BU HOME  •   BU TODAY  •   ADMISSIONS  •   ACADEMICS   •   QUICK FACTS   •   RESOURCES  •   BU SPORTS  •   SUPPORT BU  

The Q&A on Swine Flu

Q: Are seasonal flu and H1N1 (swine flu) the same?

A: Seasonal flu and H1N1 flu viruses are different viruses but both cause similar symptoms of the flu. Both flu viruses are spread from person-to-person in similar ways. The symptoms of each virus are similar, causing illness that occurs rapidly within three to six hours. There is no specific treatment to cure either flu.

Both flu viruses will last seven to 10 days on average. One reason the swine flu is causing alarm is that it may have the ability of spreading quickly when it returns this fall. If the H1N1 virus spreads rapidly, it could potentially cause large numbers of people to be sick at one time.

Q: What are the symptoms of swine flu?

A: Following is a chart listing the symptoms of the flu as they compare to a common viral cold:

Symptom	Viral Cold	Flu
Fever	Normal to 101 F	Usually high: Above 101 F
Chills	Uncommon	Very common
Body aches/headache	Usually mild	Usually severe
Fatigue	Mild	Severe
Cough	Hacking & productive	Hacking & nonproductive
Sore throat	Common	Not common
Chest discomfort	Mild to moderate	Usually very severe
Nausea/vomiting/diarrhea	Rarely occurs	Can be present

Symptoms of a viral cold usually occur relatively slowly, over the course of a day or two. Symptoms of the flu occur rapidly. With flu symptoms, you may feel fine – and in three to six hours – you can have full-blown flu symptoms and feel horrible. Another distinct symptom of the flu is a high (above 100 F) fever.

Q: How long is a person with swine flu contagious?

A: The Centers for Disease Control and Prevention (CDC) believes those infected with swine flu are contagious for 24 hours prior to the development of symptoms until possibly five days after the onset of illness.

The virus can survive on surfaces of objects an average of two to eight hours. New guidelines state if you have swine flu, please stay away from others until you have a normal temperature for 24 hours without the use of Tylenol, Advil or other pain/fever reducers.

The virus is the strongest when symptoms first begin. Your body fights the virus and kills it by increasing temperature. As long as the temperature is elevated, the virus is still strong. When the temperature is down (without the use of fever reducers) for 24 hours, the body has won the fight and the virus is greatly weakened (and cannot be spread as easily).

Q: What should I do if I get the flu?

A: Try not to spread it to others. It's unfortunate you got the flu, however, it's very important you do not spread it to others. Most importantly, you should stay home, rest and take care of yourself.

If you must go into areas where there are other people, be considerate and wear a mask, especially if you are coughing. Anytime you contaminate your hands by coughing, sneezing or blowing your nose, dispose of the tissue immediately and wash your hands with warm soap and water…or use a hand sanitizing gel to prevent the spread of the virus.

Self Care Measures:
• Rest – stay in bed or lie on a couch, it doesn’t matter. What matters is that you rest your body.
• Stay hydrated – especially if you have fever and/or nausea, vomiting and/or diarrhea. If you have an upset stomach, drink liquids and eat very bland foods. Sips of warm or cold tea, flat soda, chicken/beef/or vegetable broth, ice chips, electrolyte drinks, such as Gatoraid and Jell-O, are acceptable liquids to sip upon. Begin with sips every 10 to 15 minutes for an hour – if no vomiting, increase to a swallows every 15 minutes over the next one to two hours and increase your fluid intake each hour. You should be consuming eight glasses of fluids a day – more if you have a fever and/or vomiting and diarrhea.
• If you have diarrhea without vomiting, eat bland foods, applesauce, rice, and bananas, which may help to slow the diarrhea.
• Understand that vomiting and diarrhea are weapons that the body uses to rid itself of the virus. Do not try to stop these symptoms for 24 to 48 hours. If they persist beyond this point and remain frequent, you should be evaluated by a health care provider.
• Absolutely, no alcohol. Alcohol will increase the rate and severity of dehydration, along with aggravating other symptoms of the flu.
• Again, keep hydrated – dehydration due to loss of fluids and lack of replacement fluid will require you to go to the hospital for intravenous (IV) fluid replacement.
• For fever, take two acetaminophen (650 mg.) every four hours OR ibuprofen 400 mg. every four hours. Children and adolescents to age 21 years should avoid aspirin during viral illnesses due to the possibility of developing Reye's Syndrome.
• For head/sinus congestion, over-the-counter decongestants can be taken. Caution: If the over-the-counter cold medicine contains acetaminophen or ibuprofen, do not take additional acetaminophen or ibuprofen with these medicines.

Q: What can I do to protect myself from the flu?

A: Good hand washing is one of the most important protective mechanisms. Studies have shown viruses are spread by breathing in air borne droplets or touching objects contaminated with the virus and then touching your own mouth, nose or eyes. When people have the flu and cough, droplets containing the flu will be airborne an average of three to six feet and then fall. The objects upon which they fall become contaminated.

When people, who have the flu, cough, sneeze or blow their nose, the virus is on their hands — if they do not wash or sanitize their hands — they will distribute the virus to everything they touch. To protect yourself, stay a distance of 3 to 6 feet from ill persons; wash your hands frequently or cleanse hands frequently with a hand sanitizer. Wipe off objects that many persons use with a disinfectant wipe prior to using it.

Other things you can do to stay healthy:
• Get a flu shot against seasonal flu. If the swine flu vaccine becomes available, get vaccinated.
• Eat well-balanced, nutritional meals.
• Get seven to eight hours of sleep each night.
• Try to avoid extreme amounts of stress.
• Avoid alcohol and smoking.
• Get adequate exercise.
• During cold weather, open your windows and air out your room for 10 to 15 minutes daily.

Q: Should I make an appointment to see a health care provider or come to the Health Center if I get the flu?

A: No, not necessarily. If you do not have an underlying medical condition that could potentially cause complications if you catch the flu, the best thing you can do is to stay in bed, rest, stay hydrated and prevent the spread of the illness.

Be aware of symptoms of dehydration, which are as follows:
• Continued fever/flushed skin/chills
• Fast heart rate
• Dry mouth (mucous membranes)
• Thirst
• Skin that seems to tent when pulled away from the body (normally, it should snap back into place, smoothly)
• Minimal to no production of urine
• Urine with a dark color
• Confusion/dizziness/head rushes with movement/extreme fatigue

Contact your health care provider as soon as possible for the following:

• If you are pregnant and become ill with the flu.
• If you have a medical condition such as, heart disease, any type of respiratory illness including asthma, diabetes, autoimmune illnesses such as Lupus, etc.
• If you have the flu and also have nausea, vomiting and/or diarrhea and are not able to rehydrate by drinking fluids.
• If you have any symptoms of complications, such as dehydration.

Remember: If you have the flu and must go out into public, wear a mask or cover your face with a washable cloth or towel and practice good hand washing to protect others from getting the flu. All students who have a fever, cough or sore throat will be asked to put on a mask upon entering the Health Center AND to use hand sanitizer prior to signing in for evaluation.

Q: Should I go to the Bloomsburg Hospital if I have a concern?

A: If you feel you are developing complications from the flu, such as dehydration, you may certainly go to the emergency room for intravenous (IV) treatment. However, keep in mind the cost of using hospital services will be your direct responsibility and/or the cost will be billed to your health insurance plan. The BU Health Center will not assume responsibility for payment for hospital services and care.

Care received at the hospital and other outside health care facilities are not included in the student health fee (paid via the tuition of all students taking 9 or more credits) paid each semester.

If you do not have complications or underlying medical conditions that may be worsening, the Health Center staff encourages you NOT to go to the hospital emergency room. Check with the providers in the Health Center before choosing to go to the emergency room to determine if a visit is really necessary.

If an outbreak of swine flu does occur in the Bloomsburg area, the local hospital emergency rooms will be inundated with ill people from the community as well as the university.

Q: Is there treatment for the flu other than self-care measures?

A: Antiviral medications are available to treat the flu. The two antiviral medications advocated for the H1N1 flu are Tamiflu, which is an oral pill, and Relenza, which is an inhalation.

Tamiflu is a oral pill which is taken twice daily for five days
• Tamiflu is expensive, costing approximately $100 or more.
• Tamiflu must be taken within 48 hours of developing symptoms. The earlier the better.
• Should a large swine flu outbreak occur, antivirals will be available. The CDC advocates using antivirals only for persons with underlying medical problems.
• Many people suffer adverse effects of nausea and stomach pain when taking Tamiflu.
• Once you have the flu, Tamiflu will decrease the length of illness by an average of one and a half days and may or may not lessen the severity of symptoms.

Relenza is an inhalation which is taken twice daily for 5 days.
• Relenza is also somewhat expensive, costing approximately $60.
• Relenza must be taken within 48 hours of developing symptoms, the earlier the better.
• Should a large swine flu outbreak occur, antivirals may only be available to those with underlying medical problems.
• Relenza is not recommended for those with respiratory illnesses or conditions.
• Many people suffer adverse effects of lung irritation and nausea.
• Again, Relenza only shortens the duration of the flu by 1.5 days on average and may or may not lessen the severity of the symptoms.

Relenza and Tamiflu can be used as prophylaxis
(prevention against getting the flu)
• The usual dosing is one pill or one inhalation daily for 10 days after being exposed to the flu.

Q: What is BU doing in regard to prevention strategies?

A: BU has been working closely with the Department of Health (DOH), the Pennsylvania State Stystem of Higher Education (PASSHE), Geisinger Medical Center's Department of Infectious Disease, Bloomsburg Hospital, and other area educational and health care facilities. At the moment, the primary prevention strategy is to remain informed and educate the campus community.

Campus education is centered upon the following aspects of the flu:
• How to remain healthy
• How to prevent getting the flu
• What to do if you get the flu
• How to prevent spreading the flu
• How to treat the flu
• Knowing the complications of the flu
• Following the advice of the Department of Health which gets its information and directives from the Center for Disease Control (CDC)

BU will keep up-to-date information available on its Web site. All students and parents can also check up-to-date information on CDC's Web site.

Should students become ill with the H1N1 flu, parents should understand it would be in the best interest of the student to go home to recuperate. To prepare for this possibility, parents and students should discuss/develop a plan should the student become ill with the H1N1 flu.

Should an H1N1 flu outbreak occur, BU officials will remain up-to-date on current situations and make decisions in the best interest of all students, faculty and staff.

Q: I feel really anxious about the swine flu and living in close quarters with other students. Should I feel afraid?

A: Feeling anxious about catching the flu when you are away from home is a normal concern. The information about swine flu is confusing depending on which news station you listen to or which newspaper you read. Many times the media will hype worst case scenarios invoking fear in the public.

There are several things you should do to decrease your concerns:
• Get and understand the facts. Understand how the flu is spread and how you can prevent getting the flu, then follow the instructions you have been given. If you do not understand something you've heard on the news or read in the paper, call the Health Center and speak with one of the triage nurses at 389-4451.
• Keep things in perspective. The CDC is preparing all health care facilities for the possible worst case scenario but hoping for the best case scenario. It's better to be prepared should the worst case scenario occur than to be unprepared, hoping the worst won't happen.
• Stay healthy.
• Keep an optimistic outlook. Several drug companies are working hard to produce a H1N1 swine flu vaccine. If and when this vaccine is produced, it will be free to all who want it in Pennsylvania. The cost of the vaccine will be paid by a government grant. Whether you get the vaccine is solely up to you. It will not be mandatory.
• Develop a plan ahead of time should you become ill with the flu.

Q: Should I be tested for H1N1 if I become ill?

The CDC, state Department of Health and Geisinger Medical Center's Infectious Disease Department all agree that routine testing for H1N1 is not necessary. Flu illnesses are uncommon at this time of year, especially during summer months.

If flu symptoms are occurring now, it is most probable (98 to 99 percent) the cause of the flu is H1N1. The state Department of Health has set up suveillence stations around the state, which will continue to do random testing to determine if and when H1N1 begins to increase or decrease in the number of cases it is causing.

There are rapid flu kits available for office use. The CDC has done studies on these kits with unfavorable results. The sensitivity of these kits ranges from 20 to 70 percent. Meaning, the kit will detect (or be sensitive to) positive flu only 20 to 70 percent of the time (depending on the kit used).

The specificity of these tests is higher ranging from 90 to 95 percent. Meaning if the test is positive, then it's truly positive most of the time without the chance of false positives.

Different kits test for different flu types. Some kits test for type A flu (of which H1N1 is a type A flu), others test for types A and B and some test for B only. The results of these tests could be interpreted in various ways. Chances are if you have a very strong positive result for type A flu, it most probably is H1N1 at this time of year.

If it's negative it could mean:
• That the test is giving a false negative result for Type A
• That the flu is not a Type A flu, perhaps it’s Type B
• That the test is negative for Type A

To get an absolute accurate result, a nasopharyngeal swab must be obtained and sent to the CDC for testing. At this time, testing by the CDC is only taking place via surveillance sites and in situations of illness where positive identification is absolutely needed for the treatment of the patient.

The best thing you can do to decrease your concerns and/or fears is to keep informed from reputable news sources such as the CDC, Pennsylvania Department of Health or BU's Student Health Center Web site, to name a few.

Q: Has swine flu (novel H1N1) been diagnosed in the health center?

Yes. Protective measures should be followed everywhere by everyone until the Center for Disease Control(CDC) and Pennsylvania's Department of Health indicate the pandemic has come to an end and precautionary measures are no longer a top priority.

Bloomsburg University has taken precautionary steps to prevent the spread of the flu throughout campus and the Bloomsburg community:

• The Director of the Infectious Disease Department at Geisinger Medical Center has volunteered to keep area hospitals, university health centers, physician offices and other health care facilities updated with the latest information and treatment concerning Novel H1N1 Flu. Every two weeks Geisinger offers a conference call to all area medical facilities interested in the latest pandemic trends, studies and statistics concerning Novel H1N1 Flu. The conference calls also give area health care agencies the opportunity to ask questions and report individual experiences within their facilities. Delegated BU staff members have been attending and participating in these conference calls.
• All students with fever, cough and sore throat are urged to stay out of class to prevent the spread of the virus.
• Students, examined at the Student Health Center, who have flu symptoms and match the diagnostic criteria consistent with the flu are given the diagnosis of Influenza Like Illness (ILI). The health center does not test for type A or B flu [see Q&A concerning testing].
• Students with ILIs are given a flu kit. These kits contain disposable thermometers, face masks, disinfectant hand wipes, and instructions for care givers, self care instructions for the ill student, information about the flu, surveillance for possible complications and how to use a disposable thermometer and face mask.
• One on one flu education and counseling is done with each student diagnosed with ILI at the health center.
• If students cannot go home to recuperate, they are isolated in their dorm room or, if they live off campus, in their off campus bedroom. Students may only leave their room to use bathroom facilities. Whenever they leave their room, they must wear a mask and sanitize their hands.
• Isolated students must also dine in their rooms. Arrangements for meals are made through Residence Life.
• Isolated students must inform their roommate of their illness. The roommate may remain in the room, observing extra flu prevention precautions (wearing a mask, keeping at reasonable distance [three to six feet] from the ill roommate, good hand washing) or temporarily move until the ill student recovers.
• Students may terminate self isolation and resume classes when their temperature is normal [less than 100 degrees F] for 24 hours without the use of acetaminophen (Tylenol) or ibuprofen (Advil, Motrin, etc).
• The health center will send a Notification of Extended Illness to all professors of students diagnosed with ILIs. Students diagnosed with the flu or ILI at other health care facilities must show proof of their diagnosis and treatment from the outside health care facility.

The Student Health Center urges all students diagnosed with Influenza Like Illness to please follow preventative instructions to stop the spread of the virus to others.

Q: Does the health center test for swine flu?

No. The Center for Disease Control (CDC) and Pennsylvania's Department of Health have instructed health care facilities not to test for swine flu.
The reasoning is as follows:

• The most accurate test for swine flu entails collecting a nasopharyngeal swab (a swab is passed into the nose and partway down the back of the throat). This swab is then sent to the Department of Health for testing at a cost of approximately $300 per test. In the beginning of the Novel H1N1 Flu pandemic (April 2009), the departments of health across the country were testing nearly all cases of flu like illness (ILI)to determine if swine flu had reached the United States and to determine how quickly it was spreading. This rigorous testing continued throughout the summer and into the early fall. The CDC has now determined that swine flu is now the predominant flu this fall. The CDC has also determined that there is no need to continue testing at this time. Health care facilities are now instructed to assume that any person who presents with a flu like illness should be treated as if they have Swine flu. At this time, the state department is no longer accepting nasopharyngeal swabs for testing from any health care facility…unless there are special circumstances involved.
• Pennsylvania's Department of Health is still doing surveillance testing at designated sites throughout the state to monitor the Novel H1N1 Flu spread. Bloomsburg University and Bloomsburg Hospital are not designated surveillance sites.
• Many physician offices are testing for the flu using Rapid flu testing kits. The CDC and state department of health discourages the use of these kits because they are not accurate. The CDC did studies on the accuracy of these kits and found that some kits are only 30% accurate and at best, the highest accuracy found among all rapid testing kits was only 70%.
  What does this mean? It means that these kits are not sensitive enough to accurately pick up the presence of a type A or B virus. If the test is negative—is it truly negative or did the test not detect the virus? For every positive result, it is estimated that there are probably 5 to 10 false negative results.
• The rapid flu tests are not specific to swine flu. These kits detect either a type A or a type B virus. As previously mentioned, if an A virus is detected, the CDC has stated that H1N1 should be assumed.

Q: Does swine flu, novel flu, novel H1N1 flu, type A flu refer to the same flu?

Yes they do. In the 15th Century, the illness of influenza was so named because it was believed to be caused by the "Influence" of the stars. Now, of course, we know that influenza is caused by a virus.

Viruses are tiny yet powerful infectious agents that are composed of strands of RNA or DNA (which determine its genetic makeup) covered by an outside protein coating. Viruses are continually evolving/ mutating, exchanging gene components with other viruses and host cells and adapting to new environments in order to survive.

There are three types of influenza viruses—A, B, and C—all of which can infect humans. Only influenza A viruses are further classified or named by subtype on the basis of its protein coating. Type A viruses have two main proteins making up the protein coat. They are the H and the N proteins. H stands for Hemagglutinin and N stands for neuraminidase. These two proteins allow the virus to adhere to human cells and to replicate and spread newly formed viruses within the cell. Viruses are identified by the distribution of the H and N proteins covering itself. Type A viruses are responsible for substantial past and present widespread illnesses.

Viruses have the ability to "re-sort" or mix up their genetic make-up and develop into a whole new type of virus, called a novel virus. This is a virus to which humans have not had any prior exposure and against which they have no immunity. Because the majority of humans have no immunity to this new virus, pandemic spread will occur.

Infection by the present swine flu virus was first recognized in the United States in April 2009, after being found in other countries a few weeks earlier—namely Mexico. Novel H1N1 was called swine flu in the early months of the outbreak because it had many similarities to influenza viruses that occur in pigs. However, later analysis found that H1N1 was a reassortment of genetic material from several different viruses—swine, bird and human viruses--creating a new or "novel" virus categorized by the H and N proteins as H1N1 subtype. Hence the present virus is called Novel H1N1.

Q: Rumor has it the nasal H1N1 flu vaccine can cause a loss of smell.
Is this true?

This rumor is not true. The nasal flu vaccine does not cause loss of smell. Perhaps this rumor is based on a FDA warning about Zicam — an over-the-counter cold remedy. This cold remedy product is placed in the nose at the beginning of the first signs of a head cold. The FDA has issued a warning there have been documented cases of the loss of the sense of smell with this cold product.

---