FAQ

What is Swine Flu? Is it contagious?

Swine influenza is a disease that pigs get. The virus currently spreading among people is now generally referred to as swine flu, although the origin of the disease is still under investigation.

The WHO (World Heath Orginazation) says the new swine flu virus is highly contagious and is spreading from person to person.

Swine flu spreads in the same way as ordinary colds and flu. The virus is spread through the droplets that come out of the nose or mouth when someone coughs or sneezes.

If someone coughs or sneezes and does not cover it, those droplets can spread about one metre (3ft). If you are very close to them you might breathe these in.

If someone coughs or sneezes into their hand, those droplets and the virus within them are easily transferred to surfaces that the person touches, such as door handles, hand rails, phones and keyboards. If you touch these surfaces and touch your face, the virus can enter your system and you can become infected.

When are people most infectious?

People are most infectious soon after they develop symptoms. They can continue to shed (spread) the virus (for example, in coughs and sneezes) for up to five days (seven days in children). People become less infectious as their symptoms subside, and once their symptoms are gone they are no longer considered infectious to others.

How dangerous is it?

It is difficult to judge this at the moment. There have been deaths, but for most infected people the symptoms have not been severe.

It appears that early doses of antiviral medicines such as Tamiflu are effective in helping people to recover. In the UK we have enough antivirals to treat half the population if they were to become ill. Also, orders of Tamiflu have been placed to increase UK supplies to 50 million doses, enough to treat 80% of the population.

Will I die from swine flu?

For most people, the illness has been mild and self-limiting. The virus has caused severe illness in a minority of people, most of whom had an existing serious condition. NHS staff are well trained in treating people who are in hospital with swine flu. They can provide effective treatment for any secondary bacterial infections, such as pneumonia.

What are the complications of swine flu?

One of the most common complications of any type of flu is a secondary bacterial chest infection, such as bronchitis (infection of the airways).

This can become serious and develop into pneumonia. A course of antibiotics will usually cure this, but the infection sometimes becomes life-threatening.

Other rare complications include:

• tonsillitis,
• otitis media (a build-up of fluid in the ear),
• septic shock (infection of the blood that causes a severe drop in blood pressure),
• meningitis (infection in the brain and spinal cord), and
• encephalitis (inflammation of the brain).

What are the symptoms of swine flu?

The symptoms of swine flu are expected to be similar to the symptoms of regular seasonal flu. People with swine flu typically have a fever or high temperature (over 38°C/100.4°F) and two or more of the following symptoms:

• unusual tiredness,
• headache
• runny nose,
• sore throat,
• shortness of breath or cough,
• loss of appetite,
• aching muscles,
• diarrhea or vomiting.

For more information, see symptoms.

How long are symptoms expected to last?

As with any sort of flu, how bad the symptoms are and how long they last will vary depending on treatment and individual circumstances. Most cases reported in the UK to date have been relatively mild, with affected people starting to recover within a week.

Has the swine flu virus developed resistance to Tamiflu?

The first case of resistance of the swine flu virus to the antiviral drug oseltamivir (Tamiflu) has now been reported in England.

The resistant virus was identified in a patient with a weakened immune system. Although the virus was resistant to Tamiflu, it was susceptible to the antiviral zanamivir (Relenza) and, following treatment, the patient recovered from their illness.

Is it possible to catch swine flu twice?

Yes, because the virus can mutate (change). If you become infected with the swine flu virus, your body produces antibodies against it, which will recognise and fight off the virus if the body ever meets it again. However, if the virus mutates, your immune system may not recognise this different strain and you may become ill again, although you may have some protection from having had a similar virus previously.

Can my pet catch swine flu?

There is currently no evidence that pets could get this new strain of flu. The swine flu virus appears to be passing only from person to person or from human to swine. In general, flu viruses commonly infect just one species; for example, dogs and cats do not get seasonal flu from their owners.

Are alcohol hand rubs better than soap and water?

Both alcohol hand rubs and washing with soap and water are important to minimize the risk of spreading swine flu, as they both deactivate the flu virus. Alcohol hand rub can only be used on visibly clean hands. If hands are dirty, soap and water should be used. Hand rubs are useful when there is no easy access to a place to wash and dry your hands.

Who should be wearing a facemask?

The Health Protection Agency (HPA) recommends that healthcare workers wear a facemask if they come into close contact with a person with symptoms (within one metre), to reduce their risk of catching the virus from patients.

However, the HPA does not recommend that healthy people wear facemasks in their everyday life.

Why shouldn’t the general public wear facemasks?

There is no evidence to suggest that this is a useful preventative measure.

The virus is spread by people touching infected surfaces, or by someone coughing or sneezing at very close range. So unless you are standing very close to someone with the virus, wearing a facemask will not make a difference.

There are concerns about the risks of not using facemasks correctly. They must be changed regularly as they don’t work as well when dampened by a person’s breath. People may infect themselves if they touch the outside of their mask, or may infect others by not throwing away old masks safely.

Finally, wearing a facemask may encourage complacency. It is more important to keep your hands clean, stay at home if you feel unwell and cover your mouth when they cough or sneeze

So why do people in other countries wear facemasks?

This is an issue which each government has considered separately. France is encouraging the public to buy their own masks for use as a precaution, but it is not stocking masks centrally from government funds. Neither is the US or Cananda.

In other countries, people already wear facemasks either to avoid spreading illness or to protect themselves from pollution.

Why is swine flu affecting humans?

Because the swine flu virus has mutated (changed) and is now able to infect humans and transmit between them.

Which people are most vulnerable from swine flu?Those who are more at risk from becoming seriously ill with swine flu are people with:

·         chronic (long-term) lung disease, including people who have had drug treatment for their asthma within the past three years,

·         chronic heart disease,

·         chronic kidney disease,

·         chronic liver disease,

·         chronic neurological disease (neurological disorders include motor neurone disease, Parkinson’s disease and multiple sclerosis),

·         suppressed immune systems (whether caused by disease or treatment),

·         diabetes,

·         pregnant women,

·         people aged 65 or older, and

·         young children under five.

Should I avoid contact with people suspected of having swine flu?

People with suspected swine flu will have been asked to stay at home and restrict their contact with people. Most people should continue their normal life, including going to school or work. This includes children who attend a school with a confirmed case of swine flu.

There is no need to avoid contact with people who might simply have come into contact with those with the illness, such as the parents of children at schools with a confirmed case but who are not themselves ill.

How dangerous is it?

It is difficult to judge this at the moment. There have been deaths, but for most infected people the symptoms have not been severe.

It appears that early doses of antiviral medicines such as Tamiflu are effective in helping people to recover.

Will I die from swine flu?

For most people, the illness has been mild and self-limiting. The virus has caused severe illness in a minority of people, most of whom had an existing serious condition.

What are the complications of swine flu?

One of the most common complications of any type of flu is a secondary bacterial chest infection, such as bronchitis (infection of the airways).

This can become serious and develop into pneumonia. A course of antibiotics will usually cure this, but the infection sometimes becomes life-threatening.

Other rare complications include:

·         tonsillitis,

·         otitis media (a build-up of fluid in the ear),

·         septic shock (infection of the blood that causes a severe drop in blood pressure),

·         meningitis (infection in the brain and spinal cord), and

·         encephalitis (inflammation of the brain).

What are the symptoms of swine flu?

The symptoms of swine flu are expected to be similar to the symptoms of regular seasonal flu. People with swine flu typically have a fever or high temperature (over 38°C/100.4°F) and two or more of the following symptoms:

·         unusual tiredness,

·         headache

·         runny nose,

·         sore throat,

·         shortness of breath or cough,

·         loss of appetite,

·         aching muscles,

·         diarrhoea or vomiting.

For more information, see Symptoms.  

How does swine flu cause death?

Like any other type of flu, people can die from swine flu if they develop complications, such as pneumonia.

Has the swine flu virus developed resistance to Tamiflu?

The first case of resistance of the swine flu virus to the antiviral drug oseltamivir (Tamiflu) has now been reported in England.

The resistant virus was identified in a patient with a weakened immune system. Although the virus was resistant to Tamiflu, it was susceptible to the antiviral zanamivir (Relenza) and, following treatment, the patient recovered from their illness.

Should we expect a more severe second wave of the pandemic in the winter?

The history of previous flu pandemics suggests that the current viral strain will spread more widely in the autumn or winter, causing more illness and death. It is possible that the virus will mutate (change) into a stronger strain.

Should I go to work or school if I have been in contact with someone who I know has swine flu?

Yes, as long as you do not have flu-like symptoms. If you are feeling well, you should continue your normal activities, including going to school or work.

It can take up to seven days (normally two to five days) after infection for swine flu symptoms to develop. If you develop symptoms, stay at home and follow the general advice

Is it possible to catch swine flu twice?

Yes, because the virus can mutate (change). If you become infected with the swine flu virus, your body produces antibodies against it, which will recognise and fight off the virus if the body ever meets it again. However, if the virus mutates, your immune system may not recognise this different strain and you may become ill again, although you may have some protection from having had a similar virus previously.

Should I have a swine flu party or try to catch swine flu now, so I will be immune to more serious strains that may emerge later?

No. Don’t try to catch the virus as you may help it spread. Also, as everything about the virus is not yet known, it is too soon to assume it is only a mild infection. Catching swine flu will not necessarily protect you from strains that may emerge later

Can my pet catch swine flu?

There is currently no evidence that pets could get this new strain of flu. The swine flu virus appears to be passing only from person to person or from human to swine. In general, flu viruses commonly infect just one species; for example, dogs and cats do not get seasonal flu from their owners.

How much contact should I have with family and friends?

If you have swine flu, avoid unnecessary contact with family and friends while you are infectious, which is usually until five days after your symptoms started (seven days in children). Once your symptoms have gone, you are no longer infectious.

Keep one metre or more away from people’s faces to avoid droplets from your throat affecting others. Where possible, you can avoid exposing your partner to infection by sleeping in the spare room.

What if I need someone to care for me? Will they catch my swine flu?

If you are unable to look after yourself at home, ask a friend or relative to collect medicines and groceries for you, order any repeat prescriptions, help with basic household tasks, such as cooking, and generally care for you.

If your friend or relative keeps their distance from you wherever possible and you both have good hygiene (sneezing into a tissue and washing your hands thoroughly), there is a good chance that they will not catch the infection.

I’ve lost my appetite. What should I do?

Losing your appetite is a common symptom of flu and will usually return as you begin to feel better. Try to eat light, nutritious foods, such as soup, toast, baked beans and scrambled eggs (these are also easy to prepare). It may be easier for you to eat little and often.

What can I do to protect myself?

You can reduce, but not get rid of, the risk of catching or spreading swine flu by:

·         Always covering your nose and mouth with a tissue when coughing or sneezing.

·         Disposing of dirty tissues promptly and carefully.

·         Maintaining good basic hygiene, for example washing your hands often with soap and warm water to reduce the spread of the virus from your hands to face, or to other people.

·         Cleaning hard surfaces, such as door handles, often and thoroughly using a normal cleaning product.

You can also make the following preparations now:

·         Confirm a network of flu friends (friends and relatives) who could help you if you fall ill. They could collect medicines and other supplies for you so you do not have to leave home and possibly spread the virus.

·         Have a thermometer and enough cold and cough remedies in your medicine cupboard, in case you or your family get swine flu.

Are alcohol handrubs better than soap and water?

Both alcohol handrubs and washing with soap and water are important to minimise the risk of spreading swine flu, as they both deactivate the flu virus. Alcohol handrub can only be used on visibly clean hands. If hands are dirty, soap and water should be used. Handrubs are useful when there is no easy access to a place to wash and dry your hands.

Can swine flu be treated?

Testing has shown that the swine flu can be treated with the antiviral medicines oseltamavir (Tamiflu) and zanamivir (Relenza). However, the drugs must be taken at or near the start of the illness to be effective.

What do antivirals do?

Antivirals are not a cure, but they help you to recover by:

·         relieving some of the symptoms,

·         reducing the length of time you are ill by around one day, and

·         reducing the potential for serious complications, such as pneumonia.

 

How does Relenza work?

To reproduce and spread, a virus has to enter your body, take over healthy cells and force them to make copies of itself. Relenza stops the release of new copies of the virus from infected cells in the lungs. This slows the spread of the virus, reduces the symptoms and length of time that you feel unwell for and makes it harder for the virus to spread to other people.

Relenza should first be taken within 48 hours of symptoms appearing in adults (36 hours in children). It works better the earlier you start taking it.

How does Tamiflu work?

To reproduce and spread, a virus has to enter your body, take over healthy cells and force them to make copies of itself. Tamiflu stops the flu virus entering your cells and blocks the release of new copies of the virus. This slows the spread through your body, reduces the symptoms and the length of time that you feel unwell for and makes it harder for the virus to spread to other people.

Tamiflu should first be taken within 12 to 48 hours of symptoms appearing. It works better the earlier you start taking it.

How effective are Relenza and Tamiflu?

Relenza reduces the duration of flu symptoms by one-and-a-half days on average. Tamiflu reduces the duration of symptoms by up to two days.

Will antivirals be given to people without flu symptoms?

In most cases, no. Antivirals will generally only be given to people who have been diagnosed with swine flu.

Doctors should not offer antiviral medication as prophylaxis (prevention) to people close to patients unless they have serious existing health problems, such as cancer, or there are other special circumstances.

How are those with confirmed swine flu getting access to antivirals?

Does Tamiflu go out of date?

Yes. There will be an expiry date on the packet. The government has a programme to replace any expired doses under a rolling stock system.

If I take an antiviral and have side effects, who should I tell?

See your doctor or local hosipital to check that you are OK.

What are the names of the swine flu vaccines?

The swine flu vaccine manufactured by GlaxoSmithKline is called Pandemrix and the vaccine manufactured by Baxter is called Celvapan.

What dosage will be given for each vaccine?

The following vaccination schedule is recommended in Canada:

Pandemrix:

·         For all children aged from six months to nine years:
- two half doses (0.25ml each) given with a
minimum of three weeks between doses.

·         For individuals aged 10-59:
- one dose (0.5ml) given.

·         For individuals aged 60 years and over:
- one dose given (this advice will be reviewed
when more data become available).

·         For individuals aged 10 years and over with weakened immune systems:
- two doses (0.5ml each) given with a
minimum of three weeks between doses.

Celvapan:

For children aged from six months and adults:
- two doses (0.5ml each) given with a
minimum of three weeks between doses.

This dosage schedule is based on advice given by the Joint Committee on Vaccination and Immunisation, following consideration of clinical data available on the vaccines. The dosage and recommendations will be kept under review as more clinical data become available.

Is the vaccine safe?

Vaccines would not be licensed if they were considered unsafe. Both swine flu vaccines have been licensed.

What is the difference between an adjuvanted and non-adjuvanted vaccine?

An adjuvanted vaccine is a vaccine that includes a substance that boosts an individual’s immune system and increases their response to a vaccine. An unadjuvanted vaccine has no “booster” element.

Adjuvanted vaccines are included in common vaccines such as tetanus and Hep B.  The adjuvant in Canada’s H1N1 flu vaccine is made up of natural ingredients such as water, squalene oil and vitamin E.

When was the last time Canada used an adjuvant in a vaccine?

Adjuvants are not new.  They have been used for several decades to boost immune response to vaccines.  Many of the commonly used vaccines in Canada contain an adjuvant.  However, they have not previously been approved for use with influenza vaccines in Canada.

Are adjuvanted influenza vaccines safe for use?

The adjuvant used by GSK has been tested in approximately 45,000 people around the world and has been evaluated by Health Canada and other regulatory authorities as part of the review of the H5N1 vaccine in the pre-pandemic period.  No significant safety concerns regarding the use of the adjuvanted vaccine were detected.

In June 2009, the WHO held consultations on the safety of adjuvanted influenza vaccines to review and discuss known and theoretical safety concerns and prospective vaccine safety evaluation.  The outcome of the WHO consultation was that no significant safety concerns or barriers to evaluating or using adjuvanted vaccines for the current H1N1 virus were raised.

Clinical studies have been designed to study the risks and benefits of using both adjuvanted and unadjuvanted vaccine against the H1N1 flu virus, and Health Canada and the Public Health Agency of Canada are working closely with other national agencies to implement appropriate post-market monitoring.

Does an adjuvanted vaccine pose a risk to pregnant women?

All evidence suggests that adjuvanted vaccines are just as safe as unadjuvanted vaccines; however there is no safety data for the use of adjuvanted vaccine in pregnant women.  The WHO’s Strategic Advisory Group of Experts (SAGE) recommended in July that pregnant women should receive non-adjuvanted vaccine where possible, but that an adjuvanted vaccine could be used if necessary.

Is the Government ordering non-adjuvanted vaccine?  Who will it be recommended for and why?

The Government of Canada plans to purchase a small quantity of non-adjuvanted H1N1 flu vaccine (approx. 1.8 million doses) as part of its total order of 50.4 M doses.

The purchase of a small quantity of non-adjuvanted vaccine is a precautionary measure for pregnant women as no clinical data of the safety of adjuvanted vaccine in this group is available.

In these cases, should a non-adjuvanted vaccine prove to be effective, it may be the preferred option.  The WHO has indicated that it has no special concerns about the safety of adjuvanted H1N1 flu vaccines in general.  The WHO has also strongly recommended that pregnant women be immunized against the H1N1 flu virus, even if no non-adjuvanted vaccine is available.

Who should not receive the vaccine?

  The following groups of people should NOT receive the H1N1 flu vaccine

People who have had a previous anaphylactic (severe allergic reaction) to any element of the vaccine, OR

People with a hypersensitivity to eggs ( e.g. hives, swelling of mouth and/or throat, breathing difficulty); OR

People experiencing a high fever, OR

People who have previously experienced Guillan-Barré Syndrome within 8 weeks of receiving a seasonal flu vaccine.

How long will it take after I receive the vaccine to have immunity against the virus?  

After receiving the H1N1 flu vaccine, most people will start to develop immunity within 10 days with just one dose.

These recommendations indicate that adjuvanted vaccine is recommended and better for young children. If that’s the case, and the U.S. is only using unadjuvanted vaccine, is Canada’s vaccine safer for children?

Clinical trials have indicated that the unadjuvanted H1N1 flu vaccine does not deliver as strong of an immune response as was observed in previous trials with the adjuvanted H5N1 (avian or bird) flu vaccine. This is why Canada chose to use adjuvanted vaccine for children, administered in two half-doses 21 days apart.

Canada is confident in the safety and efficacy of this vaccine.  Vaccine safety monitoring will continue to be carried out as the vaccine is used.

The recommendation is that children between 6 months and 10 years old should get two half-doses of the adjuvanted vaccine. Why can’t they get one full dose?

The recommendation for two half-doses of vaccine in children under 10 is aligned with the seasonal flu recommendation. The seasonal flu recommendation is that children six months to 23 months receive two half doses of the vaccine, and children over the age of 23 months to 10 years who are receiving the vaccine for the first time should also receive two half doses of vaccine.  This has been shown to give children the best immune response.  Since the H1N1 flu vaccine is an influenza vaccine, the recommendation stands.

Additionally, reactions to the vaccine were higher in clinical trials for children who received a full dose as compared to those who received two half-doses.

 

Is it true that there is mercury in the vaccine? How much mercury?

Both vaccines contain a small amount of thimerosal. Thimerosal is a form of mercury used in the H1N1 flu vaccine to stabilize it and maintain its quality during storage. Thimerosal is a different form of mercury than the mercury known to cause health problems. The amount in the H1N1 adjuvanted flu vaccine is much less than the daily limit recommended for environmental exposure to mercury.  For example, there is significantly less mercury in the vaccine than you would find in a can of tuna fish.

Is it true that there is 10 times more mercury in the unadjuvanted vaccine? How can that be safe for pregnant women?

Yes, the unadjuvanted vaccine does contain 50 ug of thimerosal while the adjuvanted vaccine has only 5 ug of thimerosal. The 50 ug remains within the daily limit recommended for environmental exposure to mercury. There’s significantly less mercury in the vaccine than you would find in a can of tuna fish.

The H1N1 Flu Virus can live outside the body on hard surfaces, such as stainless steel and plastic, for up to 48 hours and on soft surfaces, such as cloth, paper, and tissues for less than 8-12 hours; however, it can only infect a person for up to 2-8 hours after being deposited on hard surfaces, and for up to a few minutes after being deposited on soft surfaces.

Why can’t babies under six months be vaccinated?

The swine flu vaccine (as with seasonal flu) does not produce enough of an immune response in children under six months to provide protection.

Will the vaccine give me swine flu?

No. The vaccine does not carry a ‘live’ virus, so it cannot give you swine flu. Some people may experience mild fever up to 48 hours after immunisation as their immune system responds to the vaccine, but this is not flu.

Is there a link between Guillain-Barre syndrome and swine flu vaccines?

Guillain Barre Syndrome (GBS), a rare neurological disorder, was an identified risk with swine flu vaccines used in the United States in 1976 – it is thought that one extra case of GBS occurred with every 100,000 doses of vaccine. The reason why the 1976 vaccine increased the risk of GBS remains unknown.

Many studies have looked at whether other flu vaccines used since 1976 carry a risk of GBS and no robust evidence of a causal link has been found. No cases of GBS have been found in the clinical trials of H5N1 vaccines.

Is the vaccine safe for people with an egg allergy?

The GlaxoSmithKline vaccine (Pandemrix) is not suitable for people who have an anaphylactic reaction (allergic reaction) to egg.

The Baxter vaccine (Celvapan) does not use eggs in its production and so would be suitable for people who have a confirmed anaphylactic reaction to egg products.

What are the ingredients in the vaccine?

The full list of ingredients of Pandemrix can be found by going to the Pandemrix summary of product characteristics.

The full list of ingredients for the Baxter vaccine can be found here.

Where can I get the swine flu vaccine?

Please check with your local government and health care provider

What should I do if my baby gets flu?

Your doctor may recommend antiviral medication for your baby, and will advise you on the dose and how to give it to them. If you are breastfeeding, you should continue this: breast milk is easily digestible and your baby will find it comforting.

How can I tell if my child has swine flu?

Call your GP immediately if your child has any of the following symptoms and a temperature of 38°C or above or feels hot:

·         tiredness

·         headache,

·         runny nose and sneezing,

·         sore throat,

·         shortness of breath,

·         loss of appetite,

·         vomiting,

·         diarrhoea, or

·         aching muscles, limb and joint pain.

If you are worried about your child, always call your GP for advice.

One thing you can do right now is to make sure you have a digital thermometer to take your child’s temperature with.

If my child has swine flu, what should I do?

If your GP confirms that your child has swine flu, keep them at home and treat their symptoms like any other cold or flu. Make sure they drink plenty of liquids, get lots of rest and take over-the-counter cold and flu remedies to help control their temperature. However, children under 16 must not be given aspirin or ready-made flu remedies containing aspirin.

Your GP will tell you whether your child should also take antiviral drugs. Antivirals such as Tamiflu shorten the symptoms by about a day and can reduce the risk of complications. Antivirals are only effective if taken within 48 hours of symptoms starting. If you are worried about your child, call your GP immediately.

However, antivirals can also have side effects. If your child’s swine flu symptoms are mild, you may not wish to give them antivirals. Your GP can advise you on this.