What is H1N1

What is H1N1?

The H1N1 flu virus (formerly known as “swine flu”) is a new flu virus causing illness in people. The virus is spreading person-to-person throughout the US as well as the rest of the world.

What are the symptoms of the H1N1 flu?

The symptoms are similar to regular flu and include:

·        Fever*

·        Cough

·        Sore throat

·        Runny or stuffy nose

·        Body aches

·        Headaches

·        Chills

·        Fatigue

*Some people do not develop a fever

Some people have also reported:

·        Diarrhea

·        Vomiting

Symptoms usually appear 2-7 days after exposure. People may infect others from 1 day before getting sick to 7 days after getting sick.

If I get the H1N1 flu, how long will I be sick?

You may be ill for a week or longer.

How does the flu spread?

The H1N1 flu virus is spread the same way as seasonal flu from person-to-person when a sick person coughs or sneezes on or around other people. People may become infected if they touch something with flu viruses on it and then touch their face, eyes, nose or mouth.

I have symptoms. Do I have it?

Many different infections have symptoms similar to the flu, so it’s difficult to tell over the phone. If you have symptoms, you should stay home until you are well. If you are pregnant, have medical problems, you should call your doctor. If you are having chest pain or shortness of breath, you should seek medical care immediately.

How is the H1N1 virus different from regular seasonal flu?

The people at greatest risk of getting the flu and being hospitalized are different. With the seasonal flu, older people are more likely to become very sick than younger people. The 2009 H1N1 flu has been causing more illness in people 25 years and younger.

If I am sick, what should I do?

·        Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

·        Cough or sneeze into your elbow or upper sleeve if tissues are not available.

·        Wash your hands often with soap and water. Hand sanitizers made with alcohol are also effective.

·        Stay home for at least 24 hours after your fever is gone, except if you need to go out for medical care or other necessities,

·        Get plenty of rest

·        Drink plenty of nonalcoholic fluids like water or juice.

What can I do so I don’t become sick?

·        Wash your hands often with soap and water. Hand sanitizers made with alcohol are also effective.

·        Avoid touching your eyes, nose, and mouth.

·        Avoid close contact with sick people

·        Get plenty of rest

·        Eat a healthy diet

·        Get vaccinated as soon as vaccine is available to you.

If I am sick, can antibiotics help me feel better?

Antibiotics won’t help with the flu because flu is a virus. Antibiotics only work on bacteria, not viruses.

What drugs can I take to help me feel better?

Over the counter medications can help you treat the symptoms of flu. Check with your doctor if you are unsure what medications you can take.

Two antiviral medications can be used to treat H1N1 influenza (Tamiflu® and Relenza®). Both medications are only available by prescription. Not everyone with 2009 H1N1 flu needs to be treated with antiviral medications.

Who should get antiviral medications?

Most people with the flu get better and don’t need antiviral medications. Some people are at a higher risk of complications and should talk to their doctor about antiviral medications. They are:

·        People hospitalized with influenza

·        Children younger than 5 years old

·        Adults 65 years and older

·        Pregnant women

·        People with chronic medical conditions

·        People with suppressed immune systems

If I get sick, how long do I have to stay home from work/school?

If you have a fever, you should stay home until you are free of fever for at least 24 hours without the use of fever reducers (Tylenol, Motrin, etc). If you have vomiting or diarrhea, stay home until you are free from these symptoms for at least 24 hours.

Should my doctor test me for H1N1 to be diagnosed?

Routine lab testing of people with H1N1 symptoms is not recommended.

What are the warning signs to seek medical care?

In children:

·        Fast breathing or trouble breathing or wheezing

·        Bluish or gray skin color

·        Severe or persistent vomiting

·        Not waking up or not interacting

·        Being so irritable that the child does not want to be held

·        Not urinating

·        High fever for more than 3 days

·        Flu-like symptoms improve but then return with fever and worse cough

In adults:

·        Difficulty breathing or shortness of breath or wheezing

·        Pain or pressure in chest or abdomen

·        Sudden dizziness

·        Confusion

·        Severe or persistent vomiting

·        Not urinating

·        High fever for more than 3 days

·        Flu-like symptoms improve but then return with fever and worse cough

Do I need to buy facemasks?

If you have the flu, you should stay home.

If you need to go out, you can wear a facemask if you would like. If you have the flu, and don’t want to wear a facemask, cover your coughs and sneezes.

If you don’t have the flu and you are healthy, a facemask is not needed even if you are taking care of someone with the flu.

If you have a chronic disease or a weakened immune system, you may want to wear a mask if you are caring for someone with the flu.

Is an H1N1 vaccine available?

Yes.   H1N1 vaccine is available as a live, weakened nasal mist and as an inactivated, injectable vaccine. Both types will be released as they become available.

The live, attenuated nasal mist form of the vaccine is only recommended for healthy, non-pregnant people aged 2-49 years old.

Pregnant women, children 6 months to 2 years of age, and individuals aged 25 to 64 years of age with underlying chronic conditions or who are immune compromised should receive the injectable H1N1 flu vaccine, once it is available.

Continue to follow the news, visit www.in.gov/flu, or sign up for the state’s Twitter site: http://twitter.com/inpublicsafety to learn when the injectable H1N1 flu vaccine is available.

Where can I get an H1N1 vaccine?

Call your local health department. As information becomes available from the local health departments, the Indiana State Department of Health will post online where you can get the H1N1 flu vaccine at: www.in.gov/flu.

Who should get the vaccine first?

Some groups of people are a higher risk of complications from the H1N1 flu. People in these groups are encouraged to be vaccinated as soon as they can. They are:

·        Pregnant women

·        People who live with or care for children younger than 6 months of age

·        Health care workers and emergency medical services personnel

·        People between 6 months and 24 years old

·        People ages 25 through 64 years of age who have chronic illnesses or compromised immune systems

I don’t belong to any of the high risk categories. Will I be able to get vaccinated?

Plenty of vaccine should be available. People who don’t belong to the high risk categories will be able to get vaccinated once those in the high risk categories have been vaccinated.

How safe is the vaccine?

The H1N1 flu vaccine is as safe as the regular flu vaccine. All flu vaccines are made the same way by the same manufacturers.

Does the H1N1 vaccine contain thimerosal preservative?

The nasal spray form of H1N1 vaccine does not contain thimerosal. Single dose syringes of the injectable vaccine do not contain thimerosal, and will be available for people with an allergy to thimerosal, young children, and pregnant women. Contact your health care provider if you have questions or concerns about thimerosal.

Will a regular seasonal flu shot prevent me from getting the H1N1 flu?

No, but it will prevent you from getting seasonal flu. Since H1N1 is a new strain, it is not included in the seasonal flu shot. Everyone is encouraged to get seasonal flu vaccine, which is available right now, and to get an H1N1 vaccine as it becomes available.

I’m pregnant. Can I get the flu vaccine?

Yes. Pregnant women can and should get both the H1N1 vaccine and the seasonal flu vaccine during any trimester of pregnancy. The vaccine protects pregnant women and also continues to protect babies after they are born. Pregnant women should receive the injectable vaccines only and not the live nasal vaccines.

If a person tests positive for influenza A should they get the vaccine?

According to the CDC, all people in a recommended vaccination target group who did not have 2009 H1N1 virus infection confirmed by PCR testing should be vaccinated with the 2009 H1N1 vaccine. People who had H1N1 illness confirmed by PCR earlier in 2009 can be considered to be immune and do not need to be vaccinated this year. However, most people with respiratory illnesses since this spring have not had PCR testing, which is the only test that can confirm infection specifically with the 2009 H1N1 virus. People who were infected with the 2009 H1N1 virus and who are not severely immune compromised will likely have immunity to subsequent infection with 2009 H1N1 virus. However, vaccination of a person with some existing immunity to the 2009 H1N1 virus will not be harmful, and patients who are uncertain about how they were diagnosed should get the 2009 H1N1 vaccine. For more information, visit www.cdc.gov/h1n1flu and select vaccination, clinician questions and answers.

If people who have tested positive are recommended to get vaccinated, is there a waiting period and recommendation of nasal spray or shot?

There is no waiting period. Injectable or nasal vaccine should be provided based on age, medical status, and availability.

Can both seasonal and H1N1 vaccines be given at the same time?

Both seasonal and 2009 H1N1 vaccines are available as inactivated and live attenuated formulations. Providers can administer seasonal and 2009 H1N1 inactivated vaccines, seasonal inactivated vaccine and 2009 H1N1 LAIV, or seasonal LAIV and inactivated 2009 H1N1 at the same visit, or at any time before or after each other. Live attenuated seasonal and live 2009 H1N1 vaccines should NOT be administered at the same visit. If a person is eligible and prefers the LAIV formulation of seasonal and 2009 H1N1 vaccine, these vaccines should be separated by a minimum of four weeks.

Is there a recommendation on nasal or shot in infants and small children? Are there recommendations for ages receiving the vaccine?

Live, attenuated vaccine (FluMist) is licensed only for healthy individuals ages 2-49 years. Other people should receive injectable vaccine. Different manufacturers for injectable vaccine have different age requirements. Follow the guidance in the manufacturer’s package insert.

Can I go to my regular doctor for the H1N1 vaccine?

Not all doctors will have H1N1 vaccines on hand. Call your local health department for information on where you can get vaccinated.

I want to get the flu vaccine, but I don’t have insurance. What can I do?

Call your local health department.

Vaccine Questions: contact Immunization Program at 317.233.7560 or 317.233.7010

Epidemiology/Disease Questions: contact Surveillance and Investigation at 317.233.7125

Lab Questions: contact ISDH Laboratory at 317.921.5500

Media Questions: contact ISDH Office of Public Affairs at 317.233.7254

Preparedness/Planning Questions: contact PHPER at 317.233.5576

Marion County Health Department Hotline: 317.221.3366 (Marion County locations only)

Revised 10-09-09

What is H1N1?	The H1N1 flu virus (formerly known as “swine flu”) is a new flu virus causing illness in people. The virus is spreading person-to-person throughout the US as well as the rest of the world.
What are the symptoms of the H1N1 flu?	The symptoms are similar to regular flu and include: · Fever* · Cough · Sore throat · Runny or stuffy nose · Body aches · Headaches · Chills · Fatigue *Some people do not develop a fever Some people have also reported: · Diarrhea · Vomiting Symptoms usually appear 2-7 days after exposure. People may infect others from 1 day before getting sick to 7 days after getting sick.
If I get the H1N1 flu, how long will I be sick?	You may be ill for a week or longer.
How does the flu spread?	The H1N1 flu virus is spread the same way as seasonal flu from person-to-person when a sick person coughs or sneezes on or around other people. People may become infected if they touch something with flu viruses on it and then touch their face, eyes, nose or mouth.
I have symptoms. Do I have it?	Many different infections have symptoms similar to the flu, so it’s difficult to tell over the phone. If you have symptoms, you should stay home until you are well. If you are pregnant, have medical problems, you should call your doctor. If you are having chest pain or shortness of breath, you should seek medical care immediately.

How is the H1N1 virus different from regular seasonal flu?	The people at greatest risk of getting the flu and being hospitalized are different. With the seasonal flu, older people are more likely to become very sick than younger people. The 2009 H1N1 flu has been causing more illness in people 25 years and younger.
If I am sick, what should I do?	· Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. · Cough or sneeze into your elbow or upper sleeve if tissues are not available. · Wash your hands often with soap and water. Hand sanitizers made with alcohol are also effective. · Stay home for at least 24 hours after your fever is gone, except if you need to go out for medical care or other necessities, · Get plenty of rest · Drink plenty of nonalcoholic fluids like water or juice.
What can I do so I don’t become sick?	· Wash your hands often with soap and water. Hand sanitizers made with alcohol are also effective. · Avoid touching your eyes, nose, and mouth. · Avoid close contact with sick people · Get plenty of rest · Eat a healthy diet · Get vaccinated as soon as vaccine is available to you.
If I am sick, can antibiotics help me feel better?	Antibiotics won’t help with the flu because flu is a virus. Antibiotics only work on bacteria, not viruses.
What drugs can I take to help me feel better?	Over the counter medications can help you treat the symptoms of flu. Check with your doctor if you are unsure what medications you can take. Two antiviral medications can be used to treat H1N1 influenza (Tamiflu® and Relenza®). Both medications are only available by prescription. Not everyone with 2009 H1N1 flu needs to be treated with antiviral medications.
Who should get antiviral medications?	Most people with the flu get better and don’t need antiviral medications. Some people are at a higher risk of complications and should talk to their doctor about antiviral medications. They are: · People hospitalized with influenza · Children younger than 5 years old · Adults 65 years and older · Pregnant women · People with chronic medical conditions · People with suppressed immune systems
If I get sick, how long do I have to stay home from work/school?	If you have a fever, you should stay home until you are free of fever for at least 24 hours without the use of fever reducers (Tylenol, Motrin, etc). If you have vomiting or diarrhea, stay home until you are free from these symptoms for at least 24 hours.
Should my doctor test me for H1N1 to be diagnosed?	Routine lab testing of people with H1N1 symptoms is not recommended.
What are the warning signs to seek medical care?	In children: · Fast breathing or trouble breathing or wheezing · Bluish or gray skin color · Severe or persistent vomiting · Not waking up or not interacting · Being so irritable that the child does not want to be held · Not urinating · High fever for more than 3 days · Flu-like symptoms improve but then return with fever and worse cough In adults: · Difficulty breathing or shortness of breath or wheezing · Pain or pressure in chest or abdomen · Sudden dizziness · Confusion · Severe or persistent vomiting · Not urinating · High fever for more than 3 days · Flu-like symptoms improve but then return with fever and worse cough
Do I need to buy facemasks?	If you have the flu, you should stay home. If you need to go out, you can wear a facemask if you would like. If you have the flu, and don’t want to wear a facemask, cover your coughs and sneezes. If you don’t have the flu and you are healthy, a facemask is not needed even if you are taking care of someone with the flu. If you have a chronic disease or a weakened immune system, you may want to wear a mask if you are caring for someone with the flu.
Is an H1N1 vaccine available?	Yes. H1N1 vaccine is available as a live, weakened nasal mist and as an inactivated, injectable vaccine. Both types will be released as they become available. The live, attenuated nasal mist form of the vaccine is only recommended for healthy, non-pregnant people aged 2-49 years old. Pregnant women, children 6 months to 2 years of age, and individuals aged 25 to 64 years of age with underlying chronic conditions or who are immune compromised should receive the injectable H1N1 flu vaccine, once it is available. Continue to follow the news, visit www.in.gov/flu, or sign up for the state’s Twitter site: http://twitter.com/inpublicsafety to learn when the injectable H1N1 flu vaccine is available.
Where can I get an H1N1 vaccine?	Call your local health department. As information becomes available from the local health departments, the Indiana State Department of Health will post online where you can get the H1N1 flu vaccine at: www.in.gov/flu.
Who should get the vaccine first?	Some groups of people are a higher risk of complications from the H1N1 flu. People in these groups are encouraged to be vaccinated as soon as they can. They are: · Pregnant women · People who live with or care for children younger than 6 months of age · Health care workers and emergency medical services personnel · People between 6 months and 24 years old · People ages 25 through 64 years of age who have chronic illnesses or compromised immune systems
I don’t belong to any of the high risk categories. Will I be able to get vaccinated?	Plenty of vaccine should be available. People who don’t belong to the high risk categories will be able to get vaccinated once those in the high risk categories have been vaccinated.
How safe is the vaccine?	The H1N1 flu vaccine is as safe as the regular flu vaccine. All flu vaccines are made the same way by the same manufacturers.
Does the H1N1 vaccine contain thimerosal preservative?	The nasal spray form of H1N1 vaccine does not contain thimerosal. Single dose syringes of the injectable vaccine do not contain thimerosal, and will be available for people with an allergy to thimerosal, young children, and pregnant women. Contact your health care provider if you have questions or concerns about thimerosal.
Will a regular seasonal flu shot prevent me from getting the H1N1 flu?	No, but it will prevent you from getting seasonal flu. Since H1N1 is a new strain, it is not included in the seasonal flu shot. Everyone is encouraged to get seasonal flu vaccine, which is available right now, and to get an H1N1 vaccine as it becomes available.
I’m pregnant. Can I get the flu vaccine?	Yes. Pregnant women can and should get both the H1N1 vaccine and the seasonal flu vaccine during any trimester of pregnancy. The vaccine protects pregnant women and also continues to protect babies after they are born. Pregnant women should receive the injectable vaccines only and not the live nasal vaccines.
If a person tests positive for influenza A should they get the vaccine?	According to the CDC, all people in a recommended vaccination target group who did not have 2009 H1N1 virus infection confirmed by PCR testing should be vaccinated with the 2009 H1N1 vaccine. People who had H1N1 illness confirmed by PCR earlier in 2009 can be considered to be immune and do not need to be vaccinated this year. However, most people with respiratory illnesses since this spring have not had PCR testing, which is the only test that can confirm infection specifically with the 2009 H1N1 virus. People who were infected with the 2009 H1N1 virus and who are not severely immune compromised will likely have immunity to subsequent infection with 2009 H1N1 virus. However, vaccination of a person with some existing immunity to the 2009 H1N1 virus will not be harmful, and patients who are uncertain about how they were diagnosed should get the 2009 H1N1 vaccine. For more information, visit www.cdc.gov/h1n1flu and select vaccination, clinician questions and answers.
If people who have tested positive are recommended to get vaccinated, is there a waiting period and recommendation of nasal spray or shot?	There is no waiting period. Injectable or nasal vaccine should be provided based on age, medical status, and availability.
Can both seasonal and H1N1 vaccines be given at the same time?	Both seasonal and 2009 H1N1 vaccines are available as inactivated and live attenuated formulations. Providers can administer seasonal and 2009 H1N1 inactivated vaccines, seasonal inactivated vaccine and 2009 H1N1 LAIV, or seasonal LAIV and inactivated 2009 H1N1 at the same visit, or at any time before or after each other. Live attenuated seasonal and live 2009 H1N1 vaccines should NOT be administered at the same visit. If a person is eligible and prefers the LAIV formulation of seasonal and 2009 H1N1 vaccine, these vaccines should be separated by a minimum of four weeks.
Is there a recommendation on nasal or shot in infants and small children? Are there recommendations for ages receiving the vaccine?	Live, attenuated vaccine (FluMist) is licensed only for healthy individuals ages 2-49 years. Other people should receive injectable vaccine. Different manufacturers for injectable vaccine have different age requirements. Follow the guidance in the manufacturer’s package insert.
Can I go to my regular doctor for the H1N1 vaccine?	Not all doctors will have H1N1 vaccines on hand. Call your local health department for information on where you can get vaccinated.
I want to get the flu vaccine, but I don’t have insurance. What can I do?	Call your local health department.