Swine flu

What is swine flu?

Swine influenza is a disease that pigs get. The virus currently spreading among people is now generally referred to as swine flu, although the origin of the disease is still under investigation. There is no evidence of this strain of the disease circulating in pigs in the UK.

There are regular outbreaks of swine flu in pigs worldwide. It does not normally infect humans, although this does sometimes happen, usually in people who have had close contact with pigs.

Swine flu viruses are usually of the H1N1 sub-type. The swine flu that has spread to humans is a version of this virus.

Why is swine flu affecting humans?

Because the swine flu virus has mutated (changed) and is now able to infect humans and transmit between them.

How is the swine flu infection diagnosed?

There is now a new self-care service, called the National Pandemic Flu Service, which allows people to check their condition online or over the telephone (0800 151 3100 or textphone 0800 151 3200) and obtain antiviral medication if swine flu is confirmed.

The following people should call their GP directly for an assessment of their symptoms and a diagnosis:

those with a serious existing illness, such as cancer
pregnant women,
those who have a sick child under one,
those with a condition that suddenly gets much worse, or
those with a condition that is still getting worse after seven days (five for a child).

For more information, go to the Flu service: Q&A.

Which people are most vulnerable from swine flu?

Those who are more at risk from becoming seriously ill with swine flu are people with:

chronic (long-term) lung disease, including people who have had drug treatment for their asthma within the past three years,
chronic heart disease,
chronic kidney disease,
chronic liver disease,
chronic neurological disease (neurological disorders include chronic fatigue syndrome, Parkinson's disease and multiple sclerosis),
suppressed immune systems (whether caused by disease or treatment),
diabetes,
pregnant women,
people aged 65 or older, and
young children under five.

For specific advice on antiviral treatment for these groups, go to People with long-term conditions, Pregnancy and children, and Older people.

Is the new swine flu virus contagious?

The Health Protection Agency (HPA) says the new swine flu virus is highly contagious and is spreading from person to person.

Swine flu spreads in the same way as ordinary colds and flu. The virus is spread through the droplets that come out of the nose or mouth when someone coughs or sneezes.

If someone coughs or sneezes and does not cover it, those droplets can spread about one metre (3ft). If you are very close to them you might breathe these in.

If someone coughs or sneezes into their hand, those droplets and the virus within them are easily transferred to surfaces that the person touches, such as door handles, hand rails, phones and keyboards. If you touch these surfaces and touch your face, the virus can enter your system and you can become infected.

See Causes for more information

How long does the virus live on surfaces?

The flu virus can live on a hard surface for up to 24 hours, and a soft surface for around 20 minutes.

What is the incubation period for swine flu?

According to the Health Protection Agency, the incubation period for swine flu (the time between infection and appearance of symptoms) can be up to seven days, but it is most likely to be between two and five days. But it is currently too early to be able to provide details on virus characteristics, including incubation period, with total certainty.

When are people most infectious?

People are most infectious soon after they develop symptoms. They can continue to shed (spread) the virus (for example, in coughs and sneezes) for up to five days (seven days in children). People become less infectious as their symptoms subside, and once their symptoms are gone they are no longer considered infectious to others.

Should I avoid contact with people suspected of having swine flu?

People with suspected swine flu will have been asked to stay at home and restrict their contact with people. Most people should continue their normal life, including going to school or work. This includes children who attend a school with a confirmed case of swine flu.

There is no need to avoid contact with people who might simply have come into contact with those with the illness, such as the parents of children at schools with a confirmed case but who are not themselves ill.

How dangerous is it?

It is difficult to judge this at the moment. There have been deaths, but for most infected people the symptoms have not been severe.

It appears that early doses of antiviral medicines such as Tamiflu are effective in helping people to recover. In the UK we have enough antivirals to treat half the population if they were to become ill. Also, orders of Tamiflu have been placed to increase UK supplies to 50 million doses, enough to treat 80% of the population.

Will I die from swine flu?

For most people, the illness has been mild and self-limiting. The virus has caused severe illness in a minority of people, most of whom had an existing serious condition. NHS staff are well trained in treating people who are in hospital with swine flu. They can provide effective treatment for any secondary bacterial infections, such as pneumonia.

What are the complications of swine flu?

One of the most common complications of any type of flu is a secondary bacterial chest infection, such as bronchitis (infection of the airways).

This can become serious and develop into pneumonia. A course of antibiotics will usually cure this, but the infection sometimes becomes life-threatening.

Other rare complications include:

tonsillitis,
otitis media (a build-up of fluid in the ear),
septic shock (infection of the blood that causes a severe drop in blood pressure),
meningitis (infection in the brain and spinal cord), and
encephalitis (inflammation of the brain).
Back to top

What are the symptoms of swine flu?

The symptoms of swine flu are expected to be similar to the symptoms of regular seasonal flu. People with swine flu typically have a fever or high temperature (over 38°C/100.4°F) and two or more of the following symptoms:

unusual tiredness,
headache
runny nose,
sore throat,
shortness of breath or cough,
loss of appetite,
aching muscles,
diarrhoea or vomiting.

For more information, see Symptoms.

How long are symptoms expected to last?

As with any sort of flu, how bad the symptoms are and how long they last will vary depending on treatment and individual circumstances. Most cases reported in the UK to date have been relatively mild, with affected people starting to recover within a week.

What if I don't recover within a week?

If your symptoms don't improve after seven days (or five days if you are under 16), contact your local NHS service on one of the telephone numbers below.

England, NHS Direct: 0845 4647
Scotland, NHS 24: 08454 242424
Wales, NHS Direct Wales: 0845 4647
Northern Ireland: contact your local GP surgery or your local out-of-hours service.
Back to top

How does swine flu cause death?

Like any other type of flu, people can die from swine flu if they develop complications, such as pneumonia.

Has the swine flu virus developed resistance to Tamiflu?

The first case of resistance of the swine flu virus to the antiviral drug oseltamivir (Tamiflu) has now been reported in England.

The resistant virus was identified in a patient with a weakened immune system. Although the virus was resistant to Tamiflu, it was susceptible to the antiviral zanamivir (Relenza) and, following treatment, the patient recovered from their illness.

Should we expect a more severe second wave of the pandemic in the winter?

The history of previous flu pandemics suggests that the current viral strain will spread more widely in the autumn or winter, causing more illness and death. It is possible that the virus will mutate (change) into a stronger strain.

Should I go to work or school if I have been in contact with someone who I know has swine flu?

Yes, as long as you do not have flu-like symptoms. If you are feeling well, you should continue your normal activities, including going to school or work.

It can take up to seven days (normally two to five days) after infection for swine flu symptoms to develop. If you develop symptoms, stay at home and follow the general advice (see What should I do if I think I’m infected?).

Is it possible to catch swine flu twice?

Yes, because the virus can mutate (change). If you become infected with the swine flu virus, your body produces antibodies against it, which will recognise and fight off the virus if the body ever meets it again. However, if the virus mutates, your immune system may not recognise this different strain and you may become ill again, although you may have some protection from having had a similar virus previously.

Should I have a swine flu party or try to catch swine flu now, so I will be immune to more serious strains that may emerge later?

No. Don't try to catch the virus as you may help it spread. Also, as everything about the virus is not yet known, it is too soon to assume it is only a mild infection. Catching swine flu will not necessarily protect you from strains that may emerge later (see Is it possible to catch swine flu twice?).

Can my pet catch swine flu?

There have been a very small number of cases worldwide in which it appears that swine flu infection has been passed from humans to both cats and dogs. Therefore transmission to pets is possible, but rare.

What is the National Pandemic Flu Service and how does it work?

The National Pandemic Flu Service is a new self-care service that will give people with swine flu symptoms fast access to information and antivirals.

It is a dedicated website and a phoneline (0800 151 3100 or textphone 0800 151 3200) where you can get information, check your symptoms and get a unique number that will give you access to antivirals if necessary.

When you are given your unique access number, you will be told where your nearest antiviral collection point is. Ask a flu friend (a healthy friend or relative) to go and pick up the antiviral medication.

If you think you have swine flu, do not go to your GP surgery or A&E. Stay at home to avoid spreading the virus.

Can children use it?

All children can use the Flu Service. However, those with poor English or who are too young should be supported by an adult or have an adult ring on their behalf.

What documents are needed to be able to collect the antivirals?

The flu friend must show their own ID as well as that of the patient. The authorisation number and ID information will be checked to ensure it matches the information provided when the assessment of symptoms was completed.

Acceptable forms of ID are:

a utility bill,
passport,
a credit or debit card,
driving licence, or
NHS card.
Back to top

Why has the government brought in this new service?

This new service will help free GPs' time, so they can deal with other illnesses that need their urgent attention.

Do I use the National Pandemic Flu Service if I'm in a high-risk group?

Contact your doctor directly rather than using the National Pandemic Flu Service if:

you have a serious existing illness,
you are pregnant,
you have a sick child under one year of age,
your condition suddenly gets much worse, or
your condition is still getting worse after seven days (five for a child).
Back to top

Are the Flu Service staff properly trained?

A range of clinicians and British Royal Medical Colleges approved the questions that are asked by the National Pandemic Flu Service. The answers to these questions can determine whether or not you have swine flu. The call centre workers have been trained to use these questions and guide people through them. They will only use these questions. If a caller needs any specific advice, they are directed to the appropriate service.

Will the Flu Service be able to distinguish between swine and other flu?

The staff are trained to identify cases of swine flu. However, the symptoms of seasonal flu are very similar and therefore there is likely to be some overlap with other circulating flu cases. As swine flu becomes more common, a higher proportion of flu-like illnesses will be swine flu.

How will the government stop people fraudulently getting Tamiflu?

The government is relying on the public to use the system responsibly. There is no need to jump the queue, because there is more than enough Tamiflu for everyone likely to catch the virus in the months ahead. Nor is there any need to buy Tamiflu from someone who has obtained it under false pretences. Anyone who needs it will be supplied free of charge.

How much contact should I have with family and friends?

If you have swine flu, avoid unnecessary contact with family and friends while you are infectious, which is usually until five days after your symptoms started (seven days in children). Once your symptoms have gone, you are no longer infectious.

Keep one metre or more away from people’s faces to avoid droplets from your throat affecting others. Where possible, you can avoid exposing your partner to infection by sleeping in the spare room.

What if I need someone to care for me? Will they catch my swine flu?

If you are unable to look after yourself at home, ask a friend or relative to collect medicines and groceries for you, order any repeat prescriptions, help with basic household tasks, such as cooking, and generally care for you.

If your friend or relative keeps their distance from you wherever possible and you both have good hygiene (sneezing into a tissue and washing your hands thoroughly), there is a good chance that they will not catch the infection.

I've lost my appetite. What should I do?

Losing your appetite is a common symptom of flu and will usually return as you begin to feel better. Try to eat light, nutritious foods, such as soup, toast, baked beans and scrambled eggs (these are also easy to prepare). It may be easier for you to eat little and often.

Should I go out?

The National Pandemic Flu Service is a new online service that gives you self-care advice and antiviral medication if you need it without going to your GP.

If you feel up to it, you may want to get some fresh air. Do not go on public transport, stay in crowded places or visit your GP or hospital when you have swine flu symptoms, as you may infect other people with the virus.

If you suddenly get much worse, seek medical advice immediately.

When should I go back to school or work?

You can go back to school or work when you are feeling well and are no longer infectious. Adults are most infectious soon after they develop symptoms and remain infectious while their symptoms continue, which is usually for up to five days. They can normally return to work within seven days. In children, symptoms continue for up to seven days and they can normally return to school within 10 days.

What should I do if I'm off work with swine flu for more than seven days?

Phone your employer and explain why you can’t go back to work yet. They will probably ask you to provide evidence that you can’t work.

If you’ve already been assessed as having swine flu by the National Pandemic Flu Service or your GP, they will have advised you to stay at home while you’re ill. If your symptoms are not improving by day seven, you should seek further medical advice by phone. You should not go to your GP practice.

For more information, including advice on sick notes, visit out Common Health Questions

What can I do?

You can reduce, but not get rid of, the risk of catching or spreading swine flu by:

Always covering your nose and mouth with a tissue when coughing or sneezing.
Disposing of dirty tissues promptly and carefully.
Maintaining good basic hygiene, for example washing your hands often with soap and warm water to reduce the spread of the virus from your hands to face, or to other people.
Cleaning hard surfaces, such as door handles, often and thoroughly using a normal cleaning product.

You can also make the following preparations now:

Confirm a network of flu friends (friends and relatives) who could help you if you fall ill. They could collect medicines and other supplies for you so you do not have to leave home and possibly spread the virus.
Know your NHS Number and those of other family members. Keep them in a safe place. It is not essential to have your NHS Number in order to receive treatment, but it can help NHS staff to find your health records. You will be able to find your NHS Number on your medical card or other items such as prescribed medication, a letter from your GP or hospital appointment card/letter.
Have a thermometer and enough cold and cough remedies in your medicine cupboard, in case you or your family get swine flu.
Back to top

Are alcohol handrubs better than soap and water?

Both alcohol handrubs and washing with soap and water are important to minimise the risk of spreading swine flu, as they both deactivate the flu virus. Alcohol handrub can only be used on visibly clean hands. If hands are dirty, soap and water should be used. Handrubs are useful when there is no easy access to a place to wash and dry your hands.

Who should be wearing a facemask?

The Health Protection Agency (HPA) recommends that healthcare workers wear a facemask if they come into close contact with a person with symptoms (within one metre), to reduce their risk of catching the virus from patients.

However, the HPA does not recommend that healthy people wear facemasks in their everyday life.

Why shouldn't the general public wear facemasks?

There is no evidence to suggest that this is a useful preventative measure.

The virus is spread by people touching infected surfaces, or by someone coughing or sneezing at very close range. So unless you are standing very close to someone with the virus, wearing a facemask will not make a difference.

There are concerns about the risks of not using facemasks correctly. They must be changed regularly as they don't work as well when dampened by a person’s breath. People may infect themselves if they touch the outside of their mask, or may infect others by not throwing away old masks safely.

Finally, wearing a facemask may encourage complacency. It is more important to keep your hands clean, stay at home if you feel unwell and cover your mouth when they cough or sneeze.

So why do people in other countries wear facemasks?

This is an issue which each government has considered separately. France is encouraging the public to buy their own masks for use as a precaution, but it is not stocking masks centrally from government funds. Neither is the US.

In other countries, people already wear facemasks either to avoid spreading illness or to protect themselves from pollution. This is not the case in the UK.

What should I do if I think I’m infected?

If you have flu-like symptoms and are concerned that you may have swine flu, stay at home, read about swine flu symptoms and check your condition using the National Pandemic Flu Service.

Phone your GP if:

you have a serious existing illness,
you are pregnant,
you have a sick child under one,
your condition suddenly gets much worse,
or
your condition is still getting worse after seven days (five for a child).

The National Pandemic Flu Service is a new online service that will assess your symptoms and, if required, provide an authorisation number that can be used to collect antiviral medication from a local collection point. For people who do not have internet access, the service can be accessed on:

Telephone: 0800 151 3100
Minicom: 0800 151 3200

For more information, go to the Flu service: Q&A.

If it is confirmed that you have swine flu, ask a healthy relative or friend to pick up your antiviral medication for you.

In the meantime, take paracetamol-based cold remedies to reduce fever and other symptoms, drink plenty of fluids and get lots of rest.

Don't go into your GP surgery or to a hospital, as you may spread the disease to others.

If I have been in close contact with an infected person, do I need treatment?

You only need antiviral treatment if you have been diagnosed with swine flu or if a doctor decides that you are at serious risk of developing severe illness. See Will antivirals be given to people without flu symptoms?.

Can swine flu be treated?

Testing has shown that the swine flu can be treated with the antiviral medicines oseltamavir (Tamiflu) and zanamivir (Relenza). However, the drugs must be taken at or near the start of the illness to be effective. See Treatment for more information.

The UK already has enough antivirals to treat half the population. Orders of Tamiflu have been placed to increase UK supplies to 50 million doses, enough to treat 80% of the population.

What do antivirals do?

Antivirals are not a cure, but they help you to recover by:

relieving some of the symptoms,
reducing the length of time you are ill by around one day, and
reducing the potential for serious complications, such as pneumonia.
Back to top

How does Relenza work?

To reproduce and spread, a virus has to enter your body, take over healthy cells and force them to make copies of itself. Relenza stops the release of new copies of the virus from infected cells in the lungs. This slows the spread of the virus, reduces the symptoms and length of time that you feel unwell for and makes it harder for the virus to spread to other people.

Relenza should first be taken within 48 hours of symptoms appearing in adults (36 hours in children). It works better the earlier you start taking it.

How does Tamiflu work?

To reproduce and spread, a virus has to enter your body, take over healthy cells and force them to make copies of itself. Tamiflu stops the flu virus entering your cells and blocks the release of new copies of the virus. This slows the spread through your body, reduces the symptoms and the length of time that you feel unwell for and makes it harder for the virus to spread to other people.

Tamiflu should first be taken within 12 to 48 hours of symptoms appearing. It works better the earlier you start taking it.

How effective are Relenza and Tamiflu?

Relenza reduces the duration of flu symptoms by one-and-a-half days on average. Tamiflu reduces the duration of symptoms by up to two days.

What if I forget to take a dose?

Even if you forget a dose of Relenza or Tamiflu, you must not double the next dose. Take the forgotten dose as soon as you remember, as long as the next one is not due for a few hours. If the next dose is due within a few hours, just carry on as you are supposed to. Don't take a catch-up dose.

What happens if I take Tamiflu but then have similar flu-like symptoms at a later stage?

If you re-call the Flu Service with the same details as before, you will be advised that you have already had an antiviral and cannot access another one through the service.

You should therefore contact your GP to explain that you have received a treatment course of antivirals but are now ill again. Your GP will assess your symptoms and determine the appropriate treatment, which might include another course of antivirals.

Does the UK have enough antivirals?

The UK has recently received a further delivery of Tamiflu and Relenza bringing the current stockpile up to 50 million doses, which is enough to treat 80% of the population.

Is one of the antivirals more appropriate for pregnant women and people with certain kidney conditions?

Relenza is an inhaled drug that will be used for pregnant women and people with certain kidney conditions who are unable to take Tamiflu. See Pregnancy and children.

I'm allergic to penicillin. Can I take antivirals?

Yes, it is safe for you to take antivirals if you have a penicillin allergy.

I am on warfarin. Can I take antivirals?

Yes, you should be able to take antivirals if you are on warfarin, but contact your GP for advice first.

Are there any interactions between Tamiflu and other drugs?

Tamiflu is not expected to alter the effect of any other medicines. If you are taking other medicines and have any questions or concerns, you should speak to your GP or pharmacist. Adults can take Tamiflu with paracetamol, ibuprofen or acetylsalicylic acid (Aspirin). Children should not be given, or take aspirin, but can take paracetamol and ibuprofen.

As a precaution, the MHRA has set up a web portal for people to report any side-effects from antivirals prescribed for swine flu.

Will antivirals be given to people without flu symptoms?

In most cases, no. Antivirals will generally only be given to people who have been diagnosed with swine flu.

Doctors should not offer antiviral medication as prophylaxis (prevention) to people close to patients unless they have serious existing health problems, such as cancer, or there are other special circumstances.

Will my child have nausea if they take Tamiflu?

As with many medicines, nausea is a known side effect of Tamiflu in a small number of cases. Symptoms may improve over the course of the treatment. It may help to take Tamiflu either with or immediately after food, and drinking some water may also lessen any feelings of nausea.

How are those with confirmed swine flu getting access to antivirals?

If antivirals are required, the National Pandemic Flu Service will provide you with an authorisation number, which can be used to collect antiviral medication from a local collection point (see How is swine flu infection diagnosed?). Alternatively, if you are in a high-risk group, your GP will advise you over the phone on how to collect your antivirals.

A healthy friend or relative can then pick up the antivirals for you from your local collection centre, usually a pharmacy or community centre.

Should people be buying their own antivirals?

No. The government has enough antivirals to treat half the population, and will increase this to cover 80% as an extra precaution. Therefore, antivirals should be available for everyone who gets ill in the pandemic and there is no need for people to buy their own.

Does Tamiflu go out of date?

Yes. There will be an expiry date on the packet. The government has a programme to replace any expired doses under a rolling stock system.

If I take an antiviral and have side effects, who should I tell?

First, see your doctor to check that you are OK. Then report your reaction to the Medicines and Healthcare products Regulatory Agency (MHRA) through its new online system (links to external site).

This new web-page, based on the Yellow Card Scheme (a website where you can report side effects to other medicines), helps the MHRA to monitor the safety of Tamiflu and Relenza.

Anyone who does not have access to the internet can ask their GP to send a report on their behalf.

How do we know if the vaccine works?

The GlaxoSmithKline vaccine (Pandemrix) has shown a strong immune response in clinical trials. Further details can be found in the special product characteristics.

Who will be a priority for vaccination with the H1N1 swine flu vaccine?

People who are most at risk from swine flu need to be vaccinated first. These groups are, in order of priority:

People aged between six months and 65 years in the seasonal flu vaccine at-risk groups.
All pregnant women.
People who live with those whose immune systems are compromised, such as cancer patients or people with HIV/AIDS.
People aged 65 and over in the seasonal flu vaccine at-risk groups.
Young children aged between six months and five years.

Frontline health and social care workers will also be offered the vaccine at the same time as the first clinical at-risk groups. Health and social care workers are both at an increased risk of catching swine flu and of spreading it to other at-risk patients.

What are the seasonal flu vaccine at-risk groups?

These are people with:

chronic respiratory disease, such as chronic obstructive pulmonary disease (COPD),
chronic heart disease, such as heart failure,
chronic kidney disease, such as kidney failure,
chronic liver disease, such as chronic hepatitis,
chronic neurological disease, such as Parkinson's disease,
diabetes requiring insulin or oral hypoglycaemic drugs, and
immunosuppression (a suppressed immune system), due to disease or treatment.
Back to top

Why are healthy people over 65 and children not a priority for the swine flu vaccine?

Healthy people aged over 65 appear to have some natural immunity to the swine flu virus. And while children are disproportionately affected by swine flu, the vast majority make a full recovery - therefore the experts do not advise that children (other than those in at-risk groups) should be vaccinated initially.

If I am in a priority group, is it compulsory to be vaccinated?

No, the swine flu vaccine is voluntary. However, the government strongly encourages everyone in an at-risk group to have it.

Ultimately, it is down to the individual to decide whether they, or any children in their care, have a vaccine or not.

How do I know if I am in a priority group?

If you are in a high-risk group, your GP will write to you about getting a vaccine.

When will everyone else who isn't in a priority group receive the vaccine?

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that the use of the vaccine in the wider healthy population should depend on how the pandemic evolves and on emerging clinical data on the use of the vaccine. This will be kept under review. The government will not announce further groups until they have further advice from the JCVI on this issue.

What are the names of the swine flu vaccines?

The swine flu vaccine manufactured by GlaxoSmithKline is called Pandemrix and the vaccine manufactured by Baxter is called Celvapan.

What dosage will be given for each vaccine?

The following vaccination schedule is recommended in the UK:

Pandemrix:

Healthy children aged over six months and below 10 years:
- a single dose of 0.25ml.
Immunocompromised children aged over six months and below 10 years:
- two doses of 0.25ml given at least three weeks apart.
Healthy children aged 10 years and over or healthy adults:
- a single dose of 0.5ml.
Immunocompromised children aged 10 years and over or immunocompromised adults:
- two doses of 0.5ml given at least three
weeks apart.

Celvapan:

All children aged over six months and below 10 years:
- two doses of 0.5ml given at least three weeks apart.
All children aged 10 years and over or adults:
- two doses of 0.5ml given at least three weeks apart.

This dosage schedule is based on advice given by the Joint Committee on Vaccination and Immunisation, following consideration of clinical data available on the vaccines. The dosage and recommendations will be kept under review as more clinical data become available.

Is the vaccine safe?

Vaccines would not be licensed if they were considered unsafe. Both swine flu vaccines have been licensed.

How will vaccine safety be monitored?

As with any new vaccine, rare and very rare side effects cannot be identified or excluded until the vaccines are used in much larger numbers of people in the general population. Therefore, effective safety monitoring systems for all medicines, including vaccines, are in place to detect and evaluate previously unobserved adverse reactions.

Why can’t babies under six months be vaccinated?

Neither of the swine flu vaccines used in the UK vaccination programme are licensed by the European regulators for use in babies under six months old.

This is partly because there are no data about the effectiveness or safety of the vaccines in babies below six months old, and partly because it is so difficult to carry out vaccine trials with infants.

Will the vaccine give me swine flu?

No. The vaccine does not carry a 'live' virus, so it cannot give you swine flu. Some people may experience mild fever up to 48 hours after immunisation as their immune system responds to the vaccine, but this is not flu.

Is there a link between Guillain-Barre syndrome and swine flu vaccines?

Guillain Barre Syndrome (GBS), a rare neurological disorder, was an identified risk with swine flu vaccines used in the United States in 1976 - it is thought that one extra case of GBS occurred with every 100,000 doses of vaccine. The reason why the 1976 vaccine increased the risk of GBS remains unknown.

Many studies have looked at whether other flu vaccines used since 1976 carry a risk of GBS and no robust evidence of a causal link has been found. No cases of GBS have been found in the clinical trials of H5N1 vaccines.

Does the vaccine contain any porcine (pork) product?

Some porcine products are used in the manufacturing process of Celvapan, although there are no detectable traces of these products in the vaccine itself.

Pandemrix does not contain porcine products.

Is the vaccine safe for people with an egg allergy?

The GlaxoSmithKline vaccine (Pandemrix) is not suitable for people who have an anaphylactic reaction (allergic reaction) to egg.

The Baxter vaccine (Celvapan) does not use eggs in its production and so would be suitable for people who have a confirmed anaphylactic reaction to egg products.

What are the ingredients in the vaccine?

The full list of ingredients of Pandemrix can be found by going to the Pandemrix summary of product characteristics.

The full list of ingredients for the Baxter vaccine can be found here.

Can the swine flu vaccine be given at the same time as other vaccines?

Yes. The swine flu vaccine can be given at the same time as other vaccines, including the seasonal flu jab.

I've already had swine flu - do I still need to be vaccinated?

You can only be certain that you have had swine flu if it was confirmed by a laboratory test. Otherwise, you may have had normal flu or something else. Unless you know for sure that you have had swine flu, and are in one of the high-risk groups, you should have the vaccination.

Will the vaccine still provide people with protection if the swine flu virus mutates?

At this stage, it is impossible to predict if or how the H1N1 swine flu virus will mutate (change). However, experiences with the H5N1 bird flu vaccine would suggest that an H1N1 vaccine would also provide a high level of immunity against closely related strains. The level of cross-protection is expected to be greatest for more closely related strains.

Does the NHS have enough syringes to administer the swine flu vaccine?

Yes, sufficient needles and syringes to mix and administer the vaccine will be provided to primary care trusts (PCTs) free of charge. Stocks will be delivered to PCTs, for onward distribution to GPs, in advance of the vaccine deliveries.

Why are pregnant women in one of the priority at-risk groups for vaccination?

There is evidence from North America, Australia and Europe that shows that pregnant women are at increased risk of severe disease and flu-related hospital admissions. This increased risk has also been observed in the UK. The risk increases with how advanced the pregnancy is, with women in the third trimester (last three months of pregnancy) particularly at risk.

The World Health Organisation (WHO) has reported that 7-10% of all hospital admissions for swine flu are pregnant women in their second or third trimester of pregnancy. Pregnant women are ten times more likely to need care in an intensive care unit compared with the general population.

Complications, based on information in relation to seasonal flu, may include:

pneumonia (infection of the lungs), and
breathing difficulties.

Is the vaccine safe for pregnant women?

Yes. Both vaccines have been licensed for use in pregnant women. Licensed vaccines, including influenza vaccines, are held to a very high standard of safety and would not be licensed if they were unsafe.

In licensing the current swine flu vaccines for use in pregnancy, the European regulators gave careful consideration to the severe burden of illness caused by swine flu in pregnant women.

They also considered the safety record of seasonal influenza vaccines and the nature of the adjuvants that were incorporated into the pandemic vaccines. (Adjuvants are additional agents that are added to vaccines to make them more effective – see below for more information)

The seasonal flu vaccine has been given to millions of pregnant women at all stages of pregnancy and has an excellent safety record, with no reported safety concerns. This is why in the UK, and many other countries, vaccination against seasonal flu is recommended for pregnant women, whatever the stage of the pregnancy.

Extensive research has also been carried out into the use of adjuvants and there is no evidence that they are associated with any risks in pregnancy.

What was the most recent advice from JCVI on vaccinating pregnant women?

JCVI recommended that pregnant women should be given the Pandemrix vaccine as this vaccine appears to give good levels of antibodies after a single dose. This means that the Pandemrix vaccine will provide more rapid protection against swine flu than Celvapan, which requires a two-dose schedule given three weeks apart.

Why is thiomersal present in the vaccine and is there any risk from it?

Pandemrix contains five micrograms of thiomersal (a mercury-containing compound) as a preservative. This is added to prevent the vaccine becoming contaminated by bacteria during preparation, storage and use.

There is no evidence of risk from thiomersal in vaccines, including for children, pregnant women and their offspring.

In 2003, the Committee on Safety of Medicines (CSM) concluded that the balance of benefits and risks of thiomersal-containing vaccines remains overwhelmingly positive.

In 2004, the European Medicines Agency (EMEA) also concluded that studies show no association between vaccination with thiomersal-containing vaccines and specific neurodevelopmental disorders such as autism.

A more recent study has also shown that there is no association between exposure to mercury during pregnancy and neurological or psychological impairment in later childhood.

Rates of autism in the US continued to rise after thiomersal was removed from childhood vaccines with no change in the rate of rise.

What is an adjuvant?

An adjuvant is a compound that can be added to a vaccine to enhance the immune response to the vaccine. The use of an adjuvant can also reduce the amount of antigen (an antigen is the active substance that causes your immune system to produce antibodies) that is needed to produce a satisfactory immune response, which in turn, makes the vaccine safer.

The adjuvant in the Pandemrix vaccine contains three substances:

squalene,
tocopherol, and
polysorbate.

Squalene is a naturally occurring substance that is manufactured in the liver of every human body and circulates in our bloodstream. Squalene used in vaccines is purified from fish oil.

Squalene has been used in as an adjuvant in a seasonal flu vaccine called FluAd that has been given to tens of millions of people since 1997 and there have been no safety concerns with Fluad or its MF59 adjuvant.

Tocopherol is a form of Vitamin E and is entirely safe when taken in the quantities that are used in the vaccine.

Polysorbate is an emulsifying agent widely used in cosmetics, food products, and pharmaceuticals including injections. An emulsifying agent is something that encourages certain liquids to mix with other liquids, when they would not normally do so.

There have been concerns about the use of adjuvanted vaccines in pregnant women; what is the Department of Health’s recommendation?

The European Medicines Agency has licensed Pandemrix, which contains an adjuvant, for use in pregnancy. This followed a thorough evaluation of the safety of the vaccine, and its adjuvant, as well as the severe disease caused by swine flu in pregnant women. In early June, WHO reviewed the safety of adjuvants and no significant safety concerns were identified.

JCVI has advised that pregnant women receive the adjuvanted vaccine Pandemrix as this vaccine appears to give adequate levels of antibodies after a single dose, providing protection more rapidly than would be offered by Celvapan.

As pregnant women are at increased risk of severe disease and hospitalisation, it is vital that they are protected as soon as possible from swine flu infection.

Have the vaccines been tested on pregnant women?

Women who are already pregnant are generally not enrolled into clinical trials.

The safety of giving a particular vaccine to pregnant women is assessed from what is already known about the ingredients in the vaccine and the results of testing that is carried out to see if the vaccine poses any risk during pregnancy.

However, non-pregnant women who are enrolled into vaccine clinical trials sometimes become pregnant shortly after vaccination or are given vaccine before they know they are pregnant. These women are followed up and the outcome of the pregnancy is documented.

Women who were, or became pregnant, during the clinical trials of the swine flu vaccine were carefully monitored and there was no evidence of any specific risk to the mother or their unborn child due to the vaccine.

In terms of effectiveness, clinical trials of the pandemic influenza vaccines provided good results in women of child-bearing age and based on experience from other influenza vaccines it is assumed that these results will be similar in both pregnant and non-pregnant women.

The Department of Health have recently published an information briefing on vaccination and pregnancy.

Why has the JCVI decided to focus on young children and carers during the second stage of the vaccination programme?

The JCVI decided to focus on young children next, and look at the possibility of offering the vaccine to carers, after carefully considering the available supplies and the number of children in critical care and infant deaths.

Why under 5s?

Evidence shows that young children are currently suffering the greatest relative impact from the disease. For example, children under five have the highest rate of hospitalisation for swine flu.

Why carers?

Like frontline health and social care workers, carers have considerable ongoing responsibilities towards the health and welfare of others and are looking after vulnerable people who need to be protected from the risk of infection.

Is there enough vaccine to immunise all children (and carers if necessary)?

The Department of Health has placed orders for sufficient H1N1 swine flu vaccination for the whole UK population. However, it is still reliant on delivery of vaccine from manufacturers. At this stage, it has decided to prioritise this age group to make optimal use of available supplies.

When will this vaccination begin?

The second phase of the vaccination programme is expected to be rolled out very shortly - the precise date to be confirmed.

Where will children be vaccinated?

The vaccine will be delivered via GPs. If your GP surgery is not offering the vaccine, contact your local primary care trust, which will make alternative arrangements for you.

Where will carers be vaccinated?

The Department of Health will be discussing the logistics of this, initally with carers organisations.

How will parents know where to go?

Parents of children in the relevant age groups will be contacted by their GPs.

Which vaccine will be given to children?

The GSK vaccine Pandemrix will be offered to the vast majority of the children in this age group. It has been licensed and approved by European regulators. It will probably also be given to carers who do not have specific health problems, such as a confirmed anaphylatic reaction to eggs.

It only seems to be a mild virus, so do people really need the vaccine?

Although the virus has so far proved mild, there have been hospitalisations and swine-flu-related deaths in the UK. (Most of these cases have been in people with underlying health conditions but a significant minority have been previously healthy people)

While the risks of very serious complications are small, the impact on those affected can be devastating. That’s why the Department of Health has recommended those in certain groups to take it up and will now be offering the vaccine to young children, who have been suffering the highest rates of hospitalisation.

Will the seasonal flu vaccine protect my child against swine flu?

No, because seasonal flu and swine flu are caused by different viruses. If you are a parent, and your child normally has a seasonal flu vaccination, they should still have it this year. The swine flu vaccine can be given at the same time as other vaccines, including the seasonal influenza vaccine. If two vaccinations are being administered on the same day, they should be given in a different site, preferably in a different limb.

How many doses will my child need?

Your GP will advise, but in many cases, one dose (0.25ml, half an adult dose) of Pandemrix should be given.

I’m concerned for my child. How do we really know that these vaccines are well tolerated and effective if they are new?

Preliminary results from H1N1 clinical trials being carried out in children down to six months of age show similar tolerability results to the H5N1 trials, with the vaccine being well-tolerated in children.

Similar flu vaccines containing a different flu virus strain (H5N1) have undergone clinical testing. The safety of the H5N1 flu vaccines have been evaluated in clinical trials in over 5,000 people. The GSK H5N1 vaccine has been tested in children down to three years of age. The trials showed that these vaccines are well tolerated and that they produce enough antibodies to provide protection.

Experience with seasonal flu vaccines has shown that changing the strain of virus in a vaccine does not substantially affect the safety profile of the vaccines.

As with any new vaccine, some very rare side effects cannot be identified or excluded until the vaccines are used in much larger numbers of people in the general population.

Will two vaccines ‘overload’ my child’s system?

The swine flu vaccine can be given at the same time as other vaccines, including the seasonal influenza vaccine. If two vaccinations are being administered on the same day, they should still be given in a different site, preferably in a different arm. Many childhood vaccines are given in combination perfectly safely.

I’ve heard scare stories about ‘thiomersal’ - are they true?

Thiomersal is a preservative that contains very small amount of mercury.

Pandemrix contains Thiomersal, Celvapan does not.

The Commission on Human Medicines (CHM) keeps the safety of vaccines, including thiomersal-containing vaccines, under continual review. The view of the CHM remains that there is no evidence of adverse effects caused by levels of thiomersal in vaccines.

Can the swine flu vaccine be given to children who have a latex allergy?

Both Pandemrix and Celvapan vaccines can be administered to people who have a latex allergy. Both vaccines are manufactured and packaged without latex.

What extra antibiotics have been purchased?

Further orders were placed for 15.2 million courses of antibiotics to help fight swine flu and 90% of those orders have now been delivered.

Why do you need antibiotics in a pandemic?

While antivirals may reduce complications, they are still likely to occur in the pandemic. Some of the most common include bacterial infections in the respiratory tract and lungs, such as pneumonia. Antibiotics are needed to treat these.

Antibiotics will be used to treat people in the community if they develop complications. In hospitals, antibiotics will be used to treat the most ill patients and may reduce the length of hospitalisation.

Are pregnant women more likely to catch swine flu?

Yes. Pregnant women are more susceptible to all infections, because their immune system is naturally suppressed in pregnancy. They are especially vulnerable to swine flu, as this virus is affecting younger age groups in particular.

Are pregnant women with swine flu more at risk of complications?

Most pregnant women with swine flu will only have mild symptoms, the same as most other people with swine flu. However, pregnant women have an increased risk of complications from any type of flu, because their immune system is naturally supressed in pregnancy. Possible complications are pneumonia (an infection of the lungs), difficulty breathing and dehydration, which are more likely to happen in the second and third trimester.

There is a small chance that these complications will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.

What precautions can pregnant women take?

If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible, and following the general hygiene advice (see What can I do?).

If a family member or someone else in close contact with you has swine flu, your doctor may prescribe antiviral medication (usually Relenza) as a preventative (prophylactic) measure. Relenza is taken through an inhaler rather than a tablet. This means it builds up in your throat and lungs but not in your blood or placenta, so it is unlikely to affect your baby.

If you think that you may have swine flu, call your doctor for an assessment immediately. If your doctor confirms swine flu over the phone, antiviral medication will be prescribed, to be taken as soon as possible.

Unless you have swine flu symptoms, carry on attending your antenatal appointments so that you can monitor the progress of your pregnancy.

Can I take antiviral drugs if I am pregnant?

Yes, on the advice of a doctor. The Department of Health has bought Relenza, an inhaled antiviral drug that treats flu and minimises any potential effect on the developing foetus. It is unlikely that Relenza will affect your pregnancy or your growing baby.

However, if your doctor or midwife thinks that a different medicine is needed (for instance, if you have unusually severe flu), you will be given Tamiflu instead.

The risk of antiviral treatment during pregnancy has been reviewed and proven to be extremely small. It is much smaller than the risk posed by the symptoms of swine flu.

What are the possible side effects of Relenza?

Some people have had wheezing or serious breathing problems when they have used Relenza. It is therefore not recommended for people with asthma or COPD. Other possible side effects include headaches, diarrhoea, nausea and vomiting.

If you take an antiviral and have side effects, see your GP to check that you are OK. Then report your reaction to the Medicines and Healthcare products Regulatory Agency (MHRA) through its new new online system.

Can I take painkillers if I am pregnant?

You can take paracetamol to reduce fever and other symptoms. This is safe to take in pregnancy.

Pregnant women must not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).

Will breastfeeding protect my baby from swine flu?

Breastfeeding does not appear to reduce the likelihood of babies getting cold or flu. However, it should help reduce the risk of associated complications, such as pneumonia and chest infections. For more information, go to Health A-Z: breastfeeding recommendations

What should I do if my baby gets flu?

Your doctor may recommend antiviral medication for your baby, and will advise you on the dose and how to give it to them. If you are breastfeeding, you should continue this: breast milk is easily digestible and your baby will find it comforting.

Should I stop breastfeeding if I need to take antiviral drugs?

Women who are breastfeeding can continue to do so while receiving antiviral treatment. If a mother is ill, she should continue breastfeeding and increase feeding frequency. If she becomes too ill to feed, expressing milk may still be possible. Antiviral drugs are excreted into breast milk in very small (insignificant) amounts, which are unlikely to have any side effects on your baby. For more information, go to Health A-Z: breastfeeding recommendations

How can I tell if my child has swine flu?

Call your GP immediately if your child has any of the following symptoms and a temperature of 38°C or above or feels hot:

tiredness
headache,
runny nose and sneezing,
sore throat,
shortness of breath,
loss of appetite,
vomiting,
diarrhoea, or
aching muscles, limb and joint pain.

If you are worried about your child, always call your GP for advice.

One thing you can do right now is to make sure you have a digital thermometer to take your child’s temperature with.

If my child has swine flu, what should I do?

If your GP confirms that your child has swine flu, keep them at home and treat their symptoms like any other cold or flu. Make sure they drink plenty of liquids, get lots of rest and take over-the-counter cold and flu remedies to help control their temperature. However, children under 16 must not be given aspirin or ready-made flu remedies containing aspirin.

Your GP will tell you whether your child should also take antiviral drugs. Antivirals such as Tamiflu shorten the symptoms by about a day and can reduce the risk of complications. Antivirals are only effective if taken within 48 hours of symptoms starting. If you are worried about your child, call your GP immediately.

However, antivirals can also have side effects. If your child’s swine flu symptoms are mild, you may not wish to give them antivirals. Your GP can advise you on this.

Can children take antivirals?

Yes, on the advice of a doctor. Tamiflu is safe for infants at a reduced dose. It was recently licensed for use in children aged under one during a pandemic outbreak.

Relenza (an inhaler) can be used by children aged five and older under the supervision of an adult.

A study published in the BMJ says that antivirals are of ‘small benefit’ for treating children with seasonal flu. So why are children with swine flu being prescribed Tamiflu?

The BMJ review is based on seasonal flu and not swine flu. As the authors note, the extent to which the findings can be applied to the current pandemic is questionable. Swine flu behaves differently to seasonal flu, and past pandemics have hit younger people hardest.

While there is uncertainty about how swine flu affects children, the government believes that offering antivirals to everyone remains a sensible and responsible way forward. However, this policy will be kept under review as more is learnt about the virus and its effects.

The BMJ research is correct to say that many people with swine flu only get mild symptoms, and they may find bed rest and over-the-counter flu remedies work for them.

But for those who experience severe symptoms, the best scientific advice indicates that Tamiflu should still be taken as soon as possible: to suggest otherwise is potentially dangerous. If people are in any doubt about whether to take Tamiflu, they should contact their GP.

Can babies under the age of one take antivirals?

Yes, Tamiflu was recently licensed for use in babies aged under one during a pandemic outbreak. The European Medicines Agency has given the following advice:

The appropriate dosage to treat children aged under one is 2-3mg/kg twice daily for five days.
It is preferable to treat children under medical supervision.
The capsule content can be diluted to prepare the correct dose.
Back to top

Can my baby take Tamiflu as a preventative measure?

Whether babies without flu symptoms can take Tamiflu should be decided by an expert in the care of young children. The recommended dose for prevention in the under-ones is 2mg/kg once a day for 10 days (but must not exceed 10 days).

The best way to protect babies aged under one is by using tissues and throwing them away, washing your hands and the baby's hands thoroughly, and frequently and thoroughly cleaning surfaces, toys and equipment.

How can I get antiviral drugs for my child?

Your GP will tell you over the phone how you can pick up the antiviral medication. Ask a flu friend (a friend or relative who does not have swine flu) to collect this for you.

I’m on immunosuppressants. Am I more at risk of catching swine flu?

Yes. If you take immunosuppressants you have a greater risk of becoming infected with any virus, including swine flu, and will be less able to fight it off once you have it.

Will my dose of immunosuppressants be altered in the event of an outbreak?

Your doctor may advise that your dose of immunosuppressants needs to change. The appropriate dose will vary from patient to patient.

Can I take antivirals if I’m on immunosuppressants?

Yes, if your doctor agrees it is safe for you to take Tamiflu or Relenza.

Am I more at risk of catching swine flu if I have HIV?

Probably not. Although HIV infects CD4 cells and reduces their number and function, there are other parts of the immune system that are able to fight flu. For more information, visit the Terrence Higgins Trust website (links to external site).

Am I more likely to suffer complications if I have HIV and catch swine flu?

If you have a low CD4 count (under 200), you may be more likely to suffer complications like pneumonia from any type of flu, including swine flu.

Can I take antivirals if I have mild to moderate kidney disease?

Yes. If you have stage one to three kidney disease, or your glomerular filtration rate (GFR) is above 30, you will be treated as any other person would be. This means you can take Relenza or Tamiflu, if necessary.

Can I take antivirals if I have severe kidney disease?

You can take some but not necessarily all antivirals. If you have stage four or five kidney disease, or your glomerular filtration rate (GFR) is below 30, you will probably be under the care of a kidney specialist. Relenza (an inhaler) is safe to take. If you find this tricky to use, your doctor may give you a reduced dose of Tamiflu tablets instead.

Are people with asthma or chronic obstructive pulmonary disease (COPD) more at risk of catching swine flu?

You are no more likely to catch swine flu than anyone else. However, if you do catch a respiratory infection, including swine flu, it may add to any breathing difficulties you have.

What advice is there for people with asthma or COPD?

Your condition places you at greater risk if you catch the disease. It is therefore all the more important that you follow good hygiene practices (see What can I do) and react quickly if you develop flu-like symptoms (see What should I do if I think I’m infected).

Can I take antivirals if I have asthma or COPD?

Yes, Tamiflu is safe to take. However, Relenza (an inhaler) is usually not given to people with asthma as on rare occasions it can cause breathing complications.

I have diabetes. Am I at more at risk of catching swine flu?

You are no more likely to catch swine flu than anyone else. However, if you do catch it, your blood glucose may increase and your diabetes treatment may need to be adjusted accordingly.

What should I do if my blood glucose increases?

If your blood glucose has increased, or you become thirsty and are urinating more, call your GP. If you are on insulin and testing your own blood glucose, you may be advised to do this more often so you can adjust your dose according to the results. If you start to vomit or become increasingly unwell, call your GP as soon as possible.

Is there any advice for people with liver disease?

If you have liver disease you are no more likely to catch swine flu than anyone else. If you do catch it, antivirals are safe to take. There is no interaction between these and other antivirals you may already be taking.

Is there any advice for people who need regular replacement hydrocortisone therapy (such as those with Addison's disease)?

You can read the swine flu information sheet for patients taking hydrocortisone, produced by the Society for Endocrinology.

Can I take antivirals if I am on epilepsy treatment?

Yes. It is thought that antiviral treatments will not affect medicines taken to control epilepsy.

I look after someone who is very ill or disabled. What if I become too ill to care for them?

As a carer, it makes sense to begin planning for a caring emergency as soon as possible. The best way to get help with planning for a caring emergency is to arrange to have a carer’s assessment done by your local authority.

If you have time you may be able to arrange for formal respite care, but you may want to talk to friends, neighbours and relatives about forming a network of flu friends who can help out and look after you if you are ill.

For more information, see Swine flu: advice for carers.

Are older people more likely to catch swine flu?

It is not yet known, but most cases so far in the UK have been in people younger than 60. Some older people may have partial resistance to the swine flu virus, due to being exposed to a similar flu virus in a previous pandemic.

Are older people more at risk of complications if they do catch it?

Older and frail people are more likely to develop complications from any type of flu, and are generally less able to fight it off.

What is the advice for travellers?

Before travelling, check the Foreign & Commonwealth Office (FCO) website for information specific to the country you are visiting. People who do not have internet access can call the FCO's 24-hour advice line on 0845 850 2829.

We are about to go on holiday. What should we do?

Wherever you go on holiday, always take the same precautions that you do when at home. Know where you can get medical advice if you or your family feel unwell, and have over-the-counter medication handy for coughs and sneezes.

If you are on holiday in the UK and you feel unwell, you can contact the local GP surgery or call the National Pandemic Flu Service helpline on 0800 151 3100.

If you are travelling to Europe, get a free European Health Insurance Card (EHIC) before you go. This entitles you to any necessary medical treatment, including treatment for swine flu, during a visit to another European Economic Area country. You can get an EHIC application form from the Post Office or by calling 0845 606 2030. You can also apply online.

If you have swine flu, don't travel until after your symptoms have stopped.

Whenever you go abroad, always check the latest travel advice from the Foreign Office: www.fco.gov.uk.

What advice are you giving to people with flu who want to travel by plane?

The Health Protection Agency is advising anyone in the UK with flu symptoms not to travel until they are no longer infectious. Similarly, any British nationals abroad with flu who want to fly home should only travel when they are no longer infectious.

What if British nationals abroad ignore this advice and try to travel anyway? Will they be putting other passengers at risk?

It is the discretion of the airline whether to carry a person with signs or symptoms of infectious disease. Any British national prevented from boarding flights when trying to return home from abroad can get advice from their nearest diplomatic mission.

Will people be screened when they arrive at their destination?

The FCO website states that medical screening for the swine flu virus has been introduced at several airports for passengers arriving on international flights, including China. In the section on China, the guidance states: "The Chinese government continues to place great emphasis on screening and surveillance, rapid detection, quarantine and treatment."

What should I do if I become ill on holiday or on the flight home?

Find out in advance where you can get medical advice if you or your family feel unwell on holiday. Have over-the-counter medication for flu with you, such as paracetamol or ibuprofen. Remember that children should not take aspirin.

If you are travelling to Europe, get a free European Health Insurance Card (EHIC). This entitles you to any necessary medical treatment, including treatment for swine flu, during a visit to another European Economic Area country. You can get an EHIC application form from the post office, by calling 0845 606 2030, or by applying online.

If you have flu-like symptoms, keep away from public places to avoid spreading it. Then contact a doctor or other health professional and tell them your symptoms.

If you become ill on your flight home, alert the cabin crew to your symptoms. There are procedures in place for dealing with passengers who become unwell on flights, and the airline will advise port health officials on the ground that a passenger requires a health assessment and may need treatment.

To access the Department of Health Swine Flu Information line when abroad, call 00 44 207 928 1010.

Will GPs have to certify people as having swine flu for travel insurance purposes?

The Association of British Insurers (ABI) has confirmed that swine flu will be treated no differently from any other illness by travel insurers. People diagnosed with swine flu before they are due to travel abroad, and any immediate family members (spouse, parents and children, with some policies covering other relatives) due to travel with them, will be covered for the cost of holiday cancellation by their travel insurance.

Insurers usually require a doctor's certificate to confirm that the patient was unable to travel. The government welcomes the comments from the ABI that they would expect insurers to be flexible on the time it takes to obtain such a certificate and that they are considering what other forms of evidence might be acceptable.

Do I need extra medical insurance?

No. You should always have insurance when you travel abroad. You do not need extra insurance for swine flu.

There are lots of cases in America and Mexico. Is it safe to travel there?

Yes. But find out in advance where to get medical advice from. If you are not sure whether you can travel to a certain country, check the latest travel advice from the Foreign Office: www.fco.gov.uk.

Is it safe to use public transport now we are in a pandemic?

Yes. Public transport has not been closed during previous pandemics, and while there is a slightly higher risk to the public, this is no more than using other public places.

Anyone who has the flu or feels unwell should stay at home and not travel.

Will the government restrict travel within the UK?

The government is not planning to restrict travel within the UK unless it becomes necessary for public health reasons. Scientific modelling shows that internal travel restrictions would have little impact on the total number of people infected by flu. However, the public is advised to avoid non-essential travel, and anyone who has the flu or feels unwell should stay at home and not travel.

What happens to visitors to the UK if they are confirmed with swine flu during their stay?

Foreign nationals should not be treated any differently from UK nationals with regard to self-isolation or other recommended measures. People with symptoms of swine flu, including foreign nationals, are advised not to travel. Overseas visitors will not be charged for NHS hospital treatment for swine flu, including antivirals.

What does WHO Phase 6 mean?

The technical definition of Phase 6 is human-to-human spread of the virus into at least two countries in one World Health Organization (WHO) region, with community level outbreaks in at least one other country in a different WHO region.

Is swine flu a mild infection and therefore no cause for concern?

It is too soon to assume it will be a mild infection. Not everything about the virus is known, and each case that comes up is being closely monitored.

The flu virus changes very rapidly. It can pick up and swap genetic material, which dramatically changes it, increasing the severity of symptoms. The virus could change in the autumn, and so this has to be prepared for.

Will hospital capacity be adequate?

Most flu sufferers can be cared for appropriately at home. The UK has well-developed methods in place for managing extra demand on the healthcare system during the pandemic. For more information, see the Department of Health guidelines on Managing demand and capacity in healthcare organisations.

Is it safe to eat pig meat?

Yes. The WHO says there is no evidence that swine flu can be spread through eating meat from infected animals. However, it is essential to cook meat properly. A temperature of 70°C (158°F) would be sure to kill the virus. Pig meat includes pork, bacon, ham and pork products, such as pork sausages and bacon.

Are the reports that 65,000 people are going to die true?

It is wrong to suggest there will be a particular number of deaths each day. Scientific and clinical experts can use sophisticated modelling techniques to help us understand how the virus may behave, but that is all they can do: guide, not predict.

What happens if someone doesn't have a flu friend?

The government has been working with organisations such as the Red Cross to meet the needs of people who may be isolated or otherwise find it difficult to identify a flu friend.

I'm observing Ramadan. What should I do if I get swine flu?

Islamic law excuses sick people from fasting. Therefore if you become infected with swine flu during Ramadan, it is sensible to break the fast and take the necessary medication for flu, including antivirals.

Antivirals are not a cure, but they help you to recover by:

relieving some of the symptoms,
reducing the length of time you are ill by around one day, and
reducing the potential for serious complications, such as pneumonia

Should I undertake the Hajj this year?

The World Health Organization and the Saudi government advise that the elderly, pregnant women, people with chronic diseases and children should postpone the Hajj and Umrah pilgrimages this year for their own safety.

It is highly likely that swine flu will be transmitted in the course of the pilgrimage.

The Saudi Government has recently changed its position and visitors to Saudi Arabia are no longer required to obtain a seasonal flu vaccination before applying for a visa. The website of the Saudi Embassy contains the latest health advice for visitors.

Comments

46 Comments about ‘Questions and answers’

Our rules:

agotlib said on 01 February 2010

A new month in the new year, and still "very shortly - the precise date to be confirmed." Hello, NHS, is there anybody out there? are you listening to yourselves? to us? to anyone? If I were to say "very shortly" to my boss, and not do anything (including not providing a progress update) for a month, I should be fired. How can we fire you?

agotlib said on 27 January 2010

Still the perpetual "very shortly - the precise date to be confirmed" . . . I guess no accountability is required for being so punctual.

agotlib said on 22 January 2010

Three weeks and counting. I guess that in NHS speak, "very shortly" means "this could be as fast as within one month. Or two."

lulu1982 said on 15 January 2010

NHS DIRECT TOLD ME MY TODDLER HAD SWINE FLU BUT SHE DIDNT!

My two (nearly 3) year old became suddenly feverish one afternoon and dramatically deteriorated...she bagan coughing, was clammy and looked very unwell complaining that she had a tummy ache and her throat hurt. I rang the GP to get an appointment but they were shut due to staff training and I was told to ring NHS Direct for help and advice.

After speaking to three different advisors (one was a nurse) they told me my daughter had swine flu (amazing how they can diagnose without an examination!!) I was immediately put throught to the pandemic flu line and given a reference number for tamiflu!

I was worried at the prospect of my daughter possibly having this virus but I was not convinced - unless a doctor examined her I did not want to give her the medication - what if they were wrong!

I rang NHS direct (again!) explaining my concern and asked for advice on how to get an emergency doctor out..it took two more phonecalls and a final threat saying I would ring for an ambulance and a trip to A&E if they did not send a doctor (which will cost more on the NHS)...finally they sent a doctor out (six hours later) who diagnosed her with acute tonsilitis and immediately put her on antibiotics!

So we have been given a tamiflu ref number that we haven't used and if she does get swine flu in the future she will not be given another reference number because we are only allowed one!

In the future I think I will take my daughter to a walk in clinic or A&E because I DO NOT TRUST the advisors on the phone at NHS any more...I can't understand how they can diagnose symptoms over the phone - the symptoms of swine flu are very similar to that of MANY other viral infections!

It's a good job that I was persistant because if I had done what I was advised my daughter could have got even more poorly!

agotlib said on 15 January 2010

This is not helpful. For at least 2 weeks, the above states, regarding young children vaccination, that the information of when vaccine could be administered will be published "very shortly - the precise date to be confirmed." Silly me. I thought "very shortly" is less then one week, not mentioning two. Can someone explain to me how long is "very shortly" in the NHS's language?

agotlib said on 04 January 2010

This is a JOKE. I have a 6-month old girl, and notwithstanding multiple calls, in-person discussions and web surfing, I never got a clear answer as to whether swine flu is dangerous to her (my local NHS office said a very firm "no" to be contradicted by public NHS announcement within 24 hours), or when and how should my daughter get the vaccine (the NHS publicly announced that I will receive a letter before Christmas, which never arrived; my GP never calld, and no date is provided here). YOU DO NOT CARE ABOUT MY DAUGTHER'S OR MY WELL BEING, JUST HOW YOU APPEAR TO AN UNEDUCATED CONSUMER. SHAME ON YOU.

SusanC_FluWiki said on 03 January 2010

I believe there may be an error in the dosage for children under 5 - shouldn't half an adult dose be 0.25ml?

"How many doses will my child need?

Your GP will advise, but in many cases, one dose (0.5ml, half an adult dose) of Pandemrix should be given."

ashleeashlee said on 09 December 2009

I was a little concerned because I am in the high risk catagory but didn't recieve any notification from my GP. This fortunatley got resolved because I called in for a perscription repeat and happend to metion the jab to the receptionist who later in the day invited me for a vacination.

I was very anxious to get the jab as I know how I suffer with my breathing even with the slightest cold so I really fear the flu having had two bad episodes several years ago. I have the seasonal jab regularly and I cant understand why individuals fear it; from my point of view it is a life saver.

As an aside a really wise elderly lady, easily 90+ was passing the day with me recently. In the conversation swine flu came about. She hit the nail on the head when she said to me:-

"You know when you have the flu because you'll not even consider venturing outside in the rain and pick up that tenner that someone has dropped. If you do you have only got a bad cold"

Having had flu some years ago, I completely agree!

Flu is horrible and at least 3-4 time more uncomfortable than a bad cold. I think a lot of people think they have had flu but it is just a bad cold. Get the jab, swine or seasonal. I bet statistics show that people who have been jabbed are those that have had flu before. I for one can understand.

Graham in Stockport said on 23 November 2009

LATEX ALLERGIES - 23.11.09
I was booked in for my swine flu jab today and told I couldn't have it because I was allergic to latex.

I arrived at the surgery 5 mins before the appointment. I was given an A4 typed sheet with pre-vaccination information.

This sheet suggested I notify the nurse if I was allergic to the seasonal flu vaccination, eggs/chicken or have a latex allergy. I've got mild asthama/eczema and use hypoallergenic washing up gloves when its my turn to do the dishes, to prevent a flare up.

No sooner had I read the sheet I was called for my jab. I explained the above and she refused to give me the jab.

I spoke with the GP who was concerned I might react badly to the Pandemrix vaccine including cardiac-arrest - Celvapan wasn't availabe yet.

I read the blue booklet 'Swine Flu Vaccination: what you need to know' beforehand which only refers to the egg allergy - nothing about latex.

In order to have the P. vaccine, I will need to go to hospital to have it administered.

I've gone from being confident about this to marginally worried and not sure if I want the jab.

Why did the blue booklet not address this issue? Has it just been discovered?

I've searched direct.gov & nhs.uk and not found anything about this issue.

Surely this issue requires certainty before the vaccination is available to everybody.

Monday 23.11.09 - 6.38pm

Caro77 said on 22 November 2009

I'm still waiting for the letter from the GP informing me that my 3 year old son, (suffers from asthma) has an appointment at the surgery for the swine flu jab...How is it possible that although my son belongs to high-risk group does not receive the vaccine yet? I called today to the surgery and they told me that "he was not on the list and that's probably because there are still people at greatest risk" We're almost in December. I'm really concern because he will start the pre-school on 1st December. Help!!!!

Swine Flu Questioner said on 21 November 2009

Hello,
My Brother was recently diognosed with Swine Flu. His flu started about 2 weeks ago and he had to go to the hospital twice. After a week he felt totally better and he feels active and he has decided to join his soccer game too! His Physician Has told him he has 100% Swine Flu but he feels perfectly fine. Did the swine flu leave him? And does he still have the risk of getting it again. Likewise my Family and i have gotten sick but have not been diognosed yet........... We are all feeling better now. Do we have the chance of getting swine flu too. And if you cough out blood what does that mean? I have 1 more question............In this circumstances can my family travel to a foreign country? Please reply as soon as possible as we need to know this peice of information very fast.!!! Thank_you and my god keep you and everyone else safe from this hideous flu.One more question. This website has different languages. will all these comments be in all the different languages too? And will the answer to our questions be sent to our email or it will only be posted on the web. Sorry for soo many questions and have a nice day. Bye

gallowaylady said on 21 November 2009

I cannot find any information about if you develop symptoms when you have had the swine flu vaccination. I have had both seasonal flu (3 weeks ago) and swine flu vacc. ( one week ago). I now have a violent cough, vomiting, really bad headache and a temperature, no appetite at all. Do I have flu/swine flu ? Why, if I have had the vaccinations?

vixu said on 28 October 2009

I rang the swine flu helpline as my 8 year old son had a high temp,sickness,headache and tummy pain. I was told to collect Tamiflu for him, I called the doctor who said the tummy pain and diahorrea were side effects from the Tamiflu, 2 days later he was rushed to hospital with a perforated appendix. I would just like to warn parents to be aware that swine flu symptoms and appendicitis are quite similar.

Henry's Girl said on 12 October 2009

I fell ill 5 days ago with a painful throat, swollen glands, headache & aching legs. I checked with the NHS helpline & they diagnosed possible swine 'flu. I decided against using the anti-viral drugs. Instead I have been drinking 2 fl oz of pure aloe vera juice twice per day, sipping hot tea with honey & taking soluble paracetamol or liquid ibruprofen every 4 hours since the symptoms started. The most imprtant thing is to drink plenty of water, at least 2.5 litres per day to flush the virus out of the system. These all seem to help & I am starting to feel much better.

hathe22 said on 01 October 2009

my computer crashed before i had chance 2 write down my number 4 my antivirus treatment!! does anyone no how to get it back? Have tried the help line and they were no use!! I have recently had brain surgery so dont what this 2 get out of hand aswel please help!!!

TammyFloo said on 28 September 2009

Hi all, I started getting ill about four days ago and wanted to pass on some information that may or may not be useful to people suffering swine flu. I have a low immune system due to being housebound, and four days ago I developed a nasty cough which got worse within two days. Over the following two days I was unable to leave my bed, in and out of conciousness, weak and unable to function properly. I slept for two days solid, drank three bottles of fresh water and basically couldn't be bothered to even speak. I didn't want to take the tamiflu because of what i'd heard of side effects etc, so struggled through without them. Yesterday I was feeling a little better (day three) but because I hadn't eaten much over the previous days, decided to eat some fruit, oranges and apples. By the end of the day, my symptoms seemed to disappear completely. No headache, no dizziness, no sickness or aches and pains. My temperature went right back down to normal and this morning when I woke, I felt completely over it. It's only day four and i'm feeling just about back to normal. Now, my flu wasn't confirmed as being swine flu but I do think that's what it was because i've never felt so ill in all my life and never ever had these symptoms before, so am assuming it was swine flu. I still have a bit of a cough but can handle that, it's the weak feeling and the inability to stay awake which I didn't like. But I really think the fresh fruit and water helped tons! It can't hurt and it's worth a try. So please keep this in mind if you start showing symptoms. I will be calling my pharmacy and GP today to let them know what I discovered and hopefully it'll help others kick the virus sooner rather than later if my theory is correct. Like I say, it can't hurt and might even help other sufferers :)

Writeoff said on 27 September 2009

Can the swine flu vaccine be given at the same time as other vaccines?

Yes. The swine flu vaccine can be given at the same time as other vaccines, including the seasonal flu jab.

From Pandemrix Summary of Product Characteristics:

4.5 Interaction with other medicinal products and other forms of interaction

Pandemrix should not be given at the same time as other vaccines. However, if co-administration with
another vaccine is indicated, immunisation should be carried out on separate limbs. It should be noted
that the adverse reactions may be intensified.

There appears to be a contradiction here.

lauray99 said on 17 September 2009

Does anyone know what to do If you lose the unique authorisation code for tamiflu?
I have flu symptoms, and work in a school. I did the online symptom checker and got an ID, but then my computer crashed. I re-did the checker and it said I had already been issued with tamiflu so I cant have any. I rang the help desk and they just said I needed to know my temperature otherwise they couldnt tell me anythin???

I need the tamiflu collection number? please help!!!

ss55 said on 16 September 2009

I had to collect Tamiflu for my sister . I was bewildered as to the collection points for Merseyside. There were 3 collection points in Liverpool and 1 on the Wirral. All 3 Liverpool collection points were a minimum of 36miles return journey. I have a car but it would not be possible to get to any of these places by public transport. A city centre collection point is also needed for people without a car as most people can get public transport into the centre. I would have driven any distance to help my sister but some people are not as fortunate. I think this needs to be addressed.

bevliz said on 16 September 2009

Last Saturday my 4 year old son became extremely ill, with sudden cough, high temperature, body aches etc, I telephoned my gp out of hours medical service for advice. I was shocked to be told a doctor would not see my son and I was passed on to the flu pandemic line, I expressed my concerns and said he's only 4 surely he should be seen by a doctor. Eventually someone did ring me back and said contact them again if his symptoms changed. The swine flu line dispensed tamiflu. Later that day we could not get my sons temperature down and he started with green dioreah, so i rang the doctors again. They were reluctant to see him, but after much persuasion they agreed. The doctor examined him and said it was tonsilitis, and gave him some antibiotics and we were told not to give him tamiflu. Two days later we got a call to say that over 20% of the children in his school were ill with what looked like swine flu so they were going to come out and take swabs. In the meantime I caught the virus my son has off him, and there is no way it was tonsilitus. I have never felt as isolated, usually if you are ill you go and see your gp but if you have swine flu they don't want to know. Please High up people in the NHS the system isn't working, people need to be able to see a GP for a firm diagnosis especially when children are involved.

Deb M said on 12 September 2009

I was given my unique number for Tamiflu, only to discover the only pharmacy given stocks of Tamifllu is in the out of town ASDA, so if you and your family don't own a car you can't get Tamiflu in my town. What idiot thought this one through, surely it would be more sensible to give the license to one of the central pharmacies in the town centre.

MGMcC said on 08 September 2009

I am really unsure if i should be back in work.

i developed symptons over a week ago at the same time as my partner, after both coming home from work we arranged to receive tamiflu via the website.

We finished the tamiflu yesterday and i am now back in work. I am suffering from quite severe exhaustion and am wondering if this is the effects of the swine flu or the tamiflu? Also, should i still be off work or am i ok to come back in?

i have had some sort of symptoms a few days shy of 2 weeks now!

Nunes said on 29 August 2009

hi..
im looking for a number of cases in the world and in UK, and if in UK have 12 957 (+/-), so i don't understand how on news 3 weeks ago hatch 100 000 new cases in UK, or last week were 11 000 cases and this week 5000. What is the exacly number of cases in UK?? and the world??

Peter48 said on 24 August 2009

Informative site- however I have an observation. When we were in Thailand nearly all public sector workers- airports, transport, security, shops, - and many ordinary people incuding kids were wearing face masks ; are we really saying that all our Far Eastern friends are mistaken in this

Their approach seems far more rigorous - they have free alcohol rub in the shopping malls/ supermarkets which is ideal where you have loads of handrails on escalators etc Schools were often closed immediately on first outbreak and fully scrubbed down.

In the UK yes we have the drugs ready but are we lax about public places - take schools/colleges - what measures will they take this Autumn - will cleaners be instructed to clean everything like door handles.

A lot of education will want to seek an easy way out ; they will not want disruption its up to authorities to bear down on schools. How will primary kids be taught to clean hands etc., How long should they be kept at home etc.,

dweenz said on 21 August 2009

For those who are asking about 'undoing' their antiviral medicine:

If medication has been given to you in the form of a capsule; you should not burst the capsule or chew it unless told to do so by your GP or other appropriatley qualified medical professional. This is because capsules are designed to break down at specific stages in the digestive system as per which the medicine works best. Depending on what the medicine is, the capsule will be designed accordingly so all capsules for all medicines will not always be the same.

By breaking the capsule before administering the medicine, you may well be reducing or increasing the effect from a medicine. You should always check with your pharmicist or GP before doing this as you may even cause the antivirals to be less beneficial or inneffective.

If you have a significant difficulty in swallowing your capsules; you may be able to recieve treatment through the administration of another antiviral medicine such as Relenza; which is inhaled instead of swallowed.

It would certainley be worth discussing this with your GP if you are experiencing a real difficulty with your current medication.

I hope this is of some help and get well soon.

kazzatink said on 21 August 2009

well i came on here to find out if I should ring the GP as if you ring and dont really need to the receptionist is a grumpy mare. I have lots of flu like symptoms. Aching muscles, runny nose, sore throat, headache, upset stomach but do not have a temperature. as soon as you say no temperature all it says is you don't need tamiflu. Not that it isnt flu.

Milliemuffin said on 18 August 2009

I’m so frustrated!! Even on this entire page it does not tell you the difference between swine flu and seasonal flu! It says a lab test can be done but how are people being diagnosed with swine flu if they are so similar? Surely less than half/less than quarter/less than a third?? Of those diagnosed just have seasonal flu???

jeanius said on 18 August 2009

If you think you have Swine Flu try to get someone else to telephone the help line for you. I phoned for myself and felt so confused and distressed I copied the number down that they gave me to take to the collection point incorrectly, even though I read it back to the person on the phone. When my husband went to collect Tamiflu they said there were not enough digits in the number and to ring the helpline again. They couldn't/wouldn't check the number with him on the helpline, couldn't give him a new number either. So three visits to the pharmacy, two to the doctor's surgery and five phone calls later I am on Tamiflu. All this took four and a half hours and who knows, I may not have swine flu anyway.

alruwais said on 16 August 2009

I was interested in the person who commented that her dog had displayed flu like symptoms; so has mine in the last 2 or 3 days since I have developed severe fatigue, aching, chills and so on - might have swine flu I suppose! Dog is sneezing and coughing, though eating as normal and wants her walks!
IS THIS SWINE FLU - or some other weird virus?
Also, my GP surgery was remarkably casual when I reported my own symptoms. "Oh, can you get along to the surgery?" !!!!????
(a) I felt much too poorly and (b) that is exactly what we were told NOT to do......
Typical British muddle, this whole pandemic. And I'm not taking Tamiflu or anything else, albeit I am 68 on Saturday!

concernedj said on 13 August 2009

The following 2 Qs on the Q&A page 13/08/09 may contradict each other...1.How long are symptoms expected to last? As with any sort of flu, how bad the symptoms are and how long they last will vary depending on treatment and individual circumstances. Most cases reported in the UK to date have been relatively mild, with affected people <<starting to recover within a week>>.When are people most infectious? ...2. People are most infectious soon after they develop symptoms. They can continue to shed (spread) the virus (for example, in coughs and sneezes) for <<up to five days>> (seven days in children). People become less infectious as their symptoms subside, and once their symptoms are gone they are no longer considered infectious to others.

Johnson's Baby said on 11 August 2009

My immune system isn't that good as I have had the lymph nodes in one armpit removed (standard breast cancer treatment). I have lympheodema as a result but I've not been able to find out if this means I'm in a high-risk category or not. Anybody know?
BTW, what happened to my previous comment? Which was that the advice to "see" your health professional if you get side-effects from Tamiflu is not very good as the whole point is to keep people away from the doctor's, isn't it ?

Gabriel's mummy said on 09 August 2009

I have a five months old baby and I have been searching for information about what I should do if my baby gets it and the more scarey question "do babies recover from the flu or are they more likely to die?" The only answer I seem to get is "babies are more at risk". How many babies under one year have survived? Basically that's what I want to know.

Flora_uk said on 07 August 2009

I first got symptoms last monday tempreture of 103.6f ached all over and had the chills by Tuesday morning tempreture had gone up to 104.6 and my throat felt like it was closing up it was very sore and the glands in my neck were also up, after phoning the pandemic help line my husband was able to get me tamiflu which as I was unable to swallow them because of the swollen throat I have been undoing them, as was suggested in the the directions contained in the box. It's only been 4 days of taking the tamiflu but I feel much better now still indoors though still got a bit of a sore throat but everthing else gone.
Have hope all those who catch it, no matter how bad you feel now it will get better. good luck

Marta1515 said on 04 August 2009

As everyone else I got estimated diagnoses of swine flu over Pandemic-Flu website. In other countries it is established by having mouth or nose swab and sending it to a special lab to test. I think our kind of estimated diagnoses adds up the number of ill cases in country.
Have I really had swine flu? Who knows? Certainly first time in my 51 years, I came down with flu in summer.
Around 4 pm last Tuesday I got sudden persistent cough. At the beginning I thought it would go away. But then I started to feel unwell. I took temperature it was 38C. Cough was so persistent, that I had difficulty of breathing; however I haven’t got any heart conditions. Next morning I woke up having sore throat, achy body, tummy pain and full package of traditional flu symptoms. I lost appetite, couldn’t even drink water; temperature was 38.5C-38.7C throughout day. When I took first tablet of Tamiflu, some hour later, tummy pain, disappeared, but other symptoms remained for another 4 days. On third day I developed pain in my face and left side of my nose. Affected got all left side of my face, up to the eye, it felt numb; nose got covered in sores from inside and outside. Also gum in my mouth got swollen, almost as with dental pain. I was worried, called GP and asked for antibiotics, which I was prescribed; my son collected those for me.

My temperature finally has gone, and symptoms have improved. But my son, 18 today got ill; got high temperature, was vomiting. I am worried that I could get ill again, because last winter I came down with flu or cold three times. Twice, when I was ill, I past flu onto my son, and then I got it back again.

Smurfette78 said on 03 August 2009

I have recently recovered from swine flu, I finished my course of Tamiflu las Wednesday. In answer to all the questions about what would happen if someone catches it a second time, I believe we should have a certain amount of immunity, as Tamiflu can be given as a preventative measure aswell as to treat it! Also, just like an injection (which gives you a small amount of an illness to create antibodies) we have the antibodies to fight it, even if it does mutate, we have a basis. We also have to remember that the media can be scaremongers, for all the people who have died there are millions of people who have survived!!!!!!!! Hope this makes you all feel a bit better about the situation. And to all those suffering with the dreaded flu at the moment, I WISH YOU WELL!!!! : )

don123 said on 03 August 2009

i would like to no what happens to people who cant swallow tablets i know quite a few people who cant swallow tablets whole can tamiflu be undone and put on a spoon im really worried bout this as none of my family have been able to take tablets and always have liquid medicine from yhe docs please answer

DawnS said on 02 August 2009

I'm looking at this site again today for advice as I have been off work since last Tuesday and taking Tamiflu since last Wednesday as I was advised I was suffering from Swine Flu. It's now 5 days since I developed a sore throat, muscle aches, headache, hot and cold sweats and an inability to stay awake. Being intent on returninging to work tomorrow Monday, I pushed myself to go out yesterday to see how I'd cope. I felt dreadful on returning home and realise now I shouldn't have gone out. Problem is everyone is saying that you should be starting to feel better after 5 days. I still have a headache, muscle aches, stiffness across my neck and shoulders, sore throat and I'm still just wanting to sleep al the time. Do I return to work tomorrow with these symptoms, am I still infectious as long as i have these symptoms. Do I go to my doctor's now or should I still stay away from the surgery, If I should stay away from work until I feel better, will I get a sick note and if so where?????? I was hoping this site would answer some of these questions for me but it doesn't. I'm confused!

George Hale said on 31 July 2009

I can't get through on the phone to my surgery under normal conditions, never mind in the middle of a flu pandemic, so I certainly hope I manage to avoid infection.

stuckindoors said on 30 July 2009

My experience is as follows: I didn't feel very good at a concert I attended 11days ago when I had developed a fever seemingly out of nowhere but the symptoms seemed to go so I went on with normal routine, going to work, going out, seeing friends etc. Then on Thursday I developed a dry cough. I then took the day off on Friday as was really achy and by Friday evening had all the classic symptoms: runny nose, fever, cough, muscle pain et al. Feeling very poorly over the weekend and after phoning up my surgery's out of hours service was diagnosed as having 'suspected' Swine Flu' and prescribed Tamiflu on account of being an asthma sufferer . My friend brought it round for me the following morning. So far I know of at least 3 friends who have had it plus children of people in our office have come down with it and now a few of them are off as well. Its spreading like wildfire! I have to say however that in my experience unpleasant though the symptoms have been it has been nowhere near as bad as the last time I had proper seasonal flu back in 1994 when I was bedbound for 3 weeks and really quite ill. Finally Elly83 it might just be a good idea to get your gp to prescribe you a course of antibiotics to sort out your tight chest as the same thing happened to me.

David Phillips said on 29 July 2009

Regarding the question "Is it possible to catch swine flu twice?"
The answer above states "Yes, because the virus can mutate (change). " But it hasn't, so actually, the answer is no - or at least, "not yet."

The answer given is opening the door to employees claiming to have the virus a second time and take additional time off work. It also implies that the virus has mutated. Please correct this and clear up the confusion.

jue.v said on 29 July 2009

I have to say it was incredibly easy to get the Tamiflu for my poorly 4 year old son, which is great.
My main concern is one shared with many others on here. If this is the only lot of Tamiflu my son can have, what happens if he catches Swine flu during autumn/winter again? It says on here somewhere on here that the winter version may be a bit more agressive than the one around at the moment - does that mean my son will not get Tamiflu when he is most likely to need it?
I think this question will keep arising and reassurances need to be made, especially where the 'most at risk groups' are concerned.
I have real concerns about whether I am making a good choice in giving him the Tamiflu if this is the only one he is going to get.

Catherine1979 said on 28 July 2009

I started showing symptoms of swine flu on Sunday, which became progressively worse through the night. My boyfriend accessed the National Pandemic website that has been set up, entered my details and hey presto - it was confirmed that I had swine flu. A code was then given for collection of Tamiflu at the local pharmacy. The following day, he went to collect the Tamiflu only to be told that the Tamiflu code was incorrect. He then telephoned the helpline who could not confirm the correct code, or in fact be of any help whatsoever. The pharmacist (very kindly) stayed open late whilst they tried to sort this out. In fact, earlier in the day this had happened to someone else at the pharmacy who was able to call the helpline and obtain their code. My boyfriend left the pharmacy empty-handed.

Having heard about this, I called the helpline twice to explain the situation and seek advice. They simply said they cannot re-issue another code (which is not what i was asking for). They could not verify the code I was given, or be of any help. I expressed my concern that only one dose is being allocated per person, and effectively I will be deemed as having had mine when I have not been able to collect it! I spoke to a supervisor there who could not offer any explanation and was rude in the process - not great when you feel unwell. They suggested I contact NHS direct which I duly did (with hesitation given that I know that they are swamped at the moment). Of course, NHS direct had no idea why I had been directed to them - they could not help. So I am in a losing situation.

I just wanted to highlight this ridiculous situation and wondered if anyone else had experienced this incompetency? I am extremely concerned that resources are not being used effectively and luckily, I am not in a high risk group, nor do i have underlying health problems etc. I hope those at risk do not experience a similar situation to mine.

Take care and get well to those affected.

edha said on 28 July 2009

my son has had a dry cough and a sore throat for about a week and a few nights ago developed a tempreature of 37.9c. I phoned the swine flu helpline to ask whether it is swine flu and they advised me that it 'probably ' was. He was given a course of tamiflu for five days in tablet form even though he is only five. I have recently found out that everyone is only given the antiviral once. I am now worried in case he was misdiagnosed and may develop it later on in the year and be refused any antivirals. My two other children have now got sore throats and tempreatures of about 37 c and I am treating the them with paracetamol. I am worried to call the swine flu helpline in case it is not swine flu and they would have had their share of anitvirals even though they might not have needed them. What should I do? Will children be given more antivirals come winter ? Will they be a priority in recieving the flu jab?

Elly83 said on 28 July 2009

I am 26 years old and have had most of the symptoms of swine flu for approximately ten days now. I rang the NHS pandemic flu service only last Saturday though as I didnt want to take antivirals for symptoms which may not have been the flu. The operator I spoke to was unfortunately unable to speak or read English very well, and I could just about understand the questions she was asking me as she attempted to read through the list. She was very nice, but the effort and time it took for us to comprehend eachother was outrageous, and as I was quite tight-chested it was even more difficult- I'd have been seriously worried if I were at the point of needing immediate medical attention, or if English wasn't my first language. She finally confirmed that I would be given the antivirals.
The assessment system seems to be quite inconsistent, as others I have heard of or read about with similar symptoms have been told they don't have swine flu and not given Tamiflu. I can't understand why two people would be treated differently if the only assessment done is over the phone by an untrained operator using a checklist of symptoms- surely that is a waste of time and resources? Not to mention the antivirals themselves? Im on day 4 of my course of Tamiflu and I'm starting to feel better, but I would hate to think that I had used up a course of antivirals that someone who has been medically confirmed as having swine flu could have used, or wasted my own quota if I had something else.
At the moment my chest is still incredibly tight and painful, so if this hasn't improved in the next day or so, I'm faced with contacting my Doctor to find out what to do next, and the prospect that I may have wasted resources that may have been put to better use- I wonder how many others are in the same situation?
Lastly, I would just like to say that the 'experience' I've had of swine flu, whilst unpleasant and uncomfortable, is just like any other flu. Lots of fluids and rest! Feel better soon all!

CFinucane said on 30 April 2009

Thanks for all your comments, which have been taken on board.

This Q&A page is developing and new content added all the time.

Information on pregnancy and children will be added very soon.

Caroline Finucane
Editor, Treatments and Conditions

Swine flu Q&A

The basics

Transmission

Vaccination - general

Vaccination and pregnancy

The second stage of the vaccination programme – young children and carers

National Pandemic Flu Service

Pregnancy and children

People with long-term conditions

Antivirals

Caring for yourself at home

Antibiotics

Older people

Actions

Travel and holidays

General questions