Influenza A (H1N1)

Background

The flu pandemic remains at phase six, as declared on 11 June 2009 by the World Health Organisation. As of 6 December 2009, more than 208 countries and territories have reported laboratory confirmed cases of pandemic influenza H1N1, including at least 9596 deaths

The severity of the virus is “moderate”, meaning most people do not need hospital treatment. According to the WHO, the new influenza H1N1 appears to be as contagious as seasonal influenza, and is spreading fast particularly among young people (ages 10 to 45).

General advice

• If you are well you can work and travel as usual
• If you have flu you should not travel until you are symptom-free
• If you have flu you should not go to work until you are symptom-free
• If you have have been in contact with people with flu you should carry on working and travelling as usual (ie, no need for quarantine of close contacts)

The best way to avoid swine flu and to stop its general spread is:

• Cover your nose and mouth when coughing or sneezing, and use a tissue when possible
• Dispose of dirty tissues promptly and carefully
• Maintain good basic hygiene by washing hands frequently
• Clean hard surfaces (eg, door handles) frequently using a normal cleaning product
• Make sure your children follow this advice

Vaccination

The World Health Organisation estimates that around 80 million doses of H1N1 pandemic vaccine have been distributed and around 65 million people worldwide have been vaccinated.

The European Medicines Agency, the official regulator that licenses treatments, has approved three vaccines: Pandemrix, Celvapan and Focetria.

The WHO has advised that the groups most at risk of complications from H1N1 should be given the vaccine first – for example, people with heart, kidney, liver or neurological diseases, diabetes or a weakened immune system, such as those who have HIV/Aids or those who are taking medicines to suppress their immune system.

You should check with the national authorities where you are to find out what vaccines have been approved and what vaccination plans have been implemented.

So far research has found no evidence of any harmful effects from the influenza H1N1 vaccine. The influenza H1N1 vaccine is a ‘dead’ vaccine; this means it does not have a ‘live’ virus in it.

Because of this, there is limited chance of the vaccine actually causing flu. It is important to remember that the influenza H1N1 vaccine does not replace the need for the seasonal flu vaccine.

You can find out more about the safety of the vaccines on the WHO website

What is swine flu?

Swine flu is a contagious respiratory disease found in pigs that is caused by type A influenza viruses. The virus often causes outbreaks in pigs, and many countries regularly vaccinate their pigs against the virus.

It's not normal for swine influenza to affect people, although there have been a small number of cases in the past. These cases were mostly in people who had been in direct contact with infected pigs.

How is influenza A (H1N1) different from normal swine flu?

The new influenza virus that has been seen in humans is very different to what normally circulates in pigs. It combines genes from humans, pigs and birds.

What are the symptoms?

The symptoms of influenza A (H1N1) influenza are similar to ordinary influenza. People with influenza A (H1N1) usually have a fever or high temperature (38°C/100.4°F) and two or more of the following symptoms:

• tiredness
  
• headache
  
• runny nose
  
• sore throat
  
• shortness of breath or a cough
  
• loss of appetite
  
• aching muscles
  
• sickness or diarrhoea

Antiviral medicines

Antiviral medicines can't cure the flu but they help to reduce the length of time you are ill by about a day, relieve some of the symptoms and reduce your risk of serious complications such as pneumonia.They need to be taken within 24-48 hours of flu symptoms starting to be effective.

It's particularly important for people who are at risk of complications to start taking antiviral medicines as soon as possible after symptoms start. If you do have flu-like symptoms and are in one of the risk groups, contact your GP as soon as possible.

The two antiviral medicines available are oseltamavir (Tamiflu) and zanamivir (Relenza). Oseltamavir is taken as a tablet and zanamivir is taken through an inhaler. Zanamivir is more suitable for pregnant women.

How long is someone infectious for?

It can take up to seven days for symptoms to start after someone is infected with influenza A (H1N1), but it is more likely to be between two and five days. If you have influenza A (H1N1), you will be infectious when you have symptoms. This is most likely to be for up to five days, although this may be longer in children.

In the UK, healthy close contacts of someone with influenza A (H1N1) will no longer be given antiviral medicines unless their GP decides they are at a higher risk of complications from the virus.

If you live outside the UK, check with your government's health authority for more information and advice.

Does your Bupa International policy cover you for treatment?

Individual policies vary, and customers must check the details of their policies to ensure coverage.

However, as a general rule:

• If you need to be admitted as an in-patient for treatment of swine flu, your costs will be covered up to your policy limits, and this includes drugs administered while in hospital
• If you do not need to be admitted, but need antiviral medication as an out-patient, you will only be covered for the cost of this medication if you have out-patient drugs covered under your policy
• Some corporate customers may be able to get hold of antiviral medications from their employer, depending on what their particular company has decided to do

Can I be evacuated/repatriated if I have swine flu?

No. The reason is that people with flu should not travel because of the risk to themselves and to other people. Commercial airliners will not take people on board with flu, and hospitals will not accept such cases.

There may be rare exceptions for particularly complex cases, which will be judged by our doctors.

If in any doubt, contact our healthline on + 44 (0) 1273 333911