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H1N1 Flu: Myths and Facts

Friday May 1, 2009
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Here are some common questions or misconceptions patients may have about swine influenza A(H1N1), with answers based on current guidelines from the Centers for Disease Control and Prevention, the World Health Organization, and state health department officials:

1. Should healthy people wear a mask when they go out in public?
Not unless they are ill and coughing, in which case they should not be going out unless they absolutely have to. Flu viruses are spread through droplets expelled from the nose and mouth of a sick person, not through airborne particles. The droplets only travel about 3 feet at most. A mask will not protect people from droplets they may touch and transmit to their eyes or face.

2. If this is such a serious illness, why not close the borders or forbid travel?
Health officials say it is far too late to prevent H1N1 flu from entering the country — it’s already here. Closing the borders would not only have little impact on the spread of the virus, it could prevent important medications and supplies from coming into and leaving the country. At this time, health officials advise against all unnecessary travel to Mexico, where the illness has hit hardest, and have a list of precautions for those who must travel there. Those who feel ill should stay home and not travel at all.

3. Should Tamiflu prescriptions be given to people who are not sick yet?
Health officials recommend treatment with Tamiflu and another antiviral, Relenza, only for those who have flu-like symptoms (fever, sore throat, cough) and have either been in close contact with someone who has a confirmed or suspected case of H1N1 flu, or who have the symptoms and have traveled to or reside in an area with known outbreaks of the illness. Taking Tamiflu if they are not sick, or if they are sick with an illness that is not H1N1 flu, will not help them get better, and it could create eventual resistance to the medication.

Certain people, including household contacts of confirmed or suspected cases of swine flu who are at high risk for influenza complications (those over 65, people with weakened immune systems), and unprotected healthcare workers who have been exposed to suspected or confirmed cases of swine flu should take antivirals as a precaution against getting sick with the illness.

4. If a patient starts to get sick, should he or she be tested for H1N1 flu?
The patient should stay home, rest, and take fever-relieving medication. He or she should not go to work and should keep sick children home from school. If he or she lives in an area with an H1N1 flu outbreak, or if the symptoms are more severe than for a usual cold or flu, or if he or she is at risk for complications from influenza, medical intervention may be necessary.

Children and infants need emergency medical attention if they are not drinking enough fluids, not waking up or interacting, have fever with a rash, and are so irritable they do not want to be held.

5. Can people get H1N1 flu from food, such as vegetables that sick workers may have picked?
Most influenza viruses live for a few hours on surfaces such as doorknobs and tables, so it is unlikely that fruit or vegetables will still carry any virus from a picker or handler by the time they are shipped to market.

6. Can people get H1N1 flu from eating pork or pork products?
No. Swine influenza viruses are not transmitted by food. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 160°F kills the H1N1 flu virus as it does other bacteria and viruses.

7. Will existing flu shots protect people from H1N1 flu?
Health officials say the current flu shot protects against seasonal influenza, but is unlikely to protect against the new flu. International and national health departments have started the process of developing a vaccine against H1N1 flu, but say it probably won’t be ready for several months, possibly longer. In areas where seasonal influenza is still appearing, the regular flu shot may help protect against that virus.

8. Is this a pandemic? What does that mean?
As of Friday, May 1, health officials have declared a “pre-pandemic” state for H1N1 flu. This means there are strong signals a pandemic is imminent and it’s time to finalize organization, communication, and implementation of plans for caring for people infected by the virus. A pandemic, as defined by WHO, is characterized by community level outbreaks of human-to-human transmission of a virus in at least three countries, with at least one of them in a different world region from the others. A pandemic has nothing to do with how strong an illness is, or how many deaths it causes.

9. When should schools close?
U.S. schools have closed only when a student has a confirmed case of swine flu. Mexico City, where the disease is more prevalent, has closed schools, restaurants, libraries, and most other places where people congregate. If conditions worsen in the United States, health officials say they have not ruled out school closures and other safety precautions. The CDC is now suggesting individuals develop a family emergency plan, including storing a supply of food, medicines (such as Tylenol and regular prescription medications), face-masks, alcohol-based hand-rubs, and other essential supplies.

10. Can this flu kill patients?
So far almost all cases of swine flu in the United States have been mild and resolved without problems. A few people were hospitalized, but almost all of those cases had complications from chronic illness or conditions. One child, a 22-month-old old boy from Mexico, has died. Health officials expect more deaths and hospitalizations as the illness progresses, but so far, they say it looks no different from seasonal flu, which causes an average 36,000 deaths in the United States per year, according to the CDC.

Those most vulnerable to seasonal influenza-related complications include people over 50; children under five; pregnant women; children and adolescents receiving long-term aspirin therapy; adults and children with chronic pulmonary, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders; adults and children with suppressed immune systems (including immunosuppression caused by medications or HIV); and residents of nursing homes or other chronic care facilities.

11. If it’s just like any other flu season, why the extraordinary precautions?
The influenza A (H1N1) virus has never been seen before. Human beings have no known immunity to it. So far, a number of people in Mexico have apparently died from complications related to it, but very little is known about those deaths and the health condition of those who died. Health officials are still investigating how quickly the virus spreads, what population groups it hits hardest, what complications it may cause, and other aspects of the illness. For this reason, recommendations and safety precautions, such as school closures, are constantly changing, and will vary from place to place depending on the severity of outbreaks. The virus could die out fairly quickly, it could mutate and become more virulent, or it could continue to act like a seasonal flu virus, and end in six to eight weeks. Individuals, workplaces, communities, governments, and healthcare facilities should prepare for all possibilities.

For more information, visit the CDC Web site at: www.cdc.gov or call 1-800-CDC-INFO.

Cathryn Domrose is a senior staff writer at Gannett Healthcare Group.

To comment, e-mail editorNTL@gannetthg.com.