Online Test Helps You Self-Diagnose H1N1 Flu

Feeling sick? Wondering if it's the H1N1 flu or just a regular old go-away-don't-come-near-me, flu?

Face it, your doctor may not be able to squeeze you right in. But you may be able to figure it out using a Web-based self-assessment tool developed by researchers at Emory University in Atlanta. The tool is now available on several national Web sites, including flu.gov , the Centers for Disease Control and Prevention (CDC), and Microsoft's H1N1 Response Center .

The online test includes questions like, do you have a fever? Have you been short of breath? Do you have a pain or pressure in your chest that you didn't have before? Were you feeling better and now a fever or cough is returning?

The online test includes questions like, do you have a fever? Have you been short of breath? Do you have a pain or pressure in your chest that you didn't have before? Were you feeling better and now a fever or cough is returning?

The H1N1 flu , also widely known as the swine flu, is a fairly new influenza virus that has spread around the world. The CDC reports that it first appeared in the United States this past April. By June 11, the World Health Organization categorized it as a pandemic . Because its extremely contagious, hospitals and health care workers have been bracing for the H1N1 to hit hard this fall.

With concerns about the new flu running high , health care providers expect to get slammed with a mounting wave of people rushing in to find out if they have the H1N1 virus.

The online test, dubbed the Strategy for Off-Site Rapid Triage, is designed to help a lot of people figure out if they need to see their doctor or go to a hospital.

"This Web site is carefully designed to encourage those who are severely ill, and those at increased risk for serious illness, to contact their doctor, while reassuring large numbers of people with a mild illness that it is safe to recover at home," Arthur Kellermann, professor of emergency medicine and an associate dean at the Emory School of Medicine, said in a statement. "Hopefully, providing easy-to-understand information to the public will reduce the number of people who are needlessly exposed to H1N1 influenza in crowded clinic and ER waiting rooms, and allow America's doctors and nurses to focus their attention on those who need us most."

iPhone App Tracks Swine Flu

A new, free iPhone app from the creators of HealthMap shows the outbreaks of the H1N1 swine flu in your area and elsewhere. The app, called Outbreaks Near Me, finds your location and shows a map with red pins indicating recent outbreaks.

The app updates every hour using reports from more than 30,000 sources. Users can report updates such as school closings through the app. The app was launched last month and now has been downloaded 81,000 times.

Red pins dot the state of California, with heavy concentrations in Los Angeles and the San Francisco Bay Area. Perhaps one of those red pins includes my friend (and many in his East Bay company) who came down with the swine flu a couple of weeks ago.

There are no warning signs, he says. One day you're happily working in your cubicle, and the next you're fighting a fever, vomiting and worse. He lost eight pounds in only a few days after losing his appetite for food and liquids. Luckily, I hadn't caught up with him in a while.

John Brownstein, an assistant professor at Children's Hospital Boston and one of HealthMap's creators, told the Wall Street Journal that the goal of the free app isn't to spark panic, rather to spread the word. To this end, he says, an app solely running on the iPhone isn't ideal. HealthMap is currently developing an app for Google's Android and, later, for RIM's BlackBerry.

Pvt hospitals still not ready for Swine flu

More than a week after Delhi Government's second deadline expired on September 15, private hospitals are yet to open doors to influenza A H1N1 patients.

Delhi reported 2,079 cases - 80 new cases - and 9 deaths till Wednesday evening. While most of the hospitals claimed to be ready and waiting for the state health department's approval, State Health Minister Kiran Walia said they were not.

"Our experts are going on a round of private hospitals virtually every day, and there are minor things that are hampering the approval process like system of ventilation," said Walia. "These hospitals aren't used to the concept of isolation and mostly work in a centralised system.

We may delay it by a few days but absolute compliance is a must. We can't cut corners and risk lives of people," she said.

"Our set-up is ready and we have conveyed this to the health department. Now, we are waiting for their inspection," said B.K. Rao, chairman of Sir Ganga Ram Hospital.

"Our infrastructure is in place, but we are awaiting formal approval from the government," said the Moolchand Medcity spokesperson. Similar reactions were given by Indraprastha Apollo Hospital, which said the hospital was waiting for the second inspection before starting the facility for swine flu patients.

On August 12, Principal Secretary (health) J.P. Singh issued a circular directing "all 200-bed non-government medical institutions/hospitals to set up a 10-bed isolation treatment facility with 15 days". The direction was issued under section 2 of the Epidemic Disease Act, 1897, which empowers the state government to take special measures and prescribe regulations in case of a dangerous epidemic disease.

"The step was taken as a precautionary measure in case the disease takes epidemic shape," said Singh. The hospitals had asked for more time and the state government extended the deadline by 15 days.

But none of the wards were functional

What scientists know about swine flu

Preliminary analysis of the swine flu virus suggests it is a fairly mild strain, scientists say.

It is believed that a further mutation would be needed in order for the H1N1 virus to cause the mass deaths that have been estimated by some.

But at this point, it is impossible to predict with any accuracy how the virus will continue to evolve.

UK experts at the National Institute for Medical Research outlined on Friday the work they are due to start on samples of the virus sent from the US.

The research, being done at the World Influenza Centre in Mill Hill, will be vital for working out the structure of the virus, where it came from, how quickly it is capable of spreading and its potential to cause illness.

Structure

Analysis done so far suggests what they are dealing with is a mild virus and nowhere near as dangerous as the H5N1 avian flu strain that has caused scientists so much concern over the past decade.

Influenza A viruses are classified according to two proteins on the outer surface of the virus - hemagglutinin (H) and neuraminidase (N).


The swine flu strain is a H1N1 virus, the same type as seasonal flu which circulates throughout the world every year, and kills roughly 0.1% of those infected or higher in an epidemic year.

Professor Wendy Barclay, chair in influenza virology at Imperial College London says initial indications suggest there is nothing about the genetic make-up of the new virus which is a cause for particular concern.

The key to its potential lies largely in the H1 protein.

"There are two aspects - one is which receptors the virus tends to bind to and what we see is that it is binding to the upper respiratory tract rather than deep in the lungs."

When a flu virus binds to the upper respiratory tract, it tends to cause mild illness but can be easily spread as people cough and sneeze, Professor Barclay explains.

If a virus binds further down in the lungs, it tends to cause much more severe illness, as in the case of the H5N1 avian flu virus which has caused concern in recent years.

"With the H1 gene we also look at the cleavage site," she adds.

"The virus has to be cut into two pieces to be active and it uses an enzyme in the host to do that.

"Most influenza viruses are restricted to the respiratory tract because they use enzymes in the lungs.

"But some, like H5 viruses can evolve to cut into two pieces outside the lungs, so they can replicate outside the respiratory tract."


Analysis

These initial indications are largely guesswork from looking at the genetic sequence of the virus and comparing that to what is known from work on other influenza viruses.

It will take weeks and months of biological analysis to properly get a handle on the potential of the H1N1 virus.

The team at Mill Hill, one of four World Health Organisation's centres for influenza research will be working in close collaboration with the Health Protection Agency who are carrying out testing in the UK, and their findings will also feed into the development of a potential vaccine.


Soon, the Wellcome Trust Sanger Institute in Cambridge will begin the genetic sequencing of the virus and will also be monitoring any mutations or changes in how virulent it is.

However, there is one other reassuring aspect about what is known so far.

That is there seems to be nothing unusual as yet in another protein in the centre of the virus, called NS1, which is linked to the strength of the immune response the virus produces.

In some more pathogenic viruses, it is this NS1 protein which initiates a "cytokine storm", a particularly severe immune reaction that can be fatal in even healthy young people.

Predictions

Scientists have also played down concerns that the milder H1N1 virus, could combine with the more dangerous H5N1 avian flu virus, causing a super virus that has the ability to both spread easily between humans and cause severe illness.

This is unlikely - or at least just as unlikely as it ever was and the H5N1 virus has been around for a decade without combining with normal seasonal flu.

Professor Jonathan Ball, an expert in molecular virology at the University of Nottingham said: "The chance of swine H1N1 combining with H5N1 is as likely as any other strain recombining.

"What this outbreak does highlight is how difficult it is to predict new pandemic strains.

"Many people suspected that H5N1 was the most likely candidate for the next pandemic strain, but now it appears that this was a mistake - but that's not to say H5N1 or another reassortment containing parts of H5N1 may not happen in the future.

"That's the trouble - you can't predict."

India's swine flu deaths 101, preventive homeopathy advised

India Tuesday reported one more swine flu death, taking the total toll due to the influenza A (H1N1) virus to 101, health authorities said here.

The latest death was reported from Goa. While two deaths in Karnataka were suspected to be due to the virus, lab reports were still awaited.

Of the 101 deaths, Maharashtra has recorded the highest number of deaths, 55, followed by 27 in Andhra Pradesh.

The union health ministry recommended preventive homeopathy medicine, Arsenicum album 30. The decision to advise people to take the preventive medicine was taken after the Central Council for Research in Homeopathy (CCRH), a state-run research wing, gave the suggestion for curbing the spread of the diseases.

'It has recommended one doze of the medicine daily on empty stomach for three days. The dose should be repeated after one month by following the same schedule in case flu like conditions prevail in the area,' the ministry said in a statement.

Meanwhile, 114 people were tested positive for the influenza A (H1N1) virus Tuesday in the country, taking the total number of cases to 4,101.

Maharashtra continued to top the charts both in terms of deaths and positive cases. On Tuesday, 48 fresh cases were from the state alone. So far, about 1,687 people have been affected due to the virus in the state.

It was followed by Delhi in the number of cases. At least 665 people have been infected with the disease in the capital. On Tuesday, 10 fresh cases were reported in the Indian capital.

Karnataka reported 22 fresh cases, taking the total number of people infected with the virus to 463 - the third highest in the country.

Other fresh cases were reported from West Bengal (18) and Orissa (3). One case each was reported from Haryana, Jammu and Kashmir and Chhattisgarh while Puducherry and Chandigarh reported two swine flu cases each.

Meanwhile, a government study has found that swine flu is killing more young and middle-aged people and those suffering from associated diseases like diabetes and chronic heart ailment.

'We have conducted a study and found that more than 50 percent of those affected by the virus were in the age group of 15-45 years,' R.K. Srivastava, director general of the Directorate General of Health Services, told reporters.

'Deaths were also due to late reporting to identified health facilities and delay in initiation of Tamiflu,' he said.

The report, which was presented to Health Minister Ghulam Nabi Azad during Monday's stock-taking meeting of the ministry, studied the first 82 deaths that occurred till Aug 31.

Among the dead were 43 men and 39 women including three pregnant women.

Srivastava said that of the 82 deaths, 61 were in urban areas and 19 in rural areas.

He said there were five deaths in the age group of 0-5 years and three from 6-15 age group. Thirteen victims were from the age group of 16 to 25 years, while 18 people died in the age group of 26-35 years.

Srivastava said 24 people died in the age group of 36-45, as compared to 18 in the age group of 46-65. Only one person died in the above 65-year category.

Q&A: Swine flu vaccination

The government has unveiled its vaccination programme.

A number of priority groups have been identified and the process should start in October.

What is the current status of the vaccine?



Doses of the vaccine have already been produced. A total of 300,000 doses from the two firms the UK has contracts with are due to be delivered this month.

Human trials are now getting under way and if they go well regulators could approve the jabs by the end of September.

Like seasonal flu vaccines, the jabs can be licensed under a fast-track procedure.

The vaccines have already been tested with a different strain of flu and proven to be safe.

So they just need limited testing with the correct strain to get the green light.

This means the process can take just a month or so, unlike new drugs which can take years to get approval.

How have the priority groups been identified?

The government's official vaccination experts have been studying at the evidence about swine flu for the past few months.

The health service just does not have enough capacity to administer the two shots of the swine flu vaccine needed to give protection to everyone in time for the winter.

So, instead, the government has announced a list of priority groups.

These are mainly people who are most at risk of complications or, in the case of health and social care workers, the people who are most likely to come into contact with the virus.

Many had thought all children would be immunised as they have been getting the infection in the highest numbers.

But the experts decided against such a mass programme as the overwhelming majority of those developing complications were the children with serious health problems.

How does this compare to the seasonal flu programme?
The initial first wave of the vaccination programme is not that different from the average seasonal flu vaccination group.

Only pregnant women and those living with people with immune system problems, such as people with HIV or those receiving chemotherapy treatment, will be getting the swine flu jab without also receiving the seasonal flu one.

The government hopes to be able to combine vaccinations for people who need both.

How will the swine flu vaccine be administered?

The government is still in negotiation with GPs about how the programme will be delivered.

But the vaccine requires people to be given two doses, three weeks apart.

That would mean the first phase of the programme will take until at least early December to complete.

Will everyone be vaccinated?

It is not clear. The government said it will make a decision on this during the winter.

It will eventually have enough vaccine for the whole population, but in most cases it has remained a relatively mild infection.

However, Chief Medical Officer Sir Liam Donaldson has warned that it could still become more deadly and while the death toll remains low, a fifth of cases have involved previously healthy people

Deal 'close' over swine flu jabs

Doctors' leaders say they are hopeful that an agreement can soon be reached in negotiations with government over the swine flu vaccination programme.


Ministers unveiled plans on Thursday to vaccinate over 13 million people in the first wave of the UK programme.

But officials were forced to admit GPs had still not signed up to the deal.

The British Medical Association has asked for extra funds to administer the two-shot jab, which some campaigners have dubbed ludicrous.

The government had hoped to have the GPs on board by the time it announced its plan this week.
But negotiations have taken longer than expected. Doctors are paid £7.51 for each seasonal flu vaccine and other jabs, such as travel inoculations.

They are not expecting that amount for what may turn out to be a mass vaccination programme, but have argued in talks that they need extra money to cover staffing and administration costs and the overtime they may need to do.

They have also asked for their bonus payments to be protected if work such as blood pressure checks is affected.

Under the programme put forward, people with health conditions, such as heart disease and diabetes, pregnant women, those with weakened immune systems and frontline health and social care workers will be the first to receive the jab.

This amounts to more than 13 million - about a fifth of the UK population.

It has not been decided whether the rest of the population will then be immunised, although the government has ordered enough vaccine to do so.

There is still time to broker a deal as the vaccination programme will not be started until regulators have approved the vaccine. This is not likely to happen until the end of September at the earliest.

'Ludicrous'
Dr Laurence Buckman, chairman of the British Medical Association's GPs committee, said: "Talks with the government remain ongoing and we are hopeful that these discussions will conclude shortly.

"Currently, the health service is working well in response to this enormous challenge and all doctors will continue to work hard on behalf of all their patients."

But Susie Squire, political director at the Taxpayers' Alliance, said: "It is the job of GPs to provide frontline healthcare - and they are well paid by taxpayers for this service.

"To pay them extra to administer swine-flu injections is ludicrous. As doctors they should understand that public health is unpredictable and sometimes there are epidemics or accidents that have to be dealt with, and this can mean unpaid overtime."

A Department of Health spokesman said: "We are now working with BMA and NHS organisations to reach a comprehensive swine flu vaccine implementation plan for this first stage of the programme."

Swine flu could kill as many as 30,000 to 90,000 people in US

Washington, August 25 (ANI): In a recently released report, the Obama administration's advisory group on Science and Technology has said that the H1N1 flu virus, dubbed 'Swine flu', could cause as many as 30,000 and 90,000 deaths in the United States and pose a serious health threat.

According to Fox News, deaths would be concentrated among children and young adults, determined the report.

In contrast, the typical seasonal flu kills between 30,000 and 40,000 annually - mainly among people over 65.

The report predicts 1.8 million will be hospitalized during the epidemic, with up to 300,000 patients requiring intensive care units.

These patients could occupy 50-100 percent of all ICU beds in affected regions at the peak of the epidemic and would place "enormous stress" on ICU units.

More needs to be done to speed up the "preparation of flu vaccine for distribution to high-risk individuals," otherwise the vaccine campaign - currently scheduled to begin in mid October - will have potentially missed the peak of the epidemic, according to the report.

The report from the President's Council of Advisors on Science and Technology, PCAST, shows a sober assessment of the dangers of a pandemic, but also serves as a pat on the back for a White House preparing for its first public health crisis.

"Based on the history of influenza pandemics over the past hundred years, PCAST places the current outbreak somewhere between the two extremes that have informed public opinion about influenza," stated the report.

"On the one hand, the 2009-H1N1 virus does not thus far seem to show the virulence associated with the devastating pandemic of 1918-19. On the other hand, the 2009-H1N1 virus is a serious threat to our nation and the world," it added.

This is due to the likelihood that more people will be infected because so few people have immunity to the strain.

As a result, PCAST recommends that the Food and Drug Administration "accelerate a decision about the availability of antiviral drugs for intravenous use."

The current expectation is that the vaccine will be available in mid-October.

According to Harold Varmus, PCAST co-chair and President of Memorial Sloan-Kettering Cancer Center, despite the long 'to-do' list, the Obama administration has thus far done a good job of preparing for a national outbreak.

"The Federal Government's response has been truly impressive and we've all been pleased to see the high level of cooperation among the many departments and agencies that are gearing up for the expected fall resurgence of H1N1 flu," he said.

Swine flu deaths mount to six India

The number of people to die of swine flu in India has risen to six with the death of a number of patients over the weekend, health officials say.

Six patients are reported to be in a serious condition in the western city of Pune, which has recorded more cases than anywhere else in India.

A number of schools in the country have been shut temporarily over fears of children contracting the disease.

Officials say there are more than 800 cases of the H1N1 flu strain in India.

The virus is thought to have killed almost 800 people around the world.

A 53-year-old doctor of indigenous medicine and a four-year-old boy died in hospitals in western Pune and southern Chennai cities early on Monday, taking the number of deaths caused by swine flu to six.

Over the weekend, three people died of the flu in western India - a 43-year-old businessman who was visiting Ahmedabad city in Gujarat state; a 42-year-old teacher in Pune city; and a 53-year-old woman in Mumbai city.

Last Monday, a 14-year-old girl became the first person in the country to die of swine flu.

Rising concerns

Health officials say that the country had enough stocks of the anti-flu drug Tamiflu.

However, panic is growing among the people with swine flu deaths making it to the front pages of newspapers and main TV news.

Several schools in western Indian and the capital, Delhi, have closed temporarily as fears grow about children contracting the flu.

In Delhi, where some 228 cases have been confirmed, health officials say that the people are panicking "because the symptoms of swine flu and common influenza are similar".

As the number of flu deaths rise in the country, health officials have asked people not to panic.

Indian PM Manmohan Singh has asked the health ministry to step up preparedness against the disease and coordinate with state governments to spread the disease.

"All state governments have been asked to set up their own swine flu helplines, create more quarantine wards not only in their hospitals but also in the big private hospitals," federal Health Minister Ghulam Nabi Azad said.

The BBC's Soutik Biswas in Delhi says though the number of swine flu deaths in India was still low, there are concerns over the ability of the badly-run and under equipped government hospitals to handle the rising tide of patients.

Also, the 12 swine flu testing centres in India will not be sufficient if the number of cases rise sharply, our correspondent says.

"We need to work out a public-private partnership between the hospitals to tackle the flu. We need to take the people, doctors and media into confidence so panic does not spread," federal Junior Health Minister Dinesh Trivedi told the BBC.

Last week, the World Health Organization announced that the first swine flu vaccines are likely to be licensed for use in the general population in September.

The swine flu (H1N1) virus first emerged in Mexico in April and has since spread to 74 countries.

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Pune/Chennai, Aug 10 (PTI) A 35-year-old ayurvedic doctor and a four-year-old boy died of swine flu in Pune and Chennai today, taking the toll due to the dreaded viral infection in the country to six. The medic, Babasahib Mane, died in the Sassoon Hospital in Pune this morning, becoming the third person in the worst-hit Maharashtra city to succumb to swine flu, a senior health official said.

Mane was ailing for sometime and blood had been found in his sputum in the last couple of days, he said. In Chennai, a four-year-old boy, who was admitted to a private hospital with kidney and liver-related complications and had tested positive for swine flu, died this morning, health officials said.

The boy had also been suffering from asthma. This is the first case of flu death in the city.

"The boy was in a very critical condition. He had been suffering from asthma and he had been taken from one hospital to another for various complications.

Ultimately he landed up in this hospital for a kidney-related problem.

and they found the boy testing positive (for swine flu)," Tamil Nadu Health Secretary V K Subburaj said.

The boy, who was on a ventilator, died following "multi- organ failure," S Ilango, Director of Public Health, said. With the two deaths today, the swine flu toll in the country has climbed to six.

British child gets Swin flu in Greece

UK, July 30, 2009, (Pal Telegraph) - The 16-year-old is on a life-support machine after suffering lung damage and complications believed to be linked to swine flu, according to the Daily Express.

The teenager, known as Sasha, had been island hopping with her family but was admitted to hospital on the island of Cephalonia.

She was flown to the country's main children's hospital in Athens on Tuesday after her condition deteriorated and she became unconscious.

Her parents, businessman Julian Newman and theatrical agent Nikki Boughton, are at her bedside. Mr Newman said: "Natasha is very bad. She has chronic respiratory failure. She has complications like pneumonia."

Doctors at the Ayia Sofia children's hospital have described the teenager's condition as "very grave".

Dr Lina Sianidou, head of the intensive care unit, said: "There is no doubt that she is suffering from swine flu. She is in a critical condition and very much struggling.

"It is clear she had this new virus for at least eight days before she sought help and that has made her condition worse."

Another hospital doctor, who asked not to be named, said: "Her condition is very grave. She was in a very bad state, running a very high temperature when she got here. She developed acute breathing problems and eventually lost consciousness in Cephalonia."

The family left their £1 million house in Highgate, north London, three weeks ago for a month's holiday. Mr Newman owns north London company J Newman Textiles Ltd.

Natasha is a pupil at prestigious public school Gordonstoun in Elgin, Scotland, where Prince Charles attended. She has recently completed her GCSE exams and is a keen musician.

Medical authorities said they were not aware she has underlying health problems. Natasha is one of three swine flu victims in intensive care in Greece, authorities revealed.

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First Swine Flu death in India

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Pune, August 03 2009: India recorded its first Swine flu death today in Pune.

A young girl named Riya Shiekh died at a private hospital in Pune on Monday, 3rd August.

She was on a ventilator in an ICU for a number of days, reports swin-flu.india.org.

Pune has recorded the most number of cases of Swine flu in India.

India now has over 551 confirmed cases flu out of which 422 have been cured and discharged.

However there have been a number of cases where the virus has reappeared in patients.

Statistics have revealed that children below the age of 15 are more susceptible to the virus.

Swine flu may keep some schools shut in September

Some schools in England could remain closed in September if the swine flu pandemic escalates over the summer, the government has admitted.

The Department for Children, Schools and Families (DCSF) said that, while it was expected schools and nurseries would open as usual at the start of the academic year, it could not be "certain what the situation will be" in the autumn.

Decisions on closures would be taken shortly before the start of the autumn term, a message to schools across the country from the department said.

The DCSF guidance, issued as many schools broke up for the summer today, said it was monitoring the spread of the H1N1 virus on a day-by-day basis. A message will be sent to schools in the last week of August telling them what to do at the start of term, it added.

The DCSF said: "As the summer term is drawing to an end, it is important to ensure that everyone will be in a position to know what will happen at the start of the autumn term.

"We expect that schools and early-years and childcare settings will reopen as usual but at this time we cannot be certain what the situation will be then; we will need to monitor developments over the summer, and take decisions based on the best advice available shortly before the start of term."

About 1,000 schools have already recorded cases of swine flu, although most have remained open, according to the DCSF.

The message to schools follows a warning from the government's chief medical officer, Sir Liam Donaldson, that up to 65,000 people could die from swine flu in the UK in a worst-case scenario.

A planning document published by the Department of Health yesterday suggested that if the current growth in cases was sustained, the number of cases could peak in early September, with up to 30% of the population suffering illness.

There are also suggestions the spread of the virus could begin to slow over July and August before a resurgence in the autumn when schools reopen.

Margaret Morrissey, of the lobby group Parents Outloud, said ministers should have closed schools across the country early for the summer.

"I do think the government has had a major event of mismanagement here. They should have shut down schools and public places, not for ever, but to stop the virus spreading," she said.

In swine flu hotspots, schools should remain closed until children had been vaccinated, Morrissey suggested. "We might have to, in some schools, keep them closed until the vaccine is in place," she said.

The campaigner also called for the government to hand money to employers so that their staff can stay at home with their children if they are affected by swine flu.

"We helped the banks out, how about helping parents?" she said.

"There could be a decision that schools have got to say to parents, 'If your finances can be supported, do you agree with having the school closed until the children are vaccinated?'"

But she added that if it was possible to open schools in September then that should happen.

At the start of the outbreak, affected schools were closed, but the Health Protection Agency is no longer recommending that approach because swine flu is now widespread within communities.

HPA guidance says: "People are likely to be repeatedly exposed to the virus in their everyday lives. Closing a school will no longer be effective in slowing the spread of the virus as people could still be exposed outside the school.

"In some special circumstances – for example, a school with children who are particularly vulnerable to infection – then school closures might still be recommended."

Parents expressed concern yesterday about the now rapid spread of the virus, and some admitted they were scared and unsure how to respond to the situation.

Gloria Newell, 49, a housing officer, who was picking up her nine-year-old daughter, Natasha, from St Mary's Church of England school in Islington, north London, said: "I am just astonished. The figures are quite shocking. There seems to be nothing really in place to cope with this. We have heard about a national vaccination scheme but we do not know when it might be in place."

In north London, another mother, Amal Khaireddine, 30, was concerned about her sons Joseph, five, Shamus, six, and Ryan, eight, all pupils at Hugh Myddelton school in Islington, where there had been several cases of swine flu. "They had sore throats and temperatures and I did what you should do and called the GP. They said … not to worry. But I think they should have been tested, some swabs should have been taken … all you are told is check the NHS website, but that is not 100% safe."

In nearby Culpepper Gardens, Richard O'Connell, 63, said he had taken his two-year-old grandson, Alfie, to the doctor because of a high temperature and had been told not to worry. "But you do worry because you don't know what to do … it's all very well telling people to look at the NHS website but what of those of us who do not have a computer?"

Anne Alexander, 62, a retired playschool worker from Highbury, north London, believed the publicity was causing "mass panic". Collecting her nine-year-old granddaughter, Niamh Stepto, from school, she said: "The reality is that it may only be as serious as normal seasonal flu."

Paola Domizio, a pathologist and mother of year-old twins Aron and Susha, said : "I'm undecided whether to panic or not. Certainly it is alarming that so many young children may be susceptible. But what can you do? Even if you keep them in all day there are no guarantees. If a vaccine is developed I suppose children will be vaccinated, but until then all you can do is follow the guidelines. So I can't say that I'm particularly panicking, although the figures do sound alarming."

Don't panic – even if you do catch swine flu

In the past few days, swine flu has turned from a topic of relatively light-hearted conversation into a serious anxiety. The figure of 65,000 deaths quoted by Sir Liam Donaldson, the Chief Medical Officer, has worked its way into the popular imagination. The fact that this is an upper limit tends to be overlooked, as does the even more important detail that it assumes an overall fatality rate of just 0.35 per cent of those infected. Fewer than one in 200 people who catch swine flu will die, according to these projections.

Even so, it is hard not to be worried, following a week in which 55,000 new cases emerged. Swine flu has not become more dangerous, but it is spreading faster than the medical authorities anticipated: since the beginning of July, the number of people consulting GPs with flu-like symptoms has increased from 15 to 40 per 100,000 per day. Hence the urgency of the Government's advice to pregnant women (whose immune systems are naturally suppressed) to avoid unnecessary travel on public transport and to parents to keep their babies away from crowds.
It is becoming clear that swine flu, while not yet more dangerous than ordinary flu, can inflict some nasty symptoms on Britain's society and economy. Holiday plans are being ruined as major airlines and tour operators refuse to transport passengers with suspected flu. This is fair enough – but, annoyingly, it is difficult to claim travel insurance for cancelled holidays because it involves doing just what the Government does not want people to do: visiting the GP. Meanwhile, dozens of British schoolchildren and teachers visiting Beijing were placed in quarantine at the weekend because three children were running high temperatures. And Italy's health ministry has advised its citizens to take extra precautions while visiting this country.

Britain is acquiring a reputation as the swine flu capital of Europe – and the figures explain why. After Mexico and the United States, we have the highest incidence of the disease in the world. Why? Perhaps this was only to be expected, given the unsettling degree to which Britain has become an international crossroads. But we also need to ask whether there should have been tighter screening at airports at the start of the Mexican epidemic.

There were claims yesterday that a clash between Whitehall departments delayed the launch of a swine flu hot line. So far, however, the Government's advice has been sensible and struck the right balance. A challenge lies ahead: to prevent infection and – almost equally important – to prevent unnecessary anxiety. Don't panic, even (or especially) if you are unlucky enough to catch swine flu.

Important information about swine flu

Swine flu is the common name that has been given to a new strain of influenza. It is called swine flu because it is thought to have originated in pigs, but this is not known for certain.

The most common symptoms are fever, sore throat, diarrhoea, headache, feeling generally unwell and a dry cough – in other words, symptoms very similar to seasonal influenza. Most people recover within a week, even without special treatment.

Pandemic
The virus was first identified in Mexico in April and has since become a pandemic, which means it has spread around the globe. It has spread quickly because it is a new type of influenza virus that few, if any, people have full resistance to.

Flu pandemics are a natural event that occur from time to time. Last century, there were flu pandemics in 1918, 1957 and 1968, when millions of people died across the world.

So far the new virus is known to have infected 77,000 people in over 100 countries around the world. However, this figure is almost certainly a large underestimate because it reflects only those cases which have been confirmed by laboratory tests.

In the majority of cases the virus has proved relatively mild. However, more than 300 people have died globally and its 'risk profile' is still not fully understood. For this reason, and because all viruses can mutate to become more potent, scientists are advising caution.

The situation in the UK
There have been nearly 10,000 cases confirmed in the UK since the outbreak started here on 27 April. Of these, over 100 have involved hospitalisation, and 15 people have died.

The UK formally moved from a 'containment' to a 'treatment' phase for swine flu on 2 July. This meant that intensive efforts to contain swine flu, via automatic school closures, for example, ended in order to free up capacity to treat the increasing numbers of people who are contracting swine flu daily.

As in other countries, the majority of cases reported so far in the UK have been mild. Only a small number have led to serious illness, and these have frequently been where patients have had underlying health problems.

There has been an argument put forward that government should restrict antivirals to those groups who are most at risk of developing serious complications from swine flu. In other words, if people are otherwise healthy, then the NHS should let the virus run its course, treating it with paracetamol and bed rest as you would normal flu.

However, the government's Scientific Advisory Group on Emergencies (SAGE) believes that there is still some doubt about the risk profile of the virus. For instance, there are reports of some cases in Argentina where young, healthy adults have apparently become extremely ill from swine flu.

While there is still this doubt, the government has decided to continue offering the antiviral medicines Tamiflu or Relenza to everyone with swine flu at their doctor’s discretion.

High-risk groups
Some people are more at risk of serious illness if they catch swine flu, and will need to start taking antivirals as soon as they are confirmed with the illness. On occasion, doctors may advise some high-risk patients to take antivirals before they have symptoms if someone close to them has swine flu.

The risk profile of the virus is still being studied but it is already known that the following people are particularly vulnerable:

people with:
- chronic lung disease,
- chronic heart disease,
- chronic kidney disease,
- chronic liver disease,
- chronic neurological disease,
- immunosuppression (whether caused
by disease or treatment), and
- diabetes mellitus,
patients who have had drug treatment for asthma in the past three years,
pregnant women,
people aged 65 years and older, and
children under five years old.
Swine flu vaccine
A vaccine to protect against swine flu is being developed but it is not available yet.

The first batches of vaccine are expected to arrive in late August, and 30 million double doses – enough for half the population – are expected to be available by the end of the year.

The government has ordered enough vaccine for the whole population and, when it becomes available, will focus on those at the greatest risk first.

Catch it, bin it, kill it
Although the UK has moved to a treatment phase for swine flu, it is important that people continue to do everything they can to stop the virus from spreading.

The key is to practise good respiratory and hand hygiene. In other words, remember to Catch it, Bin It, Kill It. Catch your sneeze in a tissue, place it quickly in a bin and wash your hands and surfaces regularly to kill the virus.

UK moves from swine flu 'containment' to 'treatment'

The UK has moved from the 'containment' to the 'treatment' phase of swine flu as the number of people catching swine flu continues to rise.

'Containment' to 'treatment'
As Swine Flu spreads and more people start to catch it in their communities, the government has moved from efforts to contain the virus to treating the increasing number of people who have the disease.

The move from containment to treatment will apply in all four nations of the UK- England, Scotland, Wales and Northern Ireland.

This means that:

GPs will be able to diagnose swine flu on the basis of symptoms rather than waiting for laboratory testing

all tracing of people who have been in contact with a sufferer will stop

people who may have been exposed to the virus will not be given anti-viral drugs

anyone who is diagnosed with swine flu will continue to be offered anti-virals until further notice
Local primary care trusts will also begin to establish anti-viral collection points in their local communities. These could be at a designated pharmacy or a community centre, depending on local need.

Health Secretary Andy Burnham said:"Most cases of swine flu have not been severe and we are in a strong position to deal with this pandemic.

"But we must not become complacent and, while doubt remains about the way the virus attacks different groups, today's decision on the move to the treatment phase reflects our caution."

Exit, first flu victim

The number of inmates in the isolation ward of the Infectious Diseases Hospital, where swine flu suspects and patients are quarantined, has dropped from seven to two since Sunday.

Seven-year-old Shruti Ghosh, the city’s first swine flu victim, was released from the Beleghata hospital on Monday.

Sourav Lahiri, who got himself admitted on Saturday with fever, tested negative for swine flu and was also released during the day.

“Shruti’s course of Tamiflu is over and she is not having fever anymore. Her parents have been asked to keep her quarantined at home for a few more days,” said Tapas Sen, the nodal officer for tackling swine flu in the state.

Shruti’s mother Sonali, who was staying with the girl in the 20-bed ward that has been divided by a curtain to separate male and female patients, had tested negative for swine flu.

The Oman residents had arrived in Calcutta last Tuesday after holidaying in Australia. Shruti was suffering from cough and fever when she landed at the city airport and was taken straight to the hospital.

The Delhi-based National Institute of Communicable Diseases, where nasal and throat swabs were sent for test, informed the hospital on June 25 that the girl was suffering from swine flu.

The only ones left in the Beleghata isolation ward are four-year-old Suchismita Das, who had tested positive for swine flu on Saturday, and her mother.

“Suchismita’s condition is stable. Her fever has subsided but she is still on medication,” said a source in the hospital.

Suchismita and her parents arrived in Calcutta from Bangkok, where they had gone on a holiday, early on Friday.

Prem Chand Yadav and Suchismita’s father Partha were released on Sunday after their swab tests proved negative.

Lahiri, 26, was the only patient who had voluntarily walked into the hospital and wanted to be tested for swine flu. He had been suffering from fever since returning from Bangkok a week ago.

Flu Pandemic Seminar 9th July LONDON

Aimed at CEOs, Directors, Senior Managers, Facility Managers, and business consultants.

This seminar is to help enable business and public bodies to plan for a possible flu pandemic. It covers all the essential information relating to affects of a pandemic, how to mitigate its impact and how to develop a pandemic plan.

Seminar Outline



Understand - the affect of a pandemic on the organisation
Businesses need to understand the affect of the pandemic on their business model. Restrictions on travel, restrictions on large gatherings, reduced staff attendence and disruption to supply all have significant impact on the successful operation of business and organisation.


Mitigate - the impact of the pandemic on the organisation
Businesses will need to take action to ensure that the impact of a flu pandemic is minimised. Supply chain is particularly important here, with supplies being stockpiled and alternative suppliers considered. Infrastructure amends will also need to be considered, including rerouting of telephone systems and purchasing of laptops.


Plan - for the action taken leading up to, and during the pandemic
This will be a series of actions which should be implemented as each of the WHO phases are reached. It is essential to have the plan written and, ideally, tested, as soon as possible.


The seminar will use case studies, exercises and personal experiences of developing pandemic plans within a number of different organisations to help develop the participant understanding of business continuity.

The Flu Pandemic seminar costs £400 (Excluding VAT).

The seminar runs from 10 am to 4 pm.

Book Here Now

Synthetic flu vaccine option?

A company claims it has created a synthetic version of the swine flu vaccine. CNN's Dr. Sanjay Gupta reports.
Watch the Videos now .

China quarantines U.S. school group over flu concerns

A group of students and teachers from a Maryland private school have been quarantined in China because of swine flu concerns, a school spokeswoman said Thursday.

The Chinese government has confined 21 students and three teachers to their hotel rooms in Kaili, China, because a passenger on their plane to China was suspected of having swine flu, or H1N1, said Vicky Temple, director of communications for the Barrie School in Silver Spring, Maryland.

Temple said the students and teachers are occupying two floors of a four-star hotel in the Guizhou province city in southern China.

The quarantine will end Friday, and the students are scheduled to return to the United States on Sunday, Temple said.

Mike Kennedy, the head of Barrie School, said U.S. consular officials have since told the school that the plane passenger does not have swine flu, or H1N1.

"So now our question has been for the last 24 hours, can this quarantine be lifted even sooner than sometime on Friday so these kids can get out and enjoy a little bit of China," he said.

"Since about noon on Monday, they have been in their hotel rooms," he said. "They've missed the lion's share of the itinerary."

China's state-run Xinhua news agency reported that the Guizhou province's health bureau announced this week that it had discovered two dozen Americans who had been within four rows of the suspected swine flu case on the plane.

The plane had departed Friday from San Francisco, California.

Kennedy said the students and teachers are permitted to speak to one another through the open doors of their hotel rooms, but are not allowed to leave. "They're being well taken care of, but they are in their hotel rooms," he said.

"It's very frustrating," he said, but added, "I understand and I'd like to say that the Chinese officials have been as kind and friendly to our kids and chaperones as they can be."

State Department spokesman Ian Kelly said in a Thursday afternoon briefing that he was aware of the report but said he didn't have any details on the circumstances or what the U.S. officials might be doing about it.

Home Remedies to Avoid Swine Flu

Always cover your mouth and nose when coughing or sneezing; ideally use something disposable like a tissue. Avoid touching your face, nose or mouth too frequently with your hands since swine flu appears to be transmitted through respiratory droplets in the same fashion as the common cold.

Wash your hands frequently with soap and water since swine flu like other viruses can be contracted by touching objects contaminated by the virus. It's unsure how long the swine flu virus can survive on surrounding surfaces.

Though alcohol based hand sanitizers don't routinely kill viruses they probably do offer some limited protection in preventing swine flu infections.

If swine flu infections have been medically confirmed in your area consider avoiding large public gatherings. Individuals can be contagious with the swine flu virus for several day before demonstrating any signs or symptoms of infection. Be particularly careful about indoor gatherings where air circulates poorly.

If you're really paranoid and don't mind looking odd then consider wearing a respiratory mask.. This barrier method does offer some basic protection against infection though not all masks are created equally. Higher quality masks capable of filtering out some respiratory infections are more expensive.

If you start feeling ill with cold or flu-like symptoms do not go to work. Stay home and begin the usual home remedies for colds and flu. Contact your health care provider, local health department or hospital emergency room if your symptoms worsen or fail to improve for information about where to go to be screened for possible swine flu infection.



What is Swine Flu? its signs and symptoms
In this video, Dr. Joe Bresee with the CDC Influenza Division describes swine flu - its signs and symptoms, how it's transmitted, medicines to treat it, steps people can take to protect themselves from it, and what people should do if they become ill.

What is H1N1 (swine flu)?
H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

To be more specific, Swine flu is a respiratory disease, caused by influenza type A which infects pigs. There are of many types, and the infection are constantly changing. Until now it had not normally infected humans, but the latest form clearly does, and is spread from person to person - probably through coughing and sneezing.

The World Health Organization has confirmed that at least some of the human cases are a never-before- seen version of the H1N1 strain of influenza type A. H1N1 is the same strain which causes seasonal outbreaks of flu in humans on a regular basis. But this latest version of H1N1 is different: it contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.

Flu viruses have the ability to swap genetic components with each other, and it seems likely that the new version of H1N1 resulted from a mixing of different versions of the virus, which may usually affect different species, in the same animal host.

Pigs provide an excellent 'melting pot' for these viruses to mix and match with each other.

Symptoms of swine flu in humans appear to be similar to those produced by standard, seasonal flu. These include fever, cough, sore throat, body aches, chills and fatigue. Most cases so far reported around the world appear to be mild, but in Mexico lives have been lost.

Why is this new H1N1 virus sometimes called “swine flu”?
This virus was originally 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 occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a “quadruple reassortant” virus.

Novel H1N1 Flu in Humans

Are there human infections with this H1N1 virus in the U.S.?
Yes. Cases of human infection with this H1N1 influenza virus were first confirmed in the U.S. in Southern California and near Guadalupe County, Texas. The outbreak intensified rapidly from that time and more and more states have been reporting cases of illness from this virus.

Is this new H1N1 virus contagious?
CDC has determined that this new H1N1 virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of this virus in people?
The symptoms of this new H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Also, like seasonal flu, severe illnesses and death has occurred as a result of illness associated with this virus.

How severe is illness associated with this new H1N1 virus?
It’s not known at this time how severe this virus will be in the general population. CDC is studying the medical histories of people who have been infected with this virus to determine whether some people may be at greater risk from infection, serious illness or hospitalization from the virus. In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions. It’s unknown at this time whether certain groups of people are at greater risk of serious flu-related complications from infection with this new virus. CDC also is conducting laboratory studies to see if certain people might have natural immunity to this virus, depending on their age.

How does this new H1N1 virus spread?
Spread of this H1N1 virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How long can an infected person spread this virus to others?
At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. 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, might potentially be contagious for longer periods. CDC is studying the virus and its capabilities to try to learn more and will provide more information as it becomes available.
Exposures Not Thought to Spread New H1N1 Flu

Can I get infected with this new H1N1 virus from eating or preparing pork?
No. 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.

Is there a risk from drinking water?
Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of the novel H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as novel H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.

Can the new H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water venues?
Influenza viruses infect the human upper respiratory tract. There has never been a documented case of influenza virus infection associated with water exposure. Recreational water that has been treated at CDC recommended disinfectant levels does not likely pose a risk for transmission of influenza viruses. No research has been completed on the susceptibility of the H1N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, interactive fountains, and other treated recreational venues. However, recent studies have demonstrated that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are adequate to disinfect avian influenza A (H5N1) virus. It is likely that other influenza viruses such as novel H1N1 virus would also be similarly disinfected by chlorine.

Can H1N1 influenza virus be spread at recreational water venues outside of the water?
Yes, recreational water venues are no different than any other group setting. The spread of this novel H1N1 flu is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Prevention & Treatment

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against this new H1N1 virus. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Take these everyday steps to protect your health:

* 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.

* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* Stay home if you are sick for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.

Other important actions that you can take are:

* Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
* 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 might could be useful and help avoid the need to make trips out in public while you are sick and contagious.

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. 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. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.

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. CDC recommends that 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.

What should I do if I get sick?
If you live in areas where people have been identified with new H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people, except to seek medical care.

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

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

* Fast breathing or trouble breathing
* 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

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

Are there medicines to treat infection with this new virus?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with the new H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current outbreak, the priority use for influenza antiviral drugs during is to treat severe influenza illness.

The US authorities say that two drugs commonly used to treat flu, Tamiflu and Relenza, seem to be effective at treating cases that have occurred there so far. However, the drugs must be administered at an early stage to be effective. Use of these drugs may also make it less likely that infected people will pass the virus on to others


What is CDC’s recommendation regarding "swine flu parties"?
"Swine flu parties" are gatherings during which people have close contact with a person who has novel H1N1 flu in order to become infected with the virus. The intent of these parties is to become infected with what for many people has been a mild disease, in the hope of having natural immunity to the novel H1N1 flu virus that might circulate later and cause more severe disease.

CDC does not recommend "swine flu parties" as a way to protect against novel H1N1 flu in the future. While the disease seen in the current novel H1N1 flu outbreak has been mild for many people, it has been severe and even fatal for others. There is no way to predict with certainty what the outcome will be for an individual or, equally important, for others to whom the intentionally infected person may spread the virus.

CDC recommends that people with novel H1N1 flu avoid contact with others as much as possible. They should stay home from work or school for 7 days after the onset of illness or until at least 24 hours after symptoms have resolved, whichever is longer.

Contamination & Cleaning

How long can influenza virus remain viable on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for up to 2-8 hours after being deposited on the surface.

What kills influenza virus?
Influenza virus is destroyed by heat (167-212°F [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. For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.

How should waste disposal be handled to prevent the spread of influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste.

What household cleaning should be done to prevent the spread of influenza virus?
To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

How should linens, eating utensils and dishes of persons infected with influenza virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid “hugging” laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry.

Eating utensils should be washed either in a dishwasher or by hand with water and soap.

The first case has already been reported from India from neighboring state of Andhra Pradesh.

What about bird flu?
The strain of bird flu which has caused scores of human deaths in South East Asia in recent years is a different strain to that responsible for the current outbreak of swine flu.

The latest form of swine flu is a new type of the H1N1 strain, while bird, or avian flu, is H5N1.

Experts fear H5N1 hold the potential to trigger a pandemic because of its ability to mutate rapidly.

However, up until now it has remained very much a disease of birds.

Those humans who have been infected have, without exception, worked closely with birds, and cases of human-to-human transmission are extremely rare - there is no suggestion that H5N1 has gained the ability to pass easily from person to person.