H1N1 Flu Daily Update: April 25, 2009

Human cases of swine influenza A (H1N1) virus infection have been identified in the U.S. in San Diego County and Imperial County, California as well as in San Antonio, Texas. Internationally, human cases of swine influenza A (H1N1) virus infection have been identified in Mexico.

Investigations are ongoing to determine the source of the infection and whether additional people have been infected with similar swine influenza viruses.

CDC is working very closely with state and local officials in California, Texas, as well as with health officials in Mexico, Canada and the World Health Organization. On April 24th, CDC deployed 7 epidemiologists to San Diego County, California and Imperial County, California and 1 senior medical officer to Texas to provide guidance and technical support for the ongoing epidemiologic field investigations. CDC has also deployed to Mexico 1 medical officer and 1 senior expert who are part of a global team that is responding to the outbreak of respiratory illnesses in Mexico.

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. There are many things you can to do preventing getting and spreading influenza:

There are everyday actions people can take to stay healthy.

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread that way.

Try to avoid close contact with sick people.

• Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
• If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Topics on this page:

• General Information
• Summary Guidance
• Guidance Documents
• Travel Notices
• Transcripts
• Reports & Publications
• Related Links
• Past Updates

General Information

Swine Flu and You
What is swine flu? Are there human infections with swine flu in the U.S.? …

Swine Flu Video Podcast
Dr. Joe Bresee, with the CDC Influenza Division, describes swine flu - its signs and symptoms, how it's transmitted, medicines to treat it, steps people can take to protect themselves from it, and what people should do if they become ill.

Key Facts about Swine Influenza (Swine Flu)
How does swine flu spread? Can people catch swine flu from eating pork? …

Swine Influenza in Pigs and People
Brochure

Información en espa?ol
Datos importantes sobre la influenza porcina…

Summary Guidance

CDC has provided the following interim guidance for this investigation.

• Residents of California and Texas
• Clinicians
• State Public Health Laboratories
• Public Health/Animal Health

Residents of California and Texas

CDC has identified human cases of swine influenza A (H1N1) virus infection in people in these areas. CDC is working with local and state health agencies to investigate these cases. We have determined that this virus is contagious and is spreading from human to human. However, at this time, we have not determined how easily the virus spreads between people. As with any infectious disease, we are recommending precautionary measures for people residing in these areas.

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
• Try to avoid close contact with sick people.
• If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
• Avoid touching your eyes, nose or mouth. Germs spread that way.

There is no vaccine available at this time, so it is important for people living in these areas to take steps to prevent spreading the virus to others. If people are ill, they should attempt to stay at home and limit contact with others. Healthy residents living in these areas should take everyday preventive actions.

People who live in these areas who develop an illness with fever and respiratory symptoms, such as cough and runny nose, and possibly other symptoms, such as body aches, nausea, or vomiting or diarrhea, should contact their health care provider. Their health care provider will determine whether influenza testing is needed.

Clinicians

Clinicians should consider the possibility of swine influenza virus infections in patients presenting with febrile respiratory illness who:

1. Live in San Diego County or Imperial County, California or San Antonio, Texas or
2. Have traveled to San Diego and/or Imperial County, California or San Antonio, Texas or
3. Have been in contact with ill persons from these areas in the 7 days prior to their illness onset.

If swine flu is suspected, clinicians should obtain a respiratory swab for swine influenza testing and place it in a refrigerator (not a freezer). Once collected, the clinician should contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory.

State Public Health Laboratories

Laboratories should send all unsubtypable influenza A specimens as soon as possible to the Viral Surveillance and Diagnostic Branch of the CDC’s Influenza Division for further diagnostic testing.

Public Health /Animal Health Officials

Officials should conduct thorough case and contact investigations to determine the source of the swine influenza virus, extent of community illness and the need for timely control measures.

Guidance Documents

Interim Guidance for Swine influenza A (H1N1): Taking Care of a Sick Person in Your Home Apr 25, 2009

Interim Guidance on Antiviral Recommendations for Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection and Close Contacts Apr 25, 2009

Interim Recommendations for Facemask and Respirator Use in Certain Community Settings Where Swine Influenza A (H1N1) Virus Transmission Has Been Detected Apr 26, 2009

Swine Influenza A (H1N1) Virus Biosafety Guidelines for Laboratory Workers Apr 24, 2009
This guidance is for laboratory workers who may be processing or performing diagnostic testing on clinical specimens from patients with suspected swine influenza A (H1N1) virus infection, or performing viral isolation.

Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting Apr 24, 2009

Interim Guidance on Case Definitions to be Used For Investigations of Swine Influenza A (H1N1) Cases Apr 26, 2009
This document provides interim guidance for state and local health departments conducting investigations of human cases of swine influenza A (H1N1) virus.  The following case definitions are for the purpose of investigations of suspected, probable, and confirmed cases of swine influenza A (H1N1) virus infection.

Travel Notices

Outbreak Notice: Swine Influenza in the United States
April 25, 2009 12 PM ET

Travel Health Precaution: Swine Influenza and Severe Cases of Respiratory Illness in Mexico
April 25, 2009 12 PM ET

Press Briefing Transcripts

Media Availability on CDC Investigation of Human Cases of Swine Influenza
April 25, 2009, 1 PM ET

Unedited Transcript of CDC Briefing on Public Health Investigation of Human Cases of Swine Influenza
April 24, 2009 2:30 PM ET

CDC Briefing on Public Health Investigation of Human Cases of Swine Influenza
April 23, 2009 press briefing…

Reports & Publications

CDC Health Advisory April 25, 2009, 3:00 ET
Investigation and Interim Recommendations: Swine Influenza (H1N1)
Distributed via Health Alert Network
CDCHAN-000281-2009-04-25-ALT-N

Update: Swine Influenza A (H1N1) Infections—California and Texas, April 2009
Morbidity and Mortality Weekly Report (MMWR) April 24, 2009 / Vol. 58 / Dispatch;1-3

Swine Influenza A (H1N1) Infection in Two Children—Southern California, March-April 2009
Morbidity and Mortality Weekly Report (MMWR) April 21, 2009 / Vol. 58 / Dispatch

Related Links

PandemicFlu.gov

WHO - Influenza-Like Illness in the United States and Mexico

Past Updates

• April 24, 2009
• April 23, 2009