Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
If you've got fever, cough, or one of the other symptoms of the flu, you may be wondering if you have contracted the H1N1 swine flu virus. The reality is that it isn't possible to know unless specialized testing is ordered, and for uncomplicated cases of the flu in non-hospitalized patients, routine testing for the H1N1 virus is not being carried out.
Experts recommend that people who suspect that they have H1N1 infection stay home and avoid contact with other people. The only time you should leave home is to access medical care if needed. That said, it is important to remember that the vast majority of flu cases (even H1N1 cases) produce only a mild illness for which doctor's visits and/or antiviral drugs are not necessary. So, the presence of cough and fever in an individual who is not at high risk for complications (see below) and who does not have warning signs of a medical emergency should not be a reason to visit an ER. The emergency department should be used for the treatment of people who are very sick or who have life-threatening emergencies (listed below). If you're in doubt, a call to your health-care practitioner can help you decide whether or not you need to access medical care.
According to the CDC, some groups of people are at higher risk for complications of the flu. The following groups of people are at higher risk for complications and should talk to their health-care practitioner if they develop symptoms of the flu:
- Children younger than 5 years old but especially children younger than 2 years old
- People 65 and older
- Pregnant women
- People who have
- blood disorders (including sickle cell disease);
- chronic lung disease (including asthma or chronic obstructive pulmonary disease [COPD]);
- heart disease;
- kidney disorders;
- liver disorders;
- neurological disorders (including conditions of the nervous system, brain, or spinal cord);
- neuromuscular disorders (including muscular dystrophy and multiple sclerosis);
- weakened immune systems (including people with AIDS).
Anyone, regardless of whether or not you are in a high-risk group, should access medical care immediately (such as in an emergency department) if you have any of these warning signs:
- fast breathing or trouble breathing,
- bluish skin color,
- not drinking enough fluids,
- not waking up or not interacting,
- being so irritable that the child does not want to be held,
- flu-like symptoms improve but then return with fever and worse cough,
- fever with a rash.
- difficulty breathing or shortness of breath,
- pain or pressure in the chest or abdomen,
- sudden dizziness,
- severe or persistent vomiting.
In summary, most people who get the H1N1 swine flu virus will have a mild flu-like illness that does not require a doctor's visit or antiviral medications. In these cases, it's best to stay at home until you have had no fever (without the use of fever-reducing medications) for at least 24 hours. Be sure to cover coughs and sneezes with a tissue and wash your hands frequently to avoid spreading the virus.