Thursday, July 23, 2009

the dreaded medical posting




it's been 2 weeks into my medical postings..

so many deaths i have encountered...

numerous procedures i have had to assist..

cvp's...LP's..CPR..intubation..all within these 2 weeks


i feel so exhausted..



blood takings...so many of them..

and not to forget also the radiological requests...to go down to the radiological department and request for the investigations..and sometimes only to get scolded by the radiologists..


not to mention, one of my colleague had recently quit his job as a doctor..which in a way fuels me to get away from here..


i dont know anymore..the feeling of depression always sinks in...the feeling to get away from the hospital always befell me...Ya Allah..do give me the strength..


With the shortage of houseman for my current posting, we would have to do quite a number of oncalls with short intervals in between in each calls...

Monday, July 13, 2009

How Allah Found Me inTexas


Assalamualaikum dear brothers and sisters..May Allah guide you always ..

this is a very heartwarming story that I had found..and I would like to share with the rest of you


By Juan Galvan

Remembering My Shahadah

Before Maghrib Prayer, I told my friend Golam, "There's lots of peace in knowing that I only have to worship one God. I don't worship money, wealth, or any of that. I don't have to please the world." Golam nodded.

"Recently," he stated, "Look at the Americans. They have all kinds of freedom. You would think everyone should be happy, yet so many people are unhappy."

I simply believed that Islam was true and I wanted to become a Muslim. But would I be a good Muslim? Maybe! Maybe not! I was thinking about this until prayer time came. Afterwards, it would be time to say Shahadah, the declaration of faith. I would officially be a Muslim.

Golam stood up and faced the crowd and announced, "There's someone who will take Shahadah. He attends the University of Texas. He grew up in Texas. He's been coming to the mosque regularly."

Next thing I realized was that I was sitting in front of the people in the mosque. I was about to go through a "Muslim baptism" as a Christian friend once put it.

The imam said, "Brother, what is your name?"

"Juan Galvan," I responded.

I was handed a microphone. He told me to repeat what he said. The Arabic I said wasn't exactly as I had practiced. I had the paper I used to practice in front of me. I wish I could remember exactly what was said.

"I testify that there is no God but Allah. I also testify that Muhammad is His servant and messenger." Then he stated, "I also testify that Jesus is His servant and prophet. God has no son and no mother."

I recalled how adamant Muhammad was to never be worshiped as a God. Stating that Jesus was also God's prophet reminded me about the significance of Jesus within Islam.

After I said the Shahadah, the imam stated, "Congratulations. God forgives the sins of those who turn towards Him. And He can turn your previous bad deeds into good deeds."

Everyone clapped then stood up to shake my hand or hug me. I felt very much at home. I tried hard not to cry. All Muslim converts have had experiences that brought them to Islam.

I wish there were a way I could tell all the Muslims I've ever met that I've embraced Islam. I want them to know how much I appreciate them for telling me about Islam. Meeting all those Muslims was a part of a series of events that brought me to where I am today.

My Background

I am a Mexican-American who comes from a modest background. I was born in Lockney, Texas, in 1974. I spent my adolescent and teenage years in such small Texas Panhandle towns as Quitaque, Turkey, Lakeview, and Memphis. None of them has a mall, a movie theater, or a McDonald's.

In these small towns, if you hear a fire truck or police car, either your neighbor's house is on fire or your neighbor is being arrested. Memphis, Texas, population 2,300, proudly proclaims itself "The Cotton Capital of the World."

I spent over half my life in Turkey and Quitaque. Turkey was named after Turkey Creek. Quitaque was named after an Indian name, which means "horse manure." I sometimes joke that I am uncultured as a result.

The population of both towns is less than 600 and shrinking. In 1972, the Turkey and Quitaque schools consolidated creating Valley School halfway between the two towns. I attended Valley School and have fond memories of life as a Valley Patriot.

Of course, our school colors were red, white, and blue. Growing up in small communities gave me much appreciation for the simplicity in God's creations. A brother once chuckled after hearing me say, "If I can become Muslim, anyone can become Muslim."

My dad was a cotton ginner. Now, he is a custodian at a junior high school in Pampa, Texas. I had eight siblings, but in 2000 my 17-year old sister died in a car wreck.

I graduated from Memphis High School in Memphis, Texas, in 1994. I did well in high school and would attend Texas Tech University in Lubbock. In 1998 I began attending the University of Texas at Austin. I graduated with a bachelor's degree in management information systems in December 2001. Not bad for a kid who had to hoe cotton most of his junior high and high school summers to pay for his clothes and school supplies!

When Faith Is Shaken

In high school, I received a jolt to my long-held belief when a Christian friend told me that the Holy Trinity was not true and that Jesus was not God. "He was wrong," I told myself. Jesus had to be God.

God and humanity were disconnected by the sin committed by Adam and Eve. God sent His only "begotten" son to die because He loved us so much. Because only God forgives, Jesus had to be God. I even had the Bible quotes to prove it! Indeed, being a devout Roman Catholic Christian, I have read almost the entire Bible.

In high school, I was a lecturer, usher, Eucharistic minister, and religious education teacher. I was the godfather for a nephew and a niece. The idea that Jesus was God made much sense.

I have always had respect for other religions. I would often attend other Christian churches and join interfaith Bible study groups. While in one such group, I told my friend Chris that I was a Catholic. Chris blatantly told me that the Catholic Church was "a false doctrine."

As you can imagine, I defended my religion. Chris accused me of worshiping Mary, saints, and the Pope. I argued that we only revere them. Of course, I explained that the Virgin Mary should be revered for being the Mother of God. And everyone loved Pope John Paul II for his many contributions.

Islam vs. Christianity

Around this time, I happened to see a man praying. His knees, hands, and forehead were touching the ground, and he was barefoot. After he finished praying, I introduced myself to him. He said his name was Armando, and that he was a Muslim. I thought to myself, "OK, freaky, you're Muslim. You can't be Muslim. What's this Hispanic guy doing, praying to Allah?"

He later told me that Spain was Muslim for over 700 years and that thousands of Spanish words have Arabic roots. The ruins of mosques with Qur'anic writings have been found in Cuba, Mexico, Texas, and Nevada.

Most importantly, Armando spoke to me about Islam. I began to realize that my reverence for Mary and saints was much more than mere reverence. Chris was right. However, we were both worshiping Jesus! Armando said that Jesus was only a prophet and that nothing and no one is worthy of worship but Allah.

I asked an African American Muslim, "Why do you worship Allah? There's no Allah mentioned in the Bible." His response was very enlightening. Allah, God, and Dios mean "God" in different languages. Allah literally means "The God" in English and "El Dios" in Spanish.

As soon as I began to study Islam, many of my questions were answered. What is the purpose of life? How can the Father be the Son? Why can't God just forgive anyone He wants? What happens to babies who die before baptism?

In the Qur'an, Allah states what means [And when they (who call themselves Christian) listen to what has been sent down to the Messenger, you see their eyes overflowing with tears because of the truth they have recognized. They say: "Our Lord! We believe; so write us down among the witnesses"] (Al-Ma'idah 5:83). Indeed, my eyes overflowed with tears as I read that verse.

However, I would not embrace Islam until three years later because of fears common among many non-Muslims interested in Islam. I was afraid of possible rejection from family and friends. I was most afraid of changing.

The Decision

During these three years, I tried to live as ordinary a life as possible. I tried to convince myself of my happiness. Sometimes I convinced myself that I was an atheist, and other times I thought I was at least an agnostic. I had absolutely rejected my Christian beliefs as falsehoods. I would always return to believing completely in one God. I feared the existence of God and His prophets for what such faith might mean for my future.

As I was driving one Saturday morning, a red truck moved into my lane. I had no time to react; I found myself hitting it. I could have died. My left lung collapsed and I needed a chest tube to survive. I had broken ribs and a broken arm.

Under these circumstances, my priorities shifted from the worldly to the spiritual. Along with my greater appreciation for the Creator came an intense desire to embrace truth. Three years before my accident, I had been given several Islamic brochures with titles such as Concept of God in Islam, Concept of Worship in Islam, and Who was Jesus?". I revisited these brochures along with comments from a Qur'an that I had borrowed.

A few months later, I stepped into a mosque for the first time on a Friday afternoon. I was perplexed by the lack of shoes and chairs in the prayer area. I was very impressed with the unity as Muslims prayed together, side by side.

I visited this mosque regularly for about a month before embracing Islam during the summer of 2001. My faith and courage were increasing and, eventually, I didn't care what anyone thought. I only wanted to please my Creator. Islam ended my doubts about the existence of a Creator. Islam is the true, universal religion of God.

I fell in love with Islam while listening to talks about brotherhood, prayer, and charity. I found myself intrigued by these guys who found time to pray five times a day. Many were college students who had figured out ways to pray at the mosque two or three times a day.

I was amazed by these people who could fast from sunrise til sunset for an entire month. I thought to myself, "Wow, that's faith!" I was impressed by the self-discipline and brotherhood among these Muslims.

They lived simple lives and were happy with what they had. They lived their lives around Islam. They were very much at peace. I wanted to be one of these Muslims.

More people would convert to Islam if we were better Muslims. If Armando had not been praying, I would not have known he was Muslim, and we would not have spoken.

My Family and Friends

After telling my dad that I had converted to Islam, he asked, "?Qué es éso?" (What is that?). I responded, "It's a religion." Then, after telling him a little about it, he replied, "?Como los Arabes?" (Like the Arabs?) I responded, "No, it's for everyone."

One of my sisters asked me once, "Don't you still love Jesus? How could you do this to the Virgin Mary?" I replied, "I still love Jesus. We believe he's a prophet. There's also a chapter called Mary in the Qur'an."

Unfortunately, there are many misconceptions among Americans, including Latinos. We have to educate everyone about Islam. Muslims and Christians both honor the Virgin Mary. God exists independent of reason, but the concept of God varies by religion. Many people think that Islam is a religion of Arabs. Yet, Arabs make up less than 25 percent of the entire Muslim population.

And, of course, I found myself defending my religious beliefs to my family after the attacks of 9/11. Soon after the attacks, one of my sisters said something like, "That leader of ya'lls, he's gonna call a holy war." CNN should take a poll to find out how many Americans believe bin Laden is the Muslim leader.

My dad asked my mom, "What'd he get himself into?" They hadn't heard from me in a while so they were a little concerned. When I talked to them, I reminded my parents that Muslims are not a gang of fifty members. There are over 1.2 billion Muslims in the world.

Some people act as if some Arab in Saudi Arabia has a long list of Muslims and can call anyone on the list when he wants to blow up a building. I have much sympathy for the families that were directly affected by the 9/11 tragedy. Muslims are imperfect; whereas Islam is perfect.

When I pray at a mosque, I get the opportunity to pray beside people of all races and nationalities. We don't distinguish each other by race, nationality, or social class, but only by piety. We're just Muslims. Together with a billion other Muslims, we form concentric circles around the Ka`bah in Makkah, Saudi Arabia.

I can't imagine never praying beside other Muslims again. When I pray, I know that brothers and sisters from around America are praying, too. When I embraced Islam, I joined the universal brotherhood of Islam transcends all other brotherhoods.

Muslims make up a global family that stems from unconditional love. Love towards your family is natural. A family's love is unconditional. Your true friends will also love you unconditionally.

Islam takes what's beautiful and makes it more beautiful. If you were a good son or daughter, you might be surprised when your parents say that you have become an even better son or daughter after your conversion.

I am often asked why I embraced Islam. "How does a Latino born in the middle of nowhere in Texas become a Muslim?" I am also asked about Latinos, in general. "Why are Latinos becoming Muslim?" I know that many people including my own family struggle to understand why I am now a Muslim, and I've come to better understand that coming to Islam is solely through God's guidance. His guidance is a mercy.

Only through God's mercy do Muslims appear at the right place at the right time in the lives of non-Muslims to introduce them to Islam. Only through His mercy does a non-Muslim become a Muslim.

A struggle occurs within everyone, every day, and everywhere. We struggle to attain what is most important for us. By embracing Islam, we tell Allah that He is the most important and that we are prepared to struggle to do what is right and to avoid what is wrong.

Have patience. You do not know the happiness that your Creator has in store for you. Today, I live in Central Florida with my wonderful wife and son. God willing, one day I will speak at the Valley School to tell them that I am now a Muslim and how Islam has made me a better person.

And every day I thank the Most Compassionate, the Most Merciful for all His blessings. I am a Mexican-American Muslim. All praise and thanks to Allah.

Juan Galvan’s conversion story was initially published in the July/August 2002 issue of Islamic Horizons Magazine under the title “How Allah Found Me in Texas.” An updated version of his conversion story was published online at ReadingIslam.com in June 6, 2007.

Tuesday, July 7, 2009

Ending to a blissful moment



THere will always be a time when you finally realize that the fun is over... And you feel at loss as to what to do next...
Today marks the end of my almost 2 weeks holiday...one of the longest holiday that i've had in recent years..or actually, for the past one year...

And unfortunately tomorrow i will begin my medical posting...my 4th posting..
It also marks my first anniversary since i've started working...which was 8.7.2008..exactly one year ago.

The feeling of disdain and morose befell me once more..actually, this kind of feeling has always enveloped me ever since I was a primary school.

I've never liked school..I always tend to find reason as to skip school..ever since kindergarten..and it had lasted until the end of secondary school.

The university years were not so bad, and I had actually liked going to university..with the more relaxed school and not so stringent rules. Even though during medical school, there were the frequent exams and all..but at the end of the day, what I can say is that I had enjoyed it very much and i've cherished every moment there.

And now come the working environment...The first posting was pure wreck for me..I had sort of enjoyed the paeds posting - especially the NICU part, but in general, since it was my first posting..there were so many adjustment for me..

And then the 2nd posting - which was O&G,-- oh my...That was a definite stress zone for me. None could have matched that.. With the ever pressing specialists and Medical officer - I had thought that I might have eventually had a breakdown.. but Alhamdulillah , I had actually survived..

3Rd posting was orthopaedics, which I had found to be quite enjoyful - there was both elements of surgical and medical based. The specialists were such wonderful bunch of people..what more with the ever cheerful yet sometimes moody MO;s , the posting was such an enjoyful posting...

and now...i'll be posted to MEdical...I don't know whether I can make it or not...I don't know whether I can survive the posting..what more with the upcoming Ramadhan...
YA Allah,..please give me the strength...

Pandemic..?Phase 6,...what's that?

Current WHO phase of pandemic alert

Current phase of alert in the WHO global influenza preparedness plan

Pandemic preparedness

In the 2009 revision of the phase descriptions, WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans. The grouping and description of pandemic phases have been revised to make them easier to understand, more precise, and based upon observable phenomena. Phases 1–3 correlate with preparedness, including capacity development and response planning activities, while Phases 4–6 clearly signal the need for response and mitigation efforts. Furthermore, periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities.

The current WHO phase of pandemic alert is 6.

Pandemic influenza phases

In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.

In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized 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.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required.

Oh no...It's another story of the dreaded H1N1...

Novel H1N1 Flu (Swine Flu) and You

Novel H1N1 Flu

What is novel H1N1 (swine flu)?
Novel H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

H1N1 Influenza virus imageWhy is novel H1N1 virus sometimes called “swine flu”?
This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a "quadruple reassortant" virus.


Novel H1N1 Flu in Humans


Are there human infections with novel H1N1 virus in the U.S.?
Yes. Cases of human infection with novel H1N1 influenza virus were first confirmed in the U.S. in Southern California and near Guadalupe County, Texas. The outbreak intensified rapidly from that time and more and more states have been reporting cases of illness from this virus. An updated case count of confirmed novel H1N1 flu infections in the United States is kept at http://www.cdc.gov/h1n1flu/update.htm. CDC and local and state health agencies are working together to investigate this situation.

Is novel H1N1 virus contagious?
CDC has determined that novel H1N1 virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

Photo of nurse and childWhat are the signs and symptoms of this virus in people?
The symptoms of novel H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Also, like seasonal flu, severe illnesses and death has occurred as a result of illness associated with this virus.

How severe is illness associated with novel H1N1 flu virus?
It’s not known at this time how severe novel H1N1 flu virus will be in the general population. In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with certain chronic medical conditions. Early indications are that pregnancy and other previously recognized medical conditions that increase the risk of influenza-related complications, like asthma and diabetes, also appear to be associated with increased risk of complications from novel H1N1 virus infection as well.

One thing that appears to be different from seasonal influenza is that adults older than 64 years do not yet appear to be at increased risk of novel H1N1-related complications thus far in the outbreak. CDC is conducting laboratory studies to see if certain people might have natural immunity to this virus, depending on their age. Early reports indicate that no children and few adults younger than 60 years old have existing antibody to novel H1N1 flu virus; however, about one-third of adults older than 60 may have antibodies against this virus. It is unknown how much, if any, protection may be afforded against novel H1N1 flu by any existing antibody.

How does novel H1N1 flu compare to seasonal flu in terms of its severity and infection rates?
CDC is still learning about the severity of novel H1N1 flu virus. At this time, there is not enough information to predict how severe novel H1N1 flu outbreak will be in terms of illness and death or how it will compare with seasonal influenza.

With seasonal flu, we know that seasons vary in terms of timing, duration and severity. Seasonal influenza can cause mild to severe illness, and at times can lead to death. Each year, in the United States, on average 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes. Of those hospitalized, 20,000 are children younger than 5 years old. Over 90% of deaths and about 60 percent of hospitalization occur in people older than 65.

So far, with novel H1N1 flu, the largest number of novel H1N1 flu confirmed and probable cases have occurred in people between the ages of 5 and 24-years-old. At this time, there are few cases and no deaths reported in people older than 64 years old, which is unusual when compared with seasonal flu. However, pregnancy and other previously recognized high risk medical conditions from seasonal influenza appear to be associated with increased risk of complications from this novel H1N1.

How does novel H1N1 virus spread?
Spread of novel H1N1 virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How long can an infected person spread this virus to others?
At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. CDC is studying the virus and its capabilities to try to learn more and will provide more information as it becomes available.

Exposures Not Thought to Spread Novel H1N1 Flu


Can I get infected with novel H1N1 virus from eating or preparing pork?
No. Novel H1N1 viruses are not spread by food. You cannot get infected with novel HIN1 virus from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Is there a risk from drinking water?
Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of novel H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as novel H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.

Can novel H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water venues?
Influenza viruses infect the human upper respiratory tract. There has never been a documented case of influenza virus infection associated with water exposure. Recreational water that has been treated at CDC recommended disinfectant levels does not likely pose a risk for transmission of influenza viruses. No research has been completed on the susceptibility of novel H1N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, interactive fountains, and other treated recreational venues. However, recent studies have demonstrated that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are adequate to disinfect avian influenza A (H5N1) virus. It is likely that other influenza viruses such as novel H1N1 virus would also be similarly disinfected by chlorine.

Can novel H1N1 influenza virus be spread at recreational water venues outside of the water?
Yes, recreational water venues are no different than any other group setting. The spread of this novel H1N1 flu is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Prevention & Treatment


What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against novel H1N1 virus. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Take these everyday steps to protect your health:

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread this way.
  • Try to avoid close contact with sick people.
  • Stay home if you are sick for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.

Other important actions that you can take are:

  • Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
  • Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs, tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious.

Photo of man sneezingWhat is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. If you are sick, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.


If I have a family member at home who is sick with novel H1N1 flu, should I go to work?
Employees who are well but who have an ill family member at home with novel H1N1 flu can go to work as usual. These employees should monitor their health every day, and take everyday precautions including washing their hands often with soap and water, especially after they cough or sneeze. Alcohol-based hand cleaners are also effective. If they become ill, they should notify their supervisor and stay home. Employees who have an underlying medical condition or who are pregnant should call their health care provider for advice, because they might need to receive influenza antiviral drugs to prevent illness. For more information please see General Business and Workplace Guidance for the Prevention of Novel Influenza A (H1N1) Flu in Workers.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water or clean with alcohol-based hand cleaner. CDC recommends that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

What should I do if I get sick?
If you live in areas where people have been identified with novel H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people. Staying at home means that you should not leave your home except to seek medical care. This means avoiding normal activities, including work, school, travel, shopping, social events, and public gatherings

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

  • Fast breathing or trouble breathing
  • Bluish or gray skin color
  • Not drinking enough fluids
  • Severe or persistent vomiting
  • 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

In adults, emergency warning signs that need urgent medical attention include:

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting
  • Flu-like symptoms improve but then return with fever and worse cough

Are there medicines to treat novel H1N1 infection?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with novel H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current outbreak, the priority use for influenza antiviral drugs during is to treat severe influenza illness.

Contamination & Cleaning

Photo of hands and soapHow long can influenza virus remain viable on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for up to 2-8 hours after being deposited on the surface.

What kills influenza virus?
Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time. For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.

How should waste disposal be handled to prevent the spread of influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste.

Photo of cleaning suppliesWhat household cleaning should be done to prevent the spread of influenza virus?
To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

How should linens, eating utensils and dishes of persons infected with influenza virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid “hugging” laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry.

Eating utensils should be washed either in a dishwasher or by hand with water and soap.

Response & Investigation

What is CDC doing in response to the outbreak?
The agency’s goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by the new virus. CDC is working with state and local health departments to enhance surveillance in the United States and to collect and analyze data to assess the impact of the virus and determine the groups at increased risk of complications. In addition, CDC continues to issue new and updated interim guidance for clinicians, public health professionals and the public for the prevention and treatment of this new virus.

To expand the national and international laboratory capacity for detecting novel H1N1 influenza, CDC has developed and distributed new influenza diagnostic kits and reagents to more than 350 laboratories, including laboratories in 131 countries. CDC’s Division of the Strategic National Stockpile (SNS) continues to send antiviral drugs, personal protective equipment, and respiratory protection devices to all 50 states and U.S. territories to help them respond to the outbreak.

The U.S. Government also is aggressively taking early steps in the process to manufacture a novel H1N1 influenza vaccine, working closely with manufacturing. CDC has isolated the new H1N1 virus, made a candidate vaccine virus that can be used to create vaccine, and has provided this virus to industry so they can begin scaling up for production of a vaccine, if necessary.

What epidemiological investigations are taking place in response to the recent outbreak?
CDC works very closely with state and local officials in areas where human cases of new H1N1 flu infections have been identified. CDC has deployed staff to several states to assist with the investigation of the impact of the novel H1N1 influenza, including the assessment of the severity of illness, how easily the virus spreads, and the amount of time people may be infectious. In states where EpiAid teams have been deployed, many epidemiological activities are taking place or planned including:

  • Active surveillance in the counties where infections in humans have been identified;
  • Studies of health care workers who were exposed to patients infected with the virus to see if they became infected;
  • Studies of households and other contacts of people who were confirmed to have been infected to see if they became infected; and
  • Study to see how long a person with the virus infection sheds the virus.

*Note: Much of the information in this document is based on studies and past experience with seasonal (human) influenza. CDC believes the information applies to novel H1N1 (swine) viruses as well, but studies on this virus are ongoing to learn more about its characteristics. This document will be updated as new information becomes available.

http://www.cdc.gov/h1n1flu/qa.htm