How to look after someone at home with H1N1 flu virus

May 3, 2009 - 16:00 EST

Note: This guidance document is being provided by the Public Health Agency of Canada in response to the recent outbreak of H1N1 flu virus (human swine flu) in Canada. This guidance has been developed to assist people in caring for someone at home who is recuperating from the virus. This guidance is based on current available scientific evidence about this emerging disease, and is subject to review and change as new information becomes available.

Six Steps to Recovery

1. Protect yourself and others

If possible, have the sick person wear a simple surgical mask¹ if you or someone else is in the same room within 2 metres (6 feet) of him/her. If the sick person cannot tolerate a mask, encourage the use of a tissue when coughing or sneezing. If you are going to be within 2 metres (6 feet), you can wear a simple surgical mask and safety glasses².

Clean your hands often, either soap and water or a hand sanitizer before and after putting on or taking off a mask, after touching anything that a sick person has touched (such as dishes, towels, clothes, and trash), before you eat and before touching your eyes, nose or mouth.

2. Allow the ill person to rest away from others.

Anyone sick with H1N1 flu virus (human swine flu) is estimated to be contagious for 7 days from the onset of the illness and should stay at home. They should generally stay at least 2 metres (6 feet) away from others, preferably in a well-ventilated room of their own. Ill people need lots of rest; visitors should be few. Phone calls and a few distractions, like a good book are helpful. Clean the phone or other surface with a bleach-based cleaner after use by the ill person as the virus can survive on a hard surface for up to 2 days.

3. Treat the fever and cough

"Coughs and sneezes spread diseases" – as the spray has the virus in it. The ill person should cover the cough with a tissue or his/her arm. Tissues should be carefully placed in a waste basket and then the hands cleaned with soap and water or a hand sanitizer. If needed, give a mild cough suppressant, especially at night to help them sleep. It is not recommended to give children under 6 years old cough suppressant. Fever often comes with chills or aches and pains. Acetaminophen or ibuprofen every 4-6 hours may help to bring down the fever and take away the aches. Do not give aspirin to children with fever as it has been linked to Reye's Syndrome , a potentially fatal disease associated with aspirin consumption by children with viral diseases. A cool face cloth to the face and neck or over the whole body can help the fever too. If antiviral medications have been ordered, ensure they get it twice a day.

4. Give lots of fluids, nutritious food and ensure a smoke-free environment with no one smoking in your home.

This all helps the body recover.

5. Keep the sick person’s things separate from others and handle anything he/she touches with care.

Each sick person should have his/her own towel, face cloth, toothbrush, etc. that are kept away from those who are well. Wash dishes, dirty laundry and towels with hot water and soap as soon as you take them out of the room. Always clean your hands afterwards and avoid touching your eyes. Line their garbage with a plastic bag, so you don’t need to touch the contents. Ideally, have a garbage bin with a foot pedal, so that you do not need to touch the garbage to put something in it. You can disinfect door knobs and light switches with a bleach-based cleaner or by cleaning them with a mixture that is 1 part bleach and 10 parts water. Clean the bathroom daily.

6. Be on alert for complications

Following these instructions, most people will begin to feel better after a few days. However, be on the lookout. Sometimes complications, such as asthma or pneumonia arise and the ill person may need to have a health assessment.

Take his/her temperature daily. Here are some signs to look for:

• Starts to feel better, then the fever returns
• Wheezing, shortness of breath or difficulty breathing, coughing up blood
• Purple or bluish lip color
• Chest pain
• Hard to wake up, unusually quiet or unresponsive, strange thoughts or actions
• New onset of diarrhea, vomiting or abdominal pain
• Signs of dehydrations such as dizziness when standing and low urine production

If any of these things occur, call a health care provider for advice. If the ill person needs to seek medical care, they should wear a surgical mask if available. This is especially important if the ill person is using public transportation. Monitor yourself and other family members for flu symptoms.

Tips on wearing a mask

• Tie the mask securely behind your head, and make sure the mask fully covers your nose and mouth
• Replace the mask when it becomes wet or damp – a mask only works when it is dry
• Avoid touching your face while wearing the mask
• Do not let the mask hang around your neck – discard after use
• Remove the mask by only touching the straps and place the used mask directly in the garbage. Wash your hands immediately.

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¹ Surgical masks are quite inexpensive and can be purchased at your local pharmacy. If you do not have a mask, other options such as covering your nose and mouth with a bandana, could also provide protection (launder after use). Respirators (such as N95 masks) will not provide any more protection than surgical masks unless they are properly fit-tested.

² Safety glasses are available at all hardware stores; you could also wear wrap-around sports glasses.