A. ABOUT THE DISEASE

1. What is Influenza A (H1N1)?
Influenza A(H1N1) is highly contagious acute respiratory disease infecting humans caused by a new virus, the result of a mutation created by mixing of the pig, bird and human influenza virus genes.

2. Where have the human cases ocurred?
Current information reveal that the earliest cases infected with new virus was first reported from Mexico and United States of America in April 2009. Subsequently cases have been reported from several other countries across the world. For current updates of affected countries, please refer to www.moh.gov.my and www.who.int

3. What are the signs and symptoms of Influenza A(H1N1)?
Early signs of Influenza A(H1N1) are flu-like, including fever, cough, headache, muscle and joint pain, sore throat and runny nose, and sometimes vomiting or diarrhea.

4. How do people become infected with Influenza A(H1N1)?
The spread begins when infected people cough or sneeze, infected droplets get on their hands, drop onto surfaces, or are dispersed into the air. An uninfected person can breathe in contamined air, or touch infected hands or surfaces, and thus be exposed. This is known as the human to human transmission of Influenza A(H1N1).

5. Is there any confirmation of transmission between pigs and humans at this point?
No.

6. What is the advice to infected persons?
- Seek medical attention and treatment from the nearest doctor.
- To prevent spread, infected persons should cover their mouth and nose appropriately when coughing and sneezing, and wash their hands regularly and throughly with soap and water.
- If you get sick with influenza, stay at home and limit contact with others to keep from infecting them. Avoid touching your eyes, nose or mouth since secretions from them contain the virus and can infect others.
- Avoid going to crowded/public places and/or using public transport especially when you are sick or have the influenza sign and symptoms.

7. How long can an infected person spread the Influenza A(H1N1) disease to others?
Person(s) with Influenza A(H1N1) virus infection should be considered potentially contagious as long as they are symptomatic and possibly for up to 7 days following the onset of the illness. Children, especially the younger ones, might potentially be contagious for larger periods.

8. How can you protect yourself from getting infected with the disease?
There is no vaccine currently available to protect against Influenza A(H1N1). However, there are certain actions that can help to reduce the spread of the virus:
- Avoid close contact with persons who appear unwell and have fever and cough.
- Wash your hands with soap and water thoroughly and often. - Avoid touching your face, especially nose and mouth, with your hands to minimize infection.
- In the event of being in an affected area, avoid crowded places and stay indoors.
- Stay informed of the situation of the disease and of the appropriate measures taken to avoid being infected.
- Practice good health habits including adequate sleep, eating nutritious food and keeping physically active.

B. ABOUT THE VACCINE

1. Is there a human vaccine available now to protect from Influenza A(H1N1)?
No. Currently seasonal human influenza vaccine does not provide protection from the current Influenza A (H1N1) virus. It is inknown whether the seasonal vaccines can provide any cross protection to the ongoing Influenza A(H1N1) virus infection im Mexico, United States of America and other affected parts of the world.

2. Will there be a new vaccine developed for the current infection?
Yes, WHO is currently working towards development of such a vaccine.

3. How long will it take to come up with a suitable vaccine?
According to WHO, it would take 4 to 6 months to manufacture.

C. ABOUT THE TREATMENT

1. What drugs are available for treatment?
Currently the Ministry of Health Malaysia has antivirals for treatment of Influenza A(H1N1).

2. Will the antivirals protect a person from being infected?
The antivirals are used for treatment of a person infected with the virus. It is not a vaccine that creates immunity against the infection. Persons not exposed to the virus are advised not to take antivirals because it would be required to consume it for a ling time and since it is very potent the medication can thus cause ill effects.

D. ABOUT TRAVEL

1. Is it safe to travel?
People should be aware that due to the highly contagious nature of the disease and its rapid spread across the world, non-essential travel by air or other means, especially to affected areas, should be postponed. If travel is essential or unavoidable, travelers and their depentends need to protect themselves appropriately. Persons who are ill should delay travel plans and returning travelers who fall ill should seek appropriate care immediately. However, WHO has not recommended travel restrictions related to the outbreak of the Influenza A(H1N1) virus.

E. ABOUT LEVELS OF PANDEMIC ALERT

1. What does the current WHO pandemic alert Phase 5 mean?
According to WHO, Phase 5 means that the virus has caused sustained community level outbreaks in at least two countris in one WHO region. At Phase 5, a pandemic is considered imminent.

2. What is sustained human to human transmission?
This occurs when three generations are involved - i.e. the virus has passed from person A to person B and then to person C.

3. What is the difference between a probable case and a confirmed case?
A probable case is who shows the symptoms of influenza such as cough, fever headache, chills and fatigue and either tests positive for type A influenza or is considered linked to another probable or confirmed case. A confirmed case is one who tests positive in a laboratory for the Influenza A(H1N1) virus.

4. At what point does WHO consider a pandemic to have started?
At Phase 6, as defined by the WHO pandemic preparedness guidelines. This phase is charactedized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this Phase will indicate that a global pandemic is under way. The goal of recommended actions during Phases 5 and 6 is to reduce the impact of the pandemic on society.

F. ABOUT THE SAFETY OF PORK

1. Is it safe to eat pork and pork products?
Yes. Influenza A(H1N1) has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other product derived from pigs. The virus is killed by cooking temperatures of 160ºF/70ºC, corresponding to the general guidance for the preparation of pork and other meat.

For additional information, please contact the Crisis Preparedness and Response Centre (CPRC), Ministry of Health Malaysia at 603-0200/603-8881 or email to cprc@moh.gov.my or visit www.moh.gov.my