This document has been updated in accordance with the CDC Recommendations for the Amount of Time Persons with Influenza-Like Illness Should be Away from Others . This document provides interim guidance and will be updated as needed.

2009 H1N1 flu virus infection (formerly known as swine flu) can cause a wide range of symptoms, including fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea.  People may be infected with the flu, including 2009 H1N1, and have respiratory symptoms without a fever.  Like seasonal flu, 2009 H1N1 flu in humans can vary in severity from mild to severe. Severe disease with pneumonia, respiratory failure and even death is possible with 2009 H1N1 flu infection. Certain groups might be more likely to develop a severe illness from 2009 H1N1 flu infection, such as pregnant women and persons with chronic medical conditions. Sometimes bacterial infections may occur at the same time as or after infection with influenza viruses and lead to pneumonias, ear infections, or sinus infections.

The following information can help you provide safer care at home for sick persons during a flu outbreak or flu pandemic.

How Flu Spreads

Don’t Get, Don’t Spread Video

Dr Joe Bresee describes how to keep from getting the flu, and spreading it to others.

The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

• check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema
• check with their health care provider about whether they should take antiviral medications
• keep away from others as much as possible. This is to keep from making others sick. Do not go to work or school while ill
• stay home for at least 24 hours after fever is gone, except to seek medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine.)
• get plenty of rest
• drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated
• cover coughs and sneezes. Wash hands often with soap and water.  If soap and water are not available, use an alcohol-based hand rub.* 
• wear a facemask – if available and tolerable – when sharing common spaces with other household members to help prevent spreading the virus to others. This is especially important if other household members are at high risk for complications from influenza.  For more information, see the Interim Recommendations for Facemask and Respirator Use
• be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention.

Medications to Help Lessen Symptoms of the Flu

Influenza Round Table: Antiviral Drugs Video

Influenza Round Table: Antiviral Drugs Dr. Joe Bresee explains the nature of antiviral drugs and how they are used.

Check with your healthcare provider or pharmacist for correct, safe use of medications

Antiviral medications can sometimes help lessen influenza symptoms, but require a prescription. Most people do not need these antiviral drugs to fully recover from the flu. However, persons at higher risk for severe flu complications, or those with severe flu illness who require hospitalization, might benefit from antiviral medications. Antiviral medications are available for persons 1 year of age and older. Ask your health care provider whether you need antiviral medication. Influenza infections can lead to or occur with bacterial infections. Therefore, some people will also need to take antibiotics. More severe or prolonged illness or illness that seems to get better, but then gets worse again may be an indication that a person has a bacterial infection. Check with your health care provider if you have concerns. Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye’s syndrome. For more information about Reye’s syndrome, visit the National Institute of Health website. Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin. Children 5 years of age and older and teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms. Children younger than 4 years of age should NOT be given over-the-counter cold medications without first speaking with a health care provider. The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus. Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS). Examples of these kinds of medications include: Generic Name Brand Name(s) Acetaminophen Tylenol® Ibuprofen Advil®, Motrin®, Nuprin® Naproxen Aleve Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. Importantly, these medications will not lessen how infectious a person is. Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications—don’t double dose! Patients with kidney disease or stomach problems should check with their health care provider before taking any NSAIDS. Check with your health care provider or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu. For more information on products for treating flu symptoms, see the FDA website.