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SUNY Downstate Medical Center - Stay Healthy

Flu Frequently Asked Questions

What is H1N1 influenza (Swine Flu)?

H1N1 is a new flu virus of that was first detected in April, 2009. The virus is infecting people and is spreading from person-to-person, and has sparked a growing outbreak of illness.

Although there have been some hospitalizations and several H1N1 flu-related deaths in New York City, the overwhelming majority of affected individuals continue to have only mild-to-moderate symptoms similar to ordinary seasonal influenza.

Most people recover in a few days. In most cases, H1N1 flu will resolve without medical attention.

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How Is H1N1 Transmitted?

Transmission is predominately droplet, which means:

The flu virus is present:

  • In large droplets expelled when you cough or sneeze, which fall quickly to the ground or on to surfaces
  • On the hands of ill people.

Transmission occurs:

  • Usually from direct hand-to-hand or hand-to-surface contact.
  • Flu virus on the hands is easily transferred to the eyes, nose, and mouth, where flu virus can enter the body and cause infection.
  • Less frequently by direct inhalation of flu virus in the air.

Implication: Hand washing is as important as respiratory precautions.

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H1N1 symptoms are similar to the symptoms of regular human seasonal influenza. Most illnesses with congestion and mild fever are NOT caused by this new type of flu.

Symptoms include:

  • fever (usually high - greater than 100 degrees)
  • headache
  • extreme tiredness
  • dry cough
  • sore throat
  • runny or stuffy nose
  • muscle aches
  • stomach symptoms, such as nausea, vomiting, and diarrhea, may occur in children but are rare in adults .

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Severe Symptoms For Adults:

  • Has difficulty breathing
  • Has purple or blue discoloration of the lips
  • Is vomiting and unable to keep liquids down
  • Has signs of dehydration such as dizziness when standing, has not urinated in 4 hours
  • Has seizures (for example, uncontrolled convulsions)
  • Has loss of consciousness
  • Has an alteration in thinking or behavior

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Severe Symptoms For Children:

  • Fast breathing or trouble breathing
  • Bluish or gray skin color
  • Not drinking enough fluids; or in infants, a lack of tears when they cry
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash

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Are You at Increased Risk for Complications from Influenza?

If you are at increased risk, you should call your physician and discuss whether you need prophylactic medications. Those at increased risk include:

  • Adults older than 65-years old, and children younger than 5 (children younger than 2 are at higher risk).
  • Pregnant women.
  • Adults and children with lung problems or pulmonary disease, including asthma.
  • Compromised respiratory function, and conditions such as pneumonia that increase the risk for aspiration.
  • Chronic heart disease, kidney or liver disease.
  • Blood disorders, such as sickle cell.
  • Metabolic disorders, such as diabetes.
  • Immunodeficiency or immune-suppression caused by medications such as corticosteroids and chemotherapy, or diseases such as HIV/AIDS, adrenal disease, or lupus.
  • Persons with neuromuscular disorders, seizure disorders, or cognitive dysfunction tht may compromise the handling of respiratory secretions.
  • Children younger than 19 years who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection
  • Persons in nursing homes and other chronic-care facilities

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Things You Can Do to Stay Healthy

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

Remember the 3-C's

1. Clean.
Wash your hands often. Scrub your hands for at least 20 seconds with soap and water or use an alcohol-based hand cleaner. Wash your hands after contact with respiratory secretions.

2. Cover.
Cover your cough. Use a tissue to cover your mouth and nose when you cough or sneeze. Do not have a tissue - The crook of your elbow will do.

3. Contain.
Contain germs by steering clear of others who are sick. Distance yourself from others (more than 3 feet). If you do get sick, stay at home until you're well again, so you do not spread more germs.

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What you should do if you think you have H1N1 Influenza:


  • Do not go to work and, if your children are ill, keep them home from school. Do not go out to do errands, and limit close contact with others to keep from infecting them.
  • You should stay at home at least 7 days after your symptoms began or 1 day after your symptoms resolve - whichever is longer.
  • In most cases, H1N1 flu will resolve without medical attention.
  • Get plenty of rest
  • Take acetaminophen (Tylenol), ibuprofen, or other fever-reducing medicine as needed. Do NOT give apirin or aspirin-containing products to children and youth under 18 years old, to avoid Reyes Syndrome, a potentially life-threatening complication.
  • Drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydranted.
  • If medications are prescribed, be sure to follow instructions exactly. If you think you are having a reaction to the medication, report it to your healthcare provider immediately.
  • If you are at risk for complications of flu or sick, call your healthcare provider. Report your symptoms, and follow their advice.

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Additional information about the swine flu and influenza may be found on the following websites:

Links to Informational Sources

Centers for Disease Control and Prevention

New York City Department of Health and Mental Hygiene


Information for Downstate Employees

Update from the New York State Department of Health - October 5, 2009 (PDF)

Memo to Downstate Employees 5/22/2009

New York State DOH letter (PDF) lifting mandatory vaccination requirement.


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