Vaccinations for the vulnerable nausea

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					Swine Flu Q & A for teachers only:

What is swine flu?

Swine influenza is a disease that pigs get. The virus currently spreading
among people is now generally referred to as swine flu, although the origin of
the disease is still under investigation. There are regular outbreaks of swine
flu in pigs worldwide. It does not normally infect humans, although this does
sometimes happen, usually in people who have had close contact with pigs.
Swine flu viruses are usually of the H1N1 sub-type. The swine flu that has
spread to humans is a version of this virus.
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Why is swine flu affecting humans?

Because the swine flu virus has mutated (changed) and is now able to infect
humans and transmit between them.

How is the swine flu infection diagnosed?

The following people should call their GP directly for an assessment of their
symptoms and a diagnosis:

      those with a serious existing illness, such as cancer
      pregnant women,
      those who have a sick child under one,
      those with a condition that suddenly gets much worse, or
      those with a condition that is still getting worse after seven days (five for a

Which people are most vulnerable from swine flu?

Those who are more at risk from becoming seriously ill with swine flu are
people with:

      chronic (long-term) lung disease, including people who have had drug
       treatment for their asthma within the past three years,
      chronic heart disease,
      chronic kidney disease,
      chronic liver disease,
      chronic neurological disease (neurological disorders include motor neurone
       disease, Parkinson's disease and multiple sclerosis),
      suppressed immune systems (whether caused by disease or treatment),
      diabetes,
      pregnant women,
      people aged 65 or older, and
      young children under five.

Is the new swine flu virus contagious?

The Health Protection Agency (HPA) says the new swine flu virus is highly
contagious and is spreading from person to person.
Swine flu spreads in the same way as ordinary colds and flu. The virus is
spread through the droplets that come out of the nose or mouth when
someone coughs or sneezes.
If someone coughs or sneezes and does not cover it, those droplets can
spread about one metre (3ft). If you are very close to them you might breathe
these in.
If someone coughs or sneezes into their hand, those droplets and the virus
within them are easily transferred to surfaces that the person touches, such
as door handles, hand rails, phones and keyboards. If you touch these
surfaces and touch your face, the virus can enter your system and you can
become infected.

How long does the virus live on surfaces?

The flu virus can live on a hard surface for up to 24 hours, and a soft surface
for around 20 minutes.
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What is the incubation period for swine flu?

According to the Health Protection Agency, the incubation period for swine flu
(the time between infection and appearance of symptoms) can be up to seven
days, but it is most likely to be between two and five days. But it is
currently too early to be able to provide details on virus characteristics,
including incubation period, with total certainty.
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When are people most infectious?

People are most infectious soon after they develop symptoms. They can
continue to shed (spread) the virus (for example, in coughs and sneezes) for
up to five days (seven days in children). People become less infectious as
their symptoms subside, and once their symptoms are gone they are no
longer considered infectious to others.
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Should I avoid contact with people suspected of having swine flu?

People with suspected swine flu will have been asked to stay at home and
restrict their contact with people. Most people should continue their normal
life, including going to school or work. This includes children who attend a
school with a confirmed case of swine flu.
There is no need to avoid contact with people who might simply have come
into contact with those with the illness, such as the parents of children at
schools with a confirmed case but who are not themselves ill.

Will I die from swine flu?

For most people, the illness has been mild and self-limiting. The virus has
caused severe illness in a minority of people, most of whom had an
existing serious condition.

What are the complications of swine flu?

One of the most common complications of any type of flu is a secondary
bacterial chest infection, such as bronchitis (infection of the airways).
This can become serious and develop into pneumonia. A course of antibiotics
will usually cure this, but the infection sometimes becomes life-threatening.
Other rare complications include:

      tonsilitis,
      otitis media (a build-up of fluid in the ear),
      septic shock (infection of the blood that causes a severe drop in blood
      meningitis (infection in the brain and spinal cord), and
      encephalitis (inflammation of the brain).

What are the symptoms of swine flu?

The symptoms of swine flu in people are expected to be similar to the
symptoms of regular human seasonal flu and include fever (a high body
temperature of 38°C/100.4°F or over), fatigue, lack of appetite and coughing
(see Symptoms). Some people with swine flu have also reported runny nose,
sore throat, nausea, vomiting and diarrhoea.
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How long are symptoms expected to last?

As with any sort of flu, how bad the symptoms are and how long they last will
vary depending on treatment and individual circumstances.

What if I don't recover within a week?

If your symptoms don't improve after seven days (or five days if you are under
16), contact your doctor.

Should I go to work or school if I have been in contact with someone who I
know has swine flu?

Yes, as long as you do not have flu-like symptoms. If you are feeling well, you
should continue your normal activities, including going to school or work.
It can take up to seven days (normally two to five days) after infection for
swine flu symptoms to develop. If you develop symptoms, stay at home and
follow the general advice

Is it possible to catch swine flu twice?

Yes, because the virus can mutate (change). If you become infected with the
swine flu virus, your body produces antibodies against it, which will recognise
and fight off the virus if the body ever meets it again. However, if the virus
mutates, your immune system may not recognise this different strain and you
may become ill again, although you may have some protection from having
had a similar virus previously.

Should I have a swine flu party or try to catch swine flu now, so I will be
immune to more serious strains that may emerge later?

No. Don't try to catch the virus as you may help it spread. Also, as everything
about the virus is not yet known, it is too soon to assume it is only a mild
infection. Catching swine flu will not necessarily protect you from strains that
may emerge later

How much contact should I have with family and friends?

If you have swine flu, avoid unnecessary contact with family and friends while
you are infectious, which is usually until five days after your symptoms started
(seven days in children). Once your symptoms have gone, you are no longer
Keep one metre or more away from people’s faces to avoid droplets from your
throat affecting others. Where possible, you can avoid exposing your partner
to infection by sleeping in the spare room.
What if I need someone to care for me? Will they catch my swine flu?

If you are unable to look after yourself at home, ask a friend or relative to
collect medicines and groceries for you, order any repeat prescriptions, help
with basic household tasks, such as cooking, and generally care for you.
If your friend or relative keeps their distance from you wherever possible and
you both have good hygiene (sneezing into a tissue and washing your hands
thoroughly), there is a good chance that they will not catch the infection.

When should I go back to school or work?

You can go back to school or work when you are feeling well and are no
longer infectious, which is when you no longer have flu-like symptoms. The
time it takes for symptoms to go is usually about five days (seven days in
children). Avoid unnecessary contact with others and stay at home during the
infectious period.

What can I do?

You can reduce, but not get rid of, the risk of catching or spreading swine flu

         Always covering your nose and mouth with a tissue when coughing or
         Disposing of dirty tissues promptly and carefully.
         Maintaining good basic hygiene, for example washing your hands often with
          soap and warm water to reduce the spread of the virus from your hands to
          face, or to other people.
         Cleaning hard surfaces, such as door handles, often and thoroughly using a
          normal cleaning product.

You can also make the following preparations now:

         Confirm a network of flu friends (friends and relatives) who could help you if
          you fall ill. They could collect medicines and other supplies for you so you do
          not have to leave home and possibly spread the virus.

Are alcohol handrubs better than soap and water?
Both alcohol handrubs and washing with soap and water are important to
minimise the risk of spreading swine flu, as they both deactivate the flu virus.
Alcohol handrub can only be used on visibly clean hands. If hands are dirty,
soap and water should be used. Handrubs are useful when there is no easy
access to a place to wash and dry your hands.
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Who should be wearing a facemask?

The Health Protection Agency (HPA) recommends that healthcare workers
wear a facemask if they come into close contact with a person with symptoms
(within one metre), to reduce their risk of catching the virus from patients.
However, the HPA does not recommend that healthy people wear facemasks
in their everyday life.
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Why shouldn't the general public wear facemasks?

There is no evidence to suggest that this is a useful preventative measure.
The virus is spread by people touching infected surfaces, or by someone
coughing or sneezing at very close range. So unless you are standing very
close to someone with the virus, wearing a facemask will not make a
There are concerns about the risks of not using facemasks correctly. They
must be changed regularly as they don't work as well when dampened by a
person’s breath. People may infect themselves if they touch the outside of
their mask, or may infect others by not throwing away old masks safely.
Finally, wearing a facemask may encourage complacency. It is more
important to keep your hands clean, stay at home if you feel unwell and cover
your mouth when they cough or sneeze.

If I have been in close contact with an infected person, do I need treatment?
You only need antiviral treatment if you have been diagnosed with swine flu or
if a doctor decides that you are at serious risk of developing severe illness.

What do antivirals do?

Antivirals are not a cure, but they help you to recover by:

      relieving some of the symptoms,
      reducing the length of time you are ill by around one day, and
      reducing the potential for serious complications, such as pneumonia.

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How does Relenza work?

To reproduce and spread, a virus has to enter your body, take over healthy
cells and force them to make copies of itself. Relenza stops the release of
new copies of the virus from infected cells in the lungs. This slows the spread
of the virus, reduces the symptoms and length of time that you feel unwell for
and makes it harder for the virus to spread to other people.
Relenza should first be taken within 48 hours of symptoms appearing in adults
(36 hours in children). It works better the earlier you start taking it.
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How does Tamiflu work?

To reproduce and spread, a virus has to enter your body, take over healthy
cells and force them to make copies of itself. Tamiflu stops the flu virus
entering your cells and blocks the release of new copies of the virus. This
slows the spread through your body, reduces the symptoms and the length of
time that you feel unwell for and makes it harder for the virus to spread to
other people.
Tamiflu should first be taken within 12 to 48 hours of symptoms appearing.
It works better the earlier you start taking it.
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How effective are Relenza and Tamiflu?

Relenza reduces the duration of flu symptoms by one-and-a-half days on
average. Tamiflu reduces the duration of symptoms by up to two days.
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What if I forget to take a dose?

Even if you forget a dose of Relenza or Tamiflu, you must not double the next
dose. Take the forgotten dose as soon as you remember, as long as the next
one is not due for a few hours. If the next dose is due within a few hours, just
carry on as you are supposed to. Don't take a catch-up dose.

Is one of the antivirals more appropriate for pregnant women and people with
certain kidney conditions?

Relenza is an inhaled drug that will be used for pregnant women and people
with certain kidney conditions who are unable to take Tamiflu.

I'm allergic to penicillin. Can I take antivirals?

Yes, it is safe for you to take antivirals if you have a penicillin allergy.
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I am on warfarin. Can I take antivirals?

Yes, you should be able to take antivirals if you are on warfarin, but contact
your GP for advice first.
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Are there any interactions between Tamiflu and other drugs?

Tamiflu is not expected to alter the effect of any other medicines. If you are
taking other medicines and have any questions or concerns, you should
speak to your GP or pharmacist. Tamiflu can be taken with paracetamol,
ibuprofen or acetylsalicylic acid (Aspirin).

Will antivirals be given to people without flu symptoms?

In most cases, no. Antivirals will generally only be given to people who have
been diagnosed with swine flu.
Doctors should not offer antiviral medication as prophylaxis (prevention) to
people close to patients unless they have serious existing health problems,
such as cancer, or there are other special circumstances.
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Will my child have nausea if they take Tamiflu?

As with many medicines, nausea is a known side effect of Tamiflu in a small
number of cases. Symptoms may improve over the course of the treatment. It
may help to take Tamiflu either with or immediately after food, and drinking
some water may also lessen any feelings of nausea.

Are pregnant women more likely to catch swine flu?

Yes. Pregnant women are more susceptible to all infections, because their
immune system is naturally suppressed in pregnancy. They are especially
vulnerable to swine flu, as this virus is affecting younger age groups in
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Are pregnant women with swine flu more at risk of complications?

Most pregnant women with swine flu will only have mild symptoms, the same
as most other people with swine flu. However, pregnant women have an
increased risk of complications from any type of flu, because their immune
system is naturally supressed in pregnancy. Possible complications are
pneumonia (an infection of the lungs), difficulty breathing and dehydration,
which are more likely to happen in the second and third trimester.
There is a small chance that these complications will lead to premature labour
or miscarriage. There is not yet enough information to know precisely how
likely these birth risks are.
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What precautions can pregnant women take?

If you are pregnant, you can reduce your risk of infection by avoiding
unnecessary travel and avoiding crowds where possible, and following the
general hygiene advice (see What can I do?).
If a family member or someone else in close contact with you has swine flu,
your doctor may prescribe antiviral medication (usually Relenza) as a
preventative (prophylactic) measure. Relenza is taken through an inhaler
rather than a tablet. This means it builds up in your throat and lungs but not in
your blood or placenta, so it is unlikely to affect your baby.
If you think that you may have swine flu, call your doctor for an assessment
immediately. If your doctor confirms swine flu over the phone, antiviral
medication will be prescribed, to be taken as soon as possible.
Unless you have swine flu symptoms, carry on attending your antenatal
appointments so that you can monitor the progress of your pregnancy.
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Can I take antiviral drugs if I am pregnant?

Yes, on the advice of a doctor. The Department of Health has bought
Relenza, an inhaled antiviral drug that treats flu without reaching the
developing foetus. It is unlikely that Relenza will affect your pregnancy or your
growing baby.
However, if your doctor or midwife thinks that a different medicine is needed
(for instance, if you have unusually severe flu), you will be given Tamiflu
The risk of antiviral treatment during pregnancy has been reviewed and
proven to be extremely small. It is much smaller than the risk posed by the
symptoms of swine flu.
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What are the possible side effects of Relenza?

Some people have had wheezing or serious breathing problems when they
have used Relenza. It is therefore not recommended for people with asthma
or COPD. Other possible side effects include headaches, diarrhoea, nausea
and vomiting.
If you take an antiviral and have side effects, see your GP to check that you
are OK. Then report your reaction to the Medicines and Healthcare products
Regulatory Agency (MHRA) through its new new online system.
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Can I take painkillers if I am pregnant?

You can take paracetamol to reduce fever and other symptoms. This is safe
to take in pregnancy.
Pregnant women must not take non-steroidal anti-inflammatory drugs
(NSAIDs) such as ibuprofen (Nurofen).
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Will pregnant women get preference for a swine flu vaccine?

Pregnant women are second priority for the swine flu vaccine. See Who will
be a priority for vaccination with the H1N1 swine flu vaccine?
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Is the vaccine safe for pregnant women?

Yes. There is no evidence of risk from vaccinating pregnant women with
inactivated vaccines, such as the swine flu vaccine. The government's swine
flu vaccination programme is underpinned by independent expert advice from
the Joint Committee on Vaccination and Immunisation and the Scientific
Advisory Group on Emergencies, and their advice will be sought regarding the
vaccination of pregnant women against swine flu.
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Will breastfeeding protect my baby from swine flu?

Breastfeeding does not appear to reduce the likelihood of babies getting cold
or flu. However, it should help reduce the risk of associated complications,
such as pneumonia and chest infections. For more information, go to Health
A-Z: breastfeeding recommendations
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What should I do if my baby gets flu?

Your doctor may recommend antiviral medication for your baby, and will
advise you on the dose and how to give it to them. If you are breastfeeding,
you should continue this: breast milk is easily digestible and your baby will
find it comforting.
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Should I stop breastfeeding if I need to take antiviral drugs?

Women who are breastfeeding can continue to do so while receiving antiviral
treatment. If a mother is ill, she should continue breastfeeding and increase
feeding frequency. If she becomes too ill to feed, expressing milk may still be
possible. Antiviral drugs are excreted into breast milk in very small
(insignificant) amounts, which are unlikely to have any side effects on your
baby. For more information, go to Health A-Z: breastfeeding
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How can I tell if my child has swine flu?

Call your GP immediately if your child has any of the following symptoms and
a temperature of 38°C or above or feels hot:
      tiredness
      headache,
      runny nose and sneezing,
      sore throat,
      shortness of breath,
      loss of appetite,
      vomiting,
      diarrhoea, or
      aching muscles, limb and joint pain.

If you are worried about your child, always call your GP for advice.
One thing you can do right now is to make sure you have a digital
thermometer to take your child’s temperature with.
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If my child has swine flu, what should I do?

If your GP confirms that your child has swine flu, keep them at home and treat
their symptoms like any other cold or flu. Make sure they drink plenty of
liquids, get lots of rest and take over-the-counter cold and flu remedies to help
control their temperature. However, children under 16 must not be given
aspirin or ready-made flu remedies containing aspirin.
Your GP will tell you whether your child should also take antiviral drugs.
Antivirals such as Tamiflu shorten the symptoms by about a day and can
reduce the risk of complications. Antivirals are only effective if taken within 48
hours of symptoms starting. If you are worried about your child, call your GP
However, antivirals can also have side effects. If your child’s swine flu
symptoms are mild, you may not wish to give them antivirals. Your GP can
advise you on this.
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Can children take antivirals?

Yes, on the advice of a doctor. Tamiflu is safe for infants aged one and above,
at a reduced dose. Relenza (an inhaler) can be used by children aged five
and older under the supervision of an adult.
Source: nhs website (

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