Center for Disease Control Traveler Alert
04/28/2009
Swine flu is concerning, but people should not panic.
There are simple things all of us can do to prevent the spread of this disease: Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
Try to avoid close contact with sick people.
If you get sick with influenza, the Center for Disease Control (CDC) recommends that you stay home from work or school and limit contact with others to keep from infecting them. Avoid touching your eyes, nose or mouth. Germs spread this way.
In Ohio, CDC has confirmed 1 U.S. human cases of swine influenza A (H1N1) virus infection in Elyria, Ohio.
Nationwide, CDC has confirmed 64 U.S. human cases of swine influenza A (H1N1) virus infection in California (10 cases), Texas (6 cases), Kansas (2 cases), New York (45 cases) and Ohio (1 case).
There are other suspected cases, public health officials are reporting on cases confirmed by lab test. As we look harder, we are likely to continue to see more cases, more hospitalizations and possibly even deaths from this outbreak.
CDC testing has confirmed the first human case of swine influenza A (H1N1) in Ohio.
o The first case occurred in a 9-year-old boy who had recently traveled to Mexico. Of the known cases in the United States, 5 have been hospitalized. No deaths have occurred from swine flu in the U.S.
This situation is evolving rapidly and numbers may change.
CDC and public health are acting aggressively to contain this infection.
People are encouraged to visit http://www.cdc.gov/swineflu/ for information.
Guidance should be considered interim and will be updated frequently.
CDC recommends that U.S. travelers avoid all nonessential travel to Mexico.
Changes to this recommendation will be posted at http://wwwn.cdc.gov/travel/.
If you must travel to Mexico, there are steps you should take to reduce your risk of infection:
First, prepare for your trip before you leave by monitoring the international situation; checking with your doctor about prescription antiviral medications; packing a travel health kit; reviewing your health insurance plan; and finding where you can get health care services while traveling.
Practice healthy habits to help stop the spread of germs including washing your hands often with soap and water, covering your mouth and nose with a tissue when you cough or sneeze, and following all local health advice. This may include being asked to wear a surgical mask to protect others.
Remember if you are traveling to Mexico, you should be sure you get a seasonal flu vaccination. It is not expected to protect against swine flu, but it will protect you against seasonal flu. Flu season runs through May in the northern hemisphere, and is just beginning in tropical and southern hemisphere countries.
After you return from Mexico pay close attention to your health for 10 days. If you become sick with a fever PLUS a cough and sore throat, or if you have trouble breathing during the 10 days after you return see a doctor.
Advice for Residents of Kansas, New York City, Ohio, San Diego and Imperial County, California, and Guadalupe County, Texas.
People who live in areas where swine influenza cases have been identified and who become ill with influenza-like symptoms, including fever, body aches, runny nose, or sore throat, and sometime also with symptoms of nausea, or vomiting or diarrhea, may want to contact their health care provider, particularly if they are worried about their symptoms.
Their health care provider will determine whether influenza testing or treatment is needed.
Ill people who experience any of the following warning signs should seek emergency medical care:
In children emergency warning signs that need urgent medical attention include:
o Fast breathing or trouble breathing
o Bluish skin color
o Not drinking enough fluids
o Not waking up or not interacting
o Being so irritable that the child does not want to be held
o Flu-like symptoms improve but then return with fever and worse cough
o Fever with a rash
In adults, emergency warning signs that need urgent medical attention include:
o Difficulty breathing or shortness of breath
o Pain or pressure in the chest or abdomen
o Sudden dizziness
o Confusion
o Severe or persistent vomiting
Background
These are swine influenza A (H1N1) viruses which are very different from seasonal human influenza A (H1N1) viruses.
Preliminary studies of the swine influenza viruses that have been tested are similar to each other. Additional testing is being done on the viruses.
The viruses contain genetic pieces from four different virus sources: North American swine influenza viruses, North American avian influenza viruses, human influenza viruses and swine influenza viruses found in Asia and Europe.
This particular genetic combination of swine influenza virus segments has not been recognized before in the United States or anywhere else worldwide.
The swine influenza viruses are resistant (not sensitive) to amantadine and rimantadine two of the antiviral medications approved to prevent and treat influenza in the U.S.
The viruses are susceptible (sensitive) to the influenza antiviral medications, oseltamivir and zanamivir.
Other Key Points
Swine influenza viruses are not transmitted by food. You cannot get swine influenza from eating pork products.
This is a rapidly evolving situation and guidance should be considered interim and updated as necessary. CDC will provide new information as it becomes available.