Welcome to the State of California 
H1N1 Health Banner
 

This Web page is no longer being maintained or updated; it is provided for historical purposes only. For current information on seasonal influenza (flu), see the California Department of Public Health Influenza Web page.

 H1N1 Frequently Asked Questions

02 H1N1 Flu Disease FAQs (Treatment)

  • 02.01 What should I do if I think I have H1N1 flu?
  • 02.02 Should I go to my doctor if I think I have H1N1 flu?
  • 02.03 When should I seek emergency or immediate care for a person with H1N1 flu?
  • 02.04 New guidelines for use of antivirals in an H1N1 pandemic were recently released. How much antiviral drugs are available in California?
  • 02.05 What over-the-counter or commercially available medications help to lessen symptoms of H1N1 flu?
  • 02.06 Can I give aspirin (acetylsalicylic acid) to children or teenagers who have the flu?
  • 02.07 Do antiviral medications like Tamiflu work?
  • 02.08 Who should get antivirals like Tamiflu?
  • 02.09 Do we have enough supplies if hospitals are overwhelmed?
  • 02.10 Do we have enough ventilators?
  • 02.11 How are antivirals used to treat H1N1 flu different from the H1N1 vaccine?
  • 02.12 What are the treatment benefits of influenza antiviral drugs for people with H1N1 or other flu illness?
  • 02.13 What are the side effects of antiviral drugs in children with H1N1 flu or other types of flu?
  • 02.14 Are H1N1 influenza viruses resistant to oseltamivir (Tamiflu)?
  • 02.15 What is Peramivir for treatment of influenza in patients who are admitted into the hospital? 
  • 02.01 What should I do if I think I have H1N1 flu?

    If you are sick, you should stay home and avoid contact with other people as much as possible so you don’t spread your illness to other people. So far, most cases of the H1N1 flu in the United States and Canada are similar to seasonal flu.

    If you come down with flu-like symptoms and you have an underlying medical condition, like a respiratory condition or immune disorder, are pregnant, or have other risk factors for complications from the flu, call your healthcare provider. Your healthcare provider will be able to determine if influenza treatment is needed.

    If you are having flu-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting and diarrhea, you may want to call your health care provider. Your health care provider will be able to let you know if influenza testing or treatment is needed.

    If you are sick and start experiencing any of the following warning signs, seek emergency medical care.

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

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash
  • In adults, emergency warning signs that need urgent medical attention include:

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting

  • 02.02 Should I go to my doctor if I think I have H1N1 flu?

    If you are having flu-like symptoms, including fever of 100.4 degrees Fahrenheit (oral temperature) or 101.4 degrees (rectal temperature) or greater, cough and/or sore throat, nausea, or vomiting and diarrhea, you may want to call your health care provider. Your health care provider will be able to let you know if influenza testing or treatment is needed.

    If you come down with these flu-like symptoms and you have a chronic medical condition like lung disease (such as asthma or chronic obstructive pulmonary disease), are pregnant, are less than 2 years of age, are on long-term aspirin therapy (and less than 19 years),  or have problems with you immune system, you should contact your doctor.

    02.03 When should I seek emergency or immediate care for a person with H1N1 flu?

    In children, emergency warning signs that need urgent medical attention right away include, fast breathing or trouble breathing, bluish or gray skin color; not drinking enough fluids, not waking up or not interacting, being so irritable that the child does not want to be held, flu-like symptoms improve but then return with fever and worse cough or fever with a rash.

    In adults, emergency warning signs that need urgent medical attention right away include difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen (stomach), sudden dizziness, confusion or severe or persistent vomiting.

    02.04 New guidelines for use of antivirals in an H1N1 pandemic were recently released. How much antiviral drugs are available in California?

    CDPH has 3.7 million treatment courses of antiviral medications stored at the state and local levels. In addition, the federal government has 5.3 million courses specifically designated for California.

    02.05 What over-the-counter or commercially available medications help to lessen symptoms of H1N1 flu?

    If you have flu-like symptoms, you can purchase the following medications, which are available at your local drug store or pharmacy. These generic drugs are commonly identified by their brand or over-the-counter name:

  • Acetaminophen is identified as Tylenol;
  • Ibuprofen is identified as Advil, Motrin or Nuprin; and
  • Naproxen is identified as Aleve.
  • Call your doctor if you are pregnant before taking over the counter medications.

    If you are sick, call your doctor. Flu can lead to, or occur with, bacterial infections. Therefore, some people will also need to take antibiotics (drugs that kill bacteria) if they have more severe or prolonged illness or an illness that seems to get better but then gets worse again.

    02.06 Can I give aspirin (acetylsalicylic acid) to children or teenagers who have the flu?

    Do NOT give aspirin (acetylsalicylic acid) to children or teenagers who have influenza (flu). This can cause a rare but serious illness called Reye's syndrome. For more information about Reye's syndrome, visit the National Institutes of Health website.

    Take the following steps to safely treat children or teenagers with the flu:

  • Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.
  • Teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin, Nuprin), to relieve symptoms. 
  • Children younger than 2 years of age should not be given over-the-counter cold medications without first speaking with a doctor. 
  • The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.
  • Fevers and aches can be treated with acetaminophen, ibuprofen, or nonsteroidal anti-inflammatory drugs (NSAIDS).
  • Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. Importantly, these medications will not lessen how infectious a person is.
  • Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications. Don't double dose! Patients with kidney disease or stomach problems should check with their doctor before taking any NSAIDS.
  • Check with your doctor or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu.
  • 02.07 Do antiviral medications like Tamiflu work?

    Antivirals can be effective if used early in the course of illness, but if overused or abused, viral resistance can develop.  Antivirals are called for in people at high risk of influenza complications, like pregnant women and health care workers.  Typically, antivirals are most effective if administered within 48 hours of the onset of symptoms to be effective.

    02.08 Who should get antivirals like Tamiflu?

    Those who should get antiviral medication as early as possible are those are showing symptoms of flu and who are in high risk groups including:

  • Pregnant women and women up to 2 weeks postpartum 
  • Children younger than 2 years old
  • Persons aged 65 years or older
  • Children and adults with underlying medical conditions, such as heart problems, diabetes, lung disease, neuromuscular disease, or immunosuppressive conditions
  • Persons younger than 19 years of age who are receiving long-term aspirin therapy.
  • In addition, persons with suspected or confirmed influenza that are hospitalized are also recommended to receive antiviral treatment.

    Persons at higher risk for influenza-related complications who have had close contact with someone likely to have had influenza may be considered for antiviral chemoprophylaxis but early treatment is an emphasized alternative after such an exposure. 

    02.09 Do we have enough supplies if hospitals are overwhelmed?

    California stands ready to make available emergency supplies — masks, respirators, ventilators, mobile field hospitals and alternate care site equipment. California has already provided respirators to local health departments for distribution to health care facilities that need them.

    02.10 Do we have enough ventilators?

    California has a cache of 2400 ventilators for use on patients who may be having trouble breathing due to serious flu. This emergency supply is in addition to the thousands of ventilators in everyday use in hospitals across the state.  When California purchased the ventilators in 2006, it automatically doubled the state supply.

    02.11 How are antivirals used to treat H1N1 flu different from the H1N1 vaccine?

    Antivirals are medications that are used to treat someone who is sick because of a viral (virus) infection. Vaccines are shots that are given to prevent disease before the onset of illness.

    02.12 What are the treatment benefits of influenza antiviral drugs for people with H1N1 or other flu illness?

    When started within 2 days after becoming sick with influenza, antiviral drugs can reduce the severity of flu symptoms and shorten the time you are sick by 1 or 2 days.

    They may also prevent serious flu complications.  Antiviral drugs may be especially important for people who are very sick (hospitalized) or people who are at increased risk of serious flu complications, such as pregnant women and women up to 2 weeks from end of pregnancy, young children, and those with chronic (long-term) health conditions.

    You should know that viral shedding can continue for a few days after treatment starts. This may cause antiviral-resistant viruses to emerge. If you're taking antiviral drugs, you still need to closely follow hand and cough hygiene recommendations to avoid spreading the flu to others.

    02.13 What are the side effects of antiviral drugs in children with H1N1 flu or other types of flu?

    Reported side effects of oseltamivir (Tamiflu) are nausea and vomiting. Among children treated with oseltamivir in clinical studies, 14 percent had vomiting, compared with 8.5 percent of children given a "placebo." A placebo is an inactive substance that looks the same as, and is given in the same way as a drug in a clinical trial. Nausea and vomiting might be less severe if oseltamivir is taken with food.

    Also, there have been reports of self-injury or delirium among persons with influenza (flu) who take oseltamivir.  Most of these reports have been in teenagers from Japan.  It's still not certain whether oseltamivir or the flu virus was responsible for these behavior changes.

    Side effects from zanamivir (Relenza) have been reported in fewer than 5 percent of people participating in clinical trials. This is the same rate for people receiving a placebo. Reported side effects are diarrhea, nausea, sinusitis, nasal signs and symptoms, bronchitis, cough, headache, dizziness, and ear, nose, and throat infections.   Also, zanamivir should not be used in people with underlying respiratory disease, including asthma.

    The United States Food and Drug Administration (FDA) advises that people taking either of the 2 medications recommended for seasonal or H1N1 flu be monitored closely for abnormal behavior.

    02.14 Are H1N1 influenza viruses resistant to oseltamivir (Tamiflu)?

    A small number of patients worldwide have been infected with a H1N1 influenza (flu) virus that is resistant to the antiviral drug oseltamivir (Tamiflu). To date, the oseltamivir-resistant viruses have been sensitive to zanamivir (Relenza). At this time, CDC continues to recommend the use of oseltamivir or zanamivir to prevent or treat H1N1 infection.

    The illnesses caused by oseltamivir-resistant viruses have been similar to those caused by oseltamivir-sensitive viruses. CDC continues to monitor H1N1 flu viruses for antiviral resistance. Among the 202 H1N1 viruses from the U.S. tested by CDC this year, none have been resistant to oseltamivir.

    02.15 What is Peramivir for treatment of influenza in patients who are admitted into the hospital?

    Peramivir is an investigational intravenous (IV) antiviral drug used to treat patients admitted to the hospital with severe influenza infection. Peramivir is an investigational drug, meaning it has not yet been approved for use by the Food and Drug Administration (FDA).
    There are other antiviral drugs used to treat H1N1 influenza that are taken orally (Tamiflu) or inhaled (Relenza).  But, there are no FDA-approved IV drugs to treat patients seriously ill with H1N1 influenza.  However, because of the public health emergency caused by the 2009 H1N1 pandemic, the FDA recently issued an Emergency Use Authorization (EUA) to allow the use of Peramivir to treat certain patients who have severe illness. Peramavir is to be used only for patients who are unable to take other antiviral medications orally. It's not intended to be used for patients who do not require hospitalization. Healthcare providers must get special permission to use this drug on patients.

     

    California Department of Public Health, Office of Public Affairs

    Updated 12/07/09


     
     
    Last modified on: 8/26/2011 12:49 PM