FAQs

Frequently Asked Questions

2009 H1N1 Influenza
Preventing H1N1
Treating H1N1
2009 H1N1 Vaccine
Older Pennsylvanians
Special Populations
Workplace and Employers
Healthcare Providers
Emergency Medical Services (EMS)
Schools (K-12)
2009 H1N1 in Pets

2009 H1N1 Influenza

What is 2009 H1N1 influenza?
2009 H1N1, also called swine flu, is a new influenza A(H1N1) virus that has not previously circulated among humans. The 2009 H1N1 flu virus was first reported in the U.S. in April 2009.

What is an influenza pandemic?
An influenza pandemic occurs when a new flu virus appears for which people have little or no immunity. On June 11, 2009, the World Health Organization (WHO) indicated that a pandemic of 2009 H1N1 flu was underway around the world.

Why are we so worried about 2009 H1N1 when more than 36,000 people die every year in the U.S. from seasonal flu?
Seasonal influenza occurs every year and, although the viruses also change yearly, many people have some immunity to those viruses which helps limit infections. Unlike seasonal flu, 2009 H1N1 is a new virus. Most people have little or no immunity to it, which means it can cause more infections than are seen with seasonal flu.

Is H1N1 different from seasonal flu?
Yes. The symptoms are similar. However, the groups most vulnerable to complications from 2009 H1N1, as well as the patterns the Centers for Disease Control and Prevention (CDC) are noticing as the virus spreads, are different.

How do people become infected with the virus?
The 2009 H1N1 flu virus appears to be as contagious as seasonal influenza and is spreading fast, particularly among people 10 to 29 years of age. The H1N1 virus is spread person-to-person by contact through the coughs and sneezes of people who are sick, as well as by touching infected objects then touching your eyes, nose or mouth.

How do I know if I have 2009 H1N1?
H1N1 causes symptoms similar to seasonal flu and can include: *fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue, and sometimes vomiting and diarrhea.

*It is important to note that not everyone with the flu will have a fever.

Preventing H1N1

What can I do to keep from getting the H1N1 flu virus?
A flu vaccine is the first and most important step in protecting against flu infection. You should determine if you are among the priority groups who should receive the 2009 H1N1 vaccination.

Reduce your risk for catching H1N1 by practicing good prevention techniques like:

sneezing and coughing into a tissue or your sleeve,
keeping your hands away from your face and not touching your mouth, nose or eyes,
washing your hands frequently with soap and water or using an alcohol-based hand sanitizer,
keeping frequently used surfaces clean, and
avoiding contact with people who are sick when possible and staying home if you get sick.

What is the best way to keep from spreading the H1N1 virus if you are sick?
If sick, you should stay home until at least 24 hours after your fever is gone (without the use of fever-reducing medicines) except to get medical care. Keep away from others as much as possible. Cover your mouth and nose with a tissue when coughing or sneezing and put your used tissue in the trash. Then clean your hands every time you cough or sneeze. Use household disinfectants on commonly used surfaces to reduce the risk of infecting others.

I think I might have some H1N1 flu symptoms. Should I still go to work?
No. Anyone who thinks they have H1N1 flu should stay home from work, school, travel, shopping, social events and public gatherings to reduce the risk of spreading the virus. Treat yourself for the flu until your fever ends naturally (without the use of fever-reducing medications). You should leave home only to seek medical care. If you get sick with flu symptoms and are at high risk of flu complications or you are concerned about your illness, call your healthcare provider for advice.

I have a family member at home who is sick with 2009 H1N1 flu. Should I go to work?
Employees who are well but who have an ill family member at home with 2009 H1N1 flu can go to work as usual. These employees should monitor their health daily and take precautions including covering their coughs and sneezes with a tissue and washing their hands often with soap and water or an alcohol-based hand sanitizer, especially after they cough or sneeze. If they become ill, they should notify their supervisor and stay home. Employees who have an underlying medical condition or who are pregnant should call their healthcare provider for advice because they might need to receive influenza antiviral drugs.

Should I do any special household cleaning if someone at home is sick with H1N1?
Daily cleaning with a household disinfectant will help reduce the spread of the virus to family members who are not sick. Focus on frequently used surfaces like handles, remote controls, bathroom surfaces, etc.

What's the best technique for washing my hands?
The CDC recommends washing with warm water and soap for at least 20 seconds (equivalent to singing the "Happy Birthday" song three times). When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. If using gel, rub your hands together until the gel is dry. Also, help children wash their hands. It keeps them healthier and encourages good prevention techniques from an early age.

Treating H1N1

I'm pregnant. Should I take any special precautions?
Pregnant women are among the priority groups of people that are more likely to develop complications from the H1N1 flu. The CDC recommends that pregnant women should consider the H1N1 vaccination. Receiving the vaccination is one step for prevention. Others include good prevention techniques like frequent hand washing, and making sure to protect yourself if a sick person is in your home.

My child has a fever. Could she have H1N1?
H1N1 symptoms can include fever over 100°F (although not everyone with the flu has a fever), along with sore throat, cough, runny or stuffy nose, fever, body aches, headache, chills, fatigue and possibly diarrhea and vomiting.

Children are among those most vulnerable to complications from the H1N1 virus so watch for warning signs that may mean your child needs emergency treatment, including fast breathing, bluish or gray skin color and not waking up or not interacting.

Are antiviral medications (Tamiflu and Relenza) recommended for H1N1?
Although most people's H1N1 symptoms will resolve without medical treatment, antiviral medications can help lessen the symptoms and are recommended particularly for those considered most vulnerable to complications from the virus. Healthcare providers can prescribe these drugs when appropriate.

Will a mask help prevent the spread of H1N1?
The CDC has suggested only a few groups of individuals should consider wearing a mask to prevent the spread of H1N1. A few of these include people most vulnerable to complications from the virus who are taking care of a sick person in their home, those sick from the virus traveling outside their home for medical care and healthcare workers who are treating individuals suspected of having H1N1.

I had H1N1 and have been coughing for several weeks. Is this normal?
In most instances, the duration of illness from influenza is about 7 days, and illness from the pandemic strain has been similar to that seen with seasonal influenza. However, there is a range of duration. For some, it can take several weeks for cough to completely go away. Seek medical care if your flu-like symptoms improve, but then return with fever and a worse cough.

What are the chances that my family can get reinfected with this virus?
Like any influenza virus, individuals already infected with 2009 H1N1 can get it again, especially as the period of time increases from the previous infection. This is because natural immunity decreases over time and the virus may mutate and evolve, meaning prior immunity may not be as effective against later versions of the virus.

2009 H1N1 Vaccine

Who should get vaccinated against H1N1?
Everyone should get vaccinated against H1N1. Five groups have been determined by the CDC as being most vulnerable to complications from the H1N1 virus. They include:

pregnant women,
children six months to adults 24 years,
healthcare providers and EMS personnel,
parents and caregivers of children under six months, and
people under 65 years of age with certain pre-existing medical conditions (like chronic lung disease such as asthma, heart disease, kidney disorders, cancer or weakened immune systems).

Initial doses of vaccine in Pennsylvania have been targeted to the priority groups. The PA DOH is encouraging certified providers to begin offering the vaccine to people outside the target groups if they feel they have vaccinated all of their high-risk patients. The department will also provide vaccine for the general public beginning in January. Check the "What's Hot" section of www.H1N1inPA.com for clinic information.

Are there any side effects to the H1N1 vaccine?
The potential side effects may be similar to those of the seasonal flu vaccine and include soreness, redness or swelling at the injection site, fever, and aches.

As with any medical intervention, there can be immediate complications from flu vaccine. Persons with allergies to eggs, or who have had previous problems with flu vaccine, should not receive it. Many people fear receiving shots, and it is expected that some recipients will be anxious beforehand or may even faint as a result. Vaccine administration sites should always be prepared for allergic reactions to the vaccine.

How much does the vaccine cost?
The federal government is providing the vaccine and the supplies to administer the vaccine free of charge. The vaccine is free at all public health vaccination clinics. Check the "What's Hot" section at www.H1N1inPA.com frequently for clinic information. Private providers may charge a vaccine administration fee.

Will any group be mandated to get vaccinated such as healthcare workers?
No, the vaccination is completely voluntary.

How is the H1N1 vaccine given?
The H1N1 vaccine is available in two forms: by syringe injection (some are thimerisol-free) or by thimerosol-free nasal spray (only for healthy people 2-49 years of age).

Will two doses of vaccine be required?
The U.S. Food and Drug Administration has approved the use of one dose of 2009 H1N1 flu vaccine for persons 10 years of age and older. Children under 10 years of age and under will need two doses of the vaccine, four weeks apart. Infants younger than 6 months are too young to get either the 2009 H1N1 or seasonal flu vaccines.

How will I know where to go to get the vaccine when it's available?
The PA DOH regularly issues press releases to update the public on the status of vaccine availability in Pennsylvania. Information is also updated frequently in the "What's Hot" section of www.H1N1inPA.com. Individuals without Internet access can call 1-877-PA-HEALTH (1-877-724-3258).

I just got the seasonal flu vaccine. Do I need a different vaccine for H1N1?
Yes. The H1N1 vaccine is recommended in addition to your seasonal flu vaccine.

Can the seasonal flu and H1N1 vaccine be given together?
Yes, these vaccines can be given at the same time. Evidence to date suggests there should be no interference or interaction between the two vaccines if they are co-administered. However, the seasonal and 2009 H1N1 nasal sprays should not be given at the same time.

Should I get vaccinated against 2009 H1N1 if I have had flu-like illness since spring 2009?
If you were ill but do not know for certain that you had 2009 H1N1, you should get vaccinated if your doctor recommends it. The symptoms of flu are similar to those caused by many other viruses. Even when influenza viruses are causing large numbers of people to get sick, other viruses are also causing illnesses. Testing is needed in order to tell if an illness is caused by a specific influenza strain or by some other virus. Since most people with flu-like illnesses will not be tested this season, the majority will not know whether they have been infected with 2009 H1N1 flu or a different virus.

I was vaccinated against the 1976 swine influenza. Do I need the 2009 H1N1 vaccine?
Yes. The 1976 swine flu virus and the 2009 H1N1 virus are different enough that it's unlikely a person vaccinated in 1976 will have full protection from the 2009 H1N1. People vaccinated in 1976 should still be given the 2009 H1N1 vaccine.

Older Pennsylvanians

Why aren't people 65 and older in the target groups?
There are two main reasons why people age 65 and older are not included in the groups recommended to get the initial doses of 2009 H1N1 vaccine:

People age 65 and older are least likely to get sick with this virus.
Initial available doses of vaccine are very limited, so the first doses are recommended to go to those who are most likely to get infected and be at risk for complications.

There has been very little 2009 H1N1 illness in people 65 and older since the virus emerged in the spring. This has been true both in the United States and in the Southern Hemisphere during their flu season. Studies of who is most likely to be infected with 2009 H1N1 show that people 65 and older are the least likely to get sick with this virus. Laboratory tests on blood samples indicate that older people likely have some pre-existing immunity to the 2009 H1N1 flu virus.

Will people age 65 years and older be able to get the 2009 H1N1 vaccine this season?
Yes. The PA DOH is encouraging certified providers that have vaccinated all of their at-risk patients to offer the vaccine to individuals outside of those groups. The PA DOH will also hold vaccine clinics beginning in January for Pennsylvanians who do not have access to it through their healthcare provider or do not have a provider. Check the "What's Hot" section of www.H1N1inPA.com or call 1-877-PA-HEALTH (1-877-724-3258) for more information.

Should people age 65 and older get the regular seasonal flu vaccine this year?
Yes. CDC's priority for people 65 and older is to have them get their regular, or "seasonal," flu vaccine as soon as possible while waiting for more doses of the 2009 H1N1 vaccine to become available. Seasonal flu viruses are expected to circulate along with 2009 H1N1 viruses this season. People age 65 and older are at increased risk for complications from seasonal influenza compared to younger people and are recommended for annual seasonal flu vaccines. This year is no exception.

What should people age 65 and older do if they feel like they have the flu?
People age 65 and older should seek medical advice quickly if they develop flu symptoms this season to see whether they might need medical evaluation and possible treatment with antiviral medications. People 65 and older are prioritized to get antiviral drugs if they become sick with the flu according to CDC's antiviral guidance this season.

Special Populations

What would you recommend to parents who have severely disabled children when H1N1 is in their school?
Not all disabled students are at high risk of complications from influenza. However, for those who are medically fragile, the presence of influenza in a school can be a concern. Since every medically fragile student is different, parents should discuss their concerns with their healthcare provider and seek recommendations and share them with school authorities. If such students are exposed to influenza in the school, they should be strongly considered as candidates for antiviral prophylaxis. If significant levels of influenza are present in the school, authorities may consider separating medically fragile students from the rest of the class or parents may consider keeping their child at home until illness subsides in the classroom.

How is information about the H1N1 virus being shared with Pennsylvanians who have disabilities?
The Department of Public Welfare will be working with its licensed facilities and advocacy groups to communicate information about the H1N1 virus and vaccine availability. The PA DOH, through its Office of Public Health Preparedness, will also share communications with the members of its Special Populations Work Group to distribute.

The PA DOH also conducts mass vaccination clinics at sites that meet Americans with Disabilities Act (ADA) requirements. Clinic information is available by visiting the "What's Hot" section of www.H1N1inPA.com. This information can also be obtained by calling 1-877-PA-HEALTH.

What 2009 H1N1 info is available for the deaf community?
DeafMD and the CDC are working hard to provide the deaf community with the most up-to-date information available to help reduce the spread and severity of the illness, and to provide information to help healthcare providers, public health officials and the public address the challenges posed by this emergency. A signed public service announcement can be viewed at www.cdc.gov/h1n1flu/deaf.htm.

Workplace And Employers

What can employers do to deal with H1N1?
Employers should encourage any employees infected with H1N1 to stay home to stop the risk of spreading the virus throughout the workplace. Employers can also consider using a preparation checklist to plan early regarding business continuity and potential absenteeism, as well as downloadable materials to aid in communication with employees. These items can be found at www.H1N1inPA.com.

What information should I give my employees regarding vaccination?
Encourage employees to get the 2009 H1N1 vaccine when it becomes available in large quantities. You should also encourage your workers to obtain a seasonal influenza vaccine, if it is appropriate for them. This helps to prevent illness from seasonal influenza strains that may circulate at the same time as the 2009 H1N1 flu.

Is it realistic to expect an hourly worker without benefits to stay home unless they're extremely ill or have to stay home with a sick child?
For the large part, this is a workplace issue. However the guidance is to stay home if you are sick. It is clear that this could be unrealistic in some circumstances. Part of the coordinated message from both employers and the PA DOH is to advise employees to plan for this scenario. They need to talk to babysitters ahead of time, speak with their employer to see how they are going to handle this situation, and get vaccinated to avoid illness.

Where can my company get information to help us plan for this pandemic and communicate with our employees?
A section is devoted to Workplaces and Employers on www.H1N1inPA.com, under "Info for Specific Groups." This section, which also includes a communication toolkit you can use to convey important information to your employees, will help your business prepare for the H1N1 pandemic.

Healthcare Providers

Where can nurses get training in vaccine administration?
The PA DOH District Offices will be offering trainings to nurses who volunteer to participate in mass vaccination clinics. The trainings will be hands-on, with models for both adult and pediatric intramuscular injections. Call 1-877-PA-HEALTH for additional information.

If a facility orders the number of doses they would need to cover their employees, what are they to do with leftover doses?
Any unused vaccinations could be used for patients meeting the priority group guidelines or be sent back to the PA DOH to be used elsewhere. Call 1-877-PA-HEALTH for additional information.

Will the state be providing a generic consent form to be used when administering the H1N1 vaccine or will each site be responsible for creating their own document?
A consent form is available at www.H1N1inPA.com. Vaccination sites can either use this form or create their own.

In our residential adolescent and adult drug and alcohol treatment center where "dormitory" living is the norm, what should our response be to persons with flu like illness?
The guidance for colleges/universities may be helpful in your planning, as it addresses dorm living. The guidance is available at www.H1N1inPA.com.

Emergency Medical Services (EMS)

Are Fire and Law enforcement included in the term "EMS personnel"?
For the priority groups, "EMS personnel" is defined by the CDC as personnel whose primary function is in healthcare provision. The PA DOH will begin offering vaccine in January to any Pennsylvania resident who wants it.

I'm a first responder, how should I manage patients with confirmed or suspected H1N1?
The CDC has specific guidance documents for EMS and 9-1-1 personnel:

Both documents can be found on the CDC Web site at http://www.cdc.gov/h1n1flu/guidance/.

Schools (K-12)

What are schools doing to deal with H1N1?
Pennsylvania schools have been advised to prepare for both student and staff H1N1 infections. In addition to encouraging good prevention techniques, commonwealth schools will follow a preparation checklist to best avoid the necessity of closing any schools.

General H1N1 Info

Is there a uniform evaluation matrix that schools should use to assess illness in students?
The general definition used for influenza-like illness is fever over 100°F (although not everyone with the flu will have a fever) with cough and/or sore throat. Children who meet these criteria should be considered to have flu unless there is an alternate explanation (like strep throat).

The requirement for returning to school is the absence of fever for at least 24 hours without the aid of fever-reducing medications. However, not all infected persons have the classic signs or symptoms of flu. Consideration should be given to this diagnosis whenever there is an outbreak of respiratory illness in a school setting. If in doubt, contact your local and/or state health department.

Because 2009 H1N1 is the same as regular flu in severity, should schools tell teachers, students, and parents not to worry?
Influenza is always a serious disease, whether due to pandemic or seasonal strains, and everyone should take steps to control and prevent the flu. While the severity of disease associated with H1N1 has been similar to seasonal flu, there are special concerns due to the pandemic strain. These include its disproportionate impact on school-age persons and the potential for disease associated with it to increase in severity, as has occurred with past pandemics. Students, parents, and other members of the public make better decisions when they are informed about health risks and know the steps they can take to reduce their risks.

Does someone develop immunity after natural infection against 2009 H1N1? Do people with known infection still need to be immunized with the pandemic vaccine?
People do develop immunity against the pandemic influenza virus after natural infection, just as they do against seasonal flu. Like with other types of flu, persons with impaired immune systems (due to disease or medication) do not develop as good a level of immunity as others. However, previous infection does not assure protection against subsequent infection, especially because the virus naturally changes over time. This is why people of all ages can repeatedly get the flu. There is no additional risk from vaccination if someone has previously had the disease.

What is meant by prophylaxis?
Prophylaxis refers to a measure taken for the prevention of a disease or condition. Vaccination is a form of prophylaxis. However, with the flu, the term generally refers to giving individuals medications like antivirals to keep them from becoming ill. The medication can be given either before or after someone is exposed to the flu. In general, pre-exposure prophylaxis is not being recommended for H1N1 as the medication would need to be taken for an extended period of time. Post-exposure prophylaxis for H1N1 is appropriate for individuals at high risk of flu complications, and is generally not recommended for other exposed persons.

If a child in a family is identified with H1N1 may schools exclude brothers and sisters or must they wait until they get the flu?
Exclusion of healthy siblings of someone with influenza is not generally recommended. They should be observed for signs or symptoms of illness over the seven days following last exposure to the ill person(s), and if they become ill they should be sent home. In addition, if the individual falls into a group at high risk of flu complications, they should be considered for antiviral prophylaxis.

What constitutes a sick room? A curtain? Wall?
A sick room is an area where an ill individual can be taken prior to evaluation or removal from the school premises. Separation means at least 6 feet of space between ill and well individuals. Ideally, there should be a physical barrier between the ill and well persons, such as a wall and a door that can be closed. If such a location is not available, a curtain is a reasonable alternative.

Preventing/Stopping the Spread of H1N1 in Schools

Do you recommend desk cleaning on a daily basis?
Pennsylvania's school guidance recommends routine cleaning and disinfection in schools, with special attention to frequently used surfaces and objects. This would especially apply to surfaces and objects that are handled by many persons (door handles or computer keyboards), where daily cleaning may be necessary when influenza-like illness is occurring.

Do you recommend disinfecting school buses?
Routine cleaning of school buses should be adequate. However, if an ill student has clearly contaminated an area of the bus with respiratory secretions, that area should be cleaned using appropriate cleaning products before the next use.

Are there recommendations for specific alcohol-based or alcohol-free hand sanitizers?
Soap and water or alcohol-based hand sanitizers are the preferred hand hygiene products for use against influenza. However, if there are reasons not to use alcohol-based hand sanitizers, non-alcohol based products are a reasonable alternative when soap and water are not readily available and are preferable to not practicing hand hygiene.

We have heard that alcohol-based hand sanitizers are flammable. Is this a concern?
These products do contain alcohol, and must be properly handled so they do not pose any health or safety risks. They can be safely and effectively used in many school settings. Care should be taken to make sure they are not intentionally or unintentionally in proximity to fire, and they are not for oral consumption.

With young children, efforts should be made to oversee or observe their use. If there are any questions or concerns about alcohol-based hand sanitizers, soap and water are an acceptable alternative.

Is there a time-limit for the use of surgical masks?
No. However, their effectiveness deteriorates over time and they become more difficult to use as they become dirty or moist. In addition, it is generally difficult for an individual to use a mask for an extended period. If in doubt, a used mask should be properly disposed of and a new one substituted. In addition, non-reusable personal protective equipment (PPE) should not be shared, and reusable PPE should only be shared after proper cleaning and disinfection.

Are masks recommended for the current level of severity or only if the H1N1 virus becomes worse?
Use of surgical masks while caring for ill individuals with pandemic influenza or to be used on ill individuals if they can tolerate the mask prior to removing them from the school is appropriate regardless of disease severity.

Student Absences due to H1N1

For absenteeism, should we contact the PA DOH only when there is a certain percentage of absent students? What are the guidelines for excessive absenteeism?
Every school should establish the baseline level of absenteeism that is expected for that school, and how much normal variation there is around that baseline. Every school will have a different baseline. As a result, there is no set definition for "excess" absenteeism, especially when it is caused by illness.

Is there a reporting vehicle for school absenteeism, such as school nurses reporting flu-like illness?
When excess absenteeism is identified, schools should promptly contact their local and/or state health department, either by e-mail or telephone, to discuss the situation and decide on an appropriate course of action. The PA DOH is requesting that some schools around the state routinely report school absenteeism and students seen with influenza-like illness as part of our enhanced monitoring of the patterns of influenza in the commonwealth.

How should schools handle a high rate of absenteeism due to hysteria/panic versus actual illness?
It is important to determine whether excess absenteeism is due to actual illness or because parents are keeping their child at home due to concerns about the safety of the school environment. If the latter occurs, frequent communications with parents about what steps are being taken to limit the spread of infection in the school should be the rule. The best method to deter panic is to proactively inform parents, students and the community about ways to prevent the spread of influenza, including vaccinations, frequent hand washing and sneezing into a tissue or upper sleeve.

Is the PA DOH requiring or recommending a doctor's note when a student returns to school after having been absent for a confirmed case of H1N1 or an ILI?
Such decisions are best made on a district-by-district basis. However, PA DOH guidance indicates that a student or staff member can return to school once they no longer have a fever for 24 hours without the use of fever-reducing medications. This recommendation is made regardless of whether or not the individual has been cleared by their healthcare provider to return. In addition, if the student or staff member is obviously ill, especially if they have a fever, they should be sent home regardless of clearance from a healthcare provider.

When monitoring attendance, at what point should schools contact parents to check on the child(ren)?
There is no specific answer to this question. In general, the period of fever for 2009 H1N1 lasts from 2-4 days after illness onset. Most children should be able to return to school after an exclusion period of 3-5 days.

How quickly will schools be informed when there is a confirmed case of pandemic influenza among the students?
As with any other disease that could be spread in school, parents are encouraged to inform school authorities if their child develops influenza like illness, or if they are diagnosed with influenza (whether or not the infection has been confirmed through laboratory testing). In this way, the school can take measures to ensure the health and safety of other students and staff, reinforce prevention messages, and be on the look out for other illness. It is important to note that only a fraction of illness due to influenza is ever laboratory confirmed. There is no requirement for a parent to report illness in their child, even if laboratory confirmed. Under the Disease Prevention and Control Law, the PA DOH is prohibited from releasing patient-specific information unless necessary for public health purposes. However, schools can be informed about the occurrence of illness without divulging patient-specific information for the purposes of assuring an appropriate response.

Who do parents contact at the Department of Education if school officials are not flexible with excessive absence of a child resulting in report of truancy and subsequent fines?
It is the responsibility of each district to determine the validity of excuses and have clear written policies regarding absences. Absences that are reported in a timely manner and qualify as excused absences for health or medical reasons do not meet the definition of truancy, so flu-related absences that are reported in a timely manner would not result in a truancy situation. Under state law, students who miss 10 consecutive school days shall be dropped from the active membership roll unless the school is provided with evidence the excuse is legal or the school is pursuing compulsory attendance prosecution.

School Closures

Will schools close because of H1N1?
Schools will take significant precautions to keep from closing due to H1N1 outbreaks.

If a school must dismiss due to the H1N1 flu, is the PA DOH still recommending the school stay closed for five school days?
There is no standard recommendation at this time. School dismissal will remain an option, but the current recommendation is to take such action only if there is evidence that other measures are not working. School districts are encouraged to work closely with their local and state health departments to evaluate the situation and respond appropriately. Cooperation between school districts and public health entities will ensure the best course of action is taken to both protect the students and minimize the impact and burden on affected families and communities.

If a school dismisses for a period of time due to H1N1, will either the federal or state education associations grant a school relief from the mandatory 180 school days?
The Pennsylvania Department of Education will review those situations individually and consider granting a waiver from the mandatory 180-day requirement on a case-by-case basis.

How is PDE recognizing these school closings?
In the case of a widespread outbreak in a school, the Pennsylvania Department of Education works closely with the Department of Health and local school officials to determine the best course of action. If it is determined that a school closing is the best option, the state will assist the district in determining the how long the school should be closed and whether students affected can be temporarily accommodated.

Should entire districts close or can one school within the district close depending on absenteeism?
School districts should always employ the least disruptive measures that will accomplish protecting the health and safety of students and staff members while allowing educational activities to continue. In most instances, this would mean decisions regarding closure should be made at the individual school level rather than the larger school district.

If we close one school due to an outbreak, but have no problems in others, may we disclose that a confirmed case was at School X, without violating disclosure?
The Disease Prevention and Control Law provisions regarding disclosure pertain to activities of the Department of Health, not to other entities. In general, schools should share with parents and other stakeholders important information such as the occurrence of influenza in their child's school and the actions that are being taken to reduce the potential for disease transmission.

About the H1N1 Vaccine

Are school-age children in the priority groups that should be vaccinated against H1N1?
Yes. Five groups have been determined by the CDC as most vulnerable to complications from the H1N1 virus. They include,

pregnant women,
children six months to adults 24 years,
healthcare providers and EMS personnel,
parents and caregivers of children under six months, and
people with certain pre-existing medical conditions (like chronic lung disease such as asthma, heart disease, kidney disorders, cancer or weakened immune systems).

Will the H1N1 vaccine be yearly, or is this a one-time vaccination?
Most experts anticipate that the pandemic influenza A/H1N1 strain will persist and probably replace one or more of the seasonal influenza strains. If that happens, it will then become a seasonal influenza strain and be incorporated into the normal seasonal influenza vaccine. So the need to receive a separate H1N1 vaccine and seasonal vaccine this year, will likely not occur in future flu seasons.

Schools as Vaccine Sites

Would a school that volunteers to be a vaccination site have to take in everyone in their area wishing to be vaccinated, such as non-public school students?
That will be a local, school district by school district decision. Non-public and private schools should contact their school districts for planning if they will not be a vaccination site.

My school district would like to offer the H1N1 vaccine, but does not have sufficient school nurse coverage to administer to every student who might want it. What are our options?
Schools can recruit volunteers from the community or they can contact the PA DOH for assistance. PA DOH nurses are available to assist with H1N1 vaccine administration. In addition the PA DOH has contracts in place with temporary nursing agencies and EMS providers to assist schools with vaccine administration.

Will the PA DOH provide hazardous material disposal assistance for the waste associated with H1N1 vaccine administration?
Yes. If a school does not have access to a service that provides hazardous material disposal, contact the PA DOH at 1-877-PA-HEALTH and request assistance.

How should schools handle leftover vaccine?
Any remaining vaccine that will not be utilized should be returned to the PA DOH for use elsewhere. Schools should contact the Department of Health District Office in their area to arrange a timely return of the unused vaccine.

For students who are medically fragile and/or take a variety of medication, should the families go to their family physician for the vaccination rather than a school setting?
Flu vaccine is routinely given to many medically fragile individuals with underlying health problems. These individuals receive the vaccine in a variety of settings. So there is no specific reason that a medically fragile individual cannot be vaccinated as part of a school immunization campaign. However, there may be concerns about them receiving a specific type of vaccine (injectable versus inhaled) or whether or not they should be vaccinated. If there is any question about a student receiving the vaccine, their healthcare provider should be contacted or they should be referred to their healthcare provider to give the vaccine.

2009 H1N1 In Pets

Do animals and humans share influenza viruses?
Many different influenza A virus subtypes occur in animals, such as cats, birds, dogs, ferrets, horses, pigs, seals, turkeys and whales. Most are not known to produce illness in humans. Influenza in pigs is of special concern because the cells that line a pig's respiratory tract can easily become infected with more than one influenza virus at the same time, including influenza viruses from both animals and humans. The genetic material of those two subtypes can mix, thereby creating new (also known as recombinant) influenza viruses. An influenza pandemic can occur when a new virus subtype to which animal and human populations have little immunity begins to spread. This happened with the 2009 pandemic H1N1 influenza A virus.

Can my pet become infected with the H1N1 virus?
Until recently, it was believed that the pandemic H1N1 virus would not jump between species and produce infections in other animals. However, several instances of pandemic H1N1 infection in cats and ferrets demonstrate that these animals can also become infected too, likely due to spread from ill persons. Domestic pets that live indoors often have very close contact with their owners and that increases their chances of being exposed to human diseases. The best public health advice with regard to your pet is to always use common sense. This includes carefully washing your hands after touching or cleaning up after your pet. Pet owners should consult a veterinarian if their pet is showing any signs of illness.

Should I get rid of my domestic pet to protect my family from pandemic H1N1?
No. You are much more likely to catch the flu from an infected person than you are from an animal. So far, all of the domestic pets infected with the H1N1 virus apparently became infected from their ill owners rather than the other way around. When you are ill with the flu, you should probably limit your contact with your pets (as you would with other people) until you are feeling better and are fever-free for at least 24 hours. As always, you should practice good sneeze etiquette (sneeze into your sleeve and/or handkerchief) around animals and people. If your pet begins showing signs of illness you should consult with a veterinarian.

What symptoms would I see in my pet?
An infected animal will exhibit flu-like symptoms that include lethargy (less active), loss of appetite, fever, runny nose and/or eyes, sneezing, coughing, or difficulty breathing.

Should I keep people who have respiratory disease away from my pet and vice-versa?
Until we know more about the risks of spreading the pandemic H1N1 virus from person to pet, pet to pet, or pet to person, it's a good idea to limit contact between an ill person and family members and pets.

Is there a vaccine for pets?
There is not a licensed and approved pandemic H1N1 vaccine for pets. The human H1N1 vaccine is not designed for animals and should not be given to pets. The canine and equine influenza vaccines will not protect dogs and horses against the pandemic H1N1 virus and should not be used in other species.

American Veterinary Medical Association
http://www.avma.org/public_health/influenza/new_virus/default.asp
United States Department of Agriculture
http://www.usda.gov/wps/portal/?navid=USDA_H1N1