Swine Flu FAQ – Update: 11th August 2009

By Dr Manohar Rai
Q: What is swine flu?
A: Pigs spread their own strains of influenza and every so often people catch one, usually after contact with the animals. Unlike more typical swine flu, it is spreading person-to-person. The present spread is due to the Influenza A (H1N1) virus
Q: How easy is it to catch this virus?
A: Scientists don't yet know if it takes fairly close or prolonged contact with someone who's sick, or if it's more easily spread. But in general, flu viruses spread through uncovered coughs and sneezes or — and this is important — by touching your mouth or nose with unwashed hands. Flu viruses can live on surfaces for several hours, like a doorknob just touched by someone who sneezed into his hand.
Q: What are the symptoms?
A: They're similar to regular human flu — a fever, cough, sore throat, body aches, headache, chills and fatigue. Some people also have diarrhea and vomiting.
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
Q: What is the Infectious period?
This is defined as 01 day prior to the case’s illness onset to 07 days after onset.
Q: What is a suspected case?
It is a person with an acute febrile respiratory with onset illness:
· Within 07 days of close contact with a person who is a confirmed case of swine influenza
· Within 07 days of travel to community either within Mexico, USA or internationally where one or more confirmed case has been detected.
· Resides in a community where there is one or more confirmed cases.
Q: How are human infections with swine influenza diagnosed?
• To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus).
• Identification as a swine flu influenza A virus requires sending the specimen to a hospital laboratory for testing.
What is a confirmed case?
Any case with an acute febrile respiratory illness with a laboratory confirmed virus infection.
Q: How long can an infected person spread swine flu to others?
• People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset.
• Children, especially younger children, might potentially be contagious for longer periods.
Q: What precautions can be taken to protect your self?
This includes commonsense precautions. Maintain good personal hygiene. Cover your coughs and sneezes, with a tissue that you throw away or by sneezing into your elbow rather than your hand. Wash hands frequently; if soap and water aren't available, hand gels can substitute. Avoid obviously sick people. Stay at home if unwell and seek medical attention. Avoid touching your eyes nose or mouth after a sneeze or cough as germs spread that way.
Q: What is the role of handing out face masks?
A: The CDC says there's not good evidence that masks really help outside of health care settings. It's safer just to avoid close contact with someone who's sick and avoid crowded gatherings in places where swine flu is known to be spreading. But if you can't do that, CDC guidelines say it's OK to consider a mask — just don't let it substitute for good precautions.
Q: Is swine flu treatable?
A: Yes, with the flu drugs Tamiflu or Relenza, but not with two older flu medications. This cannot be taken as a precautionary medicine. Overusing antiviral drugs can help germs become resistant to them.
Q: So is it safe to eat pork?
A: Yes. Swine influenza viruses don't spread through food.
Q: Is there a vaccine for Pandemic Flu?
• Because the virus is new, there will is currently no vaccine ready to protect against pandemic flu.
• Vaccine against Swine Flu virus H1N1 needs at least 6-12 months to be produced.
• Seasonal flu vaccine or past flu immunization will not provide protection
Q: What is the best way to keep from spreading the virus through coughing or sneezing?
• If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill.
• Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket.
• Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.
Q: 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.
• 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.
Q: What is the current situation?
A: Various international agencies (US Centers for Disease Control & Prevention, World Health Organization) have determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human.
WHO has placed the level at Phase 06 which is a full blown pandemic.
As of 31st July 2009, 168 countries & overseas territories have reported at least one lab confirmed case of pandemic H1N1. All continents are affected by the pandemic. There have been 1154 deaths.
WHO Recommendation:
WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1)virus. Today, global travel is commonplace and large numbers of people move around the world for business and leisure. Limiting travel and imposing travel restrictions would have very little effect on stopping the virus from spreading, but would be highly disruptive to the global community.
· People who are ill should delay travel plans.
· Returning travelers who become ill should contact their health care provider.
· Travelers can protect themselves and others by following simple prevention practices that apply while travelling and in daily life.
Q: Should I wear a mask on board flights?

WHO has issued no advice indicating that healthy persons—on aircraft or anywhere else—should wear masks.
Q: What should airlines be doing?
In normal operations airlines take measures to ensure a safe and healthy environment on board aircraft. For example, guests should be reassured that modern aircraft are equipped with very advanced air filtration systems (HEPA filters) which ensure a high level of air quality despite the confined environment.
Should additional measures become necessary to deal with Influenza A(H1N1), IATA follows the guidance of the international experts, WHO, and advises airlines accordingly.
Q: Why is screening deployed in some airports and not others?
WHO does not believe entry and exit screenings would work to reduce the spread of this disease.
WHO advises that although identifying signs and symptoms of influenza in travelers can help track the path of the outbreak, it will not reduce the spread of influenza, as the virus can be transmitted from person to person before the onset of symptoms.
WHO notes that scientific research based on mathematical modeling shows that restricting travel would be of limited or no benefit in stopping the spread of disease. Historical records of previous influenza pandemics, as well as experience with SARS, validate this.
Country-level measures to respond to a public health risk are the decision of national authorities, under the International Health Regulations 2005.
WHO advises that countries adopting measures that significantly interfere with international traffic (e.g. delaying an airplane guest for more than 24 hours, or refusing country entry or departure to a traveler) must provide WHO with the public health reasoning and evidence for their actions.
Travelers should always be treated with dignity and respect for their human rights.

Q: Is it safe for crews to be working on aircraft?
WHO has not identified any special risks arising from air travel for guestss or for crew.
Should guests become unwell while on board, IATA has worked with WHO on guidance for crew to allow for safe handling and care.
These can be found at
www.iata.org/NR/rdonlyres/DD29D97F-0E8C-4CBD-B575-
1F5067174941/0/Guidelines_cabin_crew_finalDec2008.pdf.