Swine Influenza: What New Yorkers Need To Know

John L. Sampson

April 28, 2009

What is swine influenza?
Swine flu is a respiratory infection caused by influenza viruses that regularly cause outbreaks in pigs. There have been reports of serious illness and deaths due to swine flu in Mexico, but the recently confirmed cases in the United States have been mild.

What are the symptoms of swine influenza?
Swine flu symptoms appear to be similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, lethargy, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu

How does swine influenza spread?
Swine flu viruses can be directly transmitted between pigs and people. Human-to-human transmission is also possible, and appears to be occurring with this outbreak. Spread is mainly through coughing or sneezing. People may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Who is at risk for swine influenza?
Anyone who has contact with an infected person may be exposed to swine flu. Human transmission is thought to occur in the same way as seasonal flu: through aerosolized particles that are released when an infected person coughs or sneezes.

How can I protect myself from swine influenza?

  • Encourage all people to cover their mouth and nose when they cough or sneeze.

  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
  • Try to avoid close contact with sick people.
  • If you get sick, limit contact with others to avoid infecting them.
  • What should I do if I have flu-like symptoms?

Anyone experiencing fever, cough or sore throat should stay home from work or school for at least 7 days, and not return until one to two days after the symptoms end. Wash
your hands frequently. And as always cover your mouth and nose when you cough or sneeze. You do not need to go to the hospital for mild illness, but anyone with severe symptoms, such as difficulty breathing, should seek health care and treatment immediately.

Is there a vaccine for swine flu?
At this time, there is no vaccine for swine flu. The season influenza vaccine does not provide protection against swine flu. This makes ordinary precautions, such as covering coughs and washing hands, all the more important.

If I experience flu symptoms, do I need medication?
The antiviral medicines Tamiflu (oseltamivir) and Relenza (zanamivir) can help alleviate swine flu symptoms, and are particularly important for people with severe illness or with risk factors for complications from flu. Groups that are normally at higher risk of complications include young children, the elderly, and people with chronic illness. Flu patients who belong to those risk groups should seek treatment.

What are the signs of more severe illness with swine flu?
While the current swine influenza cases have been mild so far, infected individuals should still be aware of some of the more severe illness with swine flu. If you become ill and experience any of the following warning signs, seek emergency medical care.

In children emergency warning signs that need urgent medical attention include:

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash
  • In adults, symptoms that need emergency medical attention include:
  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting

What should I do if someone I live with is sick with flu-like symptoms?
If the symptoms are severe, the person should see a medical provider. If the affected person has had close contact with a probable or confirmed case of swine flu, the provider may suggest testing for swine flu.

What should I do if someone I live with has confirmed swine flu?

Follow the same precautions you would to avoid ordinary seasonal flu:

  • Limit your contact with the affected person.
  • Avoid close contact such as kissing,  and do not share towels, glasses or toothbrushes with the affected person.
  • Avoid having visitors. If visitors must enter the home, they should avoid close  contact with the affected person.
  • Wash your hands with soap and water or with an alcohol-based hand rub.
  • Consider using a facemask or an N95 respirator. These can be purchased at a pharmacy  or hardware-type store. If you use a reusable fabric facemask, it should be  laundered with normal laundry detergent and tumble-dried in a hot dryer.
  • Wash dirty dishes and eating utensils in either a dishwasher or by hand with warm  water and soap. You do not need to separate eating utensils for use by a patient  with influenza.
  • It is fine to do your laundry in a standard washing machine with warm or cold water  and detergent. It is not necessary to separate the patient’s laundry.


Can household cleaning help prevent transmission?
Yes. To help prevent transmission, all hard surfaces, such as doorknobs, refrigerator door handles, telephones, and bathroom surfaces, should be washed with soap or detergent, rinsed with water and then disinfected and rinsed. Disinfectants are those with “registered disinfectant” on the label. If disinfectants are not available, use a chlorine bleach solution made by adding 1 tablespoon of bleach to a quart (4 cups) of water. Use a cloth to apply this to surfaces and then rinse them with water. Dispose of the used bleach solution and mix a fresh solution when repeating the cleaning process. Use sanitizer cloths to wipe electronic items (phones, computes, remote controls) that are touched often.

What can I do if my anxiety about the situation feels overwhelming?
During the outbreak of Swine Flu in New York City, you and your family may experience more stress than usual. Such a reaction is normal. If your stress feels overwhelming, consider seeking professional help. You can also call 800-LIFENET, a 24-hour, 7-day-a-week crisis hotline. LifeNet is staffed by mental-health professionals who speak a variety of languages.

English: 800-LIFENET (800-543-3638)

Spanish: 877-AYUDESE (877-298-33730)

Asian languages: 877-990-8585

Deaf/Hearing Impaired (TTY): 212-982-5284 or www.mhaofnyc.org.

The New York City Health Department is closely monitoring health trends in New York City for evidence of a wider outbreak. Agency officials are also speaking regularly with all hospitals in New York City. The hospitals have not reported evidence of citywide increases in severe lung infections.

For facts about influenza, and more information about swine flu, please visit the Health Department and CDC websites. Some specific resources:

From New York City Health Department
Facts about flu

From Centers for Disease Control and Prevention
General information about swine flu

Swine Flu Case Definitions

Swine Flu Infection Control and Patient Care

Preventing the Flu