Swine Flu FAQ
WebMD Provides Answers to Your Questions
About Swine Flu
By Daniel J. DeNoon
WebMD Health News
Reviewed by Louise Chang, MD
What is swine flu?
Like people, pigs can get influenza (flu), but swine flu
viruses aren't the same as human flu viruses. Swine
flu doesn't often infect people, and the rare human
cases that have occurred in the past have mainly
affected people who had direct contact with pigs. But
the current "swine flu" outbreak is different. It's
caused by a new swine flu virus that has changed in
ways that allow it to spread from person to person --
and it's happening among people who haven't had
any contact with pigs. That makes it a human flu
virus. In an effort to avoid confusion, the CDC is
calling the virus "novel influenza A (H1N1) virus" to
distinguish it both from flu viruses that infect mainly
pigs and from the seasonal influenza A H1N1 viruses
that have been in circulation for many years.
What are swine flu symptoms?
Symptoms of swine flu are like regular flu symptoms
and include fever, cough, sore throat, runny nose,
body aches, headache, chills, and fatigue. Many
people with swine flu have had diarrhea and vomiting.
Nearly everyone with flu has at least two of these
symptoms. But these symptoms can also be caused
by many other conditions. That means that you and
your doctor can't know, just based on your symptoms,
if you've got swine flu. Health care professionals may
offer a rapid flu test, although a negative result
doesn't necessarily mean you don't have the flu.
Only lab tests can definitively show whether you've
got swine flu. State health departments can do these
tests. But given the large volume of samples coming
in to state labs, these tests are being reserved for
patients with severe flu symptoms. Currently, doctors
are reserving antiviral drugs for people with or at risk
of severe influenza.
Who is at highest risk from H1N1 swine flu?
Most U.S. cases of H1N1 swine flu have been in older
children and young adults. It's not clear why, and it's
not clear whether this will change.
But certain groups are at particularly high risk of
severe disease or bad outcomes if they get the flu:
• Pregnant women
• Young children, especially those under 12
months of age
• Elderly people are at high risk of severe flu
disease. But relatively few swine flu cases have
been seen in people over age 65.
• People with heart disease or risk factors for
heart disease
• People with HIV infection
• People with chronic diseases
• People taking immune-suppressing drugs, such
as cancer chemotherapy or anti-rejection drugs
for transplants
People in these groups should seek medical care as
soon as they get flu symptoms.
If I think I have swine flu, what should I do? When
should I see my doctor?
If you have flu symptoms, stay home, and when you
cough or sneeze, cover your mouth and nose with a
tissue. Afterward, throw the tissue in the trash and
wash your hands. That will help prevent your flu from
spreading.
If you have only mild flu symptoms, you do not need
medical attention unless your illness gets worse. But if
you are in one of the groups at high risk of severe
disease, contact your doctor at the first sign of flu-like
illness. In such cases, the CDC recommends that
people call or email their doctor before rushing to an
emergency room.
But there are emergency warning signs.
Children should be given urgent medical attention if
they:
• Have fast breathing or trouble breathing
• Have bluish or gray skin color
• Are not drinking enough fluid
• Are not waking up or not interacting
• Have severe or persistent vomiting
• Are so irritable that the child does not want to be
held
• Have flu-like symptoms that improve but then
return with fever and a worse cough
• Have fever with a rash
Adults should seek urgent medical attention if they
have:
• Difficulty breathing or shortness of breath
 • Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms that improve, but then come
back with worsening fever or cough
Keep in mind that your doctor will not be able to
determine whether you have swine flu, but he or she
may take a sample from you and send it to a state
health department lab for testing to see if it's swine
flu. If your doctor suspects swine flu, he or she would
be able to write you a prescription for Tamiflu or
Relenza. These antiviral medications aren't a question
of life or death for the vast majority of people. Most
U.S. swine flu patients have made a full recovery
without antiviral drugs.
How does swine flu spread? Is it airborne?
The new swine flu virus apparently spreads just like
regular flu. You could pick up germs directly from
droplets from the cough or sneeze of an infected
person, or by touching an object they recently
touched, and then touching your eyes, mouth, or
nose, delivering their germs for your own infection.
That's why you should make washing your hands a
habit, even when you're not ill. Infected people can
start spreading flu germs up to a day before
symptoms start, and for up to seven days after getting
sick, according to the CDC.
The swine flu virus can become airborne if you cough
or sneeze without covering your nose and mouth,
sending germs into the air.
The U.S. residents infected with swine flu virus had
no direct contact with pigs. The only way to get the
new swine flu is from another person.
How is swine flu treated?
The new swine flu virus is sensitive to the antiviral
drugs Tamiflu and Relenza. The CDC recommends
those drugs to prevent or treat swine flu; the drugs
are most effective when taken within 48 hours of the
start of flu symptoms. But not everyone needs those
drugs. Most people who have come down with swine
flu have recovered without treatment. The Department
of Homeland Security has released 25% of its
stockpile of Tamiflu and Relenza to states. Health
officials have asked people not to hoard Tamiflu or
Relenza.
Is there a vaccine against the new swine flu virus?
No. But the CDC and the World Health Organization
are already taking the first steps toward making such
a vaccine. That's a lengthy process that takes
months. The process includes limited clinical tests to
see how well the vaccine elicits flu-neutralizing
antibodies and to evaluate vaccine safety. If
everything goes perfectly -- and flu vaccine production
is very tricky -- there could be a U.S. swine flu vaccine
in October 2009. But that is an extremely optimistic
prediction.
Even if officials decide to make a swine flu vaccine for
this winter, many questions remain. It's not yet clear
whether people will need one or two shots or whether
an immune-boosting substance called adjuvant will
have to be used. And, it's still not clear who should be
vaccinated first, and who should be at the end of the
line.
I had a flu vaccine this season. Am I protected
against swine flu?
No. This season's flu vaccine does not protect against
the new swine flu virus.
Whether or not there's a swine flu vaccine this winter,
there will be a new seasonal flu vaccine in the fall.
This year, it will be more important than ever to get a
flu shot. It may not protect against swine flu -- but it
will keep you and others from getting the seasonal flu
viruses that kill some 36,000 Americans each year.
How can I prevent swine flu infection?
The CDC recommends taking these steps:
• Wash your hands regularly with soap and water,
especially after coughing or sneezing. Or, use an
alcohol-based hand cleaner if soap and water are
not available.
• Avoid close contact -- that is, being within six feet
-- with people who have flu-like symptoms.
• Avoid touching your mouth, nose, or eyes. That's
not easy to do, so keep those hands clean.
• If you have flu-like symptoms -- fever plus at least
cough or sore throat or other flu symptoms -- stay
home for seven days after symptoms egin or until
you've been symptom-free for 24 hours --
whichever is longer.
• The CDC does not recommend using a face
mask or respirator in community or home
settings. However, the CDC says that people at
increased risk of severe flu illness may consider
wearing a N-95 respirator or face mask in
crowded settings in communities where swine flu
 is circulating or when taking care of a person with
flu-like illness. It's not known whether face masks
actually protect against flu transmission.
• People who have or are suspected of having
swine flu should wear a face mask, if available
and tolerable, when sharing common spaces with
other household members, when outside the
home, or when breastfeeding.
Should I wear a face mask or respirator?
Every day, newspapers carry pictures of people
wearing face masks to prevent swine flu transmission.
But very little is known about whether face masks
actually protect against the flu.
There's a difference between a face mask and a
respirator. A face mask does not seal tightly to the
face. Face masks include masks labeled as surgical,
dental, medical procedure, isolation, or laser masks.
Respirators are N95 or higher filtering face pieces that
fit snugly on the face. Respirators, when correctly
adjusted, filter out virus particles -- but it's hard to
breathe through them for extended periods, and they
cannot be worn by children or people with facial hair.
People who have flu-like symptoms should carry
disposable tissues to cover their coughs and sneezes.
When going out in public, or when sharing common
spaces around the home with family members, they
should put on a face mask -- if one is available and
tolerable.
People not at risk of severe flu illness can best protect
themselves from swine flu with frequent handwashing
and by staying at least six feet away from people with
flu symptoms. But if swine flu is circulating in the
community, a face mask or respirator may be
protective in crowded public places.
People at increased risk of severe flu illness --
pregnant women, for example -- may wish to consider
using a facemask under certain circumstances, such
as when providing assistance to a person with flu-like
illness. But the CDC prefers such people follow more
tried-and-true methods of staying healthy, such as
handwashing and avoiding ill people.
How long does the flu virus survive on surfaces?
Flu bugs can survive for hours on surfaces. One study
showed that flu viruses can live for up to 48 hours on
hard, nonporous surfaces such as stainless steel and
for up to 12 hours on cloth and tissues. The virus
seems to survive for only minutes on your hands --
but that's plenty of time for you to transfer it to your
mouth, nose, or eyes.
Can I still eat pork?
Yes. You can't get swine flu by eating pork, bacon, or
other foods that come from pigs.
What else should I be doing?
Keep informed of what's going on in your community.
Your state and local health departments may have
important information if swine flu develops in your
area. For instance, parents might want to consider
what they would do if their child's school temporarily
closed because of flu. Don't panic, but a little planning
wouldn't hurt.
Here's the advice from the U.S. government's
pandemicflu.gov web site:
To plan for a pandemic:
• Store a two-week supply of water and food.
During a pandemic, if you cannot get to a store,
or if stores are out of supplies, it will be
important for you to have extra supplies on
hand. This can be useful in other types of
emergencies, such as power outages and
disasters.
• Periodically check your regular prescription
drugs to ensure a continuous supply in your
home.
• Have any nonprescription drugs and other
health supplies on hand, including pain
relievers, stomach remedies, cough and cold
medicines, fluids with electrolytes, and vitamins.
• Talk with family members and loved ones about
how they would be cared for if they got sick, or
what will be needed to care for them in your
home.
• Volunteer with local groups to prepare and
assist with emergency response.
• Get involved in your community as it works to
prepare for an influenza pandemic.
Items to have on hand for an extended stay at home:
Examples of food Examples of medical,
and non- health, and emergency
perishables supplies
• Ready-to-eat • Prescribed medical
canned meats, fish, supplies such as glucose
fruits, vegetables, and blood-pressure
beans, and soups monitoring equipment
• Protein or fruit • Soap and water, or more information on preparedness planning, see the
bars alcohol-based (60-95%) U.S. government's pandemicflu.gov web site.
hand wash
Why has the swine flu infection been more severe
• Dry cereal or • Medicines for fever, in Mexico than in other countries?
granola such as acetaminophen or
ibuprofen That's not clear yet. Researchers around the world
are investigating the differences between the cases in
• Peanut butter • Thermometer Mexico and those elsewhere. The data so far
or nuts suggests that many more people in Mexico had mild
• Dried fruit • Anti-diarrheal swine flu infections than had originally been
medication appreciated.

• Crackers • Vitamins Have there been previous swine flu oubtreaks?

Yes. There was a swine flu outbreak at Fort Dix, N.J.,
• Canned juices • Fluids with in 1976 among military recruits. It lasted about a
electrolytes
month and then went away as mysteriously as it
• Bottled water • Cleansing appeared. As many as 240 people were infected; one
agent/soap died.

• Canned or • Flashlight The swine flu that spread at Fort Dix was the H1N1
jarred baby food and strain. That's the same flu strain that caused the
formula disastrous flu pandemic of 1918-1919, resulting in
• Pet food • Batteries tens of millions of deaths worldwide.

Concern that a new H1N1 pandemic might return in

• Other non- • Portable radio
perishable items
• Manual can opener
• Garbage bags
• Tissues, toilet
paper, disposable diapers
winter 1976 led to a crash program to create a
vaccine and vaccinate all Americans against swine
flu. That vaccine program ran into all kinds of
problems -- not the least of which was public
perception that the vaccine caused excessive rates of
dangerous reactions. That may not have been the
case. But after more than 40 million people were
vaccinated, the effort was abandoned.

As it turned out, there was no swine flu epidemic.

Even though it's an H1N1 type A flu bug, the new

How severe is swine flu?
The severity of cases in the current swine flu outbreak
has varied widely, from mild cases to fatalities. Most
U.S. cases have been mild, but there have been a
number of deaths and hundreds of hospitalizations --
mostly in young people aged 5 to 24 years.
How severe is swine flu? continued...
It's impossible to know whether the virus will go away
or whether it will become more deadly. Scientists are
watching closely to see which way the new swine flu
virus is heading -- but health experts warn that flu
viruses are notoriously hard to predict.
But there's a lot of planning you can do. CDC officials
predict that just about every U.S. community will have
H1N1 swine flu cases. It's possible some schools in
your community may temporarily close. So make
contingency plans just in case you are affected. For
swine flu is a different virus than the ones that
emerged in 1918 and in 1976 -- and from the
seasonal type A H1N1 virus that has been circulating
for many years.
There have been two flu pandemics since 1918 -- one
that began in 1957, and another that began in 1968.
I was vaccinated against the 1976 swine flu virus.
Am I still protected?
Probably not. The new swine flu virus is different from
the 1976 virus. And it's not clear whether a vaccine
given more than 30 years ago would still be effective.
How many people have swine flu?
That's a hard question to answer because the figure is
changing so quickly. If you want to keep track of U.S.
cases that have been confirmed by lab tests and
reported to the CDC, check the CDC's web site. If
you're looking for cases in other countries, visit the
World Health Organization's web site. And, when you
hear about large numbers of people who are ill,
remember that lab tests may not yet have been done
to confirm that they have swine flu. And, there may be
a little lag time before confirmed cases make it into
the official tally.

But these numbers are misleading, because mild flu

cases are rarely counted. Flu experts estimate that for
every confirmed case of flu, there are 20 additional flu
infections.

How serious is the public health threat of a swine

flu epidemic?
The U.S. government has declared swine flu to be a
public health emergency.

It remains to be seen how severe swine flu will be in

the U.S. and elsewhere, but countries worldwide are
monitoring the situation closely and preparing for the
possibility of a pandemic.

The World Health Organization has declared swine flu

to be a pandemic. That means that all nations can
expect to see swine flu infections -- and should
prepare for them -- but does not mean the virus has
become more severe.

The H1N1 swine flu outbreak comes at the end of the

U.S. flu season. The virus has spread across the
nation. Nobody knows whether it will stick around all
summer or whether it will get worse when flu season
begins again this fall. But the CDC is warning
Americans to prepare for a bad flu season this fall. It's
better to over prepare and look a little silly if nothing
happens than to be unprepared for an emergency.

Scientists are closely watching the Southern

Hemisphere to see whether the H1N1 swine flu
begins to circulate there. If it does, it will be important
to see whether the virus changes over time, and
whether it spreads more efficiently in the winter
months.

WebMD senior writer Miranda Hitti contributed to this

report.