1. Keep germs away from your mouth and nose. H1N1 spreads just like the flu, so wash your hands often. Use soap and warm water for 15-20 seconds. Scrub your fingernails, get in between your fingers, and don’t forget your wrists.
2. Keep alcohol-based hand sanitizer nearby in case you need to cleanse. Even a week after swine flu symptoms are gone, sufferers can still spread the virus. H1N1 may live on objects for up to 8 hours after being touched.
3. Follow the basic rules of cleanliness. Wash your hand before you eat. Sanitize often and avoid touching your mouth and nose. If you catch the swine flu, stay at home. Cough into your elbow and sneeze into tissues, then sanitize.

And you can’t always tell who’s infected. H1N1 is shed, “or excreted, to use a tackier term,” says Dr. Schaffner, in its highest concentrations the day before an individual gets really sick, mostly by traveling on the droplets that are spewed when someone coughs or sneezes.

The volume of shed virus begins to diminish thereafter, he says, but a person can still pass the germ along until 24 hours after symptoms disappear and his or her fever goes away. So if you’re sick, it’s important to stay home until symptoms improve. And if there’s a serious outbreak in your community, you might want to consider cutting out trips that aren’t really necessary. But if you know how to handle yourself at the grocery store, on the bus, or even at the World Series, you can do little things to lower your risk of catching H1N1 without turning into a complete hermit. (If you can get a flu shot, do that too.)

Even as H1N1 circulates, life goes on. Here are ways to lower your risk of catching the illness in common public settings:

#1: In movie theaters. The average big-screen movie theater has between 200 and 300 seats, and with today’s megaplexes including as many as 26 theaters per venue, that could mean upwards of 8,000 people in one building on a crowded Saturday night, many of whom may be actively shedding the virus without knowing it.

Strategy: Reschedule. First, ask yourself if seeing a blockbuster on opening night is worth the risk of H1N1. “During a season such as this, perhaps it’s better to rent a movie rather than going to a theater,” says Dr. Schaffner. Should you decide that you can’t stand another minute at home, head to the theater when you know crowds will be lightest. At the very least, you can maintain the optimum three to six feet—that’s the distance needed to prevent swine-flu transmission—between you and other potentially sick moviegoers. And wash your hands for a full 15 seconds when you head to the bathroom, or take a hand sanitizer with you. Most people avoid or minimize hand washing in the rush to return to their seats so they don’t miss anything.

#2: On an airplane. Unfortunately, if you wind up sitting next to an H1N1 patient, options are limited, says David Ellington, MD, director of the American Academy of Family Physicians. “Your major defense [against H1N1] is avoidance, and if you’re sitting right next to someone who’s coughing and hacking all over you, that’s a very tough situation.”

Strategy: Change seats. You can turn your head away from your seatmates so you’re not directly inhaling their breath and the droplets from their coughing. But if you’re lucky enough to be on an airplane that has a few empty seats, you can ask to move. If you can get at least six feet away from the offending individual, you stand a better chance. Wearing a flu mask during your flight may or may not shield you—outside of home or hospital, research on their effectiveness in real world situations is lacking. If you decide to go that route, you need to keep it tight on your face and wear it consistently to gain protection. Better yet, ask the cougher in question to wear the mask. Yeah, we know, good luck with that. But in home settings at least, research shows the infection is less likely to spread if the sick person wears a surgical-type mask.

#3: While grocery shopping. According to the Centers for Disease Control and Prevention, the H1N1 virus can live on surfaces for two to eight hours. So it would stand to reason that all those manhandled grocery carts would be prime vectors for spreading swine flu. Tests on those shopping carts have turned up everything from fecal bacteria from diapered baby bottoms to E. coli and Salmonella from raw meat, so it isn’t a stretch to assume that they could be swine-flu carriers as well.

Strategy: Wash and wipe. Your best defense is to keep your hands away from your face (and your children’s faces) while you’re at the store, and wash your hands immediately after getting home. (Keep your shopping list in your hands and you may be less likely to touch your face.) Alternatively, you can store a washcloth soaked in a weak solution of bleach and water inside a sandwich bag, and use that to wipe down the handle of your grocery cart. Note that some stores provide sanitizing wipes, but those may contain antibacterial solutions, not antiviral disinfectants, in which case they are useless against the flu virus (and toxic, to boot).

#4: At a restaurant. “Most of the transmission [of H1N1] occurs before the person gets sick,” says Dr. Schaffner, which means that any seemingly healthy chef, waiter, or fellow diner could be spreading swine flu without realizing it.

Strategy: Dine in. Given all the unknowns and potential run-ins with sick employees or diners, and tables that may have been set with swine-flu-contaminated hands, you’re better off eating at home if there’s an outbreak of swine flu in your area and you haven’t been vaccinated. Use this winter to learn how to cook—we’ve got hundreds of ideas in our Rodale Recipe Finder. Plus, you’ll cut out all the added sugar, fat, and salt. Worried that too many evenings in will make you crazy? Form a supper club with friends, so you can take turns dining at each other’s homes (club members must vow to practice good flu-prevention tactics, and take themselves out of the rotation if family members come down with the virus). And when you just have to have that restaurant experience, choose a day and time when there are fewer diners. Wash hands diligently, so you don’t bring anything home besides leftovers.

#5: In the doctor’s office. Most likely, if you’re at the doctor’s office, you’re sick already, but those who are there for non-swine-flu-related health problems can ask to be placed in a separate waiting room, or even wait outside, if weather permits. Dr. Ellington, who also runs a private practice in Virginia, says that his office has set up a designated H1N1 waiting room to protect other patients, and also asks coughing patients to put on masks. “What the benefit of that is, we don’t know scientifically,” he says, but the intent is to cut down on the spread of droplets that contain the virus.

Strategy: Watch your hands. There are lots of surfaces you have to touch between entering the office—the doorknob—to checking in for your appointment—the pen—to waiting to be called back—books, magazines, and chair armrests, just to name a few. Ultimately, “your major defense is washing your hands and trying not to rub your nose and eyes,” says Dr. Ellington. Pack a small bottle of hand sanitizer that contains at least 60 percent alcohol, and use it liberally. Bring your own books and magazines—at least they won’t be from 2006—and toys for your kids. Sign in with your own pen. If your doctor doesn’t have segregated waiting rooms for swine flu patients, maintain six feet of space between you and the other people in the waiting room.

#6. At the gym. Moderate exercise can do wonders to boost your immunity. While a crowded gym may not be the best place to be during an outbreak, it’s not good to give up exercise, either.

Strategy: Clean, then sweat. Switch to outdoor exercise as much as you can, and make sure your fitness center carries sanitation wipes so you can wipe down equipment before and after use (check that they’re antiviral, not just antibacterial). If they don’t, bring your own alcohol-based hand sanitizer with you, and then apply lotion when you get home so your skin doesn’t dry out. If you have the flu, don’t exercise, rest.

#7. At sporting events. We’re in the thick of the NFL season, and the Phillies and Yankees are about to square off in the World Series. Your local colleges and high school teams are likely keeping busy, too. Despite the crowds, outdoor sports venues are less likely to expose you to flu germs than you might think. “Yes, there are lots of people in a football stadium, but they’re outside, breezes are blowing, and they’re not in an enclosed space,” explains Dr. Schaffner.

Strategy: Practice viral blocking. Still, if someone is hacking near you, it’s best to move, or watch the game from a standing-room only spot. If it’s cold, wear a scarf—it can double as a neck warmer and a face shield, if someone starts sneezing around you, suggests Pat Rosenbaum, RN, CIC, spokesperson for the Association for Professionals in Infection Control and Epidemiology.

#8. On public transportation. You’ve probably seen it before. Someone on the bus or train is sick as a dog, hoodie up, face smooshed against the window, sneezing all over the place.

Strategy: Board with a Kleenex. “If it’s a good, juicy sneeze or cough, turn your head,” says Rosenbaum. “If you have a Kleenex, put it up to your nose and mouth for a second, that’s another way to try and block it.” She also says don’t be afraid to ask someone challenged in the respiratory-etiquette department to cover his or her mouth. Holding your breath when someone near you sneezes isn’t likely to help much, unfortunately. “If you hold your breathe for a few seconds and then inhale, you’ll inhale strongly,” she says, urging people to adopt three generic principles in any situation to prevent the spread of flu: Practice good hand hygiene, keep your hands away from your face, and try to stay three to six feet away from people.

#9. College campus. Schools are breeding grounds for germs, and close living quarters on college campuses make it tough to protect yourself if your roommate gets sick.

Strategy: Lighten your social calendar. Since H1N1 is transmitted through droplets, try to make sure your bed is at least six feet away from your sniffling roomie’s. And check with your campus health-service provider—some schools offer sick buildings where H1N1-infected students can stay. Avoid drinking a lot of alcohol (it can weaken your immune system), and steer clear of crowded campus parties if there’s an outbreak at your school. Use Facebook, or whatever social-networking tool has replaced it among college hipsters, to keep in touch with your buds. And if your campus is offering any remote learning options as a flu-control measure, take advantage.

#10. The workplace. Cubicles do provide some protection against sniffling coworkers. “But you have to wonder why they’re at work in the first place,” says Dr. Schaffner.

Strategy: Eat like a loner. If someone at work is clearly ill, talk to your supervisor and ask for the coughing coworker to be sent home. It will keep healthy workers safe and keep productivity running smoothly at the office. If people are still showing up to work sick, consider packing your own lunch and eating solo at your workspace until the outbreak eases. If many are sick at the office, you can also ask your boss if you can work from home until the outbreak subsides. Perhaps unimportant meetings can be put on hold (increasing productivity as a side benefit!).

If layoffs have hit your company hard, opt to use bathrooms located in areas with fewer workers, to lower your chances of running into a sniffling colleague. And make sure you wash your hands to stop the spread of flu in 15 seconds.

1. Pregnant women need one shot; young kids, two. Initial results from clinical trials show that pregnant women mount a healthy immune response after just one dose of the vaccine. They do, though, need the injectable version—which contains a dead virus—rather than the nasal spray, which contains a live but weakened virus.

Other adults and children ages 10 and over also need only one dose for full immunity. (They can have either the shot or nasal spray.) Children 6 months through 9 years, however, need two doses—spaced about a month apart—in order to mount a strong enough immune response if exposed to the virus. And kids under age 2, like pregnant women, should have only the injectable vaccine.

2. Hand sanitizer works better than soap when it comes to the flu virus. While you should still wash your hands to get the grime off or after using the bathroom, hand sanitizer is the cleanser of choice when trying to keep your hands germ free for hours. The Food and Drug Administration recommends products that consist of at least 60 percent alcohol. Look past the “Kills 99.9 percent of germs” on the front of the package and instead check the “drug facts” label on the back. It should list the active ingredient as some form of alcohol and the percent.

(The drugstore brand on my desk says “ethyl alcohol 62%”.) And use the sanitizer correctly: Make sure your hands are clean and then apply a palmful of the product, rubbing vigorously for 20 to 30 seconds under your nails and jewelry, up to your wrists and on the backs of your hands. Interestingly, hand sanitizer leaves skin less dry than soap because most products contain emollients.

3. Many swine flu remedies are too good to be true. The FDA recently warned against buying non-FDA-approved swine flu products on the Internet and in health food stores. These include bogus versions of the antiviral drug Tamiflu. Real Tamiflu is available only by prescription

. The FDA analyzed one “Tamiflu” product ordered online and found that it contained not the antiviral drug but talc and acetaminophen. Other bogus products include shampoos or dietary supplements purporting to protect against the flu virus. Here’s a complete listing and other bogus swine flu remedies to avoid.

4. Certain warning signs warrant an emergency room visit. The American College of Emergency Physicians says that most folks with flulike symptoms (fever, sore throat, chills, cough, and fatigue) don’t need to head to the emergency room—or even to the doctor. But people should seek out emergency care immediately if they experience the following symptoms: difficulty breathing or chest pain; rapid breathing (over 24 breaths per minute); purple or blue discoloration of the lips; inability to keep liquids down; signs of dehydration (headache, extreme thirst, dizziness, or decreased urination); confusion; or convulsions or seizures. Pregnant women, those over 65, and those with certain health conditions (such as obesity, organ transplant, diabetes

, and lung problems) also should seek medical attention from their doctor or a walk-in clinic, even if they have mild symptoms.

[More on dealing with the swine flu threat during pregnancy]

5. The vaccine is as safe as the seasonal flu vaccine. Anthony Fauci, who’s heading the H1N1 vaccine clinical trials for the National Institutes of Health, said Tuesday that people have no reason to fear the vaccine. All evidence collected so far in the trials suggests that it poses no health risks—not in children, pregnant women, or older folks. There have been some reports of adverse reactions, but they’ve been mild, like swelling or pain at the injection site.

6. High-risk individuals—like pregnant women and babies—should possibly avoid travel. Since the flu epidemic has yet to reach its peak, those at higher risk of developing severe complications from an H1N1 infection should consider putting off air travel if they haven’t been vaccinated, the Centers for Disease Control and Prevention says. That’s because many folks can pick up the infection from a crowded airport or airplane. If you’re in a high-risk category and must travel, talk to your doctor about whether to take along antiviral medications just in case you get sick and can’t get quick medical care.

7. If you’ve already got a fever, definitely stay home. Traveling with a fever is a no-no, since that’s when you’re most contagious. You also don’t want to put extra stress on your body when it’s calling for you to crawl into bed. While U.S. airports don’t have temperature sensors, foreign airports often do. If you set off the sensor while abroad, you could be forced into quarantine until your illness runs its course.

Does My Child Have H1N1 (Swine) Flu?

The symptoms of H1N1 flu are similar to symptoms of regular influenza. Your child may have a fever (temperature of 100°F or greater), as well as:

– Headache

– Sore throat

– Body aches and extreme fatigue (tiredness)

– Coughing, sneezing, runny nose

– Vomiting and diarrhea

2. What Should I Do If I Think It Is H1N1?

DON’T BE ALARMED

– Most cases of the flu cause mild illness and DO NOT require hospitalization.

– The majority of patients recover in three to five days with no problems.

SEPARATE YOUR CHILD FROM OTHERS

– Keep your child away from others to stop the spread of infection.

– At home, keep your child away from other people in the house.

– Don’t take your child on airplanes or buses, and do not send your child to school, daycare, church or other public places until your child has without fever and off medications that treat fever, such as Tylenol or Advil, for at least 24 hours.

– Other members of the household should also stay home if they begin to develop any fever with cough, sore throat, body aches, runny nose or headache.

PRACTICE GOOD HYGIENE

– Anyone who is sick and everyone around them should wash their hands frequently with soap and warm water or use an alcohol-based hand cleaner such as Purell).

– DO NOT share eating utensils, drinking glasses, washcloths, towels, beds, pillows, etc. until everyone in the household has been free of symptoms for five days.

– COVER YOUR COUGH AND SNEEZE with the crook of your elbow or use a tissue and throw away the tissue immediately.

– Use a tissue for a runny nose, then dispose of the tissue in a wastebasket immediately.

– After using a tissue, wash your hands with soap and water, or with an alcohol-based hand sanitizer. FLU SHOULD BE TREATED AT HOME MOST OF THE TIME

– The flu is caused by a VIRUS and does NOT respond to antibiotics.

– Give your child acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) as directed on the bottle for fevers, headache and body aches.

– Have your child drink plenty of fluids to stay hydrated. This is especially important if your child has high fever, vomiting or diarrhea.

3. When Should I Seek Medical Treatment?

Sometimes it is appropriate to take your child to the doctor. Children most likely to need medical treatment from their doctor for influenza infection are those who are very young or have serious medical conditions (such as cancer or lung disease, or who are on dialysis).

If you think your child needs medical treatment, CALL your pediatrician’s office first. Your doctor may want to speak with you over the phone and recommend treatments rather than have you come into the office, where your child can infect other people.

If you go to your doctor’s office, have your child wear a mask and tell the staff immediately that he or she has flulike symptoms so you can be placed in an area away from other patients.

Most cases of flu DO NOT require treatment at the emergency room. Please DO NOT take your child to the emergency room for flulike symptoms unless your child:

– Has fast breathing or trouble breathing
– Has bluish skin color
– Is not drinking enough fluids
– Is not waking up or not interacting with people as usual
– Is very irritable, doesn’t want to be held
– Has worsening fever and cough
– Has fever with rash

Source: Johns Hopkins Medical Institutions