Thursday, April 30, 2009


How long does the virus live on surfaces?

The flu virus can live on a hard surface for up to 24 hours, and a soft surface for around 20 minutes.

How quickly might swine flu spread?

After infection, it takes less than two days for symptoms to start, at which point people are most infectious.

Evidence from previous outbreaks suggests that one person will infect about two others, and that influenza spreads particularly rapidly in closed communities such as schools or residential homes.

If swine flu is going to spread worldwide, experts predict that local outbreaks will be seen within the next two to three weeks.

How dangerous is it?

It is difficult to judge this at the moment. While there have been deaths in Mexico, and the death of a 23-month-old child in Texas, symptoms exhibited by people in other countries have been relatively mild and only one person has died of the virus outside of Mexico.

Also, it appears that early doses of antiviral medicines such as Tamiflu are effective in helping people to recover. In the UK we have enough antivirals to treat half the population if they were to become ill.

How does swine flu cause death?

Like any other type of flu, people can die from swine flu if they develop complications, like pneumonia.

Why is the death rate higher in Mexico than other countries?

This is not yet understood and there could be a variety of explanations. It may be that people affected in Mexico may have sought treatment at a much later stage than those in other countries.

General living and nutritional standards may also play a role. Other experts have suggested that there may even be a second separate virus circulating in Mexico that is having an impact, but this is not known.

What can I do?

You can reduce, but not eliminate, the risk of catching or spreading swine flu by:

  • Always covering your nose and mouth with a tissue when coughing or sneezing.
  • Disposing of dirty tissues promptly and carefully.
  • Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of the virus from your hands to face, or to other people.
  • Cleaning hard surfaces, such as door handles, frequently using a normal cleaning product.
  • You can also prepare now and in the build-up to a pandemic by:

  • Confirming a network of ‘flu friends’ – friends and relatives – who could help you if you fall ill. They could collect medicines and other supplies for you so you do not have to leave home and possibly spread the virus.
  • Knowing your NHS number and those of other family members and keeping them in a safe place. You will be able to find your NHS Number on your medical card or other items such as prescribed medication, GP letter or hospital appointment card/letter.
  • Having a stock of food and other supplies available at home that will last for two weeks, in case you and your family are ill.

Who should be wearing a facemask?

The Health Protection Agency (HPA) recommends that healthcare workers should wear a facemask if they come into close contact with a person with symptoms (within one metre) to reduce their risk of catching the virus from patients.

However, the HPA does not recommend that healthy people wear facemasks to go about their everyday business.

Why shouldn't the general public wear facemasks?

Because there’s no conclusive evidence that facemasks will protect healthy people in their day-to-day lives.

The virus is spread by picking up the virus from touching infected surfaces, or by someone coughing or sneezing at very close range – so unless you are standing close to someone with the virus, wearing a facemask will not make a difference.

There are concerns about the risks posed by not using facemasks correctly.

Facemasks must be changed regularly as they are less effective when dampened by a person’s breath. People may infect themselves if they touch the outer surface of their mask, or may infect others by not disposing of old masks safely.

Finally, wearing a facemask may encourage complacency. People need to focus on good hand hygiene, staying at home if they are feeling unwell, and covering their mouth when they cough or sneeze.

So why have other countries gone down this route?

This is an issue which each government has considered separately. France is encouraging the general public to buy their own masks for use as a precaution, but it is not stockpiling masks centrally from government funds and neither is the US.

In other countries there is an existing culture of wearing facemasks for either the prevention of spreading illness or preventing the risks of pollution; this is not the case in the UK.

Is swine flu treatable?

Testing has shown that the swine flu can be treated with the antiviral medicines oseltamavir (brand name Tamiflu) and zanamivir (Relenza).

See Treatment for more information

The UK already has a stockpile of antivirals sufficient to treat up to half the population, which is a reasonable worst-case scenario. However, the drugs must be administered at an early stage to be effective.

What do antivirals do?

Antivirals are not a cure, but they help you to recover by:

  • relieving some of the symptoms,
  • reducing the length of time you are ill by around one day, and
  • reducing the potential for serious complications, such as pneumonia.

How large is the UK's stockpile of antivirals?

The government has 23 million treatments of Tamiflu and 10.5 million treatments of Relenza.

Will antivirals be given to people without flu symptoms?

Yes. The government is currently giving antivirals to the close contacts of the confirmed cases. The government will keep this under review as the situation develops.

The definition of close contacts is based on Health Protection Agency guidance, which states that individuals exposed to a probable or confirmed case within a distance of one metre or less and for longer than one hour should be offered antivirals as a precautionary measure.

How will I gain access to antivirals?

Arrangements are being put into place with local healthcare services for antivirals to be made available to those who need them.

People with symptoms and others at risk will be assessed by their GP. If antivirals are required, the GP will contact the local health protection unit, which is coordinating the distribution of antivirals.

If you have flu-like symptoms and are concerned, stay at home. You can check your symptoms on the Flu symptom checker (links to external site) or call the swine flu information line on 0800 1 513 513. If you have taken these steps and are still concerned, call your GP or NHS Direct on 0845 46 47. Do not travel out to your GP or hospital.

Is there a vaccine?

No. Influenza viruses change very quickly. For a vaccine to provide adequate protection it needs to be adapted to the particular strain in circulation.

Scientists are already working to develop a new vaccine for swine flu, but it could take up to six months to develop and manufacture enough supplies to meet what could be huge demand. The UK has agreements with manufacturers who will produce a vaccine when it becomes available.

It may take up to 12 months to have sufficient stockpiles to immunise 100% of the population.

Why does it take up to six months to produce a swine flu vaccine?

The flu vaccine production process is long and complicated. Traditional flu vaccine production relies on technology based on chicken eggs. This production technology is labour-intensive. To counter this, the government's plans include two manufacturers, only one egg-based, thus maximising chances of early development.

The flu vaccine production process is further complicated by the fact that flu virus strains continually evolve. Therefore, once a pandemic strain is identified and made available by the World Health Organization, it will take four to six months before a specific vaccine is available and evaluated for safety. However, it will be considerably longer before this vaccine can be manufactured in sufficient quantities for the entire population, given that international demand will be high.

If other countries are also being given advance supply guarantees, will we get ours first?

The agreements set out the contractual obligations, which include the delivery profiles that both manufacturers will work to for the UK supply. There are penalty clauses in place if the manufacturers fail to meet the agreed profiles.

Does the current seasonal flu vaccine work?

The current seasonal flu vaccine is designed to protect against H1N1, but it is unclear as yet whether this will offer any protection against the current strain of swine flu.

How many stocks are available of seasonal vaccine?

Flu vaccine is produced each year for the seasonal flu. Discussions are ongoing with manufacturers about how much may still be available. However, the government has determined that there are 430,000 doses of vaccine available in the UK.

Who will be a priority for vaccination?

It is important to be clear that the UK response will centre around antivirals, which are generic drugs to limit the symptoms of viruses, rather than vaccination.

There is no specific vaccine for swine flu and there is unlikely to be one available in the near future. The government has enough antivirals to treat half the population, which is the proportion who will require them in the ‘reasonable worst-case scenario’ pandemic, so it is unlikely that antiviral treatment will need to be prioritised.

What is a 'pre-pandemic' vaccine?

This is a specific vaccine against the virus most likely to cause a pandemic: the government has a stock of A/H5N1 vaccine ('bird flu' comprises strains of A/H5N1).

Will the current H5N1 pre-pandemic vaccine be effective?

The current government stockpile of H5N1 pre-pandemic vaccine, which was intended for healthcare workers, is unlikely to be effective against swine flu (A/H1N1).

What extra antibiotics have been purchased?

Antibiotics will play an important part in the response to a pandemic. The government has worked with clinicians to develop clinical management guidelines that identify the types of antibiotics needed to treat the complications arising for pandemic flu.

Work to advance further purchases has been going on as part of the government's preparations, and this is now currently being accelerated.

Why do you need antibiotics in a pandemic?

While antivirals may reduce the number of complications, there are still likely to be significant numbers of complications occurring in a pandemic. Some of the most common include bacterial infections in the respiratory tract and lungs. Antibiotics are needed to treat such complications.

Antibiotics will be used to treat people in the community if they develop complications. In hospitals, antibiotics will be used to treat the sickest patients and may reduce the length of hospitalisation.

Can children take antivirals?

Yes, on the advice of a doctor. Tamiflu is safe for infants aged one and older, at a reduced dose. Relenza (an inhaler) can be used by children aged five and older under the supervision of an adult.

Can babies under the age of one take antivirals?

Tamiflu and Relenza are not licensed for use in babies under the age of one. However, Tamiflu may be used under the supervision of a doctor if your baby is ill.

What are UK authorities doing?

The Health Protection Agency (HPA) is monitoring the situation closely. There is currently a very low level of flu activity in the UK.

The HPA and the NHS have systems in place that will alert public health authorities of any unusual strain circulating in the UK. The World Health Organization (WHO) has rated the UK, alongside France, as the best-prepared country for a swine flu outbreak.

Won't hospital capacity be inadequate?

Most flu sufferers can be cared for appropriately at home. It is not feasible to expand or staff additional hospital capacity to the extent necessary to meet the level of demand that a pandemic might generate.

Is it safe to eat pig meat?

Yes. The WHO says there is no evidence that swine flu can be transmitted through eating meat from infected animals. However, it is essential to cook meat properly. A temperature of 70°C (158°F) would be sure to kill the virus. Pig meat includes pork, bacon, ham and pork products.

Last reviewed: 30/04/2009

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