H1N1 Flu Frequently Asked Questions

September 22, 2009
The H1N1 influenza is once again on the minds of many people as we enter fall and students return to school and to college.

This is the first global flu pandemic in 41 years, and as of August 30, the World Health Organization (WHO) reported more than 254,206 laboratory-confirmed cases of 2009 H1N1 influenza virus with at least 2,837 deaths.

The H1N1 virus is a potentially serious health issue for individuals, families, schools and businesses across the country and the world. The federal government estimates that as much as 40 percent of the U.S. population could become ill with the flu this fall and winter.

While it is uncertain how widespread or severe the H1N1 flu virus will be this year, there are simple things people can do right now to prepare for it. The American Red Cross recommends that people follow common-sense public health practices and store extra supplies – steps that will be helpful for both the H1N1 virus and the seasonal flu virus each year.

The Basics

1. What is influenza? Influenza (flu) is a contagious respiratory illness caused by viruses. Infection results in mild to severe illness and can lead to death. Every year, an average of 5 to 20 percent of the U.S. population gets the flu. Some influenza viruses can also infect birds, pigs, horses, seals, whales and other animals.  

2. How is the H1N1 (swine) flu different from seasonal flu?  The H1N1 influenza (or swine flu) is a new strain of the influenza virus. Its symptoms are similar to those of the seasonal flu and may include fever, cough, sore throat, body aches, headache, chills, fatigue and the worsening of underlying chronic medical conditions. Some people have also reported diarrhea and vomiting associated with H1N1 flu. Unlike with the seasonal flu, young people are at higher risk of H1N1 infection than people 65 and older. However, infected people 65 or older are still at increased risk of H1N1 influenza-related complications. The worldwide spread of the H1N1 virus this spring was both rapid and unusual as it affected some countries outside of the timeframe of a normal flu season. While most people who have become ill with the H1N1 virus have recovered without needing medical treatment, hospitalizations and deaths have occurred.  

3. How does H1N1 spread? The H1N1 flu and seasonal flu spread in much the same way. Flu viruses spread mainly from person to person when people with influenza cough, sneeze, or touch things that others touch. People infected with the H1N1 virus can spread it to others one day before symptoms develop and up to seven or more days after becoming ill. That means that you may be able to pass the flu to someone before you know you are sick and after you start to feel better.  

4. How serious is the H1N1 flu threat? The H1N1 virus is a potentially serious health issue for families, schools and businesses across the country and world. The federal government estimates that 30 to 50 percent of the country’s population could become infected by H1N1 influenza this fall and winter. Individuals with underlying chronic health conditions may be more vulnerable to the H1N1 influenza virus. While it is uncertain exactly how widespread or severe the H1N1 flu virus will be, there are simple things people can do now to help prevent and prepare for H1N1.  

5. What should I do to keep from getting the H1N1 flu? The American Red Cross and government health officials recommend that people use common sense public health practices to reduce the spread of both the H1N1 virus and the seasonal flu virus. 

These include (click here to download and print these and other tips):  

  • Cover mouth with tissues when coughing or sneezing; if no tissue is available cough into your elbow
  • Wash hands frequently with soap and water or use an alcohol-based hand sanitizer that has an alcohol content of 62 percent or greater
  • Avoid touching eyes, nose, mouth and surfaces that may be contaminated
  • Stay in good general health by getting sufficient sleep, being physically active, managing stress, drinking plenty of fluids and eating nutritious foods
  • Minimize contact with people who are sick
  • Stay home if you become sick

6. How can I prepare for a possible resurgence of H1N1 flu? Following the three basic preparedness steps – get a kit, make a plan, and be informed – can help individuals and families be prepared. People can store extra supplies that may be needed at home (get a kit). Ask about school and employer’s plans, and have a plan in place in case it’s necessary to stay at home for an extended period of time (make a plan). Find out how public health officials will communicate if the threat becomes widespread (be informed).  

7. 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, or clean with an alcohol-based hand sanitizer. The Centers for Disease Control and Prevention (CDC) recommends that you wash your hands with soap and warm water for at least 20 seconds. Teach children to sing “Happy Birthday” twice when washing hands to know how long to wash and to keep them engaged. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers with 62 percent alcohol content or greater may be used. You can find them in most supermarkets and drugstores. When using gel, rub your hands until the gel is dry. The gel does not need water to work as the alcohol content kills germs on hands.  

8. How long can viruses live outside the body? Some viruses and bacteria can live from 2 to 8 hours on surfaces like cafeteria tables, bus poles, doorknobs and desks. Frequent hand washing and disinfecting of commonly handled surfaces with household cleaners will help you reduce the chance of contamination from these sources.

9. What should I do if I get sick? If you become ill with flu-like symptoms including fever, coughing, body aches, runny nose, sore throat, nausea, vomiting or diarrhea, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others. If you have severe illness or are at high risk for flu complications, the CDC recommends that you contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed.  If you or your child becomes 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


10. Is there a vaccine for the H1N1 flu? Vaccines for the H1N1 flu are being developed and tested, and the CDC has indicated that the vaccines could be available in October. The CDC has recommended that vaccination efforts initially focus on five groups considered most vulnerable:

  • Pregnant women
  • People who live with or care for children younger than 6 months of age
  • Healthcare and emergency medical services personnel
  • Young people between 6 months and 24 years of age
  • People aged 25 through 64 years at higher risk to experience flu-related complications because of chronic health disorders or compromised immune systems

11. How many shots do I need of the H1N1 flu vaccine? Initial scientific studies released September 10 indicate that the H1N1 vaccine appears to work for adults with just one shot. Findings also show that the vaccine is effective within ten days of being administered. Results from additional studies will be needed to determine whether children and other special groups will require one or two does of the H1N1 vaccine.

12. Does the H1N1 vaccine protect against the seasonal flu? No. The H1N1 and seasonal flu viruses are different, and people will need to get separate vaccinations for each flu strain. It is recommended that people get the seasonal flu shot when it becomes widely available in September.  

13. What is the difference between a vaccine and an antiviral? Vaccines are usually given as a preventive measure. Viral vaccines are usually made from killed or weakened versions of the live virus or pieces of the virus that stimulate an immune response to the virus. Once immunized with the weakened strain, the body produces antibodies that more effectively protect it from overall infection.

Antivirals are prescription drugs that decrease the ability of flu viruses to reproduce. While getting a flu vaccine each year is the first and most important step in protecting against flu, antiviral drugs are a second line of defense in the prevention and treatment of flu. Your health care provider will determine if antivirals are appropriate for your situation.

Pandemic Flu

14. The H1N1 flu has been labeled a global pandemic. What does that mean? In June 2009, the World Health Organization (WHO) raised the flu alert to its highest level, declaring H1N1 influenza a global pandemic. According to the WHO, increasing the alert to Phase 6 signifies that this flu has spread throughout communities in multiple countries. This does not necessarily mean the virus is causing more severe illness.  

15. When have pandemics occurred in the past? Past influenza pandemics have led to high levels of illness, death, social disruption, and economic loss. There were three influenza pandemics in the 20th century. The 1918 influenza pandemic caused at least 500,000 deaths in the United States and up to 40 million deaths worldwide. The 1957 influenza pandemic caused at least 70,000 deaths in the U.S and between 1 million and 2 million deaths worldwide. The 1968 influenza pandemic caused about 34,000 deaths in the U.S. and 700,000 deaths worldwide.  

16. Is the H1N1 flu pandemic going to be as widespread? Public health officials do not know how severe the H1N1 flu outbreak will be. The initial cases of H1N1 this spring were comparatively mild and the CDC and other health experts are watching to see if the virus mutates into something more virulent this fall. The severity of disease and the number of deaths caused by a pandemic virus vary greatly. The federal government estimates that the H1N1 virus could produce infection in 30-50 percent of the population this fall and winter. Of the infected population, half would seek medical attention and 20 to 40 percent would show symptoms. At present, the H1N1 virus seems milder than the past pandemic strains but the total number of people infected is producing significant illness worldwide.  

Preparing for a Potential Worldwide Outbreak

17. Should I keep extra food and water in my home? Yes. Stocking extra food, water and supplies at home will reduce the need for anyone who does get the virus to need to be in public during a local flu outbreak. This reduces the potential spread of the virus.

18. How long should I plan for extra supplies and water? If possible, store a two-week supply of food, water and household necessities such as disinfectants, medications, soap, tissues, thermometers, hand sanitizer and personal care items. Store one gallon of water per person per day in clean, plastic containers. Avoid using containers that can decompose or break, such as milk cartons or glass bottles. Family preparation steps should also include storing food and diapers for babies, food for special nutritional needs, essential medicines and medical items, and extra food for pets.

19. Should I plan to go to work if the H1N1 flu becomes widespread? Take the opportunity now to look into plans in your workplace for employees who get sick during a widespread flu outbreak. Ask your employer about sick-leave plans to allow staff to stay home when ill or caring for sick loved ones. Ask to see plans for how the business will function if key staff are unable to come to work. Inquire into special considerations regarding sick leave, benefits and wages when there is a widespread outbreak in the community and employees are asked by public officials to remain at home.

20. Should my children go to school or day care during a H1N1 flu outbreak? The CDC says that children should stay home if they have a flu virus and not return to school until they have not had a fever for 24 hours. In advance of major threat, parents should be reviewing the plans at their child’s school or day care and asking under what conditions the school would close if the flu were to become widespread in the community.

21. Who will care for me if I become ill? Plan now to care for yourself or loved ones who get the flu. Gathering the supplies you need ahead of time will allow you to provide care at home. Decide how the person will be cared for, which may mean that you or someone else in the household will need to stay home from work, school or other activities. If care needs exceed the capacity of an individual household, seek assistance from healthcare providers.

Coping with Widespread H1N1 Flu Outbreak

22. How can I prepare mentally and emotionally for a widespread flu outbreak? I’ve never experienced anything like this. It is okay to be concerned about the H1N1 flu outbreak. Consider how you have successfully handled challenging times in the past. Identifying these strengths will help you cope with the stress that can result from flu pandemic. Staying informed of risks and making advance preparations can provide you and loved ones with peace of mind.

23. How can I be social and stay in touch with people during a serious flu outbreak without the risk of spreading the flu? During a flu pandemic you may be asked to limit your face-to-face contact with other people. Remember that there are a number of different ways to stay connected with friends and family such as by telephone, mail and the Internet. When you encounter others during a flu pandemic, use common sense and follow guidance from local public health officials to decrease the chance of spreading the virus.

24. Where can I get help during a widespread and serious flu pandemic? Individual and family preparation is essential when you cannot depend on the services you may normally use. Follow the basic preparedness steps and ask the organizations your family relies upon about flu plans. Emergency medical services will continue to be available during a pandemic. More information on preparedness and the flu can be found at http://www.redcross.org/ and http://www.flu.gov.