Swine Flu FAQS

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.

How many H1N1 (swine) flu viruses are there?
Like all influenza viruses, swine flu viruses change constantly. Pigs can be infected by avian influenza and human influenza viruses as well as swine influenza viruses. When influenza viruses from different species infect pigs, the viruses can reassort (i.e. swap genes) and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge. Over the years, different variations of swine flu viruses have emerged. At this time, there are four main influenza type A virus subtypes that have been isolated in pigs: H1N1, H1N2, H3N2, and H3N1. However, most of the recently isolated influenza viruses from pigs have been H1N1 viruses.

How serious is H1N1 (swine) flu infection?
Like seasonal flu, H1N1 (swine) flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.

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.

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



What are the signs and symptoms of H1N1 (swine) flu in people?
The symptoms of H1N1 (swine) flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with H1N1 (swine) flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with H1N1 (swine) flu infection in people. Like seasonal flu, H1N1 (swine) flu may cause a worsening of underlying chronic medical conditions.

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


What is the difference between a vaccine and an antiviral?

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Vaccines are usually given to prevent infections. Influenza vaccines are made from either pieces of the killed influenza virus or weakened versions of the live virus that will not lead to disease. When vaccinated, the body’s immune system makes antibodies which will fight off infection if exposure to the virus occurs.

Antivirals are drugs that can treat people who have already been infected by a virus. They also can be used to prevent infection when given before or shortly after exposure and before illness occurs. A key difference between a vaccine and antiviral drug is that the antiviral drug will prevent infection only when administered within a certain time frame before or after exposure and is effective during the time that the drug is being taken while a vaccine can be given long before exposure to the virus and can provide protection over a long period of time.

How do you catch H1N1 (swine) flu?
Spread of H1N1 (swine) flu can occur in two ways:

•Through contact with infected pigs or environments contaminated with swine flu viruses.
•Through contact with a person with H1N1 (swine) flu. Human-to-human spread of H1N1 (swine) flu has been documented also and is thought to occur in the same way as seasonal flu. Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

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.


Are there medicines to treat H1N1 (swine) flu?
Yes. CDC recommends the use of oseltamivir (brand name Tamiflu ®) or zanamivir (brand name Relenza ®) for the treatment and/or prevention of infection with these H1N1 (swine) influenza viruses. 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. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms


How long can an infected person spread H1N1 (swine) flu to others?
People with H1N1 (swine) influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.


What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against H1N1 (swine) flu. 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.
•If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.


Can people catch H1N1 (swine) flu from eating pork?
No. H1N1 (swine) influenza viruses are not transmitted by food. You can not get H1N1 (swine) influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 160°F kills the H1N1 (swine) flu virus as it does other bacteria and viruses

•Do pigs carry this virus and can I catch this virus from a pig?
•At this time, there is no evidence that swine in the United States are infected with this new virus. However, there are flu viruses that commonly cause outbreaks of illness in pigs. Most of the time, these viruses do not infect people, but influenza viruses can spread back and forth between pigs and people.
•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 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.
•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.
Flu Virus and Food
•Can people get 2009 H1N1 flu virus by eating food products?
Influenza viruses are not known to be spread by eating food items. Influenza viruses are spread through inhalation or through touching contaminated surfaces and then touching the mouth, nose, or eyes.
•Could a sick restaurant worker transmit 2009 H1N1 flu virus to consumers in a restaurant or other food-service venue?
Transmission of the virus in a restaurant could occur through the normal routes of infection that could happen in any public or private setting—inhalation of the virus expelled by infected individuals when coughing or sneezing, and, by touching any surface that is contaminated with the virus and then touching the mouth, nose or eyes.
Influenza is not known to be spread through consumption of a food item. However, in accordance with long-standing FDA recommendations, food workers experiencing symptoms of respiratory illness should not work with exposed food, clean equipment, utensils, linens or unwrapped single-service or single-use articles.
In addition, the U.S. Centers for Disease Control and Prevention recommends that individuals experiencing symptoms of 2009 H1N1 flu virus stay home from work (see CDC Web site http://www.cdc.gov/swineflu/swineflu_you.htm).
•Should individuals or restaurants alter cooking methods to decrease the risk of 2009 H1N1 flu virus?
It is not necessary to alter cooking times or temperatures for any food products in order to reduce chances of contracting 2009 H1N1 flu virus, because eating food is not a known method of transmission of influenza viruses.
•What are the FDA’s requirements and recommendations for the food industry regarding workers who are sick?
Current Good Manufacturing Practice Requirements:
Long-standing federal regulations require that any person who is shown to have, or appears to have, an illness by which there is a reasonable possibility of food, food-contact surfaces, or food-packaging materials becoming contaminated must be excluded from any operations that may be expected to result in such contamination until the health condition is corrected. Plant management must take all reasonable measures and precautions to ensure this.
The regulations also require that food facility managers instruct personnel to report illnesses to their supervisors.
These regulations are contained in the Current Good Manufacturing Practice in Manufacturing, Packing, or Holding Human Food, in Part 110.10 of Title 21 of the U.S. Code of Federal Regulations: http://www.access.gpo.gov/nara/cfr/waisidx_08/21cfr110_08.html.
For Food Retailers, Restaurants and Food Service Operations:
The FDA Food Code provides model regulations for reducing risk factors known to cause foodborne illness at retail food facilities, restaurants and other food-service operations.
Most state and local authorities have adopted Food Code provisions as regulatory requirements. In addition to several other restrictions applicable to food employees experiencing certain symptoms of illness, the Food Code stipulates that employees experiencing persistent sneezing, coughing or a runny nose that causes discharges from the eyes, nose or mouth may not work with exposed food, clean equipment, utensils, linens, or unwrapped single-service or single-use articles.
Flu Virus and Animals
•Do any swine in the United States have the H1N1 flu virus that has infected humans?
There is no evidence at this time that swine in the United States are infected with this virus strain.
•Can the H1N1 virus be transferred from humans to swine or vice versa?
USDA's National Animal Disease Center in Ames, Iowa, is conducting tests to determine the transmissibility and severity of the H1N1 flu virus in pigs. The Canadian Food Inspection Agency (CFIA) through its surveillance, announced recently that it found the H1N1 flu virus in a swine herd in Alberta. The CFIA believes it is highly probable that the pigs were exposed to the virus from a Canadian who had recently returned from Mexico and had been exhibiting flu-like symptoms. Signs of illness were subsequently observed in the pigs. The individual has recovered and all of the pigs are recovering or have recovered. The pigs are in quarantine. USDA continues to monitor the U.S. swine herd and to date, this particular strain of H1N1 has not been found in U.S. swine.
•Can I get this new strain of virus from eating pork or pork products?
No. According to USDA scientists, H1N1 flu is not a foodborne disease, it is a respiratory disease. USDA continues to educate the public through its food safety efforts and reminds consumers that all meat and poultry products are safe to eat when properly prepared and cooked as this kills all foodborne pathogens. More information about safe food handling is at www.befoodsafe.gov.
•What steps can I take to make sure that I prepare my food properly?
USDA reminds consumers to practice safe food handling and preparation techniques for all meat and poultry. Eating properly handled and cooked meat and poultry products are safe. Information about safe food preparation and cooking is available at www.befoodsafe.gov.
•What is this flu that people are talking about in the news?
It is a new strain of flu that consists of a mixture of genetic material from swine, avian and human influenza viruses.
•Is USDA testing and monitoring to make sure swine are not infected with the virus and if so, how?
A network of Federal veterinarians, state animal health officials and private practitioners are regularly involved with monitoring U.S. swine for signs of significant disease.
To date, there have been no reports that the influenza virus currently causing illness in humans is circulating anywhere in the U.S. swine herd.
As a proactive measure, USDA is reaching out to all state animal health officials to affirm they have no signs of this virus type in their state.
USDA has put U.S. pork producers on a high alert for safety.
As part of a comprehensive safeguarding system, USDA's laboratories routinely provide diagnostic and research services in support of ongoing operational programs.
•How will the public be notified if the government finds H1N1 flu in a U.S. herd?
Delivering factual, timely information is a priority for USDA. Should there be a detection of influenza in the U.S. swine herd, those results would be shared with the public in a timely fashion. As with all potential animal health disease situations, USDA's National Veterinary Services Laboratories stand ready to provide support of disease control and eradication programs, reagents for diagnostic testing, training and laboratory certification.
•Can you get H1N1 flu from being around or touching swine?
The CDC says that the spread of H1N1 flu can occur in two ways:
Through contact with infected pigs or environments contaminated with H1N1 flu virus.
Through contact with a person with H1N1 flu. Human-to-human spread of the H1N1 flu is thought to occur in the same way as seasonal flu. Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
•How do we ensure that we take the appropriate measures to protect our swine?
We encourage commercial pork producers to intensify the bio-security practices they've long had in place. They should not loan equipment or vehicles to or borrow them from other farms. Swine from outside sources, such as transitional herds should not be brought back to the farm. Transitional herd is the term we use to define those herds that have some likelihood of contact with feral swine. They should permit only essential workers and vehicles to enter the farm. Swine workers should disinfect their shoes, clothes and hands. They should thoroughly clean and disinfect equipment and vehicles entering and leaving the farm and avoid visiting other livestock farms without proper cleaning and disinfection. Also, they should report sick animals immediately. The industry understands the importance of preventing spread of the virus as quickly as possible to protect the industry.
•Is there a vaccine for humans for this new strain?
The CDC should answer any questions about a vaccine. According to the CDC, there is no vaccine to protect humans from this new variant H1N1 flu. Go to www.cdc.gov for more information.
•Is my potbelly pig in danger? Can I get it from my pet?
There is no evidence at this time that the virus is in U.S. swine. Swine owners should learn the warning signs of swine influenza. Signs of swine flu in pigs can include sudden onset of fever, depression, coughing (barking), discharge from the nose or eyes, sneezing, breathing difficulties, eye redness or inflammation, and going off feed. If your pig is showing any of these signs, call your veterinarian. Buy your animals from reputable sources and ensure that you have documentation of your new pet's origin. Be sure that you get your new animals checked by a veterinarian. Keep your pigs and areas around them clean. If you have been around other animals, make sure that you clean your shoes, clothing, and other items. And don't forget to wash your hands with warm water and soap for 20 seconds before and after handling your pet.
Preventing the Flu
•What should I do to keep from getting the flu?
•What is the best way to keep from spreading the virus through coughing or sneezing?
•What is the best technique for washing my hands to avoid getting the flu?
•What kills influenza virus? What household cleaners kill the 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.
•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.
•Should I begin taking antiviral medications such as Tamiflu® if I'm planning a visit to another country known to have any type of flu?
No, the Centers for Disease Control and Prevention (CDC) specifically states that at this time persons traveling to countries where there are cases of avian or H1N1 (swine) influenza in birds, poultry, swine, or humans do not need to take Tamiflu ® to prevent illness. If you become ill in any way while in the country, you should seek medical advice immediately. If you plan to travel to any country that has reported cases of flu among birds, swine, or humans, you should consider scheduling an appointment with your health care provider before traveling to discuss risks for potential exposure to diseases. Only you and your health care provider can determine that risk and what the most appropriate precautions are for you.
Coping with the Flu
•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.
•What are the warning signs of serious illness? When should I seek emergency medical care?
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
Flu and the Workplace
•In light of the ADA’s requirements, how may employers ask employees about factors, including chronic medical conditions, that may cause them to miss work in the event of a pandemic?
An employer may survey its workforce to gather personal information needed for pandemic preparation if the employer asks broad questions that are not limited to disability-related inquiries. An inquiry would not be disability-related if it identified non-medical reasons for absence during a pandemic (e.g., mandatory school closures or curtailed public transportation) on an equal footing with medical reasons (e.g., chronic illnesses that weaken immunity). Below is a sample ADA-compliant survey that could be given to all employees before a pandemic.

ADA-Compliant Pre-Pandemic Employee Survey

Directions: Answer “yes” to the whole question without specifying the reason or reasons that apply to you. Simply check “yes” or “no” at the bottom.

In the event of a pandemic, would you be unable to come to work because of any of the following reasons:

If schools or day-care centers were closed, you would need to care for a child;If other services were unavailable, you would need to care for other dependents;

If public transport were sporadic or unavailable, you would be unable to travel to work, and/or;

If you or a member of your household fall into one of the categories identified by CDC as being at high risk for serious complications from the pandemic influenza virus, you would be advised by public health authorities not to come to work (e.g., pregnant women; persons with compromised immune systems due to cancer, HIV, history of organ transplant or other medical conditions; persons less than 65 years of age with underlying chronic conditions; or persons over 65).

Answer: YES __________ NO __________

•May an employer require entering employees to have a medical test post-offer to determine their exposure to the influenza virus?
Yes, in limited circumstances. The ADA permits an employer to require entering employees to undergo a medical examination after making a conditional offer of employment but before the individual starts work, if all entering employees in the same job category must undergo such an examination.
Example A: An employer in the international shipping industry implements its pandemic influenza preparedness plan when the WHO and the CDC confirm that a new influenza virus, to which people are not immune, is infecting large numbers of people in multiple countries. Because the employer gives these medical tests post-offer to all entering employees in the same job categories, the examinations are ADA-compliant.
•During a pandemic, may an employer require its employees to adopt infection control practices?
Yes. Requiring infection control practices, such as regular hand washing, coughing and sneezing etiquette, and tissue usage and disposal, does not implicate the ADA.
•May an employer require its employees to wear personal protective equipment (e.g., face masks, gloves, or gowns) designed to reduce the transmission of a pandemic virus?
Yes. An employer may require employees to wear personal protective equipment. However, where an employee with a disability needs a related reasonable accommodation under the ADA (e.g., non-latex gloves, or gowns designed for individuals who use wheelchairs), the employer should provide these absent undue hardship.
•May an employer encourage or require employees to telework (i.e., work from an alternative location such as home) as an infection control strategy?
Yes. An employer may encourage or require employees to telework as an infection-control strategy, based on timely information from public health authorities about pandemic conditions. Telework also may be a reasonable accommodation. Of course, employers must not single out employees either to telework or to continue reporting to the workplace on a basis prohibited by any of the EEO laws.