Below is a list of frequent questions we have received from our clients during the H1N1 flu (formerly known as Swine flu) outbreak. We encourage the ongoing submission of questions and will continue to update this document and post it to our website. These questions were answered by our team of medical directors with guidance from the Centers for Disease Control (CDC).

How does H1N1 flu spread?

Spread of this H1N1 influenza virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through the coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it, for example, a contaminated surface.

What surfaces are most likely to be sources of contamination?

Common surfaces include counters, desks, keyboards, telephones, and door handles/knobs. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface and then touches his or her own eyes, mouth or nose. Proper hand washing right after contact with the contaminated surface will block this route of transmission.

How long can the virus live outside the body?

According to the CDC, the H1N1 flu virus can survive approximately two hours on surfaces like cafeteria tables, doorknobs, and desks. Even though the chance of contracting a H1N1 flu infection from contact with contaminated surfaces is quite low, frequent hand washing will help you reduce this risk even further.

What do we do with any employees coming back from Mexico?

Employees returning from Mexico should closely monitor their health for seven days. Should they become ill with fever and other flu-like symptoms such as cough, sore throat, vomiting or diarrhea, they should seek medical help immediately. According to the New York City Department of Public Health, these employees do not need to be excluded from work as long as they are feeling well (no fever, cough, or other flu-like symptoms).

Should our employees be traveling domestically or internationally?

The CDC recommends that U.S. travelers avoid all nonessential travel to Mexico. At the present time, there is no medical reason to restrict travel to other destinations both domestically and internationally. It is, however, important that employees do not travel if they are feeling ill with flu-like symptoms.

For all international travelers, the CDC recommends the following steps to help you stay healthy:

• Be sure you are up to date with all your routine vaccinations, including a seasonal influenza vaccine. The seasonal vaccine is not expected to offer protection against H1N1 flu, but it can protect against seasonal flu which may still be circulating in Mexico and the Southern Hemisphere.
• Pack a travel health kit that contains basic first aid and medical supplies. See http://wwwn.cdc.gov/travel/contentSurvivalGuide.aspx for a list of what to include in your travel health kit.
• Identify the health-care resources in the area(s) you will be visiting.
• 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.

How long is the incubation period?

The estimated incubation period is unknown and could range from one to seven days, and is more likely one to five days.

How long should a person remain out of work after having the H1N1 Flu?

If an individual has a documented case of H1N1 flu, he or she should be out of work for one week. If the person still has symptoms at the end of the week, then he or she should remain out of work until all the symptoms disappear plus one more day.

What do we do with an employee who has a household member with H1N1 flu?

A household member with an H1N1 flu virus infection should be considered potentially contagious for up to seven days following illness onset. Persons who continue to be ill longer than 7 days after illness onset should be considered potentially contagious until symptoms have resolved. Children, especially younger children, might be contagious for longer periods. Since the incubation period is up to seven days, a symptom-free employee, who has a household member with the H1N1 flu, is at risk for approximately 14 days from the onset of symptoms in the household member. Therefore, it would be wise to keep the employee out of the workplace during this 14-day period. If an employee cannot work from home during this time period, having a seemingly healthy individual out of work for 14 days may pose a strain on the business. Another option is to allow the employee back into the workplace as long as he or she wears a properly fitted N95 respirator at all times; naturally, this may have an unsettling effect on the employee’s co-workers.

Note that the 14-day period is an approximation. The actual time period out of work may need to be adjusted on a case-by-case basis depending upon disease severity and individual circumstances.

Are there medicines to treat H1N1 flu?

Yes. The CDC recommends the use of oseltamivir (Tamiflu®) or zanamivir (Relenza®) for the treatment and/or prevention of infection with these H1N1 influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. These anti-viral medications are not a cure for the H1N1 flu; rather, if you get sick, these medications can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

What sort of decontamination is needed in the workplace of someone with H1N1 Flu?

Since the H1N1 virus only survives on surfaces for a few hours, it is not necessary to have a cleaning crew come in and formally decontaminate an entire office or building. If an employee comes down with the H1N1 flu, it may be a wise precaution to clean his or her work area with a common spray disinfectant, taking care not to damage sensitive electronics. Several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time.

Can you get H1N1 Flu from eating pork?

No. H1N1 influenza viruses are not spread by food. You cannot get H1N1 influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Should we limit visitors to our site?

In general, there is no need to limit visitors to your work site. Visitors with obvious flu-like symptoms should be instructed to leave the premises and only return when they are feeling well and free of all flu-like symptoms.

Is there a vaccine for H1N1 Flu?

Currently, there is no effective vaccine against the H1N1 influenza virus, but this is in development. The first step is to isolate the virus strain. This has been accomplished already. The next step is to grow the virus in enough quantity so that it can be presented to the vaccine manufacturers. This is the stage where the vaccine is currently at. Once the vaccine has been developed, it will have to be tested for safety as well as to determine the correct dosage. Then, of course, it will have to be manufactured in large quantities. Optimistic projections have the vaccine ready for distribution to the general public in September 2009.

Will my current flu vaccine protect me against H1N1 Flu?

The H1N1 flu virus is a novel strain in the sense that humans have not been exposed to it before. Therefore, it is highly unlikely that the current flu vaccine would offer any significant protection against the H1N1 virus.