Like seasonal flu, influenza A (H1N1) infections can vary in severity from mild to severe. Most people who have been sick with the H1N1 flu virus recover without medical treatment yet some hospitalizations and deaths have occurred. Furthermore, in seasonal flu, certain groups of people are at higher risk for flu-related complications, in particular people 65 years and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions. Currently, it seems that the risk for H1N1 flu – related complications is higher for the following groups: people less than 24 years old, pregnant women, and people 25-64 years old with underlying medical conditions (i.e. asthma, diabetes, heart or kidney disease, suppressed immune systems, and neurocognitive and neuromuscular disorders).

This virus originally was 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 infect pigs in North America. However, further studies showed that this flu virus is actually very different and has two genes from flu viruses that normally circulate in pigs in Europe and Asia, as well as avian flu genes and human flu genes. Scientists call this a "quadruple reassortant" virus.

Human infections with swine flu are rare, but can occur in persons with direct exposure to infected pigs; and even evidence of human-to-human transmission of swine flu has been documented. However, swine flu is not transmitted by food or eating pork or pork products. Viruses and bacteria are killed by cooking pork to an internal temperature of 160°F.

Flu Terms:

• Influenza A (H1N1) (also known as H1N1 flu) is a new influenza virus causing illness in humans and spreading from person to person, in much the same way as seasonal influenza.
• Swine flu is a respiratory disease caused by type A influenza viruses that causes regular outbreaks in pigs. Although people normally are not infected by such diseases, human infections have been known to occur.
• Bird flu (avian influenza, AI) is caused by influenza viruses that naturally occur among birds. Wild birds carry the viruses but do not usually get sick from them; however, AI is very contagious among birds and can kill or sicken some domestic birds. Avian flu viruses are characterized as being either low pathogenic (LPAI) – usually associated with mild disease in poultry – or highly pathogenic (HPAI) viruses, such as H5N1 – those associated with severe illness and a rapid death. In general, the risk of transmission from birds to humans is low, and has resulted from direct contact with an infected bird. Humans cannot get bird flu from properly handled and cooked poultry or eggs. Symptoms in humans depend on which virus caused the infection, and range from flu-like aches to severe life-threatening complications.
• Low pathogenic avian influenza (LPAI): A classification of the Avian Flu virus, usually associated with mild disease in poultry.
• Highly pathogenic avian influenza (HPAI): A classification of the Avian Flu virus, usually associated with severe illness and a rapid death.
• Pandemic flu is human flu that causes a global outbreak of illness. Because there is little natural immunity, the disease can be serious and spread easily from person to person.
• Seasonal (or common) flu is a viral respiratory illness that can be transmitted from person to person. There are vaccines available, and most people have some immunity.

When infected people cough or sneeze, infected droplets get on their hands, drop onto surfaces, or are dispersed into the air. Another person can be exposed by breathing in contaminated air or touching infected hands or surfaces.

Germs can spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Studies have shown that the influenza virus can survive on some surfaces and can infect a person up to 2-8 hours after being deposited on the surface. Also, droplets from a cough or sneeze of an infected person move through the air.

H1N1 viruses are NOT spread by food. You cannot get this new HIN1 virus from eating pork or pork products. Eating properly handled and cooked pork products is safe.

With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, potentially could be contagious for longer periods. The Centers for Disease Control and Prevention is studying the H1N1 flu virus and its capabilities to try to learn more and will provide more information as it becomes available.

The World Health Organization is not recommending travel restrictions related to the outbreak of H1N1 flu. 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.

Some people who have been infected with this virus also have reported diarrhea and vomiting. Also, like seasonal flu, severe illnesses and death have occurred as a result of illness associated with this virus.

Emergency warning signs that need urgent medical attention

• Fast breathing or trouble breathing
• Fever with rash
• 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

• 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

Cover your mouth and nose with a tissue when coughing or sneezing, and throw the tissue in the trash after you use it. If you don't have a tissue, cough or sneeze into your sleeve.

Wash your hands with soap and warm water frequently and thoroughly (wash for 15-20 seconds), especially after you cough or sneeze. When water and soap are not available, alcohol-based cleaners are also effective. Rub your hands until the gel is dry. The gel does not need water to work; the alcohol in it kills the germs on your hands.

If you are sick, stay home from work or school and limit contact with others.

Follow public health advice regarding social distancing measures such as school closures and avoiding crowds.

Stay informed.

If you have severe illness or you are at high risk for flu complications, contact your healthcare provider or seek medical care. Your healthcare provider will determine whether flu testing or treatment is needed.

Other important actions to stay healthy:

• To prevent the spread of germs, avoid touching your eyes, nose, and mouth.
• Avoid contact with sick people.
• Find healthy ways to deal with stress and anxiety.
• Drink plenty of fluids, and eat nutritious foods.
• 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 could be useful and could help prevent the need to make trips out in public while you are sick and contagious.
• Keep surfaces clean by wiping them down with a household disinfectant according to the directions on the product label.
• With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. If you are sick, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer.
• Influenza viruses are destroyed by heat (167-212°F or 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.
• Linens (such as bed sheets and towels), eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately; however, it is important not to share these items without first washing them thoroughly.

Antiviral drugs are prescription medicines that reduce the symptoms and duration of the flu, as well as prevent serious flu complications. They are used to treat individuals who are at higher risk of severe flu complications or who become severely ill and require hospitalization. If you have severe illness or you are at high risk for flu complications, contact your healthcare provider or seek medical care. There are two antiviral medications that are recommended for use against H1N1 flu: oseltamivir and zanamivir.

Most people do not need antiviral medication to fully recover from the flu, and so far most people who have been infected with H1N1 flu have recovered without antiviral treatment. Over-the-counter cold and flu medications used according to package instructions may help lessen some symptoms. Check ingredients on the package, so you do not double dose on acetaminophen or ibuprofen, and check with your healthcare provider or pharmacist if you are taking other medications. Importantly, these medications do not decrease the infectiousness of the person.

People who are sick also should get plenty of rest, drink clear fluids (water, electrolyte beverages, and broth, among others), cover coughs and sneezes, clean hands often and thoroughly, stay home and avoid close contact with others, and be watchful for emergency signs that may indicate a need to seek medical care.