The H1N1 flu spreads like the seasonal flu we see each year, mainly through coughs and sneezes of people who are sick with the virus. The virus may also spread by touching infected objects and then touching the eyes, nose, or mouth.

Flu-like symptoms include:

* Fever (usually high), Chills
* Headache
* Extreme tiredness or fatigue
* Cough
* Sore throat
* Runny or stuffy nose
* Muscle aches
* Stomach symptoms such as nausea, vomiting, and diarrhea are less common, but can occur in children

How long can an infected person spread this virus to others?
People infected with seasonal and 2009 H1N1 flu shed virus and may be able to infect others from 1 day before getting sick to 5 to 7 days after. This can be longer in some people, especially children and people with weakened immune systems and in people infected with the new H1N1 virus.

The following are the CDC’s recommendations for parents:

* All members of the household should wash their hands frequently, using soap and water or alcohol-based sanitizer (if soap and water are unavailable).
* Teach children to use tissues to cover their nose and mouth when sneezing or coughing. If tissues are unavailable, the crook of an elbow or a shoulder is a good substitute—not the hands, which can spread the virus to anything they touch.
* Anyone who becomes sick with the above symptoms should stay home for at least 24 hours after the fever is gone. If symptoms worsen, children should extend their stay at home for at least 3 more days, no matter how soon they feel better. This means home, not just out of school: “Children shouldn’t be… mixing in crowds or going to malls when they are sick,” said Lance Chilton, a member of the CDC. And once any member of a household gets sick, all school-age children should remain home for five days.

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


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.

Contamination & Cleaning

Your browser may not support display of this image. How long can influenza virus remain viable on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for 2 to 8 hours after being deposited on the surface.

What kills influenza virus?
Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time. For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry.

*What if soap and water are not available and alcohol-based products are not allowed in my facility?
Though the scientific evidence is not as extensive as that on hand washing and alcohol-based sanitizers, other hand sanitizers that do not contain alcohol may be useful for killing flu germs on hands.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.

How should waste disposal be handled to prevent the spread of influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste.

Your browser may not support display of this image. What household cleaning should be done to prevent the spread of influenza virus?
To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

How should linens, eating utensils and dishes of persons infected with influenza virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid “hugging” laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry.

Eating utensils should be washed either in a dishwasher or by hand with water and soap.

Important points from the CDC:

According to a recent CDC study entitled “Swine Flu Deaths Higher in Older kids,” the following are two important points in the article:

“Two-thirds of the children who died had high-risk medical conditions. Nearly all of them had and illness related to the nervous system, including mental retardation, cerebral palsy and epilepsy and other seizure disorders.”

“Of the children who were healthy before they got swine flu, many were probably killed by a one-two punch of swine flu working with a bacterial co-infection, CDC officials said.”

In addition, from the CDC website is the following statement:

How does 2009 H1N1 flu compare to seasonal flu in terms of its severity and infection rates?
With seasonal flu, we know that seasons vary in terms of timing, duration and severity. Seasonal influenza can cause mild to severe illness, and at times can lead to death. Each year, in the United States, on average 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes. Of those hospitalized, 20,000 are children younger than 5 years old. Over 90% of deaths and about 60 percent of hospitalization occur in people older than 65.

When the 2009 H1N1 outbreak was first detected in mid-April 2009, CDC began working with states to collect, compile and analyze information regarding the 2009 H1N1 flu outbreak, including the numbers of confirmed and probable cases and the ages of these people. The information analyzed by CDC supports the conclusion that 2009 H1N1 flu has caused greater disease burden in people younger than 25 years of age than older people. At this time, there are few cases and few deaths reported in people older than 64 years old, which is unusual when compared with seasonal flu. However, pregnancy and other previously recognized high risk medical conditions from seasonal influenza appear to be associated with increased risk of complications from this 2009 H1N1. These underlying conditions include asthma, diabetes, suppressed immune systems, heart disease, kidney disease, neurocognitive and neuromuscular disorders and pregnancy.


The swine flu vaccine will soon be available for those interested in receiving it, however it will not be offered at this office. Due to the small sample population on which the vaccine has been tested thus far (4,500 healthy adults), and the lack of solid evidence indicating the safety profile of this vaccine, we at All Star Pediatrics have opted not to provide this vaccine at this time. As discussed above, the swine flu, although causing people to be ill, is rarely life-threatening unless there are underlying severe medical conditions. Thus far, the swine flu has killed 3,000 people worldwide, whereas Seasonal Influenza (in the same time period) has killed 36,000 people in the United States alone.

Contact your local health department at 407-836-2600 for more information on when and where the swine flu vaccine will be provided locally.