Swine Flu – Ten Tips for Me and You

Now that America has declared a state of swine flu public health emergency, you may be asking yourself – what am I supposed to do? Here is a list of ten practical steps you can take to prepare and protect yourself and your family.

1) Know the symptoms – Here are some of the symptoms that sound like swine flu  – fevers over 100 degrees, body

aches, cough, runny nose, and sometimes, nausea and diarrhea. It’s also useful to know if you might have had an exposure – either by recent travel to Mexico, or to the areas of known cases so far in America - California, Texas, New York, Ohio and Kansas. Or you may have been exposed to a sick person who came from those areas. The incubation time for swine flu is believed to be pretty short – 48-72 hours, and the virus seems to spread easily between people. If this sounds like your symptoms, then what do you do?

2) Don’t panic – If you have a cold or flu, and the media is full of details about a potentially lethal pandemic, it’s hard to not imagine the worst. Once the announcement of confirmed cases of swine flu at St. Francis Preparatory School in New York hit the news, local hospitals were swamped with concerned people. Not only is this difficult for the healthcare system, it can also be potentially dangerous for everyone – all those people gathered in one place can help spread potential infection even more, including to hospitalized patients who are particularly vulnerable.

3) Call or go? – If you have symptoms and possible risks that sound like swine flu, call your doctor or local public health clinic before going in. You may be asked to go to a specific place to be tested, or you may be asked to stay home as long as you are able to breathe well. Anyone, however,  who is rapidly getting worse, or having difficulty breathing, needs to be seen urgently by a doctor.

4) Contain the illness - First, take care of yourself – rest, drink plenty of fluids, and take over-the-counter medications to help with fevers, aches and pains, and stomach symptoms. Do not, however, give cough or cold medicines to children under two years of age – those medications are contraindicated. Some people with respiratory illnesses feel much better with a humidifier. If you have asthma, emphysema or other lung-affecting diseases, you need to be sure to take your regularly prescribed medicine, and watch closely for worsening symptoms, including difficulty breathing. If you live alone, be sure you check in with family or friends by phone each day. They’ll want to know how you’re doing, and it’s good to have someone helping you keep watch on your symptoms. Second, take steps to contain the spread – if you live with others, practice careful hand-washing, bypass the hugs and kisses of well-wishers, and do not share telephone handsets or computers. Be especially careful to always cough into the elbow of your arm (yes! the elbow, not your hand!). Dispose of your snotty tissues yourself, to protect others. People with swine flu are believed to shed the virus for 4-5 days, but young children can spread virus for as long as 10 days – so stay home until you feel well.

5) Protection works – if you feel fine, is there anything you can do to protect yourself and limit the potential spread of the virus? Influenza is spread by coughing and sneezing (droplet transmission). Influenza is also spread by touching a surface that’s been contaminated, then touching your own face/mouth/nose (fomite transmission). The question of whether or not “close contact” spreads the virus (e.g. being in the same air space – called airborne transmission) has not been completely answered by existing research. Also unanswered is the question – if it is spread that way, then how-close-is-close? No one knows. So, given all that, what can you do? First, handwashing works. Wash, wash and wash again. Invest in some hand sanitizer for the whole family. A bottle for everyone! Use hand sanitizer for those bus and subway rides where thousands of hands touch the same strap and rail. Alcohol-based diaper wipes can be used for shared telephones, keyboards, and work-out equipment. If you get on a plane, wipe down the armrests, tray-tables and entertainment console. If you work in a place – like a cafe – where it’s not possible to wipe down the cash register between each person’s use, then do not touch your face while you work. Don’t touch your face at all until you’ve washed your hands first. Teachers at schools can be especially helpful by reminding kids to handwash, cover coughs, and sneezes, and by eliminating shared hand-held items (like hall passes) that could be replaced with individual slips of paper. Teachers and administrators play an especially important role by supporting families who keep their kids out of school because of illness.

6) What about a mask? – The data shows that masks do work - as long as there is a tight seal about the mouth and nose. That means the floppy blue pleated mask you sometimes see hanging below a person’s nose isn’t doing a thing for anyone. And, if you’re a guy, a beard is probably stopping any mask anywhere from ever working for you. Expert panels and pandemic review boards, in general, do not recommend masks despite saying they work, both because masks often aren’t properly fitted, and because masks in public are not “widely accepted.” If you’re exposed to people who cough on you, and you are able to wear a mask, be sure to pinch the metal strip across your nose down snug, and tighten the straps so the mask touches skin around all the edges. And shave that beard.

7) Eat the pork (if you want) – Swine flu gets its name because pigs can get the infection and spread it to each other – as well as to humans. This latest virus contains pieces that indicate it evolved from swine flu virus, and can now spread from person to person. Swine flu is not spread by properly prepared and cooked pork products. So if you want to eat pork, you can.

8) Getting sick -  stay home! – In our go-go-go culture and these severe economic times, it can be very hard to call a boss and cancel a day’s work. Perhaps even more so if there’s a big meeting and your third grader feels “crummy” but doesn’t (yet) look sick. Now, however, is the time to pay attention to symptoms – and if you or your loved ones are feeling like there’s a flu coming on, stay home.

9) Stockpile? – The public health department recommends that each home have two weeks of supplies, in case we must stay home – either for illness or to help contain transmission. That means two weeks of food for everyone in your home, two weeks of all medications (both over-the-counter and prescription), and, if you’re like most people, two weeks of books and DVDs.

10) Stay in? – If there is an outbreak in your community, but you’re feeling healthy, it can be a very difficult decision whether or not to stay home from vital activities like work. Luckily public health officials are acting on the latest reports, so keep an eye on the news for announcements like closures of schools. However, if you’re in an area of potential transmission, now is probably a good time to postpone some completely discretionary activities that involve large crowds,  like going to the movies or the mall.  Decisions are much harder when the activity is both not-exactly-required and not-exactly-discretionary – like going to church, for example, or community events like your school’s Open House. Right now, it’s too early for any of us to be a Swine Flu Shut-In, but you may want to have your hand sanitizer constantly with you for the next few weeks.

Know people who are worried? Feel free to email, digg, stumble, or otherwise share these practical tips to those you know.