nH1N1 Influenza Virus
Questions and Answers

Q: What nH1N1 flu?
A: nH1N1 influenza is a respiratory disease found in pigs that is caused by type A influenza viruses. As the current pandemic situation shows, human infections can and do occur. Flu viruses have been reported to spread from person to person. In the past, though, transmission was limited and not sustained beyond three people.

Q: What are the symptoms of nH1N1 flu?
A: At this time, nH1N1 flu appears like regular seasonal flu, with fever plus cough or sore throat, with or without body aches, runny nose and stomach upset.

Q: Is it contagious? How does it spread?
A: Yes, it is contagious. While it is spreading from person to person, it is not known at this time how easily the virus spreads between people. Spread of nH1N1 influenza is believed to occur in the same way that seasonal flu spreads-through coughing or sneezing of people with influenza. People may also become infected by touching something with flu viruses on it and then touching their mouth or nose.

Q: When are people contagious?
A: Infected people may infect others beginning one day before their symptoms develop, and up to 7 or more days after becoming ill.

Q: How do people know they have nH1N1 flu, rather than some other respiratory illness?
A: Patients are asked screening questions regarding their symptoms. If nH1N1 flu is suspected based on those responses, a culture (nasal swab, for example) is taken and tested. Should the test indicate influenza A, additional testing is completed for sub-types and the results are reported to the State Department of Health. NOTE - No nasal washings for influenza testing should be obtained at any time without the employee(s) using gloves and mask.

Q: I read that nH1N1 flu is affecting young people. Is this true?
A: In general, people becoming ill with nH1N1 flu are younger than is typically the case with seasonal flu, but people of any age can be affected by this influenza. Risk groups for severe illness are typically those with underlying heart, lung, kidney or neurologic conditions, diabetes or pregnancy. In addition, patients with asthma or obesity are recently experiencing more severe disease.

Q: What is the proper way to wash your hands?
A: Washing your hands often will help to protect you from germs. Use soap and water or clean with an alcohol-based hand cleaner. Be sure to wash your hands for 30 seconds and thoroughly clean all hand surfaces including between the fingers (pay particular attention to fingernails and rings). If using alcohol-based cleaner, rub your hands until the gel is dry.

Q: Are there any other disruptions in service that would be likely during a pandemic?
A: Depending on the size and scope of the pandemic, many important community services everyone uses on a daily basis could be disrupted, such as hospitals and other healthcare facilities, financial institutions, schools, child care facilities, restaurants and hotels, government facilities, places of worship, public transportation, telephone and cellular phone carriers, media, postal and other shipping companies. Here are some suggestions to best prepare for such disruptions in service:

• Keep a small amount of cash or traveler's checks on hand for easy use in the event that financial institutions or automated teller machines (ATMs) are affected.
• Keep travel to a minimum, since fuel could be in short supply.
• Maintain an adequate level of home heating oil, so you won’t run out.
• Have an emergency plan in place. Tell all family members where they should go in an emergency and where they should seek medical care. Have contact information readily available for your healthcare professionals (including your pharmacy) and other essential services.
• Take care of the kids. With the likelihood of schools and child care centers closing, the kids will be "stuck at home" and will soon be complaining of boredom. Stock up on activity books or other favorite pastimes to help keep your children occupied and happy at home.
• Plan in advance for food, water and other necessities.

Q:  Does Geisinger prepare in advance to ensure there would be sufficient supplies on hand in the event of a pandemic?
A: Yes. Geisinger has a Pandemic Plan in place and activated the early stages of this plan earlier this year when the nH1N1 influenza situation spread to the United States. The plan includes all areas of the health system, including supply chain. General questions regarding supplies can be directed to any of the main storerooms at GMC, GWV or GSWB. There is a daily call with CPSL representatives to determine supplies needs for our community practice sites. It is important to avoid hoarding of supplies to ensure that we have sufficient quantities to direct to the areas of greatest need. For "hard to get" supplies such as masks, employees may see various substitute products being used to cover the need.

Q:  Who should be tested for the nH1N1 flu?
A: The CDC recommends testing high risk individuals with flu-like symptoms. Those individuals are:

• Children less than 5 years old
• Children and adults with chronic illness such as asthma, heart disease, kidney or liver disease, neurological disease, diabetes
• Children and adolescents (less than 18 years) who are receiving long-term aspirin therapy and may be high risk for experiencing Reye Syndrome after influenza virus infection
• Hospitalized patients
• Adults and children with immunosuppression (including immunosuppression caused by medications or by HIV)

Q:  Can I continue to breastfeed my baby if I have the flu?
A: If you are breastfeeding, DO NOT STOP.  A mother's milk can help protect the baby against sickness.  Keep in mind:

• Be careful not to cough or sneeze in the baby's face
• Wash your hands before picking up the baby and put on a clean shirt
• If you are too sick to breast feed, pump your milk and have someone else feed it to your baby
• You can still breastfeed if you are taking medicine for the flu, such as Tamiflu