What you need to know about H1N1 influenza

What is H1N1 influenza?

H1N1 influenza is a respiratory illness that causes symptoms similar to those of seasonal influenza. Cases of H1N1 influenza have been reported in people around the world, including Canada. Influenza viruses change over time. The World Health Organization (WHO) sets the pandemic alert level globally and has raised it to phase six. This means the virus has shown sustained community transmission in more than one WHO region. The pandemic level is based on the spread of the virus, not the severity of illness. Health officials continue to monitor the situation, and plans for pandemic and emergency responses are ready for use. The influenza outbreak last spring was province-wide, and more cases are expected in communities across Manitoba this fall and winter. Although there has been an increase in the number of people with severe respiratory illness, this has been a small proportion of the people who have had H1N1 influenza in Manitoba. The majority of people in Manitoba who have become ill have not required hospitalization.

What precautions should I take?

Manitobans are encouraged to use routine precautionary measures to prevent infections:

• Cover a cough or sneeze by coughing or sneezing into your elbow or sleeve, or using a tissue to cover your nose and mouth. Throw the tissue in the garbage right away.
• Wash your hands often with soap and water, especially after you cough or sneeze. Hand sanitizers are also effective.
• Limit touching your eyes, nose or mouth.
• Try to stay one to two metres away from someone who is sick with influenza.
• Maintain your health by making healthy food choices, being physically active and getting enough sleep. Be aware that smoking makes you a high risk for getting seriously ill with influenza, If you smoke, you can get help quitting by calling the Manitoba Smoker's Helpline at 1-877-513-5333.

What about protecting children?

Children should take the same precautions as adults, including washing their hands regularly and covering their nose and mouth when coughing. Young children may need help with hand washing. To avoid the spread of germs, keep surfaces clean in areas where children play.

When should I seek medical care for my child?

Older children with influenza-like symptoms should stay home from school or daycare. Children less than five years of age with influenza-like symptoms should see their health-care provider within a day, especially children under two years of age. If you have questions or are concerned that your child may need care, contact your health-care provider or Health Links-Info Santé at 788-8200 or 1-888-315-9257.

Should I be tested to find out if I have H1N1 influenza?

Most Manitobans who have been infected by H1N1 influenza will have mild symptoms or may not even know they've been infected. The province gives recommendations on who should be tested, which can change throughout the course of an outbreak. Only people who are severely ill need to be tested. This may help us to understand who is at greater risk of becoming more ill, while also keeping the demands on our labs manageable. Health-care providers know how to diagnose and treat respiratory illnesses like H1N1 and don't need test results to begin your care.

What should I do if there is a confirmed case in my child's school?

Currently, there is no need to close schools or child care centres. Children who are feeling well do not need to stay home. Children who are ill should stay home until they feel better.

How do I know if I have a fever?

Fever is a sign that the body is fighting an infection or other illness. You or your child has a fever if body temperature is 38°C (100.4°F) or higher. Touching a forehead or neck is not a reliable way to check if someone has a fever. The best way to measure a person's temperature is by using a digital thermometer placed in the mouth (oral), the ear (tympanic) or under the armpit (axillary). The use of glass mercury thermometers is not recommended. You can buy a digital thermometer at your drug store. For infants and young children, the safest way to take a temperature is in the centre of the armpit. If the child is over two years of age, an ear thermometer can be used. Taking the temperature in the mouth is unsafe because young children can bite and break the thermometer. Also, the reading can be wrong because it is hard to keep a thermometer under a child's tongue. For more information on taking a child's temperature, please see the "Caring for a Child with a Fever" fact sheet .

What can I do at home to treat a fever?

• Dress in lightweight clothing and keep the room temperature around 20ºC (68ºF).
• Drink plenty of fluids in order to replace body fluids lost in sweat. If the person who is sick has urine (pee) that is darker than usual, they need to drink more.
• Offer small, nutritious meals. People sick with influenza may not be very hungry.
• Take acetaminophen (ex: Tylenol®, Tempra®). Use the dose and schedule recommended on the package or by your doctor or pharmacist. Ibuprofen (ex: Advil®, Motrin®) may be used for children older than six months and for adults.
• Do not give acetylsalicylic acid, also known as ASA, (ex: Aspirin®) to anyone under 18 years of age because it can lead to brain and liver damage (Reye's Syndrome).

How can I treat other symptoms of influenza?

• Get plenty of rest.
• Gargle with warm salt water if you have a sore throat.
• Use a cool mist humidifier to help with a stuffy nose.
• If a baby is having problems breathing because of a stuffy nose, use a rubber suction bulb to clear the mucous. These are available at drug stores. You may also use saline nose drops or spray if the mucous is very thick.

There are many over-the-counter cough and cold medicines sold in stores that do not require a doctor's prescription. These include decongestants, cough syrups, nasal drops and antihistamines. Over-the-counter cough and cold medicines should not be given to children under six years of age unless prescribed by a doctor.

Check with your doctor or pharmacist before taking or giving over-the-counter medicines to anyone. This is especially important if the person is under 12 years of age, is taking other medicines or has a chronic medical condition. Be sure to read label instructions carefully and do not take more than recommended.

Should I be wearing a face mask?

Manitoba Health and Healthy Living and the Public Health Agency of Canada do not recommend that healthy people wear masks as they go about their daily routines. There is no evidence that wearing a mask will prevent the spread of infection in the general population. People who are in close contact with someone who is sick with flu, like doctors and nurses, may be asked to wear a face mask to protect them from the virus. If a mask is to be used, it must cover the mouth and nose, and hands must be cleaned after removal of the mask.

Should I expect my healthcare provider to be wearing a mask?

When in close contact with someone who is sick with influenza, healthcare providers will wear a mask. But for usual patient visits not related to influenza or any other respiratory infection, health-care workers will not need a mask. Remember that ill health-care providers will not be at work.

When I get my influenza shot this year, will it protect me against H1N1 influenza?

This year's seasonal influenza shot protects against known flu viruses.
H1N1 is a new virus and the seasonal influenza shot will not protect against it. The influenza shot will protect against the seasonal flu.

When can I get a shot for the new H1N1 flu?

Canada has taken steps to acquire enough vaccine to immunize the population. The latest information suggests the vaccine could be ready by November.

What are antivirals?

Antivirals are drugs used for early treatment of influenza. If taken soon after a person gets sick (within 48 hours), they can reduce symptoms, shorten the length of the illness and potentially reduce serious complications. Antivirals work by reducing a virus's ability to reproduce, but they do not provide immunity from the virus.

If I have influenza-like illness, will I be given antivirals?

Tamiflu will be provided to those who are at risk of getting seriously ill or who have severe illness. People who are at higher risk for getting seriously ill with H1N1 should get medical care within 24 to 48 hours of starting to feel sick, and not wait it out for a few days first. This will allow a health-care provider to determine whether they should be given an antiviral medication like Tamiflu. Tamiflu, if taken early (the sooner the better, ideally within the first 24-48 hours from the start of symptoms), helps to prevent needing hospital care or even a stay in ICU.

I'm pregnant - should I be concerned?

Pregnant women are not more likely to get pandemic H1N1, but if they do catch the virus, they may be more likely to have severe illness that may affect their pregnancy. While pregnant women are considered more likely to develop severe illness, the vast majority of pregnant women did not require medical or hospital care during the first wave of the pandemic in Manitoba.

Any infectious illness can put a mother and unborn baby's health at risk. Generally, the risk of complications from pandemic H1N1, like pneumonia and severe respiratory distress, is greater in the second and third trimesters of pregnancy. Complications from H1N1 flu in the mother may lead to harmful effects on the fetus.

Source: Manitoba Health / Winnipeg Health Region

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