What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against novel H1N1 virus. However, a novel H1N1 vaccine is currently in production and may be ready for the public in the west by September/October and in India in next 5-6 months. As always, a vaccine will be available to protect against seasonal influenza. However, it must be remembered that 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:
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Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it |
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Wash your hands often with soap and water, especially after coughing/sneezing |
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Avoid touching your eyes, nose or mouth. Germs spread this way |
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Try to avoid close contact with sick people |
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If you are sick with flu-like illness, stay home for at least 24 hours after the fever is gone except to get medical care. (Your fever should be gone without the use of a fever-reducing medicine). Keep away from others as much as possible to keep them from getting sick.. |
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Follow public health advice regarding school closures, avoiding crowds and other social distancing measures |
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Be prepared in case you get sick and need to stay home for a week to have a supply of over-the-counter medicines, tissues and related items. Avoid the need to make trips out in public while you are sick and contagious |
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What is the best way to avoid spreading the virus through coughing or sneezing?
If you are sick with flu-like illness, it is recommended you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
Keep away from others as much as possible. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket, clean your hands, and do so every time you cough or sneeze.
If I have a family member at home who is sick with H1N1 flu, should I go to work?
Employees who are well but who have an ill family member at home with novel H1N1 flu can go to work as usual. These employees should monitor their health every day, and take everyday precautions including washing their hands often with soap and water, especially after they cough or sneeze.
If they become ill, they should notify their supervisor and stay home. Employees who have an underlying medical condition or who are pregnant should consult their physician for advice, because they might need to receive influenza antiviral drugs to prevent illness.
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 for 15 to 20 seconds.
What should I do if I get sick?
If you live in areas where people have been identified with H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, stay home and avoid contact with other people for at least 24 hours after the fever is gone and avoid going to public places and for social events.
If you have severe illness (emergency warning signs in box below) or are at high risk for flu complications, consult your physician or seek medical care at a designated screening centre. The doctor 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:
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Fast breathing or trouble breathing |
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Bluish or gray skin colour |
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Not drinking enough fluids |
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Severe or persistent vomiting |
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Not waking up or not interacting |
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Being so irritable that the child does not want to be held |
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Flu-like symptoms improve but then return with fever and worse cough |
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In adults, emergency warning signs that need urgent medical attention:
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Difficulty breathing or shortness of breath |
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Pain or pressure in the chest or abdomen |
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Sudden dizziness and confusion |
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Severe or persistent vomiting |
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Flu-like symptoms improve but then return with fever and worse cough |
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Are there medicines to treat novel H1N1 infection?
Yes. WHO recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with novel H1N1 flu virus. MoHFW recommends only oseltamivir for the above purpose.
Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) 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 pandemic, the priority use for influenza antiviral drugs is to treat severe influenza illness (for example hospitalized patients) and people who are sick who have a condition that places them at high risk for serious flu-related complications.
Is there any vaccine against this flu and are people using it in other countries?
There is no vaccine available right now to protect against novel H1N1 virus. According to WHO, at least seven manufacturers have started clinical trials and these clinical trials are going on in at least 5 countries (China, Australia, the United Kingdom, Germany and the USA). Dossiers are being submitted to regulatory authorities. The first novel H1N1 vaccine may be out by September and then subsequently by other manufacturers
In India, the production process has begun in three companies – Pune-based Serum Institute, Hyderabad’s Bharat Biotech and Delhi’s Panacea Biotech. All received vaccine seeds from the World Health Organisation (WHO). Current projections for making the H1N1 vaccine available for Indian population is anywhere from 6 months depending upon regulatory and safety clearances.
Given the rush for production of pandemic vaccine, will the vaccines be safe?
According to WHO, most safety concerns induced by vaccines are occasional fever, potential nausea and minor side effects, but in a rare occurrence, there can be a more severe adverse event. In the event of a large scale vaccination campaign, people might suffer adverse effect. Most of these events will not be associated with the vaccine but will be temporally associated, implying this is something that would have happened anyway, but is occurring after a person has had a vaccination.
Usual side effects of the vaccines include fever, pain, nausea, diarrhea, fainting. In addition, a rare side effect is Guillain-Barré Syndrome, which happens sometimes after vaccination. It has not been described for seasonal influenza vaccination so far but in one situation in the 1976 vaccination against Swine flu in the USA there was a very rare event where 30 people died out of 40 million people immunised.
USFDA has agreed to treat the pandemic H1N1as strain change from seasonal vaccines and allow marketing without trials. Manufacturers are, however, conducting trials on candidates in US. European regulatory agencies necessarily require a small clinical trial even in the fast track process.
Indian manufacturers are currently conducting pre-clinical trials in animals and will soon test them in humans. ICMR, however, has indicated that, if and when the need arises, based on existing safety data on use of seasonal vaccines in the country and abroad, India may shorten the regulatory process. Government of India indicated that if required, DCGI will take special measures for importation of vaccines from abroad.
Who will qualify for the vaccine? Are these select groups or would there be mass vaccination?
Based on the pandemic’s current estimated severity, on 7 July 2009, the Strategic Advisory Group of Experts on Immunisation (SAGE) identified the following groups in order of priority for vaccination against influenza A (H1N1) 2009 pandemic:
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Health care workers a first priority to protect the essential health infrastructure |
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Pregnant women: This group appears to be at increased risk for severe disease, potentially resulting in spontaneous abortion and/or death, especially during second and third trimesters of pregnancy |
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Individuals aged >6 months with one of several chronic medical conditions: To reduce morbidity and mortality; this group includes people with asthma and other chronic conditions such as morbid obesity |
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Healthy young adults ( >15 years and <49 years): To reduce morbidity and mortality: to reduce transmission; there is uncertainty regarding potential effectiveness of this approach |
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Healthy adults >49 years and <65 years: Reduce morbidity and mortality |
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Healthy adults aged >65 years: Reduce morbidity and mortality |
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SAGE noted that countries could use a variety of strategies to deploy vaccines but any strategy should reflect the country’s epidemiological situation, resources and ability to access vaccine, to implement mass vaccination in targeted groups and use other non-vaccine mitigation measures.
Such measures include non-pharmaceutical measures and pharmaceutical interventions, including recourse to antivirals. Under all circumstances, strengthening influenza surveillance in developing countries, particularly in Africa, was considered important.
How effective will the vaccine be in preventing infection from novel H1N1 flu?
Vaccination provides substantial protection against seasonal influenza in healthy and at-risk individuals, both children and adults—efficacy ranges from 26 percent to 87 percent depending on the vaccine match and age of the individual. However, this might also not be a foolproof strategy.
Genetic mutations arise continuously in influenza viruses — a process termed "drift" that results in emergence of immunologically distinct variant viruses which impacts the vaccine virus composition. Newer technologies can to some extent overcome these drift variants. Several regulatory and production steps to ensure safe, effective, and adequate vaccine supplies must be completed before the vaccine is made available in the market for use. '
Therefore, the main disadvantage of the vaccination is that the components in it might not match the influenza virus in circulation and poorly matched vaccines would provide reduced protection against influenza. Though more effective, a management strategy of vaccination alone might not be sufficiently reliable to control pandemic influenza.
Can I take seasonal influenza vaccine to protect myself from novel H1N1 flu?
Recent evidence suggests that seasonal flu vaccine provides no cross protection against infection due to novel H1N1flu.
Why is there so much emphasis on screening people at entry points if the virus is already in the country and many human carriers don’t have symptoms?
Genuine containment through case-based surveillance (airport screening, isolation, quarantine, contact tracing and chemoprophylaxis) can be a legitimate public health tool. Infections where this is effective includes respiratory infections (TB, smallpox), ones where routes of infection are more easily interrupted (contaminated food and water) or transmission is mostly confined to certain settings (SARS).
In some of these case-finding, contact tracing and other ways of achieving containment are highly recommended. However, that is not the case for human influenza, especially a pandemic strain.
India was apparently able to delay entry and spread of H1N1 pandemic virus through exhaustive case-based surveillance. There is however, little evidence to suggest that this has been an effective strategy in other times and countries in phase 5 and beyond of the pandemic.
Outside of outbreaks in confined setting (seasonal influenza outbreaks in residential homes), historical evidence shows that it is almost impossible to contain or even delay influenza. Even in a confined setting, it is done by whole population interventions (mass immunisation or prophylaxis) and not by case-finding and contact tracing.
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