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CDC H1N1 Flu (Swine Flu) Information

Harvard News Update (May 1st 2009)

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Classes and clinical activities at the Harvard School of Dental Medicine will be suspended through May 6 because of a cluster of nine possible cases of H1N1 influenza in the Dental School student population.

Testing indicated that two of the cases are considered “probable” for the new strain of flu, according to the Boston Public Health Commission (BPHC). The remaining seven students all exhibit symptoms of the illness and were exposed to the two students whose cases were deemed probable.

As a precautionary measure, Harvard Medical Students, who work and study in close proximity with Dental School students, will not engage in any clinical activities – meaning that they will not see patients or be at our affiliated hospitals– through May 6.

Classes and other activities for the Medical School students have been suspended through Monday, May 4, while Harvard and public health officials gather additional information about the cluster of cases. The Harvard School of Public Health, which suspended classes as a precautionary measure on Friday, plans to resume normal activities on Monday.

All nine of the Dental School students are reported to be recovering well. The H1N1 virus has not been seen in any Medical School or Public Health School students or staff.

The new strain of influenza appears to have emerged in Mexico and as of Friday evening there had been 331 confirmed cases in 11 countries from New Zealand to the U.S. There are 141 laboratory-confirmed cases in 19 U.S states, including six in Massachusetts.

We urge members of our community who experience flu-like symptoms to immediately contact Harvard University Health Services (HUHS) or their physicians. This is especially true for any individual who recently spent time in any of the countries or states where early cases of this new strain of flu have already been concentrated - or who have been in contact with a person who was infected.

Food services at Harvard Medical School and the Harvard School of Public Health have eliminated all self-service food stations in order to minimize the number of potential contact surfaces for virus transmission. Additionally, hand sanitizers are being provided to assist with hygiene.

Harvard officials are closely monitoring the situation with the BPCH and with the Harvard Medical School affiliated hospitals. The University’s emergency management team has well-established plans and procedures to address any potential disease outbreak in the University community.

Symptoms of this influenza include body aches, fever, severe malaise, chills, and in some cases, nausea, vomiting and diarrhea. HUHS has adopted established guidelines for diagnosing and treating this new strain of flu.

There are no formal University-related travel restrictions in place at this time, but the CDC has recommended that people suspend all but essential travel to Mexico.

To avoid contracting illness, HUHS advises all members of the Harvard community to:

 

  • Practice good hygiene. Wash your hands often with soap and water. Alcohol-based hand cleaners are also effective.

  • Cover your nose and mouth when you cough. Use and dispose of tissues or cough/sneeze into the crook in your elbow.

  • Avoid touching your eyes, nose or mouth. Germs spread that way.

  • Avoid close contact with sick people.

 

If you receive care from Harvard University Health Services in the Longwood area, call 617-432-1370 from 9 a.m. to 5 p.m Monday through Friday. The after-hours urgent-care number is 617-495-5711.

HUHS has posted answers to frequently asked questions about swine flu.

For additional information about this quickly evolving situation, please consult the CDC at www.cdc.gov and the World Health Organization at www.who.int/. We will update the HUHS Web site as new information becomes available.

Steven E. Hyman, M.D., Provost
David Rosenthal, M.D., Director of Harvard University Health Services

 

Signs and Symptoms

According to the Centers for Disease Control and Prevention (CDC), in humans the symptoms of the 2009 "swine flu" H1N1 virus are similar to those of influenza and of influenza-like illness in general. Symptoms include fever, cough, sore throat, body aches, headache, chills and fatigue. The 2009 outbreak has shown an increased percentage of patients reporting diarrhea and vomiting.The 2009 H1N1 virus is not zoonotic swine flu, as it is not transmitted from pigs to humans, but from person to person.

Because these symptoms are not specific to swine flu, a differential diagnosis of probable swine flu requires not only symptoms but also a high likelihood of swine flu due to the person's recent history. For example, during the 2009 swine flu outbreak in the United States, CDC advised physicians to "consider swine influenza infection in the differential diagnosis of patients with acute febrile respiratory illness who have either been in contact with persons with confirmed swine flu, or who were in one of the five U.S. states that have reported swine flu cases or in Mexico during the 7 days preceding their illness onset."A diagnosis of confirmed swine flu requires laboratory testing of a respiratory sample (a simple nose and throat swab).

 

Prevention of human to human transmission

Influenza spreads between humans through coughing or sneezing and people touching something with the virus on it and then touching their own nose or mouth.Swine flu cannot be spread by pork products, since the virus is not transmitted through food.The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can remain contagious for up to ten days. Diagnosis can be made by sending a specimen, collected during the first five days for analysis.

Recommendations to prevent spread of the virus among humans include using standard infection control against influenza. This includes frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being out in public.Although the current trivalent influenza vaccine is unlikely to provide protection against the new 2009 H1N1 strain,vaccines against the new strain are being developed and could be ready as early as June 2009.

Experts agree that hand-washing can help prevent viral infections, including ordinary influenza and the swine flu virus. Influenza can spread in coughs or sneezes, but an increasing body of evidence shows small droplets containing the virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes. Alcohol-based gel or foam hand sanitizers work well to destroy viruses and bacteria. Anyone with flu-like symptoms such as a sudden fever, cough or muscle aches should stay away from work or public transportation and should contact a doctor to be tested.

Social distancing is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community. Public health and other responsible authorities have action plans which may request or require social distancing actions depending on the severity of the outbreak.