IMPORTANT Q&A
Q39. What is the H1N1 Flu Virus? H1N1 Flu Virus has been reported around the world, and the World Health Organization (WHO) 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. Q40. 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. Q41. 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. Q42. 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. Q43. 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. Q44. Should people be avoiding exposure to pigs? Influenza viruses can be transmitted from pigs to people and vice versa via coughes 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. Q45. 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. Q46. 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. Q46. If I get sick with H1N1 Flu Virus once, does that give me immunity or can I get infected with it again? 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. Q48. 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. Q49. 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. Q50. 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. Q1. 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. Q2. 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 Q3. How many people in Canada have died from H1N1 Flu Virus? Reports of H1N1 Flu Virus Deaths in Canada Q4. Why are only the number of deaths reported and not the numbers of cases of illness? At first, it was important to understand how the virus was spreading, and what kind of illness it was causing. This is why we did individual testing to laboratory-confirm cases of H1N1 Flu Virus. We know now that the virus has spread to all provinces and territories and is spreading like regular seasonal flu. Q5. What can I do to protect myself from infection? The Public Health Agency advises Canadians to: Q6. 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. Q7. 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. Q8. 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: Q9. 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. Q10. 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. Q11. 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. Q12. Does the Government of Canada recommend the closing of schools, and other gathering places to limit the spread of the virus? In Canada, decisions about school closures are made locally. PHAC does not recommend school closures to contain the spread of the virus. PHAC recommends that people who are sick stay at home to reduce the risk of spreading infection. If this influenza virus spreads, people may want to avoid crowds to decrease the chance of exposure. Q13. 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. Q14. What protection will the Government of Canada offer to healthcare workers to protect against H1N1 Flu Virus? As per normal infection control practices, healthcare workers will need to practice frequent hand washing. When in close contact with affected patients, healthcare workers will use added safeguards such as wearing masks and eye protection. For more information on protective measures for healthcare workers, visit the Health Professionals section. Q15. 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. Q16. 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. Q17. How will the government pay for the vaccine? Although the delivery of immunization is a provincial and territorial responsibility, given the exceptional circumstances of a pandemic, the Government of Canada intends to cover 60 per cent of this purchase on a one-time basis. This investment reflects the seriousness of the situation and our commitment to showing leadership, along with the provinces and territories, on this issue. This investment will be made through a newly allocated federal fund for the H1N1 vaccine purchase. Q18. 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 Q19. What if we end up need more than 50 million doses of vaccine? Will the government be able to buy more and who will pay for it? Through our contract with GSK we have the opportunity to place further orders at a later date if we feel that there is a requirement for more vaccine to meet the needs of the Canadian people. The cost sharing of additional purchases would be negotiated at the time. Q20. Will the vaccine be free for all Canadians, even those in provinces and territories that do no provide free seasonal influenza vaccine programs? Decision on vaccine delivery and the administration of flu clinics is a provincial / territorial responsibility. The Government of Canada intends to pay 60 per cent of the cost of the vaccine purchase. Each province and territory will have to assess their capacity to deliver immunization clinics, and will have to make decisions around cost based on a number of logistical and ethical criteria. Q21. The WHO recently stated that some countries will begin to receive vaccine in September. Why will Canadians have to wait two months longer? The Government of Canada is in close communication with GSK and they have assured us that they are on track to deliver a vaccine before the winter flu season. Public safety is paramount: we will strike the right balance between the need to have an H1N1 vaccine available quickly, and the imperative to ensure that vaccine is safe and effective. Some countries may have vaccine developed for testing earlier than Canada, and those early vaccine trials will be useful in informing the global knowledge about the safety and efficacy of the vaccine. Q22. 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. Q23. How are decisions on priority groups for vaccine being made? Federal/provincial/territorial public health officials and experts on the Public Health Network Council Vaccine Supply Task Group, the Canadian Immunization Committee and the Public Health Agency of Canada are working together to develop a framework to provide guidance on vaccine program implementation. Guidelines are expected in the coming weeks. Q24. What factors are being considered in terms of vaccine priority groups? Decisions about program implementation for the pandemic vaccine will be based on a number of factors, including scientific evidence, ethical, legal and logistical considerations. A vaccine prioritization framework is currently being developed. Several factors must be weighed in developing priority groups, such as the characteristics of the illness and the vaccine, its spread and severity among different populations and the logistics of administering the vaccine. Q25: Why does the government think that Tamiflu is safe for children under 1 now? Health Canada has reviewed the available safety data with respect to the use of Tamiflu in children under 1 year old. As there are no other products available for this age group, and in the context of the current H1N1 pandemic, Health Canada has concluded that the known and potential benefits of Tamiflu outweigh the known and potential risks for children under 1 year. Treatment decisions remain with a physician, who would consider prescribing Tamiflu after weighing the potential risks and benefits to any individual patient. We know that Tamiflu thus far is effective in treating the vast majority of people who have H1N1, making their symptoms less severe and the illness lasting fewer days. We now have some evidence that there seems to be less risk in using Tamiflu in young children. By providing guidance to doctors to prescribe Tamiflu for young children, we are filling in a gap in terms of treatment availability, dosing information, and we have the opportunity to monitor its effects on children under 1 and increase our body of knowledge on this drug. Q26: If I have a child that has been diagnosed with H1N1, should I try to get Tamiflu to try to prevent my other children from catching it? Public health experts have weighed the risks and benefits in providing recommendations on the use of antivirals to prevent infection. After rigorous research and analysis, their conclusion is that the widespread use of antivirals in the community for prevention is not recommended. The use of antivirals for prevention is recommended only under a limited number of circumstances where the potential benefits outweigh the potential risks. However, these recommendations are not written in stone and decisions have to be made on a case by case basis by the physician involved. Q27: Why wasn't Tamiflu originally recommended for children under 1? There were some safety concerns identified previously from the use of Tamiflu in animal studies. At that time, there was no data available to see the effect of Tamiflu use in infants. Q28: What studies have been done on the safety? At this point, there are no formal completed studies to show the safety or effectiveness of Tamiflu in the treatment or prevention of influenza in infants (refer to Question 49). Q29: If there are no studies done, then how can you assure me that it is safe? Recently, limited data has become available on the use of Tamiflu in infants (not from formal studies but from physicians using Tamiflu in infants in other countries). An analysis of this data suggests that Tamiflu may be used in emergency situations for the treatment or prevention of influenza infection with the new pandemic virus in infants, if the physician considers that the benefits of using Tamiflu are more than the unknown risks associated with its use. Q30: How long would my child have to take it? Do they really need it? Should they be taking it if their symptoms are mild? It is very important to use the medicine for as long as your doctor has prescribed it. If you observe any unwanted effects from the use of Tamiflu, talk to your doctor and follow his or her advice to continue or stop taking the drug. If drugs like Tamiflu are stopped before completing the course, there is a danger of developing resistance to the virus, which means that the drug would not work to treat or prevent the infection in the future. Based on the available data, it is suggested that Tamiflu should be used in a dose as prescribed by your physician. For treatment of influenza infection with the new pandemic virus, Tamiflu should be used twice daily for 5 days. For prevention of infection, it should be used once daily for at least 10 days but your doctor may suggest to use Tamiflu for 14 days. Q31: What are the treatment recommendations for this age group, for example if another child in daycare has H1N1 would it be recommended for prevention for all the children in daycare or is it just for treatment of those who are sick? Public health officials across Canada have agreed that treatment is recommended only for those who are ill, unless they are living in a residential facility. Q32: What would an "adverse reaction" look like? What do I do if my child has one? The most common unwanted effects are nausea, vomiting, pain in the stomach and headache. People infected with the influenza virus, particularly children and adolescents may also develop seizures, confusion, delirium, hallucinations, agitation, anxiety or other abnormal behaviour early during their illness. These events may occur shortly after beginning TAMIFLU or may occur when flu is not treated. These events are uncommon but may result in self-injury to the patient, sometimes fatal. You should watch for unusual behaviour and contact your doctor immediately if such behaviour develops. Parents and health care professionals are encouraged to report serious adverse reactions to Health Canada's Canada Vigilance Program. For more information on what type of adverse reactions to report and how to report them, Health Canada has developed the following Guidelines to Reporting Adverse Reactions to Antiviral Drugs During an Influenza Pandemic Q33. What is the Government of Canada doing to protect Canadians from the virus here in Canada? Our primary goal is to protect the health of Canadians and their families. At this time, the most effective way to do this is to slow the spread of the disease. A number of steps are involved in doing this: Q34. What actions is Canada taking to address pandemic alert level to Phase 6? Canada is a global leader in pandemic planning and we continue to implement our overall pandemic plan for the health sector (Canadian Pandemic Influenza Plan). Our advanced level of readiness is also due to close cooperation with provinces and territories and health professionals across the country. With the escalation to Pandemic Phase 6, federal actions will be actively continued under the Canadian Pandemic Influenza Plan for the Health Sector, including: Q35. The World Health Organization (WHO) has raised the pandemic alert level to Phase Six. What are these phases? WHO 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. Q36. 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: Q37. What other recommendations is the WHO making related to Phase Six? The WHO is also recommending: Q38. 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. About H1N1 Flu Virus
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 in Canada
How to protect yourself and others
for more information for travel notices and advisories Treatment and Prevention Measures
H1N1 Flu Virus Vaccine
Use of Tamiflu for children under the age of one
. Government of Canada Actions
International Actions
currently identifies six stages of Pandemic Preparedness and Response.
