What is swine flu?
Swine influenza is a disease that pigs get. The virus currently spreading among people is now generally referred to as swine flu, although the origin of the disease is still under investigation. There is no evidence of this strain of the disease circulating in pigs in the UK.
There are regular outbreaks of swine flu in pigs worldwide. It does not normally infect humans, although this does sometimes happen, usually in people who have had close contact with pigs.
Swine flu viruses are usually of the H1N1 sub-type. The swine flu that has spread to humans is a version of this virus.
Why is swine flu affecting humans?
Because the swine flu virus has mutated (changed) and is now able to infect humans and transmit between them.
How is the swine flu infection diagnosed?
There is now a new self-care service, called the National Pandemic Flu Service, which allows people to check their condition online or over the telephone (0800 151 3100 or textphone 0800 151 3200) and obtain antiviral medication if swine flu is confirmed.
The following people should call their GP directly for an assessment of their symptoms and a diagnosis:
- those with a serious existing illness, such as cancer
- pregnant women,
- those who have a sick child under one,
- those with a condition that suddenly gets much worse, or
- those with a condition that is still getting worse after seven days (five for a child).
For more information, go to the Flu service: Q&A.
Which people are most vulnerable from swine flu?
Those who are more at risk from becoming seriously ill with swine flu are people with:
- chronic (long-term) lung disease, including people who have had drug treatment for their asthma within the past three years,
- chronic heart disease,
- chronic kidney disease,
- chronic liver disease,
- chronic neurological disease (neurological disorders include motor neurone disease, Parkinson’s disease and multiple sclerosis),
- suppressed immune systems (whether caused by disease or treatment),
- diabetes,
- pregnant women,
- people aged 65 or older, and
- young children under five.
For specific advice on antiviral treatment for these groups, go to People with long-term conditions, Pregnancy and children, and Older people.
Is the new swine flu virus contagious?
The Health Protection Agency (HPA) says the new swine flu virus is highly contagious and is spreading from person to person.
Swine flu spreads in the same way as ordinary colds and flu. The virus is spread through the droplets that come out of the nose or mouth when someone coughs or sneezes.
If someone coughs or sneezes and does not cover it, those droplets can spread about one metre (3ft). If you are very close to them you might breathe these in.
If someone coughs or sneezes into their hand, those droplets and the virus within them are easily transferred to surfaces that the person touches, such as door handles, hand rails, phones and keyboards. If you touch these surfaces and touch your face, the virus can enter your system and you can become infected.
See Causes for more information
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.
What is the incubation period for swine flu?
According to the Health Protection Agency, the incubation period for swine flu (the time between infection and appearance of symptoms) can be up to seven days, but it is most likely to be between two and five days. But it is currently too early to be able to provide details on virus characteristics, including incubation period, with total certainty.
When are people most infectious?
People are most infectious soon after they develop symptoms. They can continue to shed (spread) the virus (for example, in coughs and sneezes) for up to five days (seven days in children). People become less infectious as their symptoms subside, and once their symptoms are gone they are no longer considered infectious to others.
Should I avoid contact with people suspected of having swine flu?
People with suspected swine flu will have been asked to stay at home and restrict their contact with people. Most people should continue their normal life, including going to school or work. This includes children who attend a school with a confirmed case of swine flu.
There is no need to avoid contact with people who might simply have come into contact with those with the illness, such as the parents of children at schools with a confirmed case but who are not themselves ill.
How dangerous is it?
It is difficult to judge this at the moment. There have been deaths, but for most infected people the symptoms have not been severe.
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. Also, orders of Tamiflu have been placed to increase UK supplies to 50 million doses, enough to treat 80% of the population.
Will I die from swine flu?
For most people, the illness has been mild and self-limiting. The virus has caused severe illness in a minority of people, most of whom had an existing serious condition. NHS staff are well trained in treating people who are in hospital with swine flu. They can provide effective treatment for any secondary bacterial infections, such as pneumonia.
What are the complications of swine flu?
One of the most common complications of any type of flu is a secondary bacterial chest infection, such as bronchitis (infection of the airways).
This can become serious and develop into pneumonia. A course of antibiotics will usually cure this, but the infection sometimes becomes life-threatening.
Other rare complications include:
- tonsilitis,
- otitis media (a build-up of fluid in the ear),
- septic shock (infection of the blood that causes a severe drop in blood pressure),
- meningitis (infection in the brain and spinal cord), and
- encephalitis (inflammation of the brain).
What are the symptoms of swine flu?
The symptoms of swine flu are expected to be similar to the symptoms of regular seasonal flu. People with swine flu typically have a fever or high temperature (over 38°C/100.4°F) and two or more of the following symptoms:
- unusual tiredness,
- headache
- runny nose,
- sore throat,
- shortness of breath or cough,
- loss of appetite,
- aching muscles,
- diarrhoea or vomiting.
For more information, see Symptoms.
How long are symptoms expected to last?
As with any sort of flu, how bad the symptoms are and how long they last will vary depending on treatment and individual circumstances. Most cases reported in the UK to date have been relatively mild, with affected people starting to recover within a week.
What if I don’t recover within a week?
If your symptoms don’t improve after seven days (or five days if you are under 16), contact your local NHS service on one of the telephone numbers below.
- England, NHS Direct: 0845 4647
- Scotland, NHS 24: 08454 242424
- Wales, NHS Direct Wales: 0845 4647
- Northern Ireland: contact your local GP surgery or your local out-of-hours service.
How does swine flu cause death?
Like any other type of flu, people can die from swine flu if they develop complications, such as pneumonia.
Has the swine flu virus developed resistance to Tamiflu?
The first case of resistance of the swine flu virus to the antiviral drug oseltamivir (Tamiflu) has now been reported in England.
The resistant virus was identified in a patient with a weakened immune system. Although the virus was resistant to Tamiflu, it was susceptible to the antiviral zanamivir (Relenza) and, following treatment, the patient recovered from their illness.
Should we expect a more severe second wave of the pandemic in the winter?
The history of previous flu pandemics suggests that the current viral strain will spread more widely in the autumn or winter, causing more illness and death. It is possible that the virus will mutate (change) into a stronger strain.
Should I go to work or school if I have been in contact with someone who I know has swine flu?
Yes, as long as you do not have flu-like symptoms. If you are feeling well, you should continue your normal activities, including going to school or work.
It can take up to seven days (normally two to five days) after infection for swine flu symptoms to develop. If you develop symptoms, stay at home and follow the general advice (see What should I do if I think I’m infected?).
Is it possible to catch swine flu twice?
Yes, because the virus can mutate (change). If you become infected with the swine flu virus, your body produces antibodies against it, which will recognise and fight off the virus if the body ever meets it again. However, if the virus mutates, your immune system may not recognise this different strain and you may become ill again, although you may have some protection from having had a similar virus previously.
Should I have a swine flu party or try to catch swine flu now, so I will be immune to more serious strains that may emerge later?
No. Don’t try to catch the virus as you may help it spread. Also, as everything about the virus is not yet known, it is too soon to assume it is only a mild infection. Catching swine flu will not necessarily protect you from strains that may emerge later (see Is it possible to catch swine flu twice?).
Can my pet catch swine flu?
There is currently no evidence that pets could get this new strain of flu. The swine flu virus appears to be passing only from person to person or from human to swine. In general, flu viruses commonly infect just one species; for example, dogs and cats do not get seasonal flu from their owners.
What is the National Pandemic Flu Service and how does it work?
The National Pandemic Flu Service is a new self-care service that will give people with swine flu symptoms fast access to information and antivirals.
It is a dedicated website and a phoneline (0800 151 3100 or textphone 0800 151 3200) where you can get information, check your symptoms and get a unique number that will give you access to antivirals if necessary.
When you are given your unique access number, you will be told where your nearest antiviral collection point is. Ask a flu friend (a healthy friend or relative) to go and pick up the antiviral medication.
If you think you have swine flu, do not go to your GP surgery or A&E. Stay at home to avoid spreading the virus.
Can children use it?
All children can use the Flu Service. However, those with poor English or who are too young should be supported by an adult or have an adult ring on their behalf.
What documents are needed to be able to collect the antivirals?
The flu friend must show their own ID as well as that of the patient. The authorisation number and ID information will be checked to ensure it matches the information provided when the assessment of symptoms was completed.
Acceptable forms of ID are:
- a utility bill,
- passport,
- a credit or debit card,
- driving licence, or
- NHS card.
Why has the government brought in this new service?
This new service will help free GPs’ time, so they can deal with other illnesses that need their urgent attention.
Do I use the National Pandemic Flu Service if I’m in a high-risk group?
Contact your doctor directly rather than using the National Pandemic Flu Service if:
- you have a serious existing illness,
- you are pregnant,
- you have a sick child under one year of age,
- your condition suddenly gets much worse, or
- your condition is still getting worse after seven days (five for a child).
Are the Flu Service staff properly trained?
A range of clinicians and British Royal Medical Colleges approved the questions that are asked by the National Pandemic Flu Service. The answers to these questions can determine whether or not you have swine flu. The call centre workers have been trained to use these questions and guide people through them. They will only use these questions. If a caller needs any specific advice, they are directed to the appropriate service.
Will the Flu Service be able to distinguish between swine and other flu?
The staff are trained to identify cases of swine flu. However, the symptoms of seasonal flu are very similar and therefore there is likely to be some overlap with other circulating flu cases. As swine flu becomes more common, a higher proportion of flu-like illnesses will be swine flu.
How will the government stop people fraudulently getting Tamiflu?
The government is relying on the public to use the system responsibly. There is no need to jump the queue, because there is more than enough Tamiflu for everyone likely to catch the virus in the months ahead. Nor is there any need to buy Tamiflu from someone who has obtained it under false pretences. Anyone who needs it will be supplied free of charge.
How much contact should I have with family and friends?
If you have swine flu, avoid unnecessary contact with family and friends while you are infectious, which is usually until five days after your symptoms started (seven days in children). Once your symptoms have gone, you are no longer infectious.
Keep one metre or more away from people’s faces to avoid droplets from your throat affecting others. Where possible, you can avoid exposing your partner to infection by sleeping in the spare room.
What if I need someone to care for me? Will they catch my swine flu?
If you are unable to look after yourself at home, ask a friend or relative to collect medicines and groceries for you, order any repeat prescriptions, help with basic household tasks, such as cooking, and generally care for you.
If your friend or relative keeps their distance from you wherever possible and you both have good hygiene (sneezing into a tissue and washing your hands thoroughly), there is a good chance that they will not catch the infection.
I’ve lost my appetite. What should I do?
Losing your appetite is a common symptom of flu and will usually return as you begin to feel better. Try to eat light, nutritious foods, such as soup, toast, baked beans and scrambled eggs (these are also easy to prepare). It may be easier for you to eat little and often.
Should I go out?
The National Pandemic Flu Service is a new online service that gives you self-care advice and antiviral medication if you need it without going to your GP.
If you feel up to it, you may want to get some fresh air. Do not go on public transport, stay in crowded places or visit your GP or hospital when you have swine flu symptoms, as you may infect other people with the virus.
If you suddenly get much worse, seek medical advice immediately.
When should I go back to school or work?
You can go back to school or work when you are feeling well and are no longer infectious. Adults are most infectious soon after they develop symptoms and remain infectious while their symptoms continue, which is usually for up to five days. They can normally return to work within seven days. In children, symptoms continue for up to seven days and they can normally return to school within 10 days.
What can I do?
You can reduce, but not get rid of, 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 your hands often with soap and warm water to reduce the spread of the virus from your hands to face, or to other people.
- Cleaning hard surfaces, such as door handles, often and thoroughly using a normal cleaning product.
You can also make the following preparations now:
- Confirm 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.
- Know your NHS Number and those of other family members. Keep them in a safe place. It is not essential to have your NHS Number in order to receive treatment, but it can help NHS staff to find your health records. You will be able to find your NHS Number on your medical card or other items such as prescribed medication, a letter from your GP or hospital appointment card/letter.
- Have a thermometer and enough cold and cough remedies in your medicine cupboard, in case you or your family get swine flu.
Are alcohol handrubs better than soap and water?
Both alcohol handrubs and washing with soap and water are important to minimise the risk of spreading swine flu, as they both deactivate the flu virus. Alcohol handrub can only be used on visibly clean hands. If hands are dirty, soap and water should be used. Handrubs are useful when there is no easy access to a place to wash and dry your hands.
Who should be wearing a facemask?
The Health Protection Agency (HPA) recommends that healthcare workers 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 in their everyday life.
Why shouldn’t the general public wear facemasks?
There is no evidence to suggest that this is a useful preventative measure.
The virus is spread by people touching infected surfaces, or by someone coughing or sneezing at very close range. So unless you are standing very close to someone with the virus, wearing a facemask will not make a difference.
There are concerns about the risks of not using facemasks correctly. They must be changed regularly as they don’t work as well when dampened by a person’s breath. People may infect themselves if they touch the outside of their mask, or may infect others by not throwing away old masks safely.
Finally, wearing a facemask may encourage complacency. It is more important to keep your hands clean, stay at home if you feel unwell and cover your mouth when they cough or sneeze.
So why do people in other countries wear facemasks?
This is an issue which each government has considered separately. France is encouraging the public to buy their own masks for use as a precaution, but it is not stocking masks centrally from government funds. Neither is the US.
In other countries, people already wear facemasks either to avoid spreading illness or to protect themselves from pollution. This is not the case in the UK.
What should I do if I think I’m infected?
If you have flu-like symptoms and are concerned that you may have swine flu, stay at home, read about swine flu symptoms and check your condition using the National Pandemic Flu Service.
Phone your GP if:
- you have a serious existing illness,
- you are pregnant,
- you have a sick child under one,
- your condition suddenly gets much worse,
or - your condition is still getting worse after seven days (five for a child).
The National Pandemic Flu Service is a new online service that will assess your symptoms and, if required, provide an authorisation number that can be used to collect antiviral medication from a local collection point. For people who do not have internet access, the service can be accessed on:
- Telephone: 0800 151 3100
- Minicom: 0800 151 3200
For more information, go to the Flu service: Q&A.
If it is confirmed that you have swine flu, ask a healthy relative or friend to pick up your antiviral medication for you.
In the meantime, take paracetamol-based cold remedies to reduce fever and other symptoms, drink plenty of fluids and get lots of rest.
Don’t go into your GP surgery or to a hospital, as you may spread the disease to others.
If I have been in close contact with an infected person, do I need treatment?
You only need antiviral treatment if you have been diagnosed with swine flu or if a doctor decides that you are at serious risk of developing severe illness. See Will antivirals be given to people without flu symptoms?.
Can swine flu be treated?
Testing has shown that the swine flu can be treated with the antiviral medicines oseltamavir (Tamiflu) and zanamivir (Relenza). However, the drugs must be taken at or near the start of the illness to be effective. See Treatment for more information.
The UK already has enough antivirals to treat half the population. Orders of Tamiflu have been placed to increase UK supplies to 50 million doses, enough to treat 80% of the population.
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 does Relenza work?
To reproduce and spread, a virus has to enter your body, take over healthy cells and force them to make copies of itself. Relenza stops the release of new copies of the virus from infected cells in the lungs. This slows the spread of the virus, reduces the symptoms and length of time that you feel unwell for and makes it harder for the virus to spread to other people.
Relenza should first be taken within 48 hours of symptoms appearing in adults (36 hours in children). It works better the earlier you start taking it.
How does Tamiflu work?
To reproduce and spread, a virus has to enter your body, take over healthy cells and force them to make copies of itself. Tamiflu stops the flu virus entering your cells and blocks the release of new copies of the virus. This slows the spread through your body, reduces the symptoms and the length of time that you feel unwell for and makes it harder for the virus to spread to other people.
Tamiflu should first be taken within 12 to 48 hours of symptoms appearing. It works better the earlier you start taking it.
How effective are Relenza and Tamiflu?
Relenza reduces the duration of flu symptoms by one-and-a-half days on average. Tamiflu reduces the duration of symptoms by up to two days.