Travel Health and Swine Flu

The H1N1 virus continues to circle the globe and infect new areas thanks to the “person to person” spread.  Clearly, this influenza outbreak will have long-reaching impact on travelers.  A few things that may help travelers make informed decisions:

• The Center for Disease Control (CDC) has advised all non-essential travel to Mexico be postponed
• The World Health Organization has not advised closing international borders or suspending trade

The CDC has advised the following persons to use antiviral medication such as Zanamivir (Relenza) or Oseltamivir (Tamiflu):

• Household close contacts who are at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women) of a confirmed, probable or suspected case.
• School children who are at high-risk for complications of influenza (children with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed, probable, or suspected case.
• Travelers to Mexico who are at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women. 
• Health care workers or public health workers who were not using appropriate personal protective equipment during close contact with an ill confirmed, probable, or suspect case of swine influenza A (H1N1) virus infection during the case’s infectious period.

The following persons are instructed to consider using antiviral post-exposure treatment:

• Any health care worker who is at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women) who is working in an area of the healthcare facility that contains patients with confirmed swine influenza A (H1N1) cases, or who is caring for patients with any acute febrile respiratory illness.
• Non-high risk persons who are travelers to Mexico, first responders, or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection.

Use of N-95 respirator masks may also decrease flu transmission, although they require proper fitting to ensure adequate face to mask seal.  Simple surgical masks likely offer little protection.  A 2007 statement from the CDC discussed little evidence that using such masks decreased influenza transmission.

One important point is the reserve supply of these anti-viral drugs and availability.  These medications are prescription only and advice should be sought from a physician before use.  Second, the manufacturers of these medicines are releasing stockpiles to help cope with increasing demand and obviously, areas with known outbreaks and those with confirmed infections receive priority.

Google Maps has created a real-time mapping of the virus spread, according to WHO data

CDC Guidelines for use of antivirals for H1N1:

http://www.cdc.gov/swineflu/recommendations.htm