CEPAR Travel Advice for the Johns Hopkins Community: H1N1 Flu and Traveling this Summer May 26, 2009 Swine H1N1 flu is a respiratory disease of pigs caused by a type A influenza virus that regularly causes outbreaks of influenza among pigs. Swine H1N1 viruses do not normally infect humans, although human infections can occur. The current strain of novel H1N1 flu virus does spreads from human to human and can cause illness. This outbreak of H1N1 flu, while decreasing significantly, is still ongoing, and additional cases are expected. For more information concerning this novel H1N1 flu virus, please see the CDC H1N1 website (http://www.cdc.gov/h1n1flu/), from which much of this information was taken. Symptoms: The main symptoms of H1N1 flu in people are similar to the main symptoms of seasonal flu, and almost always include FEVER (greater than 100° F or 37.8° C). Other common symptoms include sore throat, cough, and a stuffy or runny nose. Additional, although less common symptoms may include chills, headache and body aches, fatigue, and diarrhea or vomiting. Preventive measures: To prevent the spread of novel H1N1 flu, you should avoid contact with ill persons. When you cough or sneeze, cover your nose and mouth with a tissue or your sleeve (if you do not have a tissue), and then throw used tissues in a trash-can. Several times a day, and especially after you cough or sneeze, wash your hands with soap and water, or use an alcohol-based hand gel. Precautions to minimize potential of being exposed during travel are detailed below. If you might be ill: If you think you are ill with H1N1 flu, avoid close contact with others as much as possible. Stay at home. Seek medical care if you are severely ill (such as having trouble breathing). There are antiviral medications for prevention and treatment of novel H1N1 flu that a doctor can prescribe, although, be aware these are not always indicated Do not go to work, school, or travel while ill. If you have traveled to and returned from an affected area (such as Mexico), or have been exposed to someone who is possibly infected with H1N1 flu during the last 7 days, and are experiencing symptoms consistent with H1N1 flu, you should report your illness to Occupational Health, Student Health, or your health care provider immediately and
inform them of your recent travel, as per CEPAR’s recent H1N1 travel policy. If you are traveling from the United States to affected areas, you should be aware of the risk of illness with H1N1 flu and take the precautions outlined below. Travel Within the United States CDC has not recommended that people avoid domestic travel. If you are planning travel to affected areas, the following recommendations will help you reduce your risk of infection and stay healthy. Before your trip: Monitor the outbreak situation. Check updates from CDC (http://www.cdc.gov/h1n1flu/). Be sure you are up-to-date with all your routine vaccinations, including seasonal influenza vaccine if available. If you are at high risk for flu complications, contact your health-care provider for advice before you travel. Identify the health-care resources in the area(s) you will be visiting. During your trip: Monitor the local situation. Pay attention to announcements from the local government. Follow local public health guidelines, including any movement restrictions and prevention recommendations, or the wearing of masks. Follow the preventive measures outlined above. What to do if you feel sick while traveling: Most people will recover without needing medical care. If you have severe illness or you are at high risk for flu complications, contact your health-care provider or seek local medical care. Avoid further travel for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer, except to get medical care. This is to keep from infecting others and spreading the virus further. After your trip: Closely monitor your health for 7 days. If you become ill with fever and other symptoms of H1N1 flu, follow the recommendations above. International Travel CDC’s Travel Health Warning recommending against non-essential travel to Mexico, in effect since April 27, 2009, has now been downgraded to a Travel Health Precaution for Mexico. Changes to this recommendation will be posted on the CDC website (http://wwwn.cdc.gov/travel/). Please check this site frequently for updates on all
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international travel. Please also check the State Department’s travel website (http://travel.state.gov/). If you must travel to an area that has reported cases of H1N1 flu, follow all guidance above. Be aware that Mexico is checking all exiting airline passengers for signs of H1N1 flu. Exit screening may cause significant delays at airports. At this time, the United States is not conducting enhanced entry screening of passengers arriving from Mexico, nor is the United States conducting exit screening of passengers departing for Mexico. If you are planning to travel to the southern hemisphere this summer, please pay special attention to any CDC or State Department travel advisories, since – with winter approaching – it will be the flu season there. Check if your health insurance plan will cover you abroad. Consider purchasing additional insurance that covers medical evacuation in case you become sick. Remember that U.S. embassies, consulates and military facilities do not have the legal authority, capability, and resources to evacuate or to give medications, vaccines or medical care to private U.S. citizens overseas. If you need to find local medical care, a U.S. consular officer can help you locate medical services and will inform your family or friends in the United States of your illness. To contact the U.S. Embassy or consulate in the country where you are visiting, call the Overseas Citizens Services at: 1-888-407-4747 (if calling from the U.S. or Canada), or 00 1 202-501-4444 (if calling from overseas). Some of the Hopkins insurance plans include arrangements for medical transport back to the United States, and Johns Hopkins Medicine can also arrange for such transport, although for a cost. At this time, CEPAR does not recommend carrying a treatment course of an antiviral like TamiFlu, nor masks, with you.
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