What is H1N1 Pandemic Flu?The H1N1 Virus (also known as Swine Flu or Novel Influenza A) is a virus causing respiratory illnesses in people. It was first diagnosed in the United States in April of 2009. On June 11, 2009 the World Health Organization (WHO) officially declared H1N1 a pandemic flu citing the rapid worldwide spread of the flu, not its severity, as their reason.
The H1N1 virus was originally referred to as Swine Flu because many of the early laboratory tests showed genetic markers present in influenza virus found in pigs. However, further testing has shown that it has genes similar to pigs, birds and humans.
Based on current findings of the CDC, H1N1 Flu appears to be spreading in the same way any other seasonal flu spreads. Flu spreads person-to-person by coughing, sneezing or by touching infected surfaces and then touching your nose, eyes or mouth.
Surfaces can stay infected for two hours or longer. Infected people can be infectious for one day before symptoms appear and seven or more days after becoming sick. That means people can spread the flu virus before they are even exhibiting any symptoms of the flu and before they even know they are sick.
This worldwide pandemic is being monitored and all health policies and updates are being handled by The Centers for Disease Control (CDC) in the US. They also develop and advocate health policies and implement prevention strategies.
The CDC routinely works with states to collect, compile and analyze information about influenza. Their weekly "FluView" report serves as an H1N1 map outlining the spread of the disease.
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H1N1 SymptomsH1N1 symptoms are similar to those of seasonal flu according to the CDC. They include fever, sore throat, cough, body aches, chills, and fatigue. Some suffers have exhibited vomiting and diarrhea. Severe illnesses including pneumonia and respiratory failure leading to death have been reported. The higher risk groups are not known at this time but it is suspected to be similar to the high risk groups for seasonal influenza which would include people over the age of 65, children younger than 5, pregnant women, people of any age group with chronic medical conditions (such as asthma, heart disease, or diabetes) or people who are immunosuppressed.
If you do get sick, you may be ill for a week or longer. You should stay home and avoid contact with other people as much as possible to keep from spreading the infection to others. Avoid travel and going to work or school for at least 24 hours until after your fever is gone—without the use of fever-reducing medications. If you have to leave the house to seek medical attention wear a facemask, if available and tolerable.
Children who experience any of the following symptoms should be taken to emergency medical care:
- Fast breathing or trouble breathing
- Bluish skin color
- Not drinking enough fluids
- Severe or persistent vomiting
- Not waking up or not interacting
- Being so irritable the child doesn't want to be held
- Flu-like symptoms improve but then return with fever and worse cough
In adults, emergency warning signs include:
- Difficulty breathing or shortness of breath
- Pain or pressure in chest or abdomen
- Sudden dizziness
- Confusion
- Severe or persistant vomiting
- Flu-like symptoms improve but then return with fever and worse cough
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Diagnosing H1N1The H1N1 virus can look and act much like the seasonal flu or even a common cold, as the following chart illustrates. According to the CDC, a number of different laboratory diagnostic tests can be used to determine if the respiratory distress you are experiencing is the result of a cold, seasonal flu or H1N1 flu virus including direct antigen detection tests, virus isolation in cell culture, or detection of influenza-specific RNA by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR).
These tests differ in their sensitivity and specificity in detecting influenza viruses as well as in their commercial availability, the amount of time needed from specimen collection until results are available, and the tests’ ability to distinguish between different influenza virus types (A versus B) and influenza A subtypes (e.g. novel H1N1 versus seasonal H1N1 versus seasonal H3N2 viruses).
Differences Between Cold, Seasonal Flu & H1N1 Symptoms
| Symptom |
Cold |
Seasonal Flu |
H1N1 |
| Fever |
Fever is rare with a cold. |
Fever is common with the seasonal flu. |
Fever is usually present with H1N1 in up to 80% of all flu cases. A temperature of 101°F. |
| Coughing |
A hacking, productive (mucus-producing) cough is often present with a cold. |
A dry and hacking cough is often present with the seasonal flu. |
A non-productive (non-mucus producing) cough is usually present with H1N1 (sometimes referred to as dry cough). * |
| Aches |
Slight body aches and pains can be part of a cold. |
Moderate body aches are common with the seasonal flu. |
Severe aches and pains are common with H1N1. * |
| Stuffy Nose |
Stuffy nose is commonly present with a cold and typically resolves spontaneously within a week. |
A runny nose is commonly present with the seasonal flu. |
Stuffy nose is not commonly present with H1N1. |
| Chills |
Chills are uncommon with a cold. |
Chills are mild to moderate with the seasonal flu. |
60% of people who have H1N1 experience chills. |
| Tiredness |
Tiredness is fairly mild with a cold. |
Tiredness is moderate and more likely referred to as a lack of energy with the seasonal flu. |
Tiredness is moderate to severe with H1N1. * |
| Sneezing |
Sneezing is commonly present with a cold |
Sneezing is common present with the seasonal flu. |
Sneezing is not common with H1N1. |
| Sudden Symptoms |
Cold symptoms tend to develop over a few days. |
Symptoms tend to develop over a few days and include flushed face, loss of appetite, dizziness and/or vomiting/nausea. Symptoms usually last 4-7 days, depending on the individual. Diarrhea is common. |
H1N1 has a rapid onset within 3-6 hours. H1N1 hits hard and includes sudden symptoms like high fever, aches and pains. Symptoms usually last 4-7 days, depending on the individual. Diarrhea is common. |
| Headache |
A headache is fairly uncommon with a cold. |
A headache is fairly common with the seasonal flu. |
A headache is very common with H1N1 and present in 80% of cases. * |
| Sore Throat |
Sore throat is commonly present with a cold. |
Sore throat is commonly present with the seasonal flu. |
Sore throat is not commonly present with H1N1. |
| Chest Discomfort |
Chest discomfort is mild to moderate with a cold. |
Chest discomfort is moderate with the seasonal flu. If it turns severe seek medical attention immediately! |
Chest discomfort is often severe with H1N1. |
(Chart shared by North Central District Health Department and adapted from Nebraska Pandemic Influenza Prevention and Control Guidelines, 2006)
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H1N1 PreventionH1N1 Flu, like any other flu exposure, is minimized with good hygiene techniques and by general wellness care. The following precautions are recommended by the CDC:
- Wash hands often. Alcohol-based sanitizers are also effective at killing viruses if soap and water are not available
- Get plenty of sleep, avoid stress, drink plenty of fluids, and eat nutritious foods
- Avoid touching surfaces that may be contaminated with the flu virus; common surfaces that could hold viruses would be desktops, doorknobs, or tables
- Disposable gloves can be an option for people who want extra protection
- Avoid contact with people who might be sick
The CDC has also released a document intended to provide guidance for people who are unable to avoid people who would be considered contagious with the H1N1 flu. These CDC guidelines, titled "Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission," suggest use with either a surgical mask or a N95 respirator to protect from airborne virus contamination.
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What if I get H1N1 Flu?Most of the people who have come down with symptoms of H1N1 flu in the United States have had very mild symptoms. There are, however, antiviral drugs which the CDC says are effective against this current strain of flu including the prescription anti-viral drugs Oseltamivir and Zanamivir. They can make viral illnesses milder and help sufferers get better faster. As the H1N1 virus spreads, these drugs may be in short supply so the drugs may be given first to those who are at high risk of flu complications or those who have been hospitalized.
For those who contract a milder form of H1N1 Virus, as well as those with the seasonal flu, or a common cold, the CDC recommends you stay home and avoid contact with other people except to get medical care. You should not return to work before your fever is gone (without the use of fever-reducing medicine) for at least 24 hours.
H1N1 Vaccinations are continuing during in the fall of 2009. While shortages are not expected, the initial availability and demand needs can be unpredictable. To deal with any periodic shortfalls in the manufacture and distribution of the H1N1 vaccine, the CDC’s Advisory Committee on Immunization Practices has determined which groups will receive priority immunizations, including:
- pregnant women
- people who live with or care for children 6 months old or younger
- 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
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H1N1 In the WorkplaceThe severity of illness that 2009 H1N1 influenza flu will cause (including hospitalizations and deaths) or the amount of illness that may occur as a result of seasonal influenza during the 2009-2010 influenza season cannot be predicted with a high degree of certainty. Therefore, the CDC is asking employers to plan to be able to respond in a flexible way to varying levels of severity and be prepared to refine their pandemic influenza response plans if a potentially more serious outbreak of influenza evolves during the fall and winter.
On October 21, 2009, the CDC updated their Report entitled "Guidance for Businesses and Employers To Plan and Respond to the 2009-2010 Influenza Season". Actions they are recommending employers take now include:
- Review or establish a flexible influenza pandemic plan and involve your employees in developing and reviewing your plan
- Conduct a focused discussion or exercise using your plan, to find out ahead of time whether the plan has gaps or problems that need to be corrected before flu season
- Have an understanding of your organization's normal seasonal absenteeism rates and know how to monitor your personnel for any unusual increases in absenteeism through the fall and winter
- Engage state and local health department to confirm channels of communication and methods for dissemination of local outbreak information
- Allow sick workers to stay home without fear of losing their jobs
- Develop other flexible leave policies to allow workers to stay home to care for sick family members or for children if schools dismiss students or child care programs close
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Frequently Asked H1N1 QuestionsQ. Can you get H1N1 (swine flu) from eating pork?
A. No. According to the CDC, H1N1 flu is not transmitted by food and you cannot get it from eating pork or pork products.
Q. Are there N95 respirators available for children?
A. According to 3M, a major manufacturer of respirators, respirators are not evaluated for use by children and are designed according to government performance standards for use by healthy adults in an occupational/workplace setting. In infants and toddlers respirators can cause a risk of choking or suffocation.
Q. Can a valved N95 respirator be used for protection against swine flu?
A. Again according to 3M, a valved respirator is appropriate when a person is wearing the respirator to protect themselves against the H1N1 flu. A valved respirator would not be appropriate when wearing a respirator to protect others as the valve would allow the viral particulates to escape the mask.
Sources for More Information
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Please Note: The information contained in this publication is intended for general information purposes only. This publication is not a substitute for review of the applicable government regulations and standards, and should not be construed as legal advice or opinion. Readers with specific questions should refer to the cited regulation or consult with an attorney.