Public Health Agency of Canada
(www.phac-aspc.gc.ca)
H1N1 Flu Virus in Canada
About H1N1 Flu Virus
What is the H1N1 Flu Virus?
How can an influenza virus spread from pigs to people?
Is H1N1 Flu Virus contagious? How does it spread between people?
Why are people concerned about this particular strain?
Are all cases of H1N1 Flu Virus severe?
Should people be avoiding exposure to pigs?
Can I catch swine influenza from eating pork?
What is the incubation period for H1N1 Flu Virus?
How long does the virus live outside of the body?
Can the H1N1 Flu Virus be transmitted from humans to other animals, other than pigs, such as farm animals and household pets?
H1N1 Flu Virus in Canada
Does the Government of Canada expect to see more cases of H1N1 Flu Virus in Canada? Or a Second Wave of Illness?
I understand Canada has experienced deaths related to the H1N1 virus. Does this mean the virus has grown in strength?
I understand Canada has experienced deaths related to the H1N1 virus. Does this mean the virus has grown in strength?
How to protect yourself and others
What can I do to protect myself from infection?
Should pregnant women take special precautions to protect themselves, such as avoiding crowds?
Treatment and prevention measures
Are there drugs that can treat H1N1 Flu Virus?
What are PHAC's recommendations for the use of antivirals?
How are antiviral medications made available if needed?
What is the difference between an antiviral and a vaccine?
I got my flu shot this year. Will it protect me against H1N1 Flu Virus ?
Should Canadians take any extra measures like wearing surgical masks to avoid catching H1N1 Flu Virus?
Schools, daycares and postsecondary institutions
What are PHAC’s recommendations regarding school closures?
Under what circumstances should schools close?
H1N1 Flu Virus Vaccine
How much vaccine is the government ordering?
How soon will an H1N1 vaccine be available in Canada?
How did the government decide on the amount of vaccine to order?
Who will get the vaccine first?
International actions
The World Health Organization (WHO) has raised the pandemic alert level to Phase Six. What are these phases?
The WHO has indicated that the overall level of severity of the pandemic to be moderate. What does this mean?
What other recommendations is the WHO making related to Phase Six?
Are all pandemics severe?
About H1N1 Flu Virus
What is the H1N1 Flu Virus?
H1N1 Flu Virus has been reported around the world, and the World Health Organization (WHO) has declared it a pandemic influenza virus. Swine influenza (sometimes called swine flu) is a strain of the influenza virus that usually affects pigs, but which may also make people sick.
H1N1 Flu Virus is a respiratory illness that causes symptoms similar to those of the regular human seasonal flu. The symptoms include fever, fatigue, lack of appetite, coughing and sore throat. Some people with H1N1 Flu Virus have also reported vomiting and diarrhea.
How can an influenza virus spread from pigs to people?
Different strains of influenza are commonly circulating in our environment, including strains that can cause illness in humans, birds and pigs.
Sometimes, humans and animals can pass strains of flu back and forth to one another through direct close contact - such as in pig production barns and livestock exhibits at fairs. For people in close contact with pigs, the recommendations to avoid infection are the same as for regular seasonal influenza – frequent handwashing, getting an annual flu shot, covering coughs and sneezes, and staying home when ill.
When a swine influenza virus does affect a human, there is also a risk that the animal influenza can mutate and then spread directly between humans.
Is H1N1 Flu Virus contagious? How does it spread between people?
Yes, this virus is contagious. Since most of the people who have become ill have not been in direct contact with pigs, we know that the virus has spread from person to person.
More investigation is needed on how easily the virus spreads between people, but it is believed that it is spread the same way as regular seasonal influenza.
Influenza and other respiratory infections are transmitted from person to person when germs enter the nose and/or throat. Coughs and sneezes release germs into the air where they can be breathed in by others. Germs can also rest on hard surfaces like counters and doorknobs, where they can be picked up on hands and transmitted to the respiratory system when someone touches their mouth and/or nose.
Why are people concerned about this particular strain?
The strain of H1N1 Flu Virus is a new, or novel, influenza virus.
Since this is a new strain, people will likely have no natural immunity to protect against the virus. International experts are concerned that this strain could spread quickly.
Investigation is underway to learn more about the way the virus spreads. Governments around the world and the World Health Organization are engaged to investigate and address this situation.
Are all cases of H1N1 Flu Virus severe?
No. The majority of Canadian cases of H1N1 Flu Virus have experienced mild illness and have recovered at home. Overall, the WHO is describing this pandemic as moderate.
Should people be avoiding exposure to pigs?
Influenza viruses can be transmitted from pigs to people and vice versa via coughs and sneezes, but there are not many documented cases of this actually happening. This H1N1 Flu Virus is spreading between humans – not directly from pigs to people. As a result, there is no risk from proximity to healthy pigs.
Because humans can also spread the disease to pigs, individuals with influenza symptoms should avoid close contact with pigs to reduce the risk of introducing a new influenza virus into domestic swine populations.
Government officials are conducting investigations to find out more about how this particular strain of H1N1 Flu Virus spreads.
Can I catch swine influenza from eating pork?
No. H1N1 Flu Virus is not transmitted through pork meat. Continue to follow proper handling and cooking procedures to reduce the risk of foodborne illnesses.
What is the incubation period for H1N1 Flu Virus?
This is a new virus and we continue to learn more about it and how it spreads. However, we expect the incubation period for human swine influenza to be two to seven days.
Typically, when a person is infected with an influenza virus and recovers, they develop antibodies that provide them with immunity to that particular virus. However, this is a new virus, and we continue to work with international partners to learn more about how it affects people and how it spreads.
How long does the virus live outside of the body?
The H1N1 Flu Virus can live outside the body on hard surfaces, such as stainless steel and plastic, for 24-48 hours and on soft surfaces, such as cloth, paper, and tissues for less than 8-12 hours; however, it can only infect a person for up to 2-8 hours after being deposited on hard surfaces, and for up to a few minutes after being deposited on soft surfaces.
Can the H1N1 Flu Virus be transmitted from humans to other animals, other than pigs, such as farm animals and household pets?
Scientists are currently conducting a range of studies to learn more about the H1N1 Flu Virus. Part of this work is focusing on the susceptibility of various species.
Q12. How high can the body temperature reach for an individual who has a fever who is infected with the H1N1 Flu Virus, and how long do symptoms last?
More investigation is needed on how long a person can be infectious (be able to spread the virus to others), but, it is believed that this period is for one day before the onset of symptoms and continues for approximately 7 days after symptoms have started.
What we are generally seeing in Canada with H1N1 is similar to typical influenza, whereby illness includes a sudden onset of respiratory illness with a fever (body temperature above 38ºC or 100.4ºF), cough, and potentially other symptoms such as sore throat, runny nose, muscle aches, and extreme fatigue. Most people with influenza recover completely in 1-2 weeks; however, some may have serious complications (particularly those with underlying conditions) since the severity of illness can vary. A person who is concerned about their health or wellbeing should contact a health care practitioner to discuss their personal circumstances.
H1N1 Flu Virus in Canada
Does the Government of Canada expect to see more cases of H1N1 Flu Virus in Canada? Or a Second Wave of Illness?
We fully expect that new cases will continue be identified. Although some cases have been severe, including some deaths, most of the cases continue to be mild. We continue to work with our international partners to learn more about this virus and to prepare for additional waves of illness and/or changes to the nature of the virus.
I understand Canada has experienced deaths related to the H1N1 virus. Does this mean the virus has grown in strength?
There is no evidence to suggest that the virus has become stronger.
It is important to realize that different strains of influenza result in about 4,000 Canadian deaths a year. We must take all influenza – not just the current strain – seriously, and take measures to protect ourselves
How to protect yourself and others
What can I do to protect myself from infection?
The Public Health Agency advises Canadians to:
• Wash hands thoroughly with soap and warm water, or use hand sanitizer
• Cough and sneeze in your arm or sleeve
• Keep doing what you normally do, but stay home if sick
• Check www.fightflu.ca for more information
• Check www.voyage.gc.ca for travel notices and advisories
• Talk to a health professional if you experience severe flu-like symptoms
Should pregnant women take special precautions to protect themselves, such as avoiding crowds?
It's important that people continue their daily lives during the pandemic. PHAC doesn't recommend that pregnant women avoid going to work, or community social events if they are healthy. In other crowded situations that cannot be avoided, extra precautions should be taken such as frequent handwashing, to avoid picking up the virus. Pregnant women might consider carrying hand sanitizer for the same purpose.
Treatment and prevention measures
Are there drugs that can treat H1N1 Flu Virus?
Yes. Early research indicates that there are two prescription antiviral drugs, oseltamivir (Tamiflu) and zanamivir (Relenza) that are effective in treating the H1N1 Flu Virus.
What are PHAC's recommendations for the use of antivirals?
PHAC's recommendation is that antivirals be used to treat H1N1 Flu Virus when the illness is moderate to severe and the patient is at a great risk for complications. PHAC is not recommending that antivirals be given for a mild disease or on a preventive basis at this time. The reasons for this are:
• We do not have sufficient information to suggest that this influenza virus requires the use of antivirals. Most patients in Canada are recovering well on their own.
• There is a risk that the virus could be resistant to antiviral treatment if antivirals are overused to treat mild illness.
• The antiviral stockpile is a finite resource. We want to be sure not to run out before they are really needed.
How are antiviral medications made available if needed?
Antiviral medications are prescription drugs. They may be obtained from a pharmacy with a regular prescription.
There is a national stockpile of antiviral medication, and some provinces and territories also have their own stockpiles. Every province and territory has access to the national stockpile and antivirals have been distributed on a per-capita basis.
What is the difference between an antiviral and a vaccine?
Antivirals are drugs used for the prevention and early treatment of influenza. If taken shortly after getting sick (within 48 hours), they can reduce influenza symptoms, shorten the length of illness and potentially reduce the serious complications of influenza.
Antivirals work by reducing the ability of the virus to reproduce but do not provide immunity against the virus. The H1N1 Flu Virus can be treated with two different antivirals, oseltamivir (Tamiflu) and zanamivir (Relenza).
A vaccine is any preparation intended to produce immunity to a disease by stimulating the production of antibodies. Vaccines are the primary means to prevent illness and death from influenza. They stimulate the production of antibodies against the flu virus components included in the vaccine, providing immunity against the virus.
In order to provide the best protection, a vaccine must be tailored to fight off specific strains of influenza.
I got my flu shot this year. Will it protect me against H1N1 Flu Virus ?
It is unlikely that the seasonal flu shot will provide protection against H1N1 Flu Virus. The flu shot will protect against the seasonal flu. A new pandemic vaccine will be available to all Canadians who need and want to receive it.
Should Canadians take any extra measures like wearing surgical masks to avoid catching H1N1 Flu Virus?
Canadians should continue to take normal precautions to protect themselves as they would from a regular flu. While we are investigating to learn more about how this virus spreads, our best advice is for Canadians to wash their hands frequently, cover coughs and sneezes, and stay home when ill.
The Public Health Agency of Canada does not recommend that members of the general public wear surgical masks to protect against contracting H1N1 Flu Virus. Evidence shows that this is not effective in preventing transmission of influenza in the general public. People often use masks incorrectly, or contaminate themselves when putting masks on and taking them off, which could actually increase the risk of infection.
The exception is people who are ill with H1N1 Flu Virus or people who are exhibiting flu-like symptoms. In order to protect those in close contact, like doctors, nurses, and caregivers at home, these people may be asked to wear a face mask.
Schools, daycares and postsecondary institutions
What are PHAC’s recommendations regarding school closures?
The Public Health Agency of Canada continues to recommend against the widespread proactive closure of schools. This measure may not be effective in preventing transmission, and the benefits of keeping schools open currently outweighs the risk of transmission in these settings. This recommendation will continue to be reviewed based on the situation in Canada.
Under what circumstances should schools close?
PHAC does not recommend widespread proactive school closures, but in certain circumstances, the reactive closure of some schools might be necessary. This would be a local decision in accordance with provincial/territorial legislation. One situation where school closure might be considered is if the number of school absenteeism and/or staff shortages impacts the safety of school operations.
H1N1 Flu Virus Vaccine
How much vaccine is the government ordering?
The government intends to purchase 50.4 million doses of H1N1 vaccine on behalf of the provinces, territories and federal populations.
The Government of Canada has a longstanding contract with GlaxoSmithKline to maintain vaccine production capacity in Canada in order to meet Canada’s pandemic vaccine needs promptly and effectively.
How soon will an H1N1 vaccine be available in Canada?
If all goes well, we hope to have vaccine ready for clinical trials by late September or early October, and to begin immunization in November.
How did the government decide on the amount of vaccine to order?
While we would aim to vaccinate 100 per cent of the population, from observing seasonal flu shot campaigns, we know that even in provinces with free universal access vaccination programs, usually less than 50 per cent of the population will choose to be immunized.
Ordering 50.4 million doses of pandemic vaccine amounts to ordering 50 per cent more than we would expect to use for a normal seasonal vaccination campaign.
The Government of Canada is confident that 50.4 million vaccine doses will be sufficient to meet the needs of every Canadian likely to need and want protection
Who will get the vaccine first?
In Canada we are fortunate that the issue is not whether we will have enough vaccines for everyone: it is how quickly everyone will get vaccinated. Those who need it most will get it first. Decisions around priority groups for the vaccine will be made closer to the time when the vaccine is available based on what we know about H1N1.
International actions
The World Health Organization (WHO) has raised the pandemic alert level to Phase Six. What are these phases?
WHO currently identifies six stages of Pandemic Preparedness and Response.
Phase 1: Influenza viruses are circulating in animals, especially birds. No reports of animal viruses infecting humans.
Phase 2: Human infection by an animal influenza virus. Potential pandemic threat.
Phase 3: An animal or animal-human influenza virus has caused limited disease in people. Isolated human to human transmission may occur – but not widespread.
Phase 4: Verified human to human transmission of an animal or human-animal virus causing widespread or “community-level” outbreaks. Risk of pandemic is considered much higher but not a foregone conclusion.
Phase 5: Human to human spread of the virus is confirmed in at least two countries in one WHO region. It is likely that a pandemic is imminent. Time to finalize organization, communication, and implementation of planned mitigation strategies is short.
Phase 6: The Pandemic Phase. Community outbreaks in at least one country from a second WHO region – indicating that a global pandemic is underway. The Director-General of the WHO makes the decision about an elevation of pandemic phases based on reports from countries of the impact of disease.
The WHO has indicated that the overall level of severity of the pandemic to be moderate. What does this mean?
At this time, the WHO considers the overall severity of the pandemic to be moderate. This assessment is based on the clinical and epidemiological information available to WHO to date, as well as input from its Member States on the pandemic's impact on their health systems and more generally on their social and economic functioning. Essentially, this assessment reflects that:
The overwhelming majority of patients experience mild symptoms and make a rapid and full recovery without the need for hospitalization or medical care.
Overall, national levels of clinically severe or fatal cases of respiratory illness appear similar to levels seen during local seasonal influenza periods-- although in some local areas and institutions, high levels of disease have occurred.
Overall, hospitals and health care systems in most countries generally have been able to cope with the numbers of people seeking care -- although in some localities, some facilities and systems have been stressed.
What other recommendations is the WHO making related to Phase Six?
The WHO is also recommending:
No border closure. It will not be possible to stop the virus at the border, at ports or at airports. There is no evidence that these measures stop the spread of the disease, and they may be very disruptive for international traffic and trade.
No restriction of travel. People who are infected with the virus and are capable of infecting others, may not show symptoms when travelling, so they cannot be identified from others who are not infected.
Greater emphasis on providing care with a decreased emphasis on stopping the spread of the virus. Now that a pandemic has been declared, all governments will need to focus its resources on caring for those who fall ill.
Are all pandemics severe?
No. An influenza pandemic may be mild, moderate or severe. An influenza pandemic means the virus is spread easily between humans, and affects a wide geographic area. An influenza pandemic does not necessarily cause more severe illness than seasonal influenza.