Influenza A (H1N1) Swine Flu Questions and answers Questions and answers on this page are grouped under the topics below: About the virus Symptoms Contagiousness and infection period Preparing and protecting yourself and others Immunity Who is at risk? Treatment and caring for yourself and others Government and health sector response Travel Staying away and returning to work or school Advice for businesses and schools Vaccine About the virus What is influenza A (H1N1)? The new influenza A (H1N1), commonly known as “swine flu”, is a new virus. It was first detected in people in Mexico and the United States in April 2009, and it may have been circulating in Mexico for some weeks before that. By early June 2009, over 70 countries had reported people who had at some time been sick with the new virus. The new influenza A (H1N1) can spread from person-to-person, in much the same way that regular seasonal influenza viruses spread. It is a different strain of influenza from the seasonal flu viruses which circulate around New Zealand in winter. The new influenza A (H1N1) has developed from the re-assortment of a number of other influenza viruses. For the latest information on swine flu cases around the world, see the World Health Organisation’s website: http://www.who.int/en/ Why is this new virus sometimes called ‘swine flu’? There are many forms of flu which affect animals and humans. These can mutate or exchange genes, to create a new virus. The new influenza A (H1N1) virus was originally referred to as ‘swine flu’ because some of the genetic structure of the virus is of a type that normally infects pigs. However, this new virus is circulating among people rather than pigs. How long is the epidemic likely to last? This wave of infection is likely to last some months in New Zealand, and the virus will continue to spread around the world for the next year or two. Future waves of infection in New Zealand are possible. See also: The situation Back to top Symptoms What are the symptoms? View information on Signs and symptoms. What is the difference between the flu and just a common cold? Influenza (flu) is a contagious infection of the respiratory tract (lungs and throat). The flu is not just a severe cold, but a different infection caused by a different virus. Sneezing, a runny and/or blocked nose, coughs and sore throat can all be signs of a cold. Influenza can cause similar symptoms, along with fever, headache, aches and pains and tiredness, and is generally more severe. For most of us it is unpleasant but we usually recover well by looking after ourselves at home. With the flu we often need a few days at home in bed to recover. Some people, usually people with other medical conditions, can be more severely affected by the flu and may require hospital treatment usually for complications such as pneumonia. What particular flu symptoms should I get medical advice on? Most people recover fully simply by staying at home in bed and drinking lots of fluids (but not alcohol) without the need to see a doctor or take any medicine. If you don't get better after a week or you suddenly feel much worse you should seek advice. Symptoms which may require further medical advice include difficulty breathing, or chest pain, a high temperature, drowsiness, severe vomiting, or a cough with blood or green phlegm. People at particular risk who should phone their GP or Healthline if they get influenza include pregnant women, and adults and children with respiratory disease, asthma, pneumonia, heart disease, liver disease or blood disorders. Here are some signs to look for: The ill person starts to feel better, then gets worse has a temperature of 38°C or greater has chills or severe shaking has difficulty breathing or chest pain has purple or blue discolouration of the lips is less responsive than normal, is unusually quiet, or becomes confused is vomiting and unable to keep liquids down has signs of dehydration such as dizziness when standing, not urinating, and in infants, a lack of tears when they cry has seizures or convulsions. If any of these things occur, call a doctor or Healthline 0800 611 116 for advice. See also: Who is at risk? and When to seek medical advice Back to top Contagiousness and infection period Is the new influenza A (H1N1) virus contagious? Yes. Health experts believe this new virus spreads the same way as seasonal flu. However, because it is a new virus, there is little or no immunity in the population so it is expected to spread even more swiftly, and widely, than common seasonal influenza. How could I catch the new influenza A (H1N1)? When infected people cough or sneeze, infected droplets get on their hands, drop onto surfaces, or are dispersed into the air. Another person nearby can breathe in the droplets, or touch infected hands or surfaces, and be exposed. To prevent spread, people should wash and dry their hands regularly, and sick people should cover their mouth and nose with a tissue when coughing, and stay home until they are well. How long is someone infectious? The new influenza A (H1N1) virus seems to behave in the same way as seasonal flu - people may be contagious from one day before they develop symptoms, until seven days after the onset of symptoms. Can I get the new influenza A (H1N1) virus, known as swine flu, from eating or preparing pork? No. Eating properly handled and cooked pork products will not spread the disease. How long am I infectious with the flu? From the day before first getting sick up until about seven days after getting sick. See also: How does it spread? Back to top Preparing and protecting yourself and others How can I prepare my household for a possible influenza pandemic? View inforrmation on how to Be prepared. What can I do to protect myself from getting sick? View information on Protecting yourself and others page. What does ‘have good personal hygiene' actually mean? One of the most effective ways we have to protect ourselves and others from flu and other illness is good personal hygiene. This means washing your hands regularly with soap and water, and drying them well. It means being careful to cover up coughs and sneezes with a tissue, putting used tissues into a bin, and staying away from others if you have the flu. Hand washing Many infections, especially colds, gastroenteritis and flu, are caught when we put our unwashed hands, which have germs on them, into to our mouth, nose or eyes. Hands and wrists should be regularly washed with clean soap and water. Dry your hands with something clean, such as paper towels or hot air dryers. You should always wash your hands: after using the toilet before making or eating food after handling cats, dogs or other animals if you have been around someone who is coughing or has a cold. Back to top Immunity Will catching it now protect me from a more serious strain in the future? Not necessarily. Influenza viruses can change over time, and catching the new influenza A (H1N1)'swine flu' now doesn't necessarily mean you will be immune to a variation of the current strain in the future. What is the Ministry of health's view on 'swine flu parties'? 'Swine flu parties' are not part of the Ministry of Health's public health advice. The idea of 'swine flu parties' goes against the Ministry's efforts to contain the Influenza A (H1N1) Swine Flu virus. If people deliberately made themselves ill with this virus, this would have a huge impact on already-stretched health services. Deliberately infecting yourself with Influenza A (H1N1) Swine Flu will put your health at risk. It is also hard to tell at this stage, who will be worst affected by this virus. Back to top Who is at risk? Who is at risk of developing a more serious illness from swine flu? Based on current evidence, complications from swine flu are more likely in some people including: Pregnant women. Adults and children who have serious conditions including respiratory disease, heart disease, liver disease, blood disorders and neurological conditions. Adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV). Residents of nursing homes and other chronic-care facilities. See also: Information for pregnant women and breastfeeding mothers Back to top Treatment and caring for yourself and others What medicine should I take if I think that I have the flu? Most people recover from flu without needing treatment. But flu can cause more serious problems in some people, especially if they have other serious medical problems. The only medicine that most people with influenza will need to take is medicine to bring down a fever, especially paracetamol. Children with flu should not take aspirin. Some people may need antibiotics, if they develop other infections as a result of the flu, but antibiotics won't help the flu itself. Drugs that directly fight the flu virus are called antiviral medicines. They're normally only for people who could become more seriously ill from flu. Most people with flu will not need these antiviral medicines. Antiviral medicines are generally most effective if given early- within 48 hours of the first symptoms. Antiviral drugs may shorten the time your symptoms last, but only by about one day. Antiviral drugs may also help prevent extra problems (complications), such as pneumonia. A flu vaccine will help you avoid seasonal flu and this vaccine is available till September 30th (or until current stocks run out). Note there is no vaccine available in New Zealand for influenza A (H1N1) swine flu. View more information on Treatment. What should I do if I get sick? View information on What to do if you have the flu. Should I ‘feed a cold but starve the flu’ - ie, not eat much when I have the flu? Many people may have things they do which helps them to recover from seasonal flu. For any flu or cold, drinking lots of fluids helps. For some people with influenza there can be vomiting and diarrhoea, they should still try to eat, but may only be able to tolerate some foods. It's important that anyone with diarrhoea or vomiting gets enough to drink. View more information on What to do if you have the flu. What do I need to be careful about if my young child gets the flu? Children often get sick quickly; fortunately they often recover quickly as well. Young children can be more seriously affected by influenza and fever and may sometimes require medical or even hospital treatment. Some children may get other infections as a complication, like pneumonia or ear or sinus infections, and if this happens they will need antibiotics. Get medical advice if your child's fever lasts more than three to four days or if your child complains of symptoms like trouble breathing, ear pain, or a worsening cough. Young children under age two - even healthy children - are more likely than older children to need hospital care from complications of flu, although most people do recover without the need for any medical care. View more information on Caring for a baby or child with the flu. See also: Protecting and caring for yourself and others Back to top Government and health sector response What is the Government doing in response to the outbreak? The Ministry of Health has implemented its pandemic emergency response. Now that the virus is spreading in our communities the health sector has moved on to the next phase - called "Manage it" An important part of the Manage it approach includes individuals with mild to moderate flu symptoms looking after themselves at home in the same way they would with ordinary winter flu. This is to ensure hospitals and medical services can look after those who develop a more severe illness, or have existing conditions that may lead to complications. Because most cases will recover without needing medical treatment, swabbing and testing to identify the exact type of seasonal influenza will be carried out only to support the management of more serious cases or those who are most vulnerable to develop serious complications. People who become unwell with any type of influenza should look after themselves at home until they have fully recovered. They should call their GP if they develop more serious illness or if they have underlying conditions that make them more vulnerable. Antiviral drugs will be prescribed for people who need this treatment because of more severe influenza symptoms or who are at higher risk of developing complications. Government stocks of antiviral drugs and personal protective equipment are available to help us deal with the new flu virus. Government has purchased antiviral medicine Tamiflu sufficient to treat around a third of the population, and this has recently been supplemented with 135,000 treatment courses of another antiviral medicine, Relenza. Healthline, 0800 611 116, which normally takes calls from individuals wanting health advice, has been bolstered to allow them to take calls from the public who are concerned and are seeking advice about influenza. What other actions are being taken in response to the recent outbreak? Health authorities are: in regular contact with the World Health Organization to ensure we are well informed about international developments and acting in concert with global initiatives to limit the spread of the disease monitoring the spread of the disease and getting good information about individual cases in New Zealand planning for the possible need to increase or change the focus of our response. See also: The situation. Back to top Travel Should I avoid travel? No, unless you are sick and then you should stay home till you are better. What should I do before I leave home? Seek advice on influenza A (H1N1) before leaving. Your local medical authorities will advise on any precautions that should be taken before leaving and while you are in transit. This may include advice on medication, personal hygiene and other precautions. Now that the new influenza A (H1N1) "swine flu" is spreading in communities, you need to be well-informed about what you need to do if you become unwell with an influenza-like illness before you leave home or while travelling. If I get sick while I am in New Zealand, who should I contact? You should call a doctor in the first instance. Tourism operators, hotels and motels will have contacts details for local doctors and contact details for registered medical practitioners and medical centres can be found at the front of all local telephone directories (phone book). When in New Zealand you should contact a health provider by phone first, to avoid potentially infecting others. Travellers who are concerned about their health may also contact Healthline on 0800 611 116 (freephone) 24 hours a day, seven days a week for information and advice. Healthline is a free service staffed by registered nurses. Who will pay for my medical care if I don’t have travel insurance? Visitors to New Zealand will need to meet at least some of the cost of medical care themselves. This is likely to be the cost of visiting a doctor which can be between $80 NZD and $100 NZD plus the additional cost of medication if you are not seriously ill. If you have mild to moderate symptoms of influenza, Tamiflu can be purchased over the counter at pharmacies for around $75 a course, and does not require a prescription. However, if you are very ill, or are at risk of getting very ill as part of a public health or infection control response, Tamiflu will be provided at no charge from the national stockpile (though you may need to pay a dispensing or consultation fees). Note, if you require medical care for any condition unrelated to influenza A (H1N1) Swine Flu, you will be responsible for paying for the costs of your health care. If I get sick will I be quarantined in New Zealand? Now that the virus is beginning to spread within New Zealand, isolation and quarantine of cases and contacts amongst incoming travellers is no longer a focus. If you do get sick you are asked to isolate yourself (stay away from other people and don't go out in public) until you have recovered, or for 72 hours if you complete a course of anti-viral medication. Do I need travel insurance? Travel insurance is strongly recommended for all overseas travel. Will I be able to get help if my English language skills are not very good? Yes. Local District Health Boards have access to translators in a huge range of languages. When you phone to make an appointment with a doctor, or speak to a health professional ask for a translator. Healthline 0800 611 116 uses Language Line Monday to Friday, 9 a.m. to 6 p.m. When you call Healthline during these hours, the nurse or call handler can usually arrange for an interpreter. Outside these hours Healthline uses other interpreter services as far as possible. It is not always possible to locate an interpreter in a particular language at short notice. See also: Information for travellers and Travel health Back to top Staying away and returning to work or school When do I need to stay at home because I might have the flu? If you have flu-like symptoms, stay at home until essentially well, that is not sneezing and coughing as this is how the virus spreads. This is usually around three to four days after symptoms start, but may be up to a week. Studies show that most healthy adults may be able to infect others from one day prior to becoming sick up until about seven days after they first develop symptoms. Some young children and people with weakened immune systems may be contagious for slightly longer. When is it safe for me to go back to work or school? Stay at home until essentially well, that is not sneezing and coughing as this is how the virus spreads. This is usually around three to four days after symptoms start, but may be up to a week. Back to top Advice for businesses and schools What should a business do to prepare for a flu epidemic? In essence, businesses should encourage staff with flu symptoms to stay home until they are well. They should encourage good hygiene habits with staff and provide advice and reminders of the steps people can take to protect themselves (wash hands, cover coughs and sneezes, use tissues for sneezes and put the used ones in a lined bin). Businesses should also have a plan for how they will cope with significant numbers of staff away sick at the same time. There is good advice for businesses on the Department of Labour website: Pandemic planning (www.dol.govt.nz) What should a business do when an employee shows up with the flu? Send them home and ask them to stay away from work until they are well. What should a school do to prepare for the flu? Schools should have plans in place for dealing with flu and flu pandemics. More information is provided on the Ministry of Education website: Ministry of Education Pandemic Preparation information (www.minedu.govt.nz) What should a school do when a student or a teacher shows up with the flu? Send them home and ask them to stay there until they are well. See also: Information for employers and employees and Information for education providers and parents Back to top Vaccine Will I be able to be immunised against pandemic influenza? Yes. Next year’s seasonal influenza vaccine will contain the pandemic (swine flu) strain and should be available from March. This means that immunisation from pandemic influenza will be available as part of the seasonal influenza programme. The annual influenza immunisation programme usually runs from March to June. Who is able to get seasonal influenza immunisation? Seasonal influenza immunisation is widely available to people through their GP practice or local health provider, although some people may have to pay for it. Some employers pay for influenza vaccinations for their staff. Seasonal influenza immunisation is free (paid for by the Government) for those aged 6 months to 64 years with certain pre-existing health conditions, and for all those over 65. Who is eligible for free seasonal influenza immunisation? The Government subsidises influenza immunisations for: People aged 65 years or over People aged 6 months to 64 years with the following conditions: Cardiovascular disease - ischaemic heart disease, congestive heart disease, rheumatic heart disease, congenital heart disease, cerebrovascular disease. Chronic respiratory disease - asthma (if on regular preventive therapy), and other chronic respiratory disease with impaired lung function. Diabetes. Chronic renal disease. Cancer (patient currently has cancer), excluding basal and squamous skin cancer if not invasive. Other conditions - autoimmune disease, immune suppression, human immunodeficiency virus (HIV), transplant recipients, neuromuscular and central nervous system diseases, haemoglobinopathies and children on long term aspirin. In 2010 the Government will also subsidise seasonal influenza immunisations for some extra groups who are at particular risk from the pandemic strain: pregnant women people who are morbidly obese (for guidance, those people with a Body Mass Index 35 and greater) children aged 6 months to 4 years old who are enrolled in Access Primary Health Practices. These are GP practices in higher deprivation communities which generally have a high proportion of low income patients. Will seasonal influenza immunisation be compulsory? There are no plans to make seasonal influenza immunisation compulsory or to exclude un-immunised children from schools. Are there risks from seasonal influenza immunisation? Influenza vaccines have been used widely for many years now and their safety is well known. Like any vaccine side effects do occur, most are minor and temporary such as pain at the injection site, general discomfort, headache, raised temperature. In rare cases influenza vaccines can cause more serious adverse reactions (approximately 1-10 per million doses administered). What level of protection does seasonal influenza immunisation offer? Influenza vaccines typically provide protection from the types of influenza they target for at least six months to around 70% of people who receive them. Who supplies New Zealand’s seasonal influenza vaccine? The Ministry has contracts with two suppliers for seasonal influenza vaccine – Sanofi Aventis and CSL Biotherapies. Do the seasonal influenza vaccines used in New Zealand contain thiomersal or squalene? The seasonal influenza vaccines used in New Zealand do not contain thiomersal or squalene. Neither of the seasonal vaccines used in New Zealand contain any adjuvants. What if the pandemic worsens before the 2010 seasonal influenza immunisation programme starts? If the pandemic becomes more severe before the seasonal influenza programme starts, the Government has a contingency plan to offer pandemic immunisation to front-line workers who would be most at risk or who provide critical emergency services. The Government has purchased 300,000 doses of pandemic vaccine for this contingency. Not all of the vaccine has arrived yet and it has not yet been licensed for use in New Zealand. If there is enough vaccine available, then pandemic immunisation may also be offered to people with who are at greater risk of severe outcomes from pandemic influenza. Emergency pandemic immunisation would only be offered once a vaccine has been licensed for use in New Zealand. Is a separate pandemic vaccine available in New Zealand now? No pandemic influenza vaccine is currently approved for use in New Zealand. See also: Media releases from the Minister of Health: Free vaccine extended to swine flu at risk groups (3 November 2009 - beehive.govt.nz) Government secures strategic stock of swine flu vaccine (6 July 2009 - beehive.govt.nz) Related cabinet paper: Pandemic influenza immunisation (PDF, 152 KB) Back to top Website feedback We welcome your feedback on this page. Page last updated: 5 November 2009