Patients should be encouraged to stay home if they become ill, to avoid close contact with people who are sick, to wash their hands often, and to avoid touching their eyes, nose, and mouth. The CDC recommend the following actions when human infection with swine flu is confirmed in a community:

Home isolation

  • Patients who develop flulike illness (ie, fever with either cough or sore throat) should be strongly encouraged to self-isolate in their home for 7 days after the onset of illness or at least 24 hours after symptoms have resolved, whichever is longer.
  • To seek medical care, patient should contact their health care providers to report illness (by telephone or other remote means) before seeking care at a clinic, physician’s office, or hospital.
  • Patients who have difficulty breathing or shortness of breath or who are believed to be severely ill should seek immediate medical attention.
  • If the patient must go into the community (eg, to seek medical care), he or she should wear a face mask to reduce the risk of spreading the virus in the community when coughing, sneezing, talking, or breathing. If a face mask is unavailable, ill persons who need to go into the community should use tissues to cover their mouth and nose while coughing.
  • While in home isolation, patients and other household members should be given infection control instructions, including frequent hand washing with soap and water. Use alcohol-based hand gels (containing at least 60% alcohol) when soap and water are not available and hands are not visibly dirty. Patients with swine influenza should wear a face mask when within 6 feet of others at home.

Household contacts who are not ill

  • Remain home at the earliest sign of illness.
  • Minimize contact in the community to the extent possible.
  • Designate a single household family member as caregiver for the patient to minimize interactions with asymptomatic persons.

School dismissal and childcare facility closure

  • Strong consideration should be given to close schools upon a confirmed case of swine flu or a suspected case epidemiologically linked to a confirmed case.
  • Decisions regarding broader school dismissal within these communities should be left to local authorities, taking into account the extent of influenzalike illness within the community.
  • Cancelation of all school or childcare related gatherings should also be announced.
  • Encourage parents and students to avoid congregating outside of the school if school is canceled.
  • Duration of schools and childcare facilities closings should be evaluated on an ongoing basis depending on epidemiological findings.
  • Consultation with local or state health departments is essential for guidance concerning when to reopen schools. If no additional confirmed or suspected cases are identified among students (or school-based personnel) for a period of 7 days, schools may consider reopening.
  • Schools and childcare facilities in unaffected areas should begin preparation for possible school closure.

Social distancing

  • Large gatherings linked to settings or institutions with laboratory-confirmed cases should be canceled (eg, sporting events or concerts linked to a school with cases); other large gatherings in the community may not need to be canceled at this time.
  • Additional social distancing measures are currently not recommended.
  • Persons with underlying medical conditions who are at high risk for complications of influenza should consider avoiding large gatherings.

Reference :

  1. World Health Organization. Influenza-like illness in the United States and Mexico. WHO Epidemic and Pandemic Alert and Response. Available at Accessed April 27, 2009.
  2. U.S. Department of Health and Human Services. Determination that a Public Health Emergency Exists. U.S. Department of Health and Human Services. Available at Accessed April 27, 2009.
  3. CDC. Swine Influenza (Flu). Centers for Disease Control and Prevention. Available at Accessed April 28, 2009.
  4. CDC. Guidance for Clinicians & Public Health Professionals. Available at Accessed April 27, 2009.

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