I don't have any flu symptoms, but think I may have been
exposed to Swine Flu - what should I do?
bold">Do not take Tamiflu if you do not have any symptoms. Taking Tamiflu prophylactically could be a danger to
your personal health, as well as the larger public health effort against Swine
Flu. Monitor your health for 10 days and contact a medical professional if you
do experience flu symptoms.
If I have flu-like symptoms, how long will it take to
diagnose me?
Dr. Walter “Ben” Koppel, MEDEX Medical Director, urges anyone with flu-like
symptoms to consider themselves as having the flu until proven otherwise. The
laboratory test for the swine flu takes a few days to obtain results. Even if
the test is negative, patients should still be treated as if they have the
disease.
Can I conduct my own testing? Is there a kit?
Actual identification of the type of influenza virus is not essential for
treatment. Treatment for all viral respiratory conditions is the same –
antiviral, fluids, fever medication, supportive care and isolation. All testing
would take time and can be expensive. Any self diagnosis test kits may not be
effective in properly diagnosing the Swine Flu.
Any unnecessary travel to risk-prone areas should be postponed or cancelled. If travel is needed,
you should always check the CDC, WHO and your government’s public health authority websites for any
travel advisories that may be issued for the country in question. Also, contacting MEDEX Assistance
is always a smart way to obtain accurate and unbiased information. For tips on traveling to a risk-prone area,
make sure you read and follow appropriate health precautions.
People at higher/highest risk for contracting the Swine Flu are:
People who have direct contact with pigs
People with compromised immune systems or any other condition that can compromise respiratory function or the handling of respiratory secretions. These conditions include difficulty breathing or swallowing; brain injury or disease; spinal cord injuries; seizure disorders, and other nerve or muscle disorders.)
Adults of any age and children six-months and older with chronic heart or lung conditions, including asthma
Adults of any age and children six-months and older and adults who require regular medical care or were in a hospital during the previous year because of a metabolic disease such as diabetes, chronic kidney disease, or a weakened immune system (including those immune system problems caused by medicines or by infection with human immunodeficiency virus [HIV/AIDS]);
People 65 years and older
Children from six-months to 18 years of age who are on long-term aspirin therapy
Women who are pregnant
All children 6 to 23 months of age
Should I seek treatment locally or return home?
If you have flu symptoms, MEDEX Assistance advises travelers to seek treatment immediately and locally for the following reasons:
Local medical professionals are most familiar with Swine Flu and are therefore more likely to have the latest information and treatment options available to you
Local treatment avoids potential spread of Swine Flu (and the common flu too)
There may be travel restrictions for anyone who displays flu symptoms
How is the Mexican health care system?
Mexico City has reliable medical care, through physicians and hospitals. So far,
metropolitan Mexico City medical resources are not reporting that they are overwhelmed by
Swine Flu cases. Certainly public hospital will likely be the first to see any surge in
patients requiring admission to the hospital for severe flu symptoms. Mexico City has several
private, acute care hospitals with appropriate physicians to attend flu patients. For expatriates
and families, their first line of medical defense should be their personal physicians; internist,
gynecologist and pediatrician. If a family does not have a personal physician, a fellow employee
maybe able to recommend their practitioner and MEDEX can make referral to physicians.
Will the common flu vaccine help me avoid Swine Flu?
The common flu vaccine may not be effective against Swine Flu. However, MEDEX Assistance does
advise travelers going to risk-prone areas to get the common flu vaccine to serve as a differentiator
if flu symptoms present.
Will gamma globulin protect me?
An injection of gamma globulin, or blood proteins, is sometimes given in an attempt to boost a
patient’s immunity against disease. However, this is not an effective prophylactic measure. Because
the swine flu is a new strain of flu virus, no one has any antibodies yet to help develop the gamma globulin.
What if I start experiencing flu symptoms & want to purchase Tamiflu?
Purchasing Tamiflu overseas may be difficult for a number of reasons. First, some local officials have
already stopped purchase of the drug by foreign physicians to combat stockpiling. If you do try to purchase
the drug overseas, make sure you are working with a reputable medical facility or pharmacy. With a shortage
of Tamiflu, counterfeit supplies may be a problem. MEDEX Assistance can direct you to a reputable provider,
but cannot guarantee availability.
I'm traveling to a risk-prone area -- will my physician write me a prescription for Tamiflu?
Here are some reasons why your doctor may refuse to do this:
Your physician may determine that you are not at high risk for contracting the disease
There is a short supply of Tamiflu worldwide. Medical professionals and public health officials are discouraging widespread prescriptions which could limit supply when and where it is needed most.
Taking Tamiflu prophylactically is not recommended. Tamiflu is a prescription drug because it should be administered by a medical professional when symptoms are verified. It is dangerous for individuals to obtain Tamiflu and self-administer the drug.
Widespread and/or incorrect usage of Tamiflu could result in a mutation of the Swine Flu virus, rendering Tamiflu completely useless.
Your physician may advise that you seek care locally if you experience flu symptoms (see answer above to “Should I seek care locally or return home?”).
If I do bring Tamiflu with me, what should I do during travel?
Follow typical travel tips for traveling with prescription drugs, including the following
Carry all medications in your carry-on luggage
To minimize the suspicion of customs officials, carry medications in their original labeled containers (not mixed in other containers)
Carry your original, written prescriptions and, in a separate place, write down the name (including the generic name), strength and dose of your medications, with your doctor's name and contact information
Also, be sure to keep the Tamiflu in a secure location in hotel rooms, such as the hotel room safe or your luggage.
Store Tamiflu as directed by the manufacturer:
Capsules: Store at 77°F (25°C); excursions permitted from 59° to 86°F (15° to 30° C)
Tamiflu Suspension: Stored under refrigeration from 36° to 46°F (2° to 8°C) Do not freeze
Can MEDEX provide me with Tamiflu?
Worldwide, national governments are in control of the stocks of Tamiflu and Relenza and are using them to treat confirmed cases. It is not currently available at pharmacies and hospitals in Mexico City. MEDEX is continuing the inquiry of Tamiflu availability in Mexico.
Also, MEDEX is unable to assist you in importing Tamiflu to any country, as it is under strict control by the government.
What if I start experiencing flu symptoms & I have Tamiflu in my possession already?
MEDEX Assistance advises travelers who are experiencing flu symptoms in a risk-prone area to still seek medical care
immediately – even if they brought Tamiflu with them. If a physician in your home country prescribed Tamiflu prior
to your travels, try to contact your physician for specific instructions. You may also see a local medical professional
who can provide advice. MEDEX Assistance can assist you in finding a local medical professional. Keep in mind that Tamiflu
should be administered by a medical professional within 48 hours from the first sign of flu symptoms. Also, remember that
Tamiflu has not been confirmed as a reliable treatment for Swine Flu. If you do have Swine Flu, local medical professionals
will be most up-to-date on additional/ alternative treatments that may be available.
Can MEDEX help me identify the best hosptals and clinics to go to?
Yes, MEDEX clients can call our Emergency Response Center to hospital information. Clients with access to the MEDEX Member Center can log in online and find this information in the MEDEX 360ºm Global Medical Monitor portion of the site
What should I do in case of an emergency because of the influenza?
MEDEX can help you locate preferred providers and assist with direct billing. It’s important to remember that when epidemic concerns exist, many local hospitals and doctors may still expect patients to pay cash upfront for services. With a higher influx of patients, cash payment is preferred and more expedient; this could be true for hospitals with which MEDEX already has billing arrangements.
Is MEDEX ready to support me for a medical evacuation?
MEDEX can always assist with evacuation if it is permissible by both the US government and the government of the country where you are located. The evacuation will be reviewed by our medical team and would take place only if it is medically necessary.
What should I do if I am in a country where swine flu cases have been detected and want to get home, or if I have travelers in a country that is affected by swine flu?
Any kind of travel during this epidemic is limited to government and airline rules and regulations. If you become sick, MEDEX will monitor your care, as we would during a non-epidemic situation.
The Avian flu gets its name because it is typically
transmitted between, affects, infects, and can be fatal
to birds. "Avian flu," or "bird flu," is a collective
name for a variety of viruses that occur naturally
among birds. Generally carried by wild birds,
the bird flu is extremely contagious among bird populations
and can make domesticated birds (including chickens,
ducks and turkeys) fatally ill.
Although the Avian flu does not typically infect
humans, there have been numerous cases of human infections
reported since 1997. Almost all of these cases
were caused by the H5N1 strain of virus. The
causes of the infections are the result of direct
contact with infected poultry or through direct contact
with contaminated surfaces at venues such as live
bird markets. Confirmed reports of the spread
of avian flu viruses from one ill person to another
remain rare. The World Health Organization (WHO) has recently confirmed one case of human-to-human transmission of the H5N1 virus, in which the virus mutated and was passed to a third person. Officials confirm that the virus died with the third person and did not transmit to others.
How do I keep from getting it?
If a human becomes infected with avian flu today, it is
mostly likely from close contact with infected birds.
Therefore, any unnecessary contact with birds and
bird products, including uncooked poultry, should
be avoided. Careful and frequent hand washing
is one of the most important preventative practices
to avoid the avian flu and other diseases.
Is there a cure?
At this time, a cure for avian flu has not yet been
developed. However, antiviral treatments have
proven somewhat effective in treating the disease.
Scientists around the world are currently conducting
studies to find a cure for humans infected with the
disease. They are also investigating vaccine
options to prevent the spread of the disease.
What are the symptoms?
Symptoms of avian flu in humans are similar to the
symptoms of the common flu: Fever higher than
100°F (38°C) associated with a sore throat; difficulty
breathing and other respiratory symptoms such as a
dry or hacking cough; a feeling of exhaustion; severe
muscle aches; and thin mucus, such as a runny nose.
Because these symptoms are similar to the common flu,
avian flu cannot be diagnosed based on symptoms alone,
but requires a laboratory test. Swab samples
are taken from the throat or the nose and tested on
a molecular level. The incubation period for avian
flu may be as long as seven days, so symptoms may
not develop until a week after exposure.
What do I do if I think I have it?
If you think you may have Avian Flu, contact your
healthcare provider immediately. Be sure to
tell them your symptoms, whether you have had direct
contact with poultry, and where you have recently
traveled. Antiviral treatments are only successful
if they are administered within two days of initial
symptoms.
Won't I be protected if I received my seasonal flu shot?
The flu can come from any one of a number of viruses.
Each year, the U.S. Food and Drug Administration predetermines
the particular flu virus for which a vaccine will
be developed. Due to the varying types of viruses,
the vaccine for the common flu of that year will not
prevent the spread of the Avian Flu.
How does it spread?
Avian flu is spread through direct contact with infected
birds, either living or dead. Most specifically,
the virus is found in their saliva, nasal secretions,
and feces. Surfaces that have been exposed to
any of these bird products may also be contaminated.
Health officials believe that nearly all people who
have contracted the Avian Flu have done so through
close contact with infected birds.
Is there a vaccine?
To be most effective, a vaccine must be created based
upon the virus causing the pandemic. As a pandemic
is not yet occurring, vaccine manufacturers do not
know for which virus to develop a vaccine. Currently,
there are not any vaccines ready for commercial production,
and none are expected to be widely available until
several months after the start of a pandemic.
What is the status of vaccine development and production?
Experimental vaccines are being tested to determine
which formulations will be the most effective.
Once a virus has emerged as a pandemic, vaccination
production for that strain of flu can begin.
It is difficult to create a vaccine because the virus
is likely to mutate, possibly making that particular
vaccine ineffective.
Should I wear a surgical mask or gloves to prevent exposure to the avian flu?
Surgical masks and gloves are not recommended for
routine use in preventing influenza exposure.
However, in the event of a pandemic, they can be helpful
in limiting exposure to the disease.
Who is most vulnerable to bird flu?
As with the common flu, the populations most at risk
would be young children and the elderly. Also
at risk are people who have direct contact with poultry,
birds and their excretions and secretions, people
with compromised immune systems, anyone with chronic
heart or lung conditions, and women who are pregnant.
Can I still eat chicken?
Yes. Chicken that is cooked to a temperature
of 158° F (70° C) is safe for consumption. Cooked
eggs are also safe to consume. If handling raw
poultry or eggs, take precaution. Keep raw meat
separate from cooked meat, and wash your hands and
all surfaces and utensils afterwards.
If mammals can contract it, should I be concerned about my dog and cat?
While it is possible for domestic cats to contract
the avian flu virus, there have been very few reports
around the world. Any reported incidents of
pets contracting the disease are directly related
to occurrences of the animal consuming an infected
bird. There is no evidence that cats have spread
the virus to humans. There is very limited information
on dogs being affected by the avian flu, however,
the CDC, USDA, and several veterinary organizations
are working to gain more knowledge in this area.
As of July 2009, 436 people had been diagnosed with avian flu,
and 262 people had died from the disease.
If there has not yet been any documented human-to-human transmission, why
all the concern about a pandemic?
There is a possibility that the H5N1 strain will
mutate into a virus that affects humans. In
humans, the H5N1 virus is aggressive, with rapid deterioration
and high fatality, with primary viral pneumonia and
multi-organ failure common. If the virus mutates
into a form that is highly infectious for humans,
it will spread easily between people and could create
a global outbreak.
What countries have human cases?
Countries that have confirmed human cases of Avian Flu include:
Azerbaijan
Cambodia
China
Djibouti
Egypt
Indonesia
Iraq
Bangladesh
Lao People's Democratic Republic
Myanmar
Nigeria
Pakistan
Thailand
Turkey
Vietnam
Please refer to our maps page for further details.
What countries have non-human
cases?
Do migratory birds spread
the disease?
Yes, migratory birds have been known to spread the
disease among bird populations.
Are any travel restrictions
to avian flu countries recommended?
At this time, neither the CDC, WHO, nor MEDEX recommends
travel restrictions to countries affected by the avian
flu.
Why is the death rate
so high?
The death rate for individuals affected by avian
flu is so high because humans have no natural immunity
toward the disease. Vaccinations, once developed,
will help humans develop immunity towards the disease
and should therefore lower the death rate.
A pandemic is a global disease outbreak, identifiable
by meeting three conditions: 1) it affects humans
and causes illness; 2) there is little or no human
immunity; and 3) it spreads easily and consistently
among humans. There have been three influenza
pandemics in the 20th century. Worldwide,
40 million people died in 1918, 2 million people died
in 1957, and 700,000 people died in 1968. The
sharp decline in the death rate is due primarily to
advances in hygiene and medicine.
How should I prepare for a pandemic?
You can prepare for a pandemic by staying informed
about the situation. Take appropriate
steps to prevent transmission of the disease, such
as washing your hands frequently, limiting your exposure
to birds and people who may be infected, and seeing
a physician as soon as you suspect symptoms.
What changes are needed for H5N1 to become a pandemic virus?
H5N1 may become a pandemic virus in one of two ways.
It can gradually mutate into a form that infects humans,
or it can exchange genes with an influenza strain
that already infects humans, creating a new virus.
The World Health Organization, the World Organization
for Animal Health, and the Food and Agriculture Organization
are currently monitoring the global movement of the
H5N1 and other influenza strains.
What are the warning signals that a pandemic is about to start?
Early warning signs of an upcoming pandemic begin
with clusters of patients exhibiting the same symptoms.
When these patients are closely related, there is
a possibility of human-to-human transmission.
Each reported avian flu case is researched to confirm
the diagnosis, identify the source of that particular
outbreak, and determine the occurrence of human-to-human
transmission.
Can a pandemic be prevented?
Typically, if identified and contained within the
first 30 days of an outbreak, a pandemic may be prevented.
However, it may take some countries up to 30 days
to confirm the diagnosis and determine the cause of
the transmission of the disease. In many instances,
the 30-day timeframe has been surpassed before an
official statement has been declared by the local
government, bringing to question the world's ability
to contain a pandemic.
Is the world adequately prepared for a pandemic?
The World Health Organization has urged all countries
to develop pandemic preparedness plans, however only
approximately 40 have actually done so. While
many countries are stockpiling antiviral drugs, the
manufacturers are unable to keep up with the current
demand for the medication. If a pandemic is
in the immediate future, most developing countries
will have little or no access to vaccines and antiviral
drugs.
If there is an outbreak of pandemic flu, is there any way to protect myself?
As with any other flu virus, the best way to protect
yourself against avian flu is through frequent hand
washing. One of the most preventable methods
of transference is by covering the nose and mouth
when coughing or sneezing. Anyone with a cough
and a fever of over 100°F (38°C) should seek medical
attention.
Should I ask my doctor for Tamiflu now so that I can take it if there is
ever a pandemic?
Stockpiling Tamiflu or any other antiviral medication
is not recommended for individuals. Antiviral
medications including Tamiflu and Relenza have not
yet been proven effective against the H5N1 influenza
strain and are in short supply. By stockpiling,
individuals would be taking these medications away
from the people who could most benefit from them,
not only during a pandemic, but also during regular
flu season. Governments are currently creating
their own stockpiles for the event of a pandemic.
Is a bird flu pandemic imminent?
The timing and severity of a pandemic cannot be predicted.
Many scientists believe that it is only a matter of
time before the avian flu, or some other disease,
reaches pandemic proportions.
What is the government doing to prepare for bird flu?
Governments around the world are taking steps to
prepare for an avian flu outbreak. In the United
States, preparing for a pandemic is a collaborative
effort between federal, state, and local officials.
The U.S. Department of Health and Human Services is
working with the World Health Organization and other
nations to contain outbreaks, developing a national
stockpile of antiviral medication, and supporting
the manufacture of possible vaccines. In addition,
they are working with other federal agencies to prepare
for the impact that a pandemic may have on local and
national infrastructure.
The steps that other countries are taking to prepare
for the Avian Flu range from little or no preparations
to full pandemic response plans. Indonesia has
promised free medication to victims; Australia has
thermal imaging screeners ready to deploy to airports
within hours should a pandemic outbreak occur; and
Greece, having prepared for biological concerns during
the 2004 Summer Olympics, has a set contingency plan
in place. To find out more information about
specific countries, check with that country's government
website.
Are there specific items I should keep on hand in the case of a pandemic?
In the event of a pandemic, you may wish to have
antibacterial hand gel or soap available. Gloves
and masks may help limit your exposure, but are not
necessarily an effective precautionary step.
What is the shelf life of Tamiflu?
According to the manufacturer, Roche, the shelf life
of Tamiflu is 5 years.
If a pandemic develops, many people will be unable
to go to work. Others may stay home to care
for family, or be too scared to leave their house.
Businesses will experience absenteeism, and can therefore
expect a drop in productivity. You can expect
disruptions in transportation, trade, payment systems,
and major utilities. The World Bank estimates
that a flu pandemic would cost $800 billion
in a single year.
What if there is an outbreak
in a location where I have travelers?
If you have travelers where there is an outbreak,
they should immediately begin to monitor their health
for symptoms. Remind them to wash their hands
frequently, to cover their nose and mouth when they
cough or sneeze, and to limit their exposure to live
birds and people who are ill. If your company
wishes for those travelers to return to their home
countries, you should be aware of any travel restrictions
that may be placed upon them, such as being quarantined
upon their return home. Contact MEDEX for assistance
in this matter.
How can I prepare my business for a pandemic?
Your business can prepare by developing a business
continuity plan. With almost a quarter of the
population expected to be infected, your business
should be prepared for the drop in demand, as well
as the rise in absenteeism. The plan should
include information about continuing operations without
key individuals being present. It is possible
for a flu pandemic to last longer than a year, so
making sure that your business is properly prepared
is essential to economic survival. Fortunately,
many companies specialize in developing business continuity
plans. For more information on business planning,
please click here.
Are there specific items
that I should have my international travelers take
with them on their trips?
To limit flu exposure, international travelers may
wish to have antibacterial hand gel with them.
This can help limit exposure not just to avian flu,
but other viruses as well.
How can I prepare my employees?
You can prepare your employees by making sure that
they know and understand basic avian flu facts.
There are many locations throughout the world that
are not yet affected by the virus, and others where
the virus has not yet affected humans.
Protecting themselves against the avian flu is no
different than protecting themselves against the common
flu virus - frequent hand washing, and limited exposure
to possible sources of infection. In locations
affected by avian flu, it is best for travelers to
avoid live bird markets and other locations with poultry
and fowl.
What absenteeism rate should I expect?
The Centers for Disease Control and Prevention estimate
that up to 35% of the workforce could be affected
by the avian flu at any given time.
The Ontario (Canada) Ministry of Health projects a 35% illness rate and a 40-50% absence rate.
Please note that this information does not negate the traveler's responsibilities to contact MEDEX should they require medical assistance. This report is for the private use and may not be republished without prior written consent from MEDEX. The information presented in this website is for general reference only. The information presented in this website is time-sensitive and accurate to the best of our knowledge at the time of production.
