United States Travel Precaution
Issued by CDC
Apr 26, 2009
Swine Influenza in the United States
This information is current as of today, April 27, 2009 at 10:16
Updated: April 26, 2009
Revised April 26 to reflect updated guidance on antiviral use in travelers.
As of 9 am April 26 2009, 20 human cases of swine influenza A (H1N1) virus infection have been identified in California, Texas, New York City, Kansas and Ohio. This strain of influenza virus is unique because it is a combination of genes from swine, bird, and human influenza viruses. Infected individuals report flu-like symptoms of fever, aches and pains, sore throats, coughing and trouble breathing. Some people have also reported diarrhea and vomiting. These cases may be linked to an outbreak of influenza-like-illness in Mexico.
At this time only two of the 20 cases in the US have been hospitalized and all have recovered. However, CDC and state public and animal health authorities are still in the early stages of the investigations.
Further updates to the US investigation and any related travel recommendations will be posted on www.cdc.gov/travel when available. CDC Recommendations
CDC has NOT recommended that people avoid travel at this time. If you are planning travel to these areas, the following recommendations will help you to reduce your risk of infection and stay healthy.Monitor the International Situation
Check updates from the:Prepare for your trip before you leave
During your visit to an area affected by Swine InfluenzaMonitor the local situation
- Visit CDC's Travelers’ Health Website to learn about any disease risks and CDC health recommendations for areas you plan to visit.
- Be sure you are up-to-date with all your routine vaccinations, including seasonal influenza vaccine if available.
- Identify the health-care resources in the area(s) you will be visiting.
Practice healthy habits to help stop the spread of influenza
- Pay attention to announcements from the local government.
- Follow local public health guidelines, including any movement restrictions and prevention recommendations.
Seek medical care if you feel sick
- Wash your hands often with soap and water. This removes germs from your skin and helps prevent diseases from spreading.
- Use waterless alcohol-based hand gels (containing at least 60% alcohol) when soap is not available and hands are not visibly dirty.
- Cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a wastebasket.
- If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands.
- Wash your hands after coughing or sneezing, using soap and water or an alcohol-based hand gel.
- Follow all local health recommendations. For example, you may be asked to put on a surgical mask to protect others.
After you return from your trip
- If you are ill with fever and other symptoms of swine flu like cough and sore throat, see a doctor, especially if you think you may have had contact with someone with swine flu or severe respiratory illness in the past 7 days before becoming ill.
- Antiviral Medications: Persons traveling within the US that are at high risk of severe illness from influenza (for example persons with chronic conditions such as diabetes, lung disease, heart disease, and the elderly) are recommended to take antiviral medications for prevention of swine influenza during travel. The recommended antiviral drugs for swine influenza are oseltamivir (brand name Tamiflu) and zanamivir (brand name Relenza). Both are prescription drugs that fight against swine flu by keeping flu viruses from reproducing in your body. These drugs can prevent infection if taken as a preventative. Talk to your doctor about correct indications for using influenza antiviral medications. Always seek medical care if you are severely ill.
- Antiviral chemoprophylaxis (pre-exposure or post-exposure) is recommended for the following individuals:
- Household close contacts who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) of a confirmed or suspected case.
- School children who are at high-risk for complications of influenza (persons with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed or suspected case.
- Travelers to Mexico who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).
- Border workers (Mexico) who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).
- Health care workers or public health workers who had unprotected close contact with an ill confirmed case of swine influenza A (H1N1) virus infection during the case’s infectious period.
- Antiviral chemoprophylaxis can be considered for the following:
- Any health care worker who is at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) who is working in an area with confirmed swine influenza A (H1N1) cases, and 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.
- For more information on CDCs recommendations for antiviral use during the swine flu outbreak, please visit www.cdc.gov/swineflu
- You should avoid further travel until you are free of symptoms, unless traveling locally for medical care.
- Closely monitor your health for 7 days
- If you become ill with fever and other symptoms of swine flu like cough and sore throat and possibly vomiting and diarrhea during this period, call your doctor or clinic for an appointment right away. Your doctor may test you for influenza and decide whether influenza antiviral treatment is indicated.
- When you make the appointment, tell the doctor the following:
- Your symptoms,
- Where you traveled, and
- If you have had close contact with a person infected with swine flu.
- Avoid leaving your home while sick except to get local medical care, or as instructed by your doctor. Do not go to work or school while ill. If you must leave your home (for example, to seek medical care) wear a surgical mask to keep from spreading your illness to others.
- Always cover your nose and mouth with a tissue when you cough or sneeze. Throw away used tissues in a trash can.
- Wash your hands with soap and water often and especially after you cough or sneeze. If soap and water are not available, use an alcohol-based hand gel containing at least 60% alcohol.
- Avoid close contact with other people as much as possible.
- Wear a surgical mask if you are in contact with other people.
If you have specific questions about the swine influenza cases see http://www.cdc.gov/contact/ or call 1-800-232-4636, which is 1-800-CDC-INFO.
To learn more about travel health, visit www.cdc.gov/travel .
For the swine Influenza situation in the United States, visit http://www.cdc.gov/flu/swine/investigation.htm
For the swine Influenza situation in Mexico, visit: