H1N1 Swine Flu Information |
Gorham High School Nurse - Joyce LaRou RN 222-1105
Gorham Middle School Nurse - Teresa Merrill RN 222-1224
Village School Nurse - Elizabeth Ewing RN 222-1336
Narragansett School Nurse - Elizabeth Greatorex 222-1260
White Rock School Nurse - Carrie Chasse 222-1062
Parent Resources:
Seasonal Flu
* Usually during fall and winter months
* Affects 5-20% of the population
* Age 5 years and under and over age 65 years higher risk group
* Accounts for over 200,000 hospitalizations and 36,000 deaths annually in the U.S.
* Symptoms include fever, headache, fatigue, cough, sore throat, runny or stuffy nose, muscle aches, nausea, vomiting, diarrhea
* Complications include sinus infection, bacterial pneumonia, dehydration
* Best defense is through vaccination and hand washing (warm soap and water at least 20 seconds or alcohol-based hand sanitizer if running water is not available)
* Transmitted via cough, sneeze, or touching contaminated surface and then touching eyes, nose, or mouth
Who should be vaccinated?
* Age 6 months up to the 19th birthday
* Pregnant women
* Age 50 or older
* Persons with chronic medical conditions
* Nursing home and long term care patients
* Health care workers
* Household contacts of high risk persons or of infants less than 6 months old who can’t be vaccinated
Who should not receive the vaccine?
* Severe allergy to eggs
* Severe reaction to flu vaccine in the past
* Guillian-Barre syndrome within 6 weeks of a flu shot
* Less than 6 months old
* Any person who is febrile and ill on the day of administration
H1N1 Influenza:
* First noted as resembling swine flu
* Novel or new virus
* First noted in April 2009
* Transmitted same way as seasonal
* Same symptoms as seasonal
* Age 60 or older may have some antibodies but how much protection is unclear
* Predict 40-50% of population will get H1N1 and more deaths than with seasonal influenza
* Virus lives 2-8 hours on a surface, clean common “touch” surfaces
Who should receive the vaccine?
Novel H1N1 Vaccination Recommendations
With the new H1N1 virus continuing to cause illness, hospitalizations and deaths in the US during the normally flu-free summer months and some uncertainty about what the upcoming flu season might bring, CDC's Advisory Committee on Immunization Practices has taken an important step in preparations for a voluntary novel H1N1 vaccination effort to counter a possibly severe upcoming flu season. On July 29, ACIP met to consider who should receive novel H1N1 vaccine when it becomes available.
Novel H1N1 Vaccine
Every flu season has the potential to cause a lot of illness, doctor’s visits, hospitalizations and deaths. CDC is concerned that the new H1N1 flu virus could result in a particularly severe flu season this year. Vaccines are the best tool we have to prevent influenza. CDC hopes that people will start to go out and get vaccinated against seasonal influenza as soon as vaccines become available at their doctor’s offices and in their communities (this may be as early as August for some). The seasonal flu vaccine is unlikely to provide protection against novel H1N1 influenza. However a novel H1N1 vaccine is currently in production and may be ready for the public in the fall. The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine – it is intended to be used along-side seasonal flu vaccine.
CDC’s Advisory Committee on Immunization Practices (ACIP), a panel made up of medical and public health experts, met July 29, 2009, to make recommendations on who should receive the new H1N1 vaccine when it becomes available. While some issues are still unknown, such as how severe the virus will be during the fall and winter months, the ACIP considered several factors, including current disease patterns, populations most at-risk for severe illness based on current trends in illness, hospitalizations and deaths, how much vaccine is expected to be available, and the timing of vaccine availability.
The groups recommended to receive the novel H1N1 influenza vaccine include:
* Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
* Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus;
* Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
* All people from 6 months through 24 years of age
- Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
- Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
* Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.
We do not expect that there will be a shortage of novel H1N1 vaccine, but flu vaccine availability and demand can be unpredictable and there is some possibility that initially, the vaccine will be available in limited quantities. So, the ACIP also made recommendations regarding which people within the groups listed above should be prioritized if the vaccine is initially available in extremely limited quantities. For more information see the CDC press release CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1.
Once the demand for vaccine for the prioritized groups has been met at the local level, programs and providers should also begin vaccinating everyone from the ages of 25 through 64 years. Current studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.
H1N1 Swine Flu Vaccine Information
Vaccine types are live and inactivated (see below or click on the links to read more about the vaccines.)
Questions & Answers: 2009 H1N1 Nasal Spray Vaccine
Influenza A (H1N1) Monovalent Nasal-Spray Flu Vaccine (Live Attenuated Influenza Vaccine [LAIV]
What is the nasal spray flu vaccine?
What is the nasal spray flu vaccine? There are two types of flu vaccine: the flu shot and the nasal spray vaccine. Both types of vaccine are being made against 2009 H1N1. The nasal spray flu vaccine (sometimes called LAIV for Live Attenuated Influenza Vaccine) is a vaccine made with live, weakened viruses that cannot grow at normal body temperature and is given via a nasal sprayer. This vaccine was approved for seasonal influenza viruses in 2003 and tens of millions of doses of the vaccine have been given in the United States.
How is the 2009 H1N1 nasal spray vaccine different from the seasonal nasal spray vaccine?
The 2009 H1N1 nasal spray vaccine is being made in the same way as the seasonal nasal spray vaccine, but instead of containing three weakened live flu viruses, it only contains weakened 2009 H1N1 virus. (That is why it’ is called a “monovalent” vaccine.). The recommendations for who can get the 2009 H1N1 nasal spray vaccine are the same as for seasonal nasal spray vaccine. LAIV is recommended for use in healthy* people 2 years to 49 years of age who are not pregnant.
Who can be vaccinated with the 2009 H1N1 nasal-spray flu vaccine (LAIV)?
The 2009 H1N1 nasal spray vaccine is recommended for use in healthy people 2 years Through 49 years of age who are not pregnant. See below
Can health care providers get the live attenuated influenza vaccine?
Yes. LAIV is a very good option for most health care providers who are healthy, younger than 50 years old, and not pregnant. However, health care providers should not get LAIV if they are providing medical care for patients who require special environments in the hospital because they are profoundly immunocompromised (e.g., those who work in bone marrow transplant units). Although no immunocompromised patient has been shown to be harmed by use of LAIV among health care workers, the recommendation against the use of LAIV in health care workers with this type of patient contact is intended as an extra precaution for fragile immunocompromised patients. Health care workers with this type of patient contact can get LAIV, but if they do, they should wait 7 days after being vaccinated before returning to duties that include care of severely
immunocompromised patients in special environments.
Who should not be vaccinated with the 2009 H1N1 nasal-spray flu vaccine LAIV?
Certain people should not get a nasal spray flu vaccine, including the 2009 H1N1 nasal spray vaccine. This includes:
People younger than 2 years of age;
Pregnant women;
People 50 years of age and older;
People with a medical condition that places them at higher risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease; people with medical conditions such as diabetes or kidney failure; or people with illnesses that weaken the immune system, or who take medications that can weaken the immune system;
Children younger than 5 years old with a history of recurrent wheezing;
Children or adolescents receiving aspirin therapy;
People who have had Guillain-Barré syndrome (GBS), a rare disorder of the nervous system, within 6 weeks of getting a flu vaccine,
People who have a severe allergy to chicken eggs or who are allergic to any of the nasal spray vaccine components.
Should the nasal-spray flu vaccine be given to patients with chronic diseases other than those specifically listed above?
No. The nasal-spray flu vaccine is approved for use only in healthy* people 2 years to 49 years of age who are not pregnant.
Are there any contraindications to giving breastfeeding mothers the 2009 H1N1 vaccine?
Breastfeeding is not a contraindication for the nasal spray flu vaccine. Women who are breastfeeding can get the nasal spray vaccine, including 2009 H1N1 vaccine.
Can the nasal-spray flu vaccine be given to patients when they are ill?
The nasal-spray flu vaccine can be given to people with minor illnesses (e.g., diarrhea or mild upper respiratory tract infection with or without fever). However, if nasal congestion is present that might limit delivery of the vaccine to the nasal lining, then delaying of vaccination until the nasal congestion is reduced should be considered.
Can people receiving the nasal-spray flu vaccine LAIV pass the vaccine viruses to others?
In clinical studies, transmission of vaccine viruses to close contacts occurred only rarely. The current estimated risk of getting infected with vaccine virus after close contact with a person vaccinated with the nasal-spray flu vaccine is low (0.6%-2.4%). Because the viruses are weakened, infection is unlikely to result in influenza illness symptoms since the vaccine viruses have not been shown change into typical or naturally occurring influenza viruses.
Can contacts of people with weakened immune systems get the nasal-spray flu vaccine?
People who are in contact with others with severely weakened immune systems when they are being cared for in a protective environment (for example, people with hematopoietic stem cell transplants), should not get the nasal spray vaccine, including the 2009 H1N1 nasal spray vaccine if they will come into contact with the severely immunocompromised person within 7 days of vaccination. People who have contact with others with lesser degrees of immunosuppression (for example, people with diabetes, people with asthma taking corticosteroids, or people infected with HIV) can get the nasal spray vaccine.
What side effects are associated with the nasal-spray flu vaccine?
In children, side effects can include runny nose, headache, wheezing, vomiting, muscle aches, and fever. In adults, side effects can include runny nose, headache, sore throat, and cough. Fever is not a common side effect in adults receiving the nasal spray flu vaccine.
How effective is the nasal-spray seasonal flu vaccine?
In one large study among children aged 15-85 months, the seasonal nasal-spray flu vaccine reduced the chance of influenza illness by 92% compared with placebo. In a study among adults, the participants were not specifically tested for influenza. However, the study found 19% fewer severe febrile respiratory tract illnesses, 24% fewer respiratory tract illnesses with fever, 23-27% fewer days of illness, 13-28% fewer lost work days, 15-41% fewer health care provider visits, and 43-47% less use of antibiotics compared with placebo. A recent study suggested that seasonal LAIV may not be as effective as seasonal inactivated vaccine in adults, but more data are needed to confirm if one is better than the other. Both vaccines are expected to be effective against 2009 H1N1.
When should the 2009 H1N1 nasal-spray flu vaccine be given?
Flu vaccination should begin as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. By early October 2009, extensive 2009 H1N1 flu activity was being reported in the United States. It’s possible that there may be waves of 2009 H1N1 activity during the 2009-2010 flu season that hit communities more than once over the course of the influenza season, which typically peaks in January or February but can last as late as May.
How many doses of nasal spray vaccine are needed?
In adults, only one dose of 2009 H1N1 vaccine, including the 2009 H1N1 nasal spray vaccine, is needed for protection.
All children 2 through 9 years of age getting a 2009 H1N1 vaccine will need two doses of 2009 H1N1 vaccine (either the 2009 H1N1 flu shot or the 2009 H1N1 nasal spray vaccine), The first dose should being given as soon as vaccine becomes available. The second dose should be given 28 or more days after the first dose. The first dose "primes" the immune system; the second dose provides immune protection. Children who only get one dose of vaccine when they need two doses may have reduced or no protection. Be sure to follow up to get your child a second dose if they need one. It usually takes about two weeks after the second dose for protection to begin.
Can people who got the flu shot last year get the nasal-spray flu vaccine LAIV this year?
Yes, people who got inactivated influenza vaccine (the flu shot) last year can get the nasal-spray flu vaccine this year.
Can the nasal-spray flu vaccine be given at the same time as other vaccines?
The nasal spray flu vaccine can be given at the same time or around the same time as an inactivated (killed) vaccine or any other live vaccine except for the seasonal nasal spray vaccine. (The seasonal nasal spray vaccine and the 2009 H1N1 nasal spray vaccine should not be given at the same time.) The 2009 H1N1 flu shot (inactivated 2009 H1N1 vaccine) can be given at the same visit as any other vaccine, including pneumococcal polysaccharide vaccine.
Can the 2009 H1N1 nasal spray vaccine and the seasonal nasal spray vaccine be given at the same time to the same person?
No. The seasonal nasal spray vaccine and the 2009 H1N1 nasal spray vaccine should not be given at the same time. This is because the nasal spray vaccines might not be as effective if given together. It is fine to receive the 2009 H1N1 nasal spray at the same time as the seasonal influenza (flu) shot, or the seasonal flu shot at the same time as the 2009 H1N1 nasal spray vaccine.
Can the nasal-spray flu vaccine be used together with influenza antiviral medications?
If a person is taking an influenza antiviral drug (including Tamiflu® or Relenza®, then the nasal spray flu vaccine should not be given until 48 hours after the last dose of the influenza antiviral medication was given. If a person takes antiviral drugs within two weeks of getting the nasal spray flu vaccine, that person should get revaccinated. (The antiviral drugs will have killed the vaccine viruses that are supposed to cause the immune response against those viruses.)
If a child under the age of 9 years is getting seasonal influenza vaccine for the first time and requires 2 doses, does the same type of vaccine have to be used for both doses?
Ideally the same type of vaccine should be used for both doses as we know a series of two doses of the same type of vaccine has worked in clinical trials. No information is available about how effective a series of two different vaccines might be. If different types of vaccine are used for the first and second doses, however, there is no need to revaccinate a child. The doses should be separated by at least one month (28 days).
How is the nasal-spray flu vaccine stored?
The nasal-spray flu vaccine, including both the seasonal and 2009 H1N1 nasal spray vaccines, must be stored in a refrigerator at 2-8°C (35-46°F).
Can health care workers who cannot receive the nasal spray vaccine (e.g., pregnant women, older adults, persons with chronic medical conditions) administer this vaccine to others?
Yes. Health care workers who cannot get the nasal spray vaccine themselves can administer the vaccine to others.
What personal protective equipment is recommended for health care workers who are giving the 2009 H1N1 nasal spray vaccine?
Personal protective equipment (gloves and masks) are not needed when administering the nasal spray vaccine, including the 2009 H1N1 nasal spray vaccine.
Does the nasal spray flu vaccine contain thimerosal?
No, neither the seasonal nor the 2009 H1N1 nasal-spray flu vaccines contain thimerosal or any other preservative.
Can the nasal spray flu vaccine give you the flu?
Unlike the flu shot, the nasal spray flu vaccine does contain live viruses. However, the viruses are attenuated (weakened) and cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose. The viruses cannot infect the lungs or other areas where warmer temperatures exist. Some children and young adults 2 years to 17 years of age have reported experiencing mild reactions after receiving seasonal nasal spray flu vaccine, including runny nose, nasal congestion or cough, chills, tiredness/weakness, sore throat and headache. Some adults 18 years to 49 years of age have reported runny nose or nasal congestion, cough, chills, tiredness/weakness, sore throat and headache. These side effects are mild and short-lasting, especially when
compared to symptoms of influenza infection.
Who makes the nasal spray vaccine?
The nasal spray vaccine for use in the United States is being made by MedImmune, the same company that makes the seasonal nasal spray vaccine called “FluMist®.” The 2009 H1N1 nasal spray vaccine is being made using the same manufacturing process that has been used since 2003 to make the seasonal nasal spray vaccine.
More Information About Flu Vaccine
Additional Resources for on the Use of Nasal Spray Vaccines in Health Care Settings
Parent Resources:
Interim Guidance for Novel H1N1 Flu (Swine Flu): Taking Care of a Sick Person in Your Home
This document has been updated in accordance with the CDC Recommendations for the Amount of Time Persons with Influenza-Like Illness Should be Away from Others. Novel H1N1 flu virus infection (formerly known as swine flu) can cause a wide range of symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue.
Some people have reported diarrhea and vomiting associated with novel H1N1 flu. Like seasonal flu, novel H1N1 flu in humans can vary in severity from mild to severe. Severe disease with pneumonia, respiratory failure and even death is possible with novel H1N1 flu infection. Certain groups might be more likely to develop a severe illness from novel H1N1 flu infection, such as pregnant women and persons with chronic medical conditions. Sometimes bacterial infections may occur at the same time as or after infection with influenza viruses and lead to pneumonias, ear infections, or sinus infections.
The following information can help you provide safer care at home for sick persons during a flu outbreak or flu pandemic.
How Flu Spreads
The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.
People with novel H1N1 flu who are cared for at home should:
• check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema
• check with their health care provider about whether they should take antiviral medications
• keep away from others as much as possible. This is to keep from making others sick. Do not go to work or school while ill
• stay home for at least 24 hours after fever is gone, except to seek medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine.)
• get plenty of rest
• drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated
• cover coughs and sneezes. Clean hands with soap and water or an alcohol-based hand rub often and especially after using tissues and after coughing or sneezing into hands
• wear a facemask – if available and tolerable – when sharing common spaces with other household members to help prevent spreading the virus to others. This is especially important if other household members are at high risk for complications from influenza. For more information, see the Interim Recommendations for Facemask and Respirator Use
• be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention.
Medications to Help Lessen Symptoms of the Flu
Check with your healthcare provider or pharmacist for correct, safe use of medications. Antiviral medications can sometimes help lessen influenza symptoms, but require a prescription. Most people do not need these antiviral drugs to fully recover from the flu. However, persons at higher risk for severe flu complications, or those with severe flu illness who require hospitalization, might benefit from antiviral medications. Antiviral medications are available for persons 1 year of age and older. Ask your health care provider whether you need antiviral medication.
Influenza infections can lead to or occur with bacterial infections. Therefore, some people will also need to take antibiotics. More severe or prolonged illness or illness that seems to get better, but then gets worse again may be an indication that a person has a bacterial infection. Check with your health care provider if you have concerns.
Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye’s syndrome. For more information about Reye’s syndrome, visit the National Institute of Health website.
• Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.
• Children 5 years of age and older and teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.
• Children younger than 4 years of age should NOT be given over-the-counter cold medications without first speaking with a health care provider.
• The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.
• Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS).
Examples of these kinds of medications include:
Generic Name Brand Name(s)
Acetaminophen Tylenol®
Ibuprofen Advil®, Motrin®, Nuprin®
Naproxen Aleve
• Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. Importantly, these medications will not lessen how infectious a person is.
• Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications—don’t double dose! Patients with kidney disease or stomach problems should check with their health care provider before taking any NSAIDS.
Check with your health care provider or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu. For more information on products for treating flu symptoms, see the FDA website.
When to Seek Emergency Medical Care
Get medical care right away if the sick person at home:
• has difficulty breathing or chest pain
• has purple or blue discoloration of the lips
• is vomiting and unable to keep liquids down
• has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry
• has seizures (for example, uncontrolled convulsions) is less responsive than normal or becomes confused
Steps to Lessen the Spread of Flu in the Home
When providing care to a household member who is sick with influenza, the most important ways to protect yourself and others who are not sick are to:
• Keep the sick person away from other people as much as possible especially others who are at high risk for complications from influenza
• Remind the sick person to cover their coughs, and clean their hands with soap and water or an alcohol-based hand rub often, especially after coughing and/or sneezing
• Have everyone in the household clean their hands often, using soap and water or an alcohol-based hand rub. Children may need reminders or help keeping their hands clean
• Ask your health care provider if household contacts of the sick person - particularly those contacts who may be pregnant or have chronic health conditions—should take antiviral medications such as oseltamivir (Tamiflu®) or zanamivir (Relenza®) to prevent the flu
• If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable. Infants should not be cared for by sick family members.
Placement of the sick person
• Keep the sick person in a room separate from the common areas of the house. (For example, a spare bedroom with its own bathroom, if that’s possible.) Keep the sickroom door closed.
• Unless necessary for medical care or other necessities, people who are sick with an influenza-like-illness should stay home and keep away from others as much as possible, including avoiding travel, for at least 24 hours after fever is gone except to get medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine). This is to keep from making others sick. Children, especially younger children, might potentially be contagious for longer periods.
• If persons with the flu need to leave the home (for example, for medical care), they should wear a facemask, if available and tolerable, and cover their nose and mouth when coughing or sneezing
• Have the sick person wear a facemask – if available and tolerable – if they need to be in a common area of the house near other persons.
• If possible, sick persons should use a separate bathroom. This bathroom should be cleaned daily with household disinfectant.
Protect other persons in the home
• The sick person should not have visitors other than caregivers. A phone call is safer than a visit.
• If possible, have only one adult in the home take care of the sick person. People at increased risk of severe illness from flu should not be the designated caretaker, if possible.
• If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable. For more information, see the Interim Recommendations for Facemask and Respirator Use.
• Avoid having pregnant women care for the sick person. (Pregnant women are at increased risk of influenza-related complications and immunity can be suppressed during pregnancy).
• Avoid having sick family members care for infants and other groups at high risk for complications of influenza.
• All persons in the household should clean their hands with soap and water or an alcohol-based hand rub frequently, including after every contact with the sick person or the person’s room or bathroom.
• Use paper towels for drying hands after hand washing or dedicate cloth towels to each person in the household. For example, have different colored towels for each person.
• If possible, consideration should be given to maintaining good ventilation in shared household areas (e.g., keeping windows open in restrooms, kitchen, bathroom, etc.).
• Antiviral medications can be used to prevent the flu, so check with your health care provider to see if some persons in the home should use antiviral medications.
If you are the caregiver
• Avoid being face-to-face with the sick person.
• When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.
• Clean your hands with soap and water or use an alcohol-based hand rub* after you touch the sick person or handle used tissues, or laundry.
• Talk to your health care provider about taking antiviral medication to prevent the caregiver from getting the flu.
• If you are at high risk of influenza associated complications, you should not be the designated caretaker, if possible.
• If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. Designate a person who is not at high risk of flu associated complications as the primary caretaker of household members who are sick with influenza, if at all possible. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable. For more information, see the Interim Recommendations for Facemask and Respirator Use
• Monitor yourself and household members for flu symptoms and contact a telephone hotline or health care provider if symptoms occur. Using Facemasks or Respirators
• Avoid close contact (less than about 6 feet away) with the sick person as much as possible.
• If you must have close contact with the sick person (for example, hold a sick infant), spend the least amount of time possible in close contact and try to wear a facemask (for example, surgical mask) or N95 disposable respirator.
• An N95 respirator that fits snugly on your face can filter out small particles that can be inhaled around the edges of a facemask, but compared with a facemask it is harder to breathe through an N95 mask for long periods of time. More information on facemasks and respirators can be found at H1N1 Flu (Swine Flu) website.
• Facemasks and respirators may be purchased at a pharmacy, building supply or hardware store.
• Wear an N95 respirator if you help a sick person with respiratory treatments using a nebulizer or inhaler, as directed by their doctor. Respiratory treatments should be performed in a separate room away from common areas of the house when at all possible.
• Used facemasks and N95 respirators should be taken off and placed immediately in the regular trash so they don’t touch anything else.
• Avoid re-using disposable facemasks and N95 respirators, if possible. If a reusable fabric facemask is used, it should be laundered with normal laundry detergent and tumble-dried in a hot dryer.
• After you take off a facemask or N95 respirator, clean your hands with soap and water or an alcohol-based hand sanitizer.
• For more information, see the Interim Recommendations for Facemask and Respirator Use Household Cleaning, Laundry, and Waste Disposal
• Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.
• Keep surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.
• 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.
• Wash linens (such as bed sheets and towels) by using household laundry soap and tumble dry on a hot setting. Avoid “hugging” laundry prior to washing it to prevent contaminating yourself. Clean your hands with soap and water or alcoholbased hand rub right after handling dirty laundry.
• Eating utensils should be washed either in a dishwasher or by hand with water and soap.
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Contact the Centers Ho Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30333, USA
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