This question and answer article explains the rationale behind the number of days people should stay home if they have a flu-like illness. The Centers for Disease Control (CDC) on August 5, 2009, revised the time frame based what state departments of health have learned from this spring and summer’s outbreak. Given that the H1N1 virus will likely reappear this fall and winter in addition to the other seasonal influenza viruses that crop up, it is important to adhere to these new guidelines to prevent the spread of influenza.

1. I am not a health-care worker. How long should I stay out of work if I have a flu-like illness?

Previously the CDC recommended that people stay home for 7 days or until they were fever-free for 24 hours, whichever was longer. Given the data on the H1N1 (Swine) flu virus that has been collected this past spring and summer, the infections have tended to be mild with fevers lasting 2-4 days. The CDC is now recommending that people with flu-like symptoms stay home 24 hours after their fever has ended (without using medication to bring their fever down like acetaminophen or ibuprofen).

This is less disrupting for families and gives more flexibility for people who have a mild illness, enabling them to return to work or school earlier while allowing those who are more seriously affected to remain at home. It is estimated that viral shedding occurs one day before symptom onset until symptoms resolve (generally 7 days in adults, 10 days in children).

2. I am a health care worker. How long should I remain home if I have a flu-like illness?

The CDC has not changed its initial recommendation that health care workers stay at home for 7 days after the start of symptoms or 24 hours after the fever is gone, whichever is longer.

Because the virus is shed even after the fever has ended, it is important not to expose others who are at risk for developing complications to the flu.

3. What are the symptoms of the flu?

The symptoms of both the H1N1 (Swine) flu and the seasonal flu are the same. They can include:

• fever, headache
• chills
• fatigue
• sore throat
• body aches/pains
• runny/stuffy nose
• vomiting/diarrhea

It is important to keep in mind that not everyone will get all the symptoms – and not everyone will get a fever.

4. Treating Influenza

Treatment includes anti-viral medications (oseltamivir and zanamivir), and rest. Your health care provider may prescribe inhalers and other medications as necessary. It is best to start anti-viral medications soon after symptoms begin (generally within 2 days). Remember that aspirin is not given to children 18 years of age and younger because of the concern of developing Reye’s syndrome.