ Kimura H, Abiko C, Peng G, et al (April 1997). "Interspecies
transmission of influenza C virus between humans and pigs". Virus
Res. 48 (1): 71–9. PMID 9140195.
http://linkinghub.elsevier.com/retrieve/pii/S0168-1702(96)01427-X.
6. ^ a b Matsuzaki Y, Sugawara K, Mizuta K, et al (February 2002).
"Antigenic and genetic characterization of influenza C viruses which
caused two outbreaks in Yamagata City, Japan, in 1996 and 1998".
J. Clin. Microbiol. 40 (2): 422–9. PMID 11825952. PMC: 153379.
http://jcm.asm.org/cgi/pmidlookup?view=long&pmid=11825952.
7. ^ Lynch JP, Walsh EE (April 2007). "Influenza: evolving strategies in
treatment and prevention". Semin Respir Crit Care Med 28 (2):
144–58. doi:10.1055/s-2007-976487. PMID 17458769.
8. ^ a b c "Swine Influenza". Swine Diseases (Chest). Iowa State
University College of Veterinary Medicine.
http://www.vetmed.iastate.edu/departments/vdpam/swine/diseases
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89. Situation Update

90. Each week CDC analyzes information about
influenza disease activity in the United States and
publishes findings of key flu indicators in a report
called FluView. During the week of August 16-22,
2009, a review of these key indictors found that influenza activity is
either stable, or is increasing in some areas. Activity appears to be
increasing in the Southeast based on influenza-like illness data
reported by health care providers. Below is a summary of the most
recent key indicators:
Novel H1N1 Flu (Swine Flu) and You
August 5, 2009 5:00 PM ET
On this Page
 Novel H1N1 Flu
 Novel H1N1 Flu in Humans
 Prevention & Treatment

 Contamination & Cleaning
 Exposures Not Thought to Spread Novel H1N1 Flu
Novel H1N1 Flu
What is novel H1N1 (swine flu)?

Novel H1N1 (referred to as “swine flu” early on) is a new influenza virus
causing illness in people. This new virus was first detected in people in
the United States in April 2009. This virus is spreading from person-to-
person worldwide, probably in much the same way that regular seasonal
influenza viruses spread. On June 11, 2009, the World Health
Organization (WHO) signaled that a pandemic of novel H1N1 flu was
underway.
Why is novel H1N1 virus sometimes called

“swine flu”?
This virus was originally referred to as “swine flu”
because laboratory testing showed that many of
the genes in this new virus were very similar to
influenza viruses that normally occur in pigs
(swine) in North America. But further study has shown that this new virus
is very different from what normally circulates in North American pigs. It
has two genes from flu viruses that normally circulate in pigs in Europe
and Asia and bird (avian) genes and human genes. Scientists call this a
"quadruple reassortant" virus.
Novel H1N1 Flu in Humans
Are there human infections with novel H1N1 virus in the U.S.?
Yes. Human infections with the new H1N1 virus are ongoing in the
United States. Most people who have become ill with this new virus have
recovered without requiring medical treatment.
CDC routinely works with states to collect, compile and analyze
information about influenza, and has done the same for the new H1N1
virus since the beginning of the outbreak. This information is presented in
a weekly report, called FluView.
Is novel H1N1 virus contagious?

CDC has determined that novel H1N1 virus is contagious and is spreading
from human to human.
How does novel H1N1 virus spread?

Spread of novel H1N1 virus is thought to occur in the same way that
seasonal flu spreads. Flu viruses are spread mainly from person to person
through coughing or sneezing by people with influenza. Sometimes
people may become infected by touching something – such as a surface
or object – with flu viruses on it and then touching their mouth or nose.
What are the signs and symptoms of this virus

in people?
The symptoms of novel H1N1 flu virus in people
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 this virus also have reported diarrhea
and vomiting. Severe illnesses and death has occurred as a result of
illness associated with this virus.
How severe is illness associated with novel H1N1 flu virus?

Illness with the new H1N1 virus has ranged from mild to severe. While
most people who have been sick have recovered without needing medical
treatment, hospitalizations and deaths from infection with this virus have
occurred.
In seasonal flu, certain people are at “high risk” of serious complications.

This includes people 65 years and older, children younger than five years
old, pregnant women, and people of any age with certain chronic medical
conditions. About 70 percent of people who have been hospitalized with
this novel H1N1 virus have had one or more medical conditions previously
recognized as placing people at “high risk” of serious seasonal flu-related
complications. This includes pregnancy, diabetes, heart disease, asthma
and kidney disease.
One thing that appears to be different from seasonal influenza is that

adults older than 64 years do not yet appear to be at increased risk of
novel H1N1-related complications thus far. CDC laboratory studies have
shown that no children and very few adults younger than 60 years old
have existing antibody to novel H1N1 flu virus; however, about one-third
of adults older than 60 may have antibodies against this virus. It is
unknown how much, if any, protection may be afforded against novel
H1N1 flu by any existing antibody.
How does novel H1N1 flu compare to seasonal flu in terms of its
severity and infection rates?
With seasonal flu, we know that seasons vary in terms of timing, duration
and severity. Seasonal influenza can cause mild to severe illness, and at
times can lead to death. Each year, in the United States, on average
36,000 people die from flu-related complications and more than 200,000
people are hospitalized from flu-related causes. Of those hospitalized,
20,000 are children younger than 5 years old. Over 90% of deaths and
about 60 percent of hospitalization occur in people older than 65.
When the novel H1N1 outbreak was first detected in mid-April 2009, CDC
began working with states to collect, compile and analyze information
regarding the novel H1N1 flu outbreak, including the numbers of
confirmed and probable cases and the ages of these people. The
information analyzed by CDC supports the conclusion that novel H1N1 flu
has caused greater disease burden in people younger than 25 years of
age than older people. At this time, there are few cases and few deaths
reported in people older than 64 years old, which is unusual when
compared with seasonal flu. However, pregnancy and other previously
recognized high risk medical conditions from seasonal influenza appear to
be associated with increased risk of complications from this novel H1N1.
These underlying conditions include asthma, diabetes, suppressed
immune systems, heart disease, kidney disease, neurocognitive and

neuromuscular disorders and pregnancy.
How long can an infected person spread this virus to others?

People infected with seasonal and novel H1N1 flu shed virus and may be
able to infect others from 1 day before getting sick to 5 to 7 days after.
This can be longer in some people, especially children and people with
weakened immune systems and in people infected with the new H1N1
virus.
Prevention & Treatment
What can I do to protect myself from getting sick?

There is no vaccine available right now to protect against novel H1N1
virus. However, a novel H1N1 vaccine is currently in production and may
be ready for the public in the fall. As always, a vaccine will be available to
protect against seasonal influenza
There are everyday actions that can help prevent the spread of germs
that cause respiratory illnesses like influenza.
Take these everyday steps to protect your health:
 Cover your nose and mouth with a tissue when you cough or
sneeze. Throw the tissue in the trash after you use it.
 Wash your hands often with soap and water, especially after you
cough or sneeze. Alcohol-based hand cleaners* are also effective.
 Avoid touching your eyes, nose or mouth. Germs spread this way.
 Try to avoid close contact with sick people.
 If you are sick with flu-like illness, CDC recommends that you stay
home for at least 24 hours after your fever is gone except to get
medical care or for other necessities. (Your fever should be gone
without the use of a fever-reducing medicine.) Keep away from
others as much as possible to keep from making others sick.
Other important actions that you can take are:
 Follow public health advice regarding school closures, avoiding

crowds and other social distancing measures.
 Be prepared in case you get sick and need to stay home for a week
or so; a supply of over-the-counter medicines, alcohol-based hand
rubs,* tissues and other related items might could be useful and
help avoid the need to make trips out in public while you are sick
and contagious
What is the best way to keep from spreading

the virus through coughing or sneezing?
If you are sick with flu-like illness, CDC
recommends that you stay home for at least 24
hours after your fever is gone except to get
medical care or for other necessities. (Your fever
should be gone without the use of a fever-reducing
medicine.)
Keep away from others as much as possible. Cover your mouth and nose
with a tissue when coughing or sneezing. Put your used tissue in the
waste basket. Then, clean your hands, and do so every time you cough or
sneeze.
If I have a family member at home who is sick with novel H1N1

flu, should I go to work?
Employees who are well but who have an ill family member at home with
novel H1N1 flu can go to work as usual. These employees should monitor
their health every day, and take everyday precautions including washing
their hands often with soap and water, especially after they cough or
sneeze. Alcohol-based hand cleaners are also effective.* If they become
ill, they should notify their supervisor and stay home. Employees who
have an underlying medical condition or who are pregnant should call
their health care provider for advice, because they might need to receive
influenza antiviral drugs to prevent illness. For more information please
see General Business and Workplace Guidance for the Prevention of Novel
Influenza A (H1N1) Flu in Workers.
What is the best technique for washing my hands to avoid getting

the flu?
Washing your hands often will help protect you from germs. Wash with
soap and water or clean with alcohol-based hand cleaner*. CDC
recommends that when you wash your hands -- with soap and warm
water -- that you wash for 15 to 20 seconds. When soap and water are
not available, alcohol-based disposable hand wipes or gel sanitizers may
be used. You can find them in most supermarkets and drugstores. If
using gel, rub your hands until the gel is dry. The gel doesn't need water
to work; the alcohol in it kills the germs on your hands.
What should I do if I get sick?

If you live in areas where people have been identified with novel H1N1 flu
and become ill with influenza-like symptoms, including fever, body aches,
runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you

should stay home and avoid contact with other people. CDC recommends
that you stay home for at least 24 hours after your fever is gone except
to get medical care or for other necessities. (Your fever should be gone
without the use of a fever-reducing medicine.) Stay away from others as
much as possible to keep from making others sick.Staying at home
means that you should not leave your home except to seek medical care.
This means avoiding normal activities, including work, school, travel,
shopping, social events, and public gatherings.
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.
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
Are there medicines to treat novel H1N1 infection?

Yes. CDC recommends the use of oseltamivir or zanamivir for the
treatment and/or prevention of infection with novel H1N1 flu virus.
Antiviral drugs are prescription medicines (pills, liquid or an inhaled
powder) that fight against the flu by keeping flu viruses from reproducing
in your body. If you get sick, antiviral drugs can make your illness milder
and make you feel better faster. They may also prevent serious flu
complications. During the current pandemic, the priority use for influenza
antiviral drugs is to treat severe influenza illness (for example
hospitalized patients) and people who are sick who have a condition that
places them at high risk for serious flu-related complications.
What is CDC’s recommendation regarding "swine flu parties"?

"Swine flu parties" are gatherings during which people have close contact
with a person who has novel H1N1 flu in order to become infected with
the virus. The intent of these parties is for a person to become infected
with what for many people has been a mild disease, in the hope of having
natural immunity novel H1N1 flu virus that might circulate later and
cause more severe disease.
CDC does not recommend "swine flu parties" as a way to protect against
novel H1N1 flu in the future. While the disease seen in the current novel
H1N1 flu outbreak has been mild for many people, it has been severe and
even fatal for others. There is no way to predict with certainty what the
outcome will be for an individual or, equally important, for others to
whom the intentionally infected person may spread the virus.
CDC recommends that people with novel H1N1 flu avoid contact with
others as much as possible. If you are sick with flu-like illness, CDC
recommends that you stay home for at least 24 hours after your fever is
gone except to get medical care or for other necessities. (Your fever
should be gone without the use of a fever-reducing medicine.) Stay away
from others as much as possible to keep from making others sick.
Contamination & Cleaning
How long can influenza virus remain viable on

objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive
on environmental surfaces and can infect a person for 2 to 8 hours after

being deposited on the surface.
What kills influenza virus?

Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition,
several chemical germicides, including chlorine, hydrogen peroxide,
detergents (soap), iodophors (iodine-based antiseptics), and alcohols are
effective against human influenza viruses if used in proper concentration
for a sufficient length of time. For example, wipes or gels with alcohol in
them can be used to clean hands. The gels should be rubbed into hands
until they are dry.
*What if soap and water are not available and alcohol-based

products are not allowed in my facility?
Though the scientific evidence is not as extensive as that on hand
washing and alcohol-based sanitizers, other hand sanitizers that do not
contain alcohol may be useful for killing flu germs on hands.
What surfaces are most likely to be sources of contamination?

Germs can be spread when a person touches something that is
contaminated with germs and then touches his or her eyes, nose, or
mouth. Droplets from a cough or sneeze of an infected person move
through the air. Germs can be spread when a person touches respiratory
droplets from another person on a surface like a desk, for example, and
then touches their own eyes, mouth or nose before washing their hands.
How should waste disposal be handled to prevent the spread of

influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues
and other disposable items used by an infected person be thrown in the
trash. Additionally, persons should wash their hands with soap and water
after touching used tissues and similar waste.
What household cleaning should be done to

prevent the spread of influenza virus?
To prevent the spread of influenza virus it is
important to keep surfaces (especially bedside
tables, surfaces in the bathroom, kitchen counters
and toys for children) clean by wiping them down
with a household disinfectant according to
directions on the product label.
How should linens, eating utensils and dishes of persons infected

with influenza virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do not
need to be cleaned separately, but importantly these items should not be

shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using
household laundry soap and tumbled dry on a hot setting. Individuals
should avoid “hugging” laundry prior to washing it to prevent
contaminating themselves. Individuals should wash their hands with soap
and water or alcohol-based hand rub immediately after handling dirty
laundry.
Eating utensils should be washed either in a dishwasher or by hand with

water and soap.
Exposures Not Thought to Spread Novel H1N1 Flu
Can I get infected with novel H1N1 virus from eating or preparing
pork?
No. Novel H1N1 viruses are not spread by food. You cannot get infected
with novel HIN1 virus from eating pork or pork products. Eating properly
handled and cooked pork products is safe.
Is there a risk from drinking water?

Tap water that has been treated by conventional disinfection processes
does not likely pose a risk for transmission of influenza viruses. Current
drinking water treatment regulations provide a high degree of protection
from viruses. No research has been completed on the susceptibility of
novel H1N1 flu virus to conventional drinking water treatment processes.
However, recent studies have demonstrated that free chlorine levels
typically used in drinking water treatment are adequate to inactivate
highly pathogenic H5N1 avian influenza. It is likely that other influenza
viruses such as novel H1N1 would also be similarly inactivated by
chlorination. To date, there have been no documented human cases of
influenza caused by exposure to influenza-contaminated drinking water.
Can novel H1N1 flu virus be spread through water in swimming

pools, spas, water parks, interactive fountains, and other treated
recreational water venues?
Influenza viruses infect the human upper respiratory tract. There has
never been a documented case of influenza virus infection associated with
water exposure. Recreational water that has been treated at CDC
recommended disinfectant levels does not likely pose a risk for
transmission of influenza viruses. No research has been completed on the
susceptibility of novel H1N1 influenza virus to chlorine and other
disinfectants used in swimming pools, spas, water parks, interactive
fountains, and other treated recreational venues. However, recent studies

have demonstrated that free chlorine levels recommended by CDC (1–3
parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are
adequate to disinfect avian influenza A (H5N1) virus. It is likely that other
influenza viruses such as novel H1N1 virus would also be similarly
disinfected by chlorine.
Can novel H1N1 influenza virus be spread at recreational water

venues outside of the water?
Yes, recreational water venues are no different than any other group
setting. The spread of this novel H1N1 flu is thought to be happening in
the same way that seasonal flu spreads. Flu viruses are 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.
Note: Much of the information in this document is based on studies and

past experience with seasonal (human) influenza. CDC believes the
information applies to novel H1N1 (swine) viruses as well, but studies on
this virus are ongoing to learn more about its characteristics. This
document will be updated as new information becomes available.
Interim Guidance for Novel H1N1 Flu (Swine Flu): Taking

Care of a Sick Person in Your Home
On this Page
 How Flu Spreads
 Medications to Help Lessen Symptoms of the Flu
 Steps to Lessen the Spread of Flu in the Home

 Household Cleaning, Laundry, and Waste Disposal
This document has been updated in accordance with the CDC

Recommendations for the Amount of Time Persons with Influenza-Like
Illness Should be Away from Others . This document provides interim
guidance and will be updated as needed.
Novel H1N1 flu virus infection (formerly known as swine flu) can cause a
wide range of symptoms, including fever, cough, sore throat, body aches,
headache, chills and fatigue. Some people have reported diarrhea and
vomiting associated with novel H1N1 flu. Like seasonal flu, novel H1N1 flu
in humans can vary in severity from mild to severe. Severe disease with
pneumonia, respiratory failure and even death is possible with novel
H1N1 flu infection. Certain groups might be more likely to develop a
severe illness from novel H1N1 flu infection, such as pregnant women
and persons with chronic medical conditions. Sometimes bacterial
infections may occur at the same time as or after infection with influenza
viruses and lead to pneumonias, ear infections, or sinus infections.
The following information can help you provide safer care at home for
sick persons during a flu outbreak or flu pandemic.
How Flu Spreads
The main way that influenza viruses are thought to

spread is from person to person in respiratory
droplets of coughs and sneezes. This can happen
when droplets from a cough or sneeze of an
infected person are propelled through the air and
deposited on the mouth or nose of people nearby.
Influenza viruses may also be spread when a
person touches respiratory droplets on another person or an object and
then touches their own mouth or nose (or someone else’s mouth or nose)
before washing their hands.
People with novel H1N1 flu who are cared for at home should:
 check with their health care provider about any special care they
might need if they are pregnant or have a health condition such as
diabetes, heart disease, asthma, or emphysema
 check with their health care provider about whether they should
take antiviral medications
 keep away from others as much as possible. This is to keep from
making others sick. Do not go to work or school while ill
 stay home for at least 24 hours after fever is gone, except to seek
medical care or for other necessities. (Fever should be gone without
the use of a fever-reducing medicine.)
 get plenty of rest
 drink clear fluids (such as water, broth, sports drinks, electrolyte
beverages for infants) to keep from being dehydrated
 cover coughs and sneezes. Clean hands with soap and water or an
alcohol-based hand rub often and especially after using tissues and
after coughing or sneezing into hands
 wear a facemask – if available and tolerable – when sharing
common spaces with other household members to help prevent
spreading the virus to others. This is especially important if other
household members are at high risk for complications from
influenza. For more information, see the Interim Recommendations
for Facemask and Respirator Use
 be watchful for emergency warning signs (see below) that might
indicate you need to seek medical attention.
Medications to Help Lessen Symptoms of the Flu
Check with your healthcare provider or pharmacist for correct, safe

use of medications
Antiviral medications can sometimes help lessen influenza symptoms, but
require a prescription. Most people do not need these antiviral drugs to
fully recover from the flu. However, persons at higher risk for severe flu
complications, or those with severe flu illness who require hospitalization,
might benefit from antiviral medications. Antiviral medications are
available for persons 1 year of age and older. Ask your health care
provider whether you need antiviral medication.
Influenza infections can lead to or occur with bacterial infections.

Therefore, some people will also need to take antibiotics. More severe or
prolonged illness or illness that seems to get better, but then gets worse
again may be an indication that a person has a bacterial infection. Check
with your health care provider if you have concerns.
Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers

who have the flu; this can cause a rare but serious illness called Reye’s
syndrome. 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.
 The safest care for flu symptoms in children younger than 2 years of
age is using a cool-mist humidifier and a suction bulb to help clear
away mucus.
 Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or
nonsteroidal anti-inflammatory drugs (NSAIDS). Examples of these kinds of medications include:
Generic Name Brand Name(s)

Acetaminophen
Tylenol®
Ibuprofen Advil®, Motrin®, Nuprin®
Naproxen Aleve
 Over-the-counter cold and flu medications used according to the
package instructions may help lessen some symptoms such as cough
and congestion. Importantly, these medications will not lessen how
infectious a person is.
 Check the ingredients on the package label to see if the medication
already contains acetaminophen or ibuprofen before taking additional
doses of these medications—don’t double dose! Patients with kidney
disease or stomach problems should check with their health care
provider before taking any NSAIDS.
Check with your health care provider or pharmacist if you are taking other
over-the-counter or prescription medications not related to the flu. For
more information on products for treating flu symptoms, see the FDA
website.
When to Seek Emergency Medical Care
Get medical care right away if the sick person at home:
 has difficulty breathing or chest pain

 has purple or blue discoloration of the lips
 is vomiting and unable to keep liquids down
 has signs of dehydration such as dizziness when standing, absence of
urination, or in infants, a lack of tears when they cry

 has seizures (for example, uncontrolled convulsions)
is less responsive than normal or becomes confused
Steps to Lessen the Spread of Flu in the Home
When providing care to a household member who is sick with influenza,

the most important ways to protect yourself and others who are not sick
are to:
 keep the sick person away from other people

as much as possible (see “placement of the
sick person”) especially others who are at high
risk for complications from influenza
 remind the sick person to cover their coughs,
and clean their hands with soap and water or
an alcohol-based hand rub often, especially
after coughing and/or sneezing
 have everyone in the household clean their hands often, using soap
and water or an alcohol-based hand rub. Children may need
reminders or help keeping their hands clean
 ask your health care provider if household contacts of the sick
person—particularly those contacts who may be pregnant or have
chronic health conditions—should take antiviral medications such as
oseltamivir (Tamiflu®) or zanamivir (Relenza®) to prevent the flu
 If you are in a high risk group for complications from influenza, you
should attempt to avoid close contact (within 6 feet) with household
members who are sick with influenza. If close contact with a sick
individual is unavoidable, consider wearing a facemask or respirator,
if available and tolerable. Infants should not be cared for by sick
family members. For more information, see the Interim
Recommendations for Facemask and Respirator Use
Placement of the sick person

 Keep the sick person in a room separate from the common areas of
the house. (For example, a spare bedroom with its own bathroom, if
that’s possible.) Keep the sickroom door closed.
 Unless necessary for medical care or other necessities, people who
are sick with an influenza-like-illness should stay home and keep
away from others as much as possible, including avoiding travel, for

at least 24 hours after fever is gone except to get medical care or
for other necessities. (Fever should be gone without the use of a
fever-reducing medicine). This is to keep from making others sick.
Children, especially younger children, might potentially be
contagious for longer periods.
 If persons with the flu need to leave the home (for example, for
medical care), they should wear a facemask, if available and
tolerable, and cover their nose and mouth when coughing or
sneezing
 Have the sick person wear a facemask – if available and tolerable –
if they need to be in a common area of the house near other
persons.
 If possible, sick persons should use a separate bathroom. This
bathroom should be cleaned daily with household disinfectant (see
below).
Protect other persons in the home

 The sick person should not have visitors other than caregivers. A
phone call is safer than a visit.
 If possible, have only one adult in the home take care of the sick
person. People at increased risk of severe illness from flu should not
be the designated caretaker, if possible.
members who are sick with influenza. If close contact with a sick
individual is unavoidable, consider wearing a facemask or respirator,
if available and tolerable. For more information, see the Interim
Recommendations for Facemask and Respirator Use.
 Avoid having pregnant women care for the sick person. (Pregnant
women are at increased risk of influenza-related complications and
immunity can be suppressed during pregnancy).
 Avoid having sick family members care for infants and other groups
at high risk for complications of influenza.
 All persons in the household should clean their hands with soap and
water or an alcohol-based hand rub* frequently, including after
every contact with the sick person or the person’s room or
bathroom.
 Use paper towels for drying hands after hand washing or dedicate
cloth towels to each person in the household. For example, have
different colored towels for each person.
 If possible, consideration should be given to maintaining good
ventilation in shared household areas (e.g., keeping windows open
in restrooms, kitchen, bathroom, etc.).
 Antiviral medications can be used to prevent the flu, so check with
your health care provider to see if some persons in the home should
use antiviral medications.
If you are the caregiver

 Avoid being face-to-face with the sick person.
 When holding small children who are sick, place their chin on your
shoulder so that they will not cough in your face.
 Clean your hands with soap and water or use an alcohol-based hand
rub* after you touch the sick person or handle used tissues, or
laundry.
 Talk to your health care provider about taking antiviral medication to
prevent the caregiver from getting the flu.
 If you are at high risk of influenza associated complications, you
should not be the designated caretaker, if possible.
members who are sick with influenza. Designate a person who is not
at high risk of flu associated complications as the primary caretaker
of household members who are sick with influenza, if at all possible.
If close contact with a sick individual is unavoidable, consider
wearing a facemask or respirator, if available and tolerable. For
more information, see the Interim Recommendations for Facemask
and Respirator Use
 Monitor yourself and household members for flu symptoms
and contact a telephone hotline or health care provider if
symptoms occur.
Using Facemasks or Respirators

 Avoid close contact (less than about 6 feet
away) with the sick person as much as
possible.
 If you must have close contact with the sick person (for example,
hold a sick infant), spend the least amount of time possible in close
contact and try to wear a facemask (for example, surgical mask) or
N95 disposable respirator.
 An N95 respirator that fits snugly on your face can filter out small
particles that can be inhaled around the edges of a facemask, but
compared with a facemask it is harder to breathe through an N95
mask for long periods of time. More information on facemasks and
respirators can be found at H1N1 Flu (Swine Flu) website.
 Facemasks and respirators may be purchased at a pharmacy,
building supply or hardware store.
 Wear an N95 respirator if you help a sick person with respiratory
treatments using a nebulizer or inhaler, as directed by their doctor.
Respiratory treatments should be performed in a separate room
away from common areas of the house when at all possible.
 Used facemasks and N95 respirators should be taken off and placed
immediately in the regular trash so they don’t touch anything else.
 Avoid re-using disposable facemasks and N95 respirators, if
possible. If a reusable fabric facemask is used, it should be
laundered with normal laundry detergent and tumble-dried in a hot
dryer.
 After you take off a facemask or N95 respirator, clean your hands
with soap and water or an alcohol-based hand sanitizer.
 For more information, see the Interim Recommendations for
Facemask and Respirator Use
Household Cleaning, Laundry, and Waste Disposal

 Throw away tissues and other disposable
items used by the sick person in the trash.
Wash your hands after touching used tissues
and similar waste.
 Keep surfaces (especially bedside tables,
surfaces in the bathroom, and toys for
children) clean by wiping them down with a
household disinfectant according to directions on the product label.
 Linens, eating utensils, and dishes belonging to those who are sick
do not need to be cleaned separately, but importantly these items
should not be shared without washing thoroughly first.
 Wash linens (such as bed sheets and towels) by using household
laundry soap and tumble dry on a hot setting. Avoid “hugging”
laundry prior to washing it to prevent contaminating yourself. Clean
your hands with soap and water or alcohol-based hand rub right
after handling dirty laundry.
 Eating utensils should be washed either in a dishwasher or by hand
with water and soap.
Novel H1N1 Influenza Vaccine
August 28, 2009, 5:30 PM ET
What are the plans for developing novel H1N1 vaccine?
Vaccines are the most powerful public health tool for control of influenza,
and the U.S. government is working closely with manufacturers to take
steps in the process to manufacture a novel H1N1 vaccine. Working
together with scientists in the public and private sector, CDC has isolated
the new H1N1 virus and modified the virus so that it can be used to make
hundreds of millions of doses of vaccine. Vaccine manufacturers are now
using these materials to begin vaccine production. Making vaccine is a
multi-step process which takes several months to complete. Candidate
vaccines will be tested in clinical trials over the few months.
When is it expected that the novel H1N1 vaccine will be

available?
The novel H1N1 vaccine is expected to be available in the fall. More

specific dates cannot be provided at this time as vaccine availability
depends on several factors including manufacturing time and time needed
to conduct clinical trials
Will the seasonal flu vaccine also protect against the novel
H1N1 flu?
The seasonal flu vaccine is not expected to protect against the novel
H1N1 flu.
Can the seasonal vaccine and the novel H1N1 vaccine be

given at the same time?
It is anticipated that seasonal flu and novel H1N1 vaccines may be

administered on the same day. However, we expect the seasonal vaccine
to be available earlier than the H1N1 vaccine. The usual seasonal
influenza viruses are still expected to cause illness this fall and winter.
Individuals are encouraged to get their seasonal flu vaccine as soon as it
is available.
Who will be recommended to receive the 2009 H1N1

vaccine?
CDC’s Advisory Committee on Immunization Practices (ACIP) has

recommended that certain groups of the population receive the novel
H1N1 vaccine when it first becomes available. These target groups
include pregnant women, people who live with or care for children
younger than 6 months of age, healthcare and emergency medical
services personnel, persons between the ages of 6 months and 24 years
old, and people ages of 25 through 64 years of age who are at higher risk
for novel H1N1 because of chronic health disorders or compromised
immune systems.
We do not expect that there will be a shortage of 2009 H1N1 vaccine, but
availability and demand can be unpredictable. There is some possibility
that initially the vaccine will be available in limited quantities. In this
setting, the committee recommended that the following groups receive
the vaccine before others: pregnant women, people who live with or care
for children younger than 6 months of age, health care and emergency
medical services personnel with direct patient contact, children 6 months
through 4 years of age, and children 5 through 18 years of age who have
chronic medical conditions.
The committee recognized the need to assess supply and demand issues
at the local level. The committee further recommended that once the
demand for vaccine for these target groups has been met at the local
level, programs and providers should begin vaccinating everyone from
ages 25 through 64 years. Current studies indicate the risk for infection
among persons age 65 or older is less than the risk for younger age
groups. Therefore, as vaccine supply and demand for vaccine among
younger age groups is being met, programs and providers should offer
vaccination to people over the age of 65.
Do those that have been previously vaccinated against the

1976 swine influenza need to get vaccinated against the 200
9 H1N1 influenza?
The 1976 swine flu virus and the 2009 H1N1 virus are different enough
that its unlikely a person vaccinated in 1976 will have full protection from
the 2009 H1N1. People vaccinated in 1976 should still be given the 2009
H1N1 vaccine.
Where will the vaccine be available?
Every state is developing a vaccine delivery plan. Vaccine will be available

in a combination of settings such as vaccination clinics organized by local
health departments, healthcare provider offices, schools, and other
private settings, such as pharmacies and workplaces. For more
information, see State/Jurisdiction Contact Information for Health Care
Providers Interested in Providing H1N1 Vaccine.
Are there other ways to prevent the spread of illness?
Take everyday actions to stay healthy.
 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 hands cleaners are also effective.
 Avoid touching your eyes, nose or mouth. Germs spread that way.
 Stay home if you get sick. CDC recommends that you stay home
from work or school and limit contact with others to keep from
infecting them.
Follow public health advice regarding school closures, avoiding crowds

and other social distancing measures. These measures will continue to be
important after a novel H1N1 vaccine is available because they can
prevent the spread of other viruses that cause respiratory infections.
What about the use of antivirals to treat novel H1N1

infection?
Antiviral drugs are prescription medicines (pills, liquid or an inhaled

powder) that fight against the flu by keeping flu viruses from reproducing
in your body. If you get sick, antiviral drugs can make your illness milder
and make you feel better faster. They may also prevent serious flu
complications. This fall, antivirals may be prioritized for persons with
severe illness or those at higher risk for flu complications.
Interim Recommendations for Facemask and Respirator Use

to Reduce Novel Influenza A (H1N1) Virus Transmission
This document has been updated in accordance with the CDC

Recommendations for the Amount of Time Persons with Influenza-Like
Illness Should be Away from Others . This document provides interim
guidance and will be updated as needed
This document provides updated interim guidance on the use of

facemasks and respirators for decreasing the exposure to novel influenza
A (H1N1) virus. This guidance replaces other CDC guidance on mask
and/or respirator use that may be included in other CDC documents in
regards to the outbreak of novel H1N1 virus. No change has been made
to guidance on the use of facemasks and respirators for health care
settings. This document includes guidance on facemask and respirator
use for a wider range of settings than was included in previous
documents and includes recommendations for those who are at increased
risk of severe illness from infection with the novel H1N1 virus compared
with those who are at lower risk of severe illness from influenza
infection.For more information about human infection with novel
influenza A (H1N1) virus, visit the CDC H1N1 Flu website. Other CDC
novel H1N1 guidance will be updated with the information contained in
this document as soon as possible.
Detailed background information and recommendations regarding the use

of facemasks and respirators in non-occupational community settings can
be found on PandemicFlu.gov in the document Interim Public Health
Guidance for the Use of Facemasks and Respirators in Non-Occupational
Community Settings during an Influenza Pandemic. Information on the
use of facemasks and respirators in health care settings can be found at
http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm.
Information on the effectiveness of facemasks and

respirators for decreasing the risk of influenza
infection in community settings is extremely
limited. Thus, it is difficult to assess their potential
effectiveness in decreasing the risk of novel
influenza A (H1N1) virus transmission in these settings. In the absence of

clear scientific data, the interim recommendations below have been
developed on the basis of public health judgment, the historical use of
facemasks and respirators in other settings for preventing transmission of
influenza and other respiratory viruses, and on current information on the
spread and severity of the novel influenza A (H1N1) virus.
In areas with confirmed human cases of novel influenza A (H1N1) virus

infection, the risk for infection can be reduced through a combination of
actions. No single action will provide complete protection, but an
approach combining the following steps can help decrease the likelihood
of transmission. These recommended actions are:
 Wash hands frequently with soap and water or use alcohol-based

hand cleaner* when soap and water are not available.
 Cover your mouth and nose with a tissue when coughing or
sneezing.
 Avoid touching your eyes, nose and mouth
 People who are sick with an influenza-like illness (ILI) (fever plus at
least cough or sore throat and possibly other symptoms like runny
nose, body aches, headaches, chills, fatigue, vomiting and diarrhea)
should stay home and keep away from others as much as possible,
including avoiding travel, for at least 24 hours after fever is gone
except to get medical care or for other necessities. (Fever should be
gone without the use of fever-reducing medicine).
 Avoid close contact (i.e. being within about 6 feet) with persons with
ILI.
In addition, influenza antiviral medications are an important tool for the

treatment and prevention of influenza, including novel H1N1. Also see
Guidance on the use of antiviral medications.
Facemasks and Respirators
Recommendations for the uses of facemasks and/or respirators are listed

in Table 1 below for different settings where a person may be exposed to
novel H1N1 virus. These recommendations also differ based on whether
the person exposed to novel H1N1 is in a group at increased risk for
severe illness from influenza infection. More information on preventing
influenza transmission in health care settings can be found in the Interim
Guidance for Infection Control for Care of Patients with Confirmed or
Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare

Setting.
In community and home settings, the use of facemasks and respirators

generally are not recommended. However, for certain circumstances as
described in Table 1, a facemask or respirator may be considered,
specifically for persons at increased risk of severe illness from influenza.
Use of N95 respirators or facemasks generally is not recommended for

workers in non-healthcare occupational settings for general work
activities. For specific work activities that involve contact with people
who have ILI, such as escorting a person with ILI, interviewing a person
with ILI, providing assistance to an individual with ILI, the following are
recommended:
 workers should try to maintain a distance of 6 feet or more from the

person with ILI;
 workers should keep their interactions with ill persons as brief as
possible;
 the ill person should be asked to follow good cough etiquette and
hand hygiene and to wear a facemask, if able, and one is available;
 workers at increased risk of severe illness from influenza infection
(see footnote 3 of table 1) should avoid people with ILI (possibly by
temporary reassignment); and,
 where workers cannot avoid close contact with persons with ILI,
some workers may choose to wear a facemask or N95 respirator on
a voluntary basis.
In the occupational healthcare setting, respiratory protection is

recommended. Because infection control precautions, including
respiratory protection, are imperfect, workers who are at increased risk of
severe illness from influenza, and who are caring for a patient with
known, probable, or suspected novel H1N1 or ILI, may consider
temporary reassignment to avoid exposure.
Additional recommendations for use of facemasks by people who have ILI

that may be due to novel H1N1 infection are included in Table 2.
There are important differences between facemasks and respirators.

Facemasks do not seal tightly to the face and are used to block large
droplets from coming into contact with the wearer’s mouth or nose. Most
respirators (e.g. N95) are designed to seal tightly to the wearer’s face
and filter out very small particles that can be breathed in by the user. For
both facemasks and respirators, however, limited data is available on

their effectiveness in preventing transmission of H1N1 (or seasonal
influenza) in various settings. However, the use of a facemask or
respirator is likely to be of most benefit if used as early as possible when
exposed to an ill person and when the facemask or respirator is used
consistently. (Ref. 1. MacIntyre CR, et al. EID 2009;15:233-41. 2.
Cowling BJ, et al. Non-pharmaceutical interventions to prevent household
transmission of influenza. The 8th Asia Pacific Congress of Medical
Virology, Hong Kong, 26-28 February 2009.)
Facemasks: Unless otherwise specified, the term ”facemasks” refers to

disposable facemasks cleared by the U.S. Food and Drug Administration
(FDA) for use as medical devices. This includes facemasks labeled as
surgical, dental, medical procedure, isolation, or laser masks. Such
facemasks have several designs. One type is affixed to the head with two
ties, conforms to the face with the aid of a flexible adjustment for the
nose bridge, and may be flat/pleated or duck-billed in shape. Another
type of facemask is pre-molded, adheres to the head with a single elastic
band, and has a flexible adjustment for the nose bridge. A third type is
flat/pleated and affixes to the head with ear loops. Facemasks cleared by
the FDA for use as medical devices have been determined to have specific
levels of protection from penetration of blood and body fluids. Facemasks
help stop droplets from being spread by the person wearing them. They
also keep splashes or sprays from reaching the mouth and nose of the
person wearing the facemask. They are not designed to protect against
breathing in very small particle aerosols that may contain viruses.
Facemasks should be used once and then thrown away in the trash.
Respirators: Unless otherwise specified, "respirator" refers to an N95 or

higher filtering face piece respirator certified by the CDC/National
Institute for Occupational Safety and Health (NIOSH). A respirator is
designed to protect the person wearing the respirator against breathing in
very small particle aerosols that may contain viruses. A respirator that
fits snugly on the face can filter out virus-containing small particle
aerosols that can be generated by an infected person, but compared with
a facemask it is harder to breathe through a respirator for long periods of
time. Respirators are not recommended for children or people who have
facial hair.
Where respirators are used in a non-occupational setting, fit testing,

medical evaluation and training are recommended for optimal
effectiveness.
When respiratory protection is required in an occupational setting,

respirators must be used in the context of a comprehensive respiratory
protection program as required under OSHA’s Respiratory Protection
standard (29 CFR 1910.134). This includes fit testing, medical evaluation
and training of the worker. When required in the occupational setting,
tight-fitting respirators cannot be used by people with facial hair that
interferes with the face seal.
When respirators are used on a voluntary basis in an occupational

setting, requirements for voluntary use of respirators in work sites can be
found on the OSHA website.
Employers should continue to evaluate workplace hazards related to the

novel H1N1 influenza A situation in accordance with CDC and OSHA
guidance. Mandatory use of respiratory protection may be required when
work activities in occupational settings confer risk that is task/function
based, and risk analyses conducted by the employer could identify
hazardous work activities. For example, performing activities which
generate large amounts of aerosols require respiratory protection
regardless of the setting in which it is performed (i.e. in a hospital, an
outpatient setting, a prison).
For additional information on facemasks and respirators, see the

CDC/NIOSH website, the Food and Drug Administration website, and the
Occupational Safety and Health Administration website.
Groups at Higher Risk for Severe Illness from Novel

Influenza A (H1N1) Infection
Groups of people at higher risk for severe illness from novel influenza A
(H1N1) infection are thought to be the same as those people at higher
risk for severe illness from seasonal influenza. These groups include:
 Children younger than 5 years old

 Persons aged 65 years or older
 Children and adolescents (younger than 18 years) who are receiving
long-term aspirin therapy and who might be at risk for experiencing
Reye syndrome after influenza virus infection
 Pregnant women
 Adults and children who have asthma, chronic pulmonary,
cardiovascular, hepatic, hematological, neurologic, neuromuscular,
or metabolic disorders such as diabetes;
 Adults and children who have immunosuppression (including

immunosuppression caused by medications or by HIV)
 Residents of nursing homes and other chronic-care facilities.
Table 1. CDC Interim Recommendations for Facemask and Respirator Use

for Home, Community, and Occupational Settings for Non-Ill Persons to
Prevent Infection with Novel H1N1 1 2
Setting Persons not at Persons at increased

increased risk of severe risk of severe illness
illness from influenza from influenza (High-
(Non-high risk persons) Risk Persons) 3
Community
No novel H1N1 in Facemask/respirator not Facemask/respirator not

community recommended recommended
Novel H1N1 in Facemask/respirator not Facemask/respirator not

community: not recommended recommended
crowded setting
Novel H1N1 in Facemask/respirator not Avoid setting.

community: recommended If unavoidable, consider
crowded setting facemask or respirator 4 5
Home
Caregiver to Facemask/respirator not Avoid being caregiver. If

person with recommended unavoidable, use facemask
influenza-like or respirator 4 5
illness
Other household Facemask/respirator not Facemask/respirator not

members in home recommended recommended
Occupational (non-health care)
No novel H1N1 in Facemask/respirator not Facemask/respirator not

community recommended recommended
Novel H1N1 in Facemask/respirator not Facemask/respirator not

community recommended but could be recommended but could be
considered under certain considered under certain
circumstances 4 5 circumstances 4 5
6
Occupational (health care)
Caring 7 for Respirator Consider temporary

persons with reassignment. Respirator
known, probable or
suspected novel
H1N1 or influenza-
like illness
1 The effectiveness of respirators and facemasks in preventing

transmission of novel H1N1 (or seasonal influenza) in various settings is
not known. Use of a facemask or respirator is likely to be of most benefit
if used correctly and consistently when exposed to an ill person. (Ref. a)
MacIntyre CR, et al. EID 2009;15:233-41. b) Cowling BJ, et al. Non-
pharmaceutical interventions to prevent household transmission of
influenza. The 8th Asia Pacific Congress of Medical Virology, Hong Kong,
26-28 February 2009.)
2 For the purpose of this document, respirator refers to N95 or any other
NIOSH-certified filtering face piece respirator.
3 Persons at increased risk of severe illness from influenza (i.e. high-risk

persons) include those groups at higher risk for severe illness from
seasonal influenza, including: children younger than 5 years old;
persons aged 65 years or older; children and adolescents (younger than
18 years) who are receiving long-term aspirin therapy and who might be
at risk for experiencing Reye syndrome after influenza virus infection;

pregnant women; adults and children who have pulmonary, including
asthma, cardiovascular, hepatic, hematological, neurologic,
neuromuscular, or metabolic disorders, such as diabetes; adults and
children who have immunosuppression (including immunosuppression
caused by medications or by HIV); and, residents of nursing homes and
other chronic-care facilities.
4 The optimal use of respirators requires fit testing, training and medical
clearance. Proper use is recommended to maximize effectiveness. The
use of facemasks may be considered as an alternative to respirators,
although they are not as effective as respirators in preventing inhalation
of small particles, which is one potential route of influenza transmission.
There is limited evidence available to suggest that use of a respirator
without fit-testing may still provide better protection than a facemask
against inhalation of small particles. Respirators are not recommended for
children or persons who have facial hair (see FDA website).
5 Use of N95 respirators or facemasks generally is not recommended for

workers in non-healthcare occupational settings for general work
activities. For specific work activities that involve contact with people
who have influenza-like illness (ILI) (fever plus at least either cough or
sore throat and possibly other symptoms like runny nose, body aches,
headaches, chills, fatigue, vomiting and diarrhea), such as escorting a
person with ILI, interviewing a person with ILI, providing assistance to an
individual with ILI, the following are recommended: a) workers should try
to maintain a distance of 6 feet or more from the person with ILI; b)
workers should keep their interactions with the ill person as brief as
possible; c) the ill person should be asked to follow good cough etiquette
and hand hygiene and to wear a facemask, if able, and one is available;
d) workers at increased risk of severe illness from influenza infection (see
footnote 3) should avoid people with ILI (possibly by temporary
reassignment); and, e) where workers cannot avoid close contact with
persons with ILI, some workers may choose to wear a facemask or N95
respirator on a voluntary basis (See footnote 1). When respirators are
used on a voluntary basis in an occupational work setting, requirements
for voluntary use of respirators in work sites can be found on the OSHA
website.
6 See case definitions of confirmed, probable, and suspected novel

influenza A (H1N1). Also see infection control in the health care setting.
When respiratory protection is required in an occupational setting,
respirators must be used in the context of a comprehensive respiratory
protection program as required under OSHA’s Respiratory Protection
standard (29 CFR 1910.134). This includes fit testing, medical evaluation
and training of the worker.
7 “Caring” includes all activities that bring a worker into proximity to a patient with known, probable, or
suspected novel H1N1 or ILI, including both providing direct medical care and support activities like
delivering a meal tray or cleaning a patient’s room.
Table 2. CDC Interim Recommendations For Facemask Use For Persons Ill
With Confirmed, Probable, Or Suspected Novel Influenza A (H1N1)1 To
Prevent Transmission Of Novel H1N1 2
Setting Recommendation
Home (when sharing common Facemask preferred, if available and

spaces with other household tolerable, or tissue to cover
members) cough/sneeze
Health care settings (when Facemask, if tolerable

outside of patient room)
Non-health care setting Facemask preferred, if available and

tolerable, or tissue to cover
cough/sneeze
Breastfeeding Facemask preferred, if available and

tolerable, or tissue to cover
cough/sneeze
1 See definitions for confirmed, probable, and suspect novel influenza A

(H1N1) infection. Also see information on infection control in health care
settings.
2 Ill persons should be placed in well ventilated areas when possible and
placed in areas where at least 6 feet distance can be maintained between
the ill person and other well and ill persons. Selected references: a)
Blumenfeld HL, et al. J Clin Invest 1959;38:199-212. b) Bridges CB, et
al. Clin Infect Dis 2003;37:1094-1101. c) Foster MG and Cookson AH.
Lancet 1918 (Nov. 2): 588-90. d) Gregg MB. Ann NY Acad Sci
1980;353:45-53. e) WHO. Infection prevention and control of epidemic-
and pandemic-prone acute respiratory diseases in health care. June
2007. f) Fabian P, et al. Plos One 2008;3:e2691.

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SWAIN FLU SUSANTA ROUT--1

Know the Difference between Cold and Swine Flu Symptoms

Symptom Cold Swine Flu

Swine influenza is endemic in pigs

Electron microscope image of the reassorted H1N1 influenza virus

Swine influenza virus is common throughout pig populations worldwide.

During the mid-20th century, identification of influenza subtypes became

Swine influenza is known to be caused by influenza A subtypes H1N1,[8]

Although there is no formal national surveillance system in the United

Veterinary medical pathologist, Tracey McNamara, set up a national

Swine influenza was first proposed to be a disease related to human

Swine flu has been reported numerous times as a zoonosis in humans,

1918 pandemic in humans

strain remains elusive.[24] It is estimated that anywhere from 50 to

1976 U.S. outbreak

Main article: 1976 swine flu outbreak

President Ford receives swine flu vaccination

This new strain appeared to be closely related to the strain involved in

The vaccination program was plagued by delays and public relations

There were reports of Guillain-Barré syndrome, a paralyzing

influenza vaccines, with an incidence of about one case per million

Overall, there were 1098 cases of Guillain-Barré Syndrome (GBS)

Influenza-like illness (ILI) was reportedly widespread among the pigs

1998 US outbreak in swine

2007 Philippine outbreak in swine

On August 20, 2007 Department of Agriculture officers investigated the

2009 outbreak in humans

In late April, Margaret Chan, the World Health Organization's director-

The new strain was initially described as an apparent reassortment of at

Transmission between pigs

The main route of transmission is through direct contact between infected

Interaction with avian H5N1 in pigs

from H2N2 by antigenic shift.[64] In August 2004, researchers in China

Main symptoms of swine flu in swine.[2]

These H5N1 infections may be quite common: in a survey of 10

Signs and symptoms

In pigs influenza infection produces fever, lethargy, sneezing, coughing,

Main symptoms of swine flu in humans[68]

Direct transmission of a swine flu virus from pigs to humans is

According to the Centers for Disease Control and Prevention (CDC), in

Because these symptoms are not specific to swine flu, a differential

confirmed swine flu requires laboratory testing of a respiratory sample (a

The most common cause of death is respiratory failure. Other causes of

Thermal scanning of passengers arriving at Singapore Changi airport.

Different medical kits are available for diagnosis of swine flu.[73]

Prevention of swine influenza has three components: prevention in swine,

Methods of preventing the spread of influenza among swine include

Control of swine influenza by vaccination has become more difficult in

enough to have significant cross-protection, and custom (autogenous)

Facility management includes using disinfectants and ambient

Prevention of pig to human transmission

Swine can be infected by both avian and human influenza strains of

The transmission from swine to human is believed to occur mainly in

Prevention of human to human transmission

Influenza spreads between humans through coughing or sneezing and

Recommendations to prevent spread of the virus among humans include

Experts agree that hand-washing can help prevent viral infections,

Social distancing is another tactic. It means staying away from other

1. ^ International Committee on Taxonomy of Viruses. "The Universal

3. ^ Heinen PP (15 September 2003). "Swine influenza: a zoonosis".

12. ^ Yassine HM, Al-Natour MQ, Lee CW, Saif YM (November

22. ^ Kay RM, Done SH, Paton DJ (August 1994). "Effect of