H1N1 Influenza (Swine Flu)

What Is Swine Flu?

Swine flu is a contagious respiratory virus that affects pigs year-round. In spring 2009, a new strain of swine flu surfaced (influenza type A [H1N1] virus). It contains a combination of different flu viruses that affect pigs, birds, and humans. Because of the human component of the virus, this strain can spread from person-to-person more easily than others.

How Is it Spread?

Swine flu spreads in the same way that other flu viruses do — through the air when a person who has the virus sneezes, coughs, or speaks. People also can catch the virus after touching a contaminated object that someone with the virus sneezed or coughed on.

As with other flu viruses, people can be contagious a day or so before their symptoms start, so they can pass it on before they even know they're sick.

You can't get swine flu from eating pork or pork products. Eating properly cooked pork is safe.

Who Is Especially at Risk?

As with other types of flu, kids with chronic medical conditions (like diabetes, heart disease, or asthma or other lung problems) can have more problems coping with the illness. They might get sicker and need more medical support; in some cases, hospitalization may be necessary.

Pregnant women who catch the flu also are more likely to get sicker. Having the flu can increase the risk for complications during pregnancy, labor, and delivery.

In infants, the flu can be life threatening and requires immediate medical attention.

Signs and Symptoms

Symptoms of swine flu are similar to the common flu: fever, cough, sore throat, body aches, headache, chills, and fatigue, and sometimes diarrhea and vomiting. Swine flu also can cause pneumonia, which can make it hard to breathe.

Kids with any of these symptoms need immediate medical attention:

• fast breathing or trouble breathing
• bluish skin color
• not drinking enough fluids
• very sleepy or lethargic
• in babies, being so irritable they don't want to be held
• fever with a rash
• flu-like symptoms improve, then return with fever and a worse cough

If you think your child has the flu, call your doctor — particularly if you live in any of the states that have reported swine flu outbreaks. Doctors can find out if someone has swine flu by taking a swab sample from the person's nose and throat and sending it to a lab to be analyzed. Doctors won't know the results of this test for a few days.

Treatment

Kids without chronic health conditions usually tolerate infection with flu viruses fairly well. In fact, most children with swine flu get better on their own without medical treatment.

Currently, there is no medicine to treat this strain of swine flu specifically, but it does appear that some of the antiviral medicines used to treat common seasonal flu may ease symptoms and shorten the duration of illness.

If your child has a chronic condition, like asthma, make sure to check with your doctor to help ensure the condition is under control. Likewise, if you're pregnant and come down with flu symptoms or have been exposed to someone who has the flu, see a doctor right away. You may need to take antiviral medications as a precaution for yourself and your baby.

These at-home tips can help most otherwise healthy kids cope with the flu:

• make sure they drink lots of fluids to prevent dehydration
• encourage them to get plenty of sleep and take it easy
• offer acetaminophen or ibuprofen to relieve fever and aches (but do not give kids aspirin unless your doctor instructs you to do so)
• dress them in layers, since the flu often makes them cold one minute and hot the next (wearing layers — like a T-shirt, sweatshirt, and robe — makes it easy to add or subtract clothes as needed)

Remember to call a doctor if your child seems to get better but then feels worse, develops a high fever, has any trouble breathing, or seems confused.

Protecting Your Family

Scientists have developed a vaccine against this strain of swine flu, which should be available sometime in fall 2009. The vaccine is recommended for those who are at higher risk of catching swine flu or having complications from it, and those who are around young infants or who work in health care settings.

The Centers for Disease Control and Prevention (CDC) specifically recommends the swine flu vaccine for:

• pregnant women
• people who live with (or care for) children younger than 6 months old
• kids and young people from 6 months to 24 years old
• people ages 25 to 64 with chronic health conditions or compromised immune systems
• health care and emergency services personnel

The swine flu vaccine does not protect against seasonal flu, so it's important for high-risk groups to also receive the seasonal flu vaccine. Both vaccines may be administered on the same day.

Vaccinating your family against swine flu isn't the only preventive measure you can take. The CDC also recommends these precautions:

• Cover your nose and mouth with a tissue when you sneeze or cough and put used tissues in the trash.
• If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands.
• Clean your hands after coughing or sneezing — wash with soap and water or use alcohol-based hand cleaner.
• Avoid touching your eyes, nose, and mouth.
• Keep sick kids home from childcare or school and limit their contact with others; kids should stay home 10 days after the onset of illness.
• If you recently traveled to Mexico and now have flu symptoms, tell your doctor.

Breastfeeding mothers who have the flu can continue breastfeeding, even if they're on antiviral medicines. But they may have to take additional precautions (like wearing a facemask) to reduce the risk to their baby. Talk to your doctor about how you can help keep your baby healthy.

Eating Pork

Because the flu virus isn't transmitted through food, the CDC and U.S. Department of Agriculture (USDA) say it's safe to eat pork. Of course, pork should be well cooked to avoid any illness. Cook pork to an internal temperature of 160º F or higher (use a meat thermometer to check the temperature). Don't eat pork that looks pinkish or bloody inside.

There's no evidence that touching raw pork will transmit the virus, but it's always wise to wash your hands and all surfaces after touching any raw meat.

Are U.S. Pigs Affected?

Outbreaks of swine flu have been found in pigs in Mexico and Canada. The infected pigs in Canada contracted the illness from a herder who had previously been in Mexico. All infected pigs have been quarantined.

So far, there's no evidence that any pigs in the United States are infected with this new strain of swine flu. Signs of flu in pigs are similar to those in humans.

If you raise pigs or have a pet pig, call your vet if the pig seems to lack energy or has a fever, is sneezing or coughing, is having trouble breathing, or has a discharge coming from its eyes or nose.

Talking to Kids

Listening to news reports about swine flu can upset kids because they may focus on worst-case scenarios. You can help ease their fears by being available to answer their questions.

You can tell kids that there's no need to panic about swine flu. Most people with swine flu recover within a week or two. The media and governments are on high alert to help limit the spread of the disease and help people who may become ill. The last flu pandemic that was serious enough to affect millions of people happened a century ago — before people had access to the medical knowledge, care, and medications that we have today.

Reviewed by: Steven Dowshen, MD
Date reviewed: August 2009