Monday, April 27, 2009

CDC's latest travel precaution

Travel Health Precaution
Swine Influenza and Severe Cases of Respiratory Illness in Mexico
This information is current as of today, April 27, 2009 at 13:43

Updated: April 26, 2009

Revised April 26 9 a.m. to reflect updated guidance on antiviral use in travelers.
Current Situation

Since March 18, 2009, the Government of Mexico has reported an increase in the number of cases of influenza-like-illness. occurring in several areas of Mexico. Please visit the website of the World Health Organization, for further details about these cases.

CDC has confirmed that seven of 14 respiratory specimens from patients sent to the CDC by the Mexican National Influenza Center are positive for swine influenza virus and are similar to the swine influenza viruses recently identified in the US.

CDC and state public and animal health authorities are currently investigating 20 cases of swine flu in humans in California, Texas, Kansas, Ohio, and New York City. Some of the US cases have been linked to travel to Mexico. At this time only two of the 20 cases in the US have been hospitalized and all have recovered.

This investigation is still in the early stages. Further updates to this investigation and any related travel recommendations will be posted on www.cdc.gov/travel when available.
CDC Recommendations

CDC has NOT recommended that people avoid travel to Mexico at this time. If you are planning travel to Mexico, follow these recommendations to reduce your risk of infection and help you stay healthy.
Monitor the International Situation

Check updates from the:

* Centers for Disease Control and Prevention
* Secretaria de Salud
* World Health Organization

Prepare for your trip before you leave

* Visit CDC's Travelers’ Health Website to learn about any disease risks and CDC health recommendations for areas you plan to visit.
* See a travel medicine specialist or a doctor familiar with travel medicine at least 4–6 weeks before you leave to answer your questions and make specific recommendations for you.
* Antiviral Medications: Travelers from the US going to Mexico that are at high risk of severe illness from influenza (for example persons with chronic conditions such as diabetes, lung disease, heart disease, and the elderly) are recommended to take antiviral medications for prevention of swine influenza during travel. The recommended antiviral drugs for swine influenza are oseltamivir (brand name Tamiflu®) and zanamivir (brand name Relenza®). Both are prescription drugs that fight against swine flu by keeping flu viruses from reproducing in your body. These drugs can prevent infection if taken as a preventative. Talk to your doctor about correct indications for using influenza antiviral medications. Always seek medical care if you are severely ill.
* Antiviral chemoprophylaxis (pre-exposure or post-exposure) is recommended for the following individuals:
1. Household close contacts who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) of a confirmed or suspected case.
2. School children who are at high-risk for complications of influenza (persons with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed or suspected case.
3. Travelers to Mexico who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).
4. Border workers (Mexico) who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).
5. Health care workers or public health workers who had unprotected close contact with an ill confirmed case of swine influenza A (H1N1) virus infection during the case’s infectious period.
* Antiviral chemoprophylaxis can be considered for the following:
1. Any health care worker who is at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) who is working in an area with confirmed swine influenza A (H1N1) cases, and who is caring for patients with any acute febrile respiratory illness.
2. Non-high risk persons who are travelers to Mexico, first responders, or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection.
For more information on CDC's recommendations for antiviral use during the swine flu outbreak, please visit www.cdc.gov/swineflu.
* Be sure you are up-to-date with all your routine vaccinations, including seasonal influenza vaccine if available.
* Pack a travel health kit that contains basic first aid and medical supplies. See Pack Smart in Your Survival Guide to Safe and Healthy Travel for a list of what to include in your travel health kit.
* Identify the health-care resources in the area(s) you will be visiting.
* Check if your health insurance plan will cover you abroad. Consider purchasing additional insurance that covers medical evacuation in case you become sick. For more information, see Medical Information for Americans Traveling Abroad from the U.S. Department of State.
* Remember that U.S. embassies, consulates and military facilities do not have the legal authority, capability, and resources to give medications, vaccines or medical care to private U.S. citizens overseas.

During your visit to an area affected by swine flu
Monitor the local situation

* Pay attention to announcements from the local government.
* Follow local public health guidelines, including any movement restrictions and prevention recommendations.

Practice healthy habits to help stop the spread of germs

* Wash your hands often with soap and water. This removes germs from your skin and helps prevent diseases from spreading.
o Use waterless alcohol-based hand gels (containing at least 60% alcohol) when soap is not available and hands are not visibly dirty.
* Cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a wastebasket.
* If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands.
* Wash your hands after coughing or sneezing, using soap and water or an alcohol-based hand gel.
* Follow all local health recommendations. For example, you may be asked to put on a surgical mask to protect others.

Seek medical care if you feel sick

* If you are ill with fever and other symptoms of swine flu like cough and sore throat, see a doctor, especially if you think you may have had contact with someone with swine flu or severe respiratory illness in the past 7 days before becoming ill.
* If you need to find local medical care while in Mexico, a U.S. consular officer can help you locate medical services and will inform your family or friends in the United States of your illness. To contact the U.S. Embassy or consulate in Mexico, call the Overseas Citizens Services at:
o 1-888-407-4747 if calling from the U.S. or Canada
o 00 1 202-501-4444 if calling from overseas
o US Embassy in Mexico

* See the information on the page “Know What To Do if You Become Sick or Injured on Your Trip" to help you.
* You should avoid further travel until you are free of symptoms, unless traveling locally for medical care.

After you return from Mexico

* Closely monitor your health for 7 days
* If you become ill with fever and other symptoms of swine flu like cough and sore throat and possibly vomiting and diarrhea during this period, call your doctor or clinic for an appointment right away. Your doctor may test you for influenza and decide whether influenza antiviral treatment is indicated.
* When you make the appointment, tell the doctor the following:
o Your symptoms,
o Where you traveled, and
o If you have had close contact with a person infected with swine flu.
* Avoid leaving your home while sick except to get local medical care, or as instructed by your doctor. Do not go to work or school while ill. If you must leave your home (for example, to seek medical care) wear a surgical mask to keep from spreading your illness to others.
* Always cover your nose and mouth with a tissue when you cough or sneeze. Throw away used tissues in a trash can.
* Wash your hands with soap and water often and especially after you cough or sneeze. If soap and water are not available, use an alcohol-based hand gel containing at least 60% alcohol.
* Avoid close contact with other people as much as possible.
* Wear a surgical mask if you are in contact with other people.

Additional Information

If you have specific questions about the swine influenza cases see http://www.cdc.gov/contact/ or call 1-800-232-4636, which is 1-800-CDC-INFO.

To learn more about travel health, visit www.cdc.gov/travel.

For the swine Influenza situation in Mexico, visit:

* Secretaria de Salud: Secretary of Health, Mexico [Web page in Spanish]
* World Health Organization: Influenza-Like Illness in the United States and Mexico
* Pan American Health Organization

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