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2009 H1N1 Influenza Shots and Pregnant Women: Questions and Answers

Sunday, November 8th, 2009
2009 H1N1 Influenza Shots and Pregnant Women

2009 H1N1 Influenza Shots and Pregnant Women

Why does CDC advise pregnant women to receive the 2009 H1N1 influenza (flu) vaccine (shot)?
Getting the flu shot is the single best way to protect against the flu. It is important for a pregnant woman to receive both the 2009 H1N1 flu shot and the seasonal flu shot. A pregnant woman who gets any type of flu has a greater chance for serious health problems. Compared with people in general who get 2009 H1N1 flu (formerly called “swine flu”), pregnant women with 2009 H1N1 flu are more likely to be admitted to hospitals. Pregnant women are also more likely to have serious illness and death from 2009 H1N1 flu. When a pregnant woman gets a flu shot, it can protect both her and her baby. Research has found that pregnant women who had a flu shot get sick less often with the flu than do pregnant women who did not get a flu shot. Babies born to mothers who had a flu shot in pregnancy also get sick with flu less often than do babies whose mothers did not get a flu shot.
Will the seasonal flu shot also protect against the 2009 H1N1 flu?
Seasonal flu and 2009 H1N1 flu are caused by different viruses. The seasonal flu vaccine will not protect against the 2009 H1N1 flu. Also, the 2009 H1N1 flu vaccine will not protect against seasonal flu.

Are there flu vaccines that pregnant women should not get?
The seasonal and 2009 H1N1 flu vaccines can be given by shot or by nasal spray. Pregnant women should get the “flu shot”—a vaccine made with killed flu virus. This one is given with a needle, usually in the arm. The other type of flu vaccine—a nasal spray—is not approved for pregnant women. This vaccine is made with live, weakened flu virus. Nasal spray flu vaccine should be used only in healthy people 2-49 years of age who are not pregnant. The nasal spray vaccine is safe for women after they have delivered, even if they are nursing.

Can the seasonal flu shot and the 2009 H1N1 flu shot be given at the same time?
Seasonal and 2009 H1N1 flu shots can be given on the same day but should be given at different sites (e.g., one shot in the left arm and the other shot in the right arm). If a woman is getting her vaccines after delivery, she can get the nasal spray flu vaccine. However, she should not get the seasonal and 2009 H1N1 nasal spays on the same day; they should be given 4 weeks apart.

Is the 2009 H1N1 flu shot safe for pregnant women?
The seasonal flu shot has been given to millions of pregnant women over many years. Flu shots have not been shown to cause harm to pregnant women or their babies. The 2009 H1N1 flu vaccine is being made in the same way and at the same places where the seasonal flu vaccine is made.

What studies have been done on the 2009 H1N1 flu shots and have any been done in pregnant women?
Studies to test the 2009 H1N1 flu shots in healthy children and adults and pregnant women are being done now. Results are available from some of the studies done in non-pregnant adults and children. These results show that the immune system responded well to the 2009 H1N1 vaccine, and the safety results were very similar to those seen in studies of seasonal flu vaccine. These studies are being conducted by the National Institute of Allergy and Infectious Diseases (NIAID) and the vaccine manufacturers. More information can be found at http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm.

Does the 2009 H1N1 flu shot have mercury in it?
There is no evidence that thimerosal (a mercury preservative in vaccine that comes in multi-dose vials) is harmful to a pregnant woman or a fetus. However, because some women are concerned about thimerosal during pregnancy, vaccine companies are making preservative-free seasonal flu vaccine and 2009 H1N1 flu vaccine in single-dose syringes for pregnant women and small children. CDC advises pregnant women to get flu shots either with or without thimerosal.

Does the 2009 H1N1 flu shot have an adjuvant or squalene in it?
Adjuvants are agents that are sometimes added to a vaccine to make it more effective. There are no adjuvants (such as squalene) in either the 2009 H1N1 or seasonal flu shot used in the United States.

Can the 2009 H1N1 flu shot be given at any time during pregnancy?
Both seasonal flu shots and 2009 H1N1 flu shots are recommended for pregnant women at any time during pregnancy.

How many 2009 H1N1 flu shots will a pregnant woman need to get?
The U.S. Food and Drug Administration (FDA) has approved the use of one shot for full protection for persons 10 years and older. Therefore, a pregnant woman is recommended to get one dose of the 2009 H1N1 vaccine.

Should the 2009 H1N1 flu shot be given to a pregnant woman who had flu between April 2009 and now? Do I need a test to know if I need the shot or not?
A pregnant woman who had a flu-like illness at any time in the past should still get the 2009 H1N1 shot because she cannot assume that the illness she had was caused by the 2009 H1N1 virus. Pregnant women who had flu symptoms in the past do not need to be tested now, but should get the vaccine.

What are the possible side effects of the 2009 H1N1 flu shots?
The side effects from 2009 H1N1 flu shots are expected to be like those from seasonal flu shots. The most common side effects after flu shots are mild, such as being sore and tender and/or red and swollen where the shot was given. Some people might have headache, muscle aches, fever, and nausea or feel tired. If these problems happen, they usually begin soon after the shot and may last as long as 1-2 days. Some people may faint after getting any shot. Sometimes, flu shots can cause serious problems like severe allergic reactions. But, life-threatening allergic reactions to vaccines are very rare. A person who has a severe (life-threatening) allergy to eggs or to anything else in the vaccine should not get the shot, even if she is pregnant. Pregnant women should tell the person giving the shots if they have any severe allergies or if they have ever had a severe allergic reaction following a flu shot.

What if a pregnant woman gets the live nasal spray flu vaccine instead of the flu shot?
The nasal spray flu vaccine has not been approved for pregnant women. It differs from the flu shot because it is made with live, weakened virus. However, sometimes a pregnant woman might get the nasal spray flu vaccine—for example, before she knew she was pregnant. If this happened, she would not be expected to have any additional problems. The weakened, live flu virus has never been shown to be passed to the unborn baby. However, if a woman does get the nasal spray vaccine while she is pregnant, she should talk to her healthcare provider.

If a pregnant woman delivers her baby before receiving her seasonal flu shot or her 2009 H1N1 flu shot, should she still receive them?
Yes. Besides protecting her from infection, the shot may also help protect her infant. Flu shots are only given to infants 6 months of age and older. Everyone who lives with or gives care to an infant less than 6 months of age should get both the seasonal flu and 2009 H1N1 vaccines. A woman can get either the shots or the nasal spray after she delivers.

Can a breastfeeding mother receive the flu shot or the nasal spray?
Yes. Both seasonal and 2009 H1N1 flu vaccines should be given to breastfeeding mothers and breastfeeding women can receive either the shot or the nasal spray form of the vaccine. Breastfeeding is fully compatible with flu vaccination, and preventing the flu in mothers can reduce the chance that the infant will get the flu. Also, by breastfeeding, mothers can pass on to the infant the antibodies that their bodies make in response to the flu shots, which can reduce the infant’s chances of getting sick with the flu. This is especially important for infants less than 6 months old, who have no other way of receiving vaccine antibodies, since they are too young to be vaccinated.

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What is H1N1 (swine) flu?

Tuesday, May 12th, 2009

What is H1N1 (swine) flu?
H1N1 Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses. Outbreaks of swine flu happen regularly in pigs. People do not normally get swine flu, but human infections can and do happen. Most commonly, human cases of swine flu happen in people who are around pigs but it’s possible for swine flu viruses to spread from person to person also.

Are there human infections with H1N1 (swine) flu in the U.S.?
In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were first reported in Southern California and near San Antonio, Texas. CDC and local and state health agencies are working together to investigate this situation. An updated case count of confirmed H1N1 (swine) flu infections in the United States is kept at http://www.cdc.gov/swineflu/investigation.htm. CDC and local and state health agencies are working together to investigate this situation, you can always keep coming hete at theswineflublog.com for latest information.

How do you catch H1N1 (swine) flu?
Spread of H1N1 (swine) flu can occur in two ways:
•Through contact with infected pigs or environments contaminated with swine flu viruses.
•Through contact with a person with H1N1 (swine) flu. Human-to-human spread of H1N1 (swine) flu has been documented also and is thought to occur in the same way as seasonal flu. Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

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Person-to-Person Transmission Now Common Route for Swine Flu in U.S.

Saturday, May 9th, 2009

The number of confirmed or suspected cases of swine flu in the United States was approaching 1,900, federal health officials said late Thursday, with most new cases now caused by person-to-person transmission and not some link to Mexico, as was the case when the outbreak began nearly two weeks ago.

“Only about 10 percent of confirmed cases have a travel history for Mexico,” which is believed to be the source of the outbreak, Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, said during an afternoon teleconference. “This indicates ongoing transmission in communities. We would expect that as this [virus] travels more around the country that we are going to see that number go down. While there may have been introduction from travel to Mexico, the spread that’s ongoing does not require travel to Mexico,” he added.

Besser said there were now 1,823 probable and confirmed cases in 44 states, with most of the infections mild and leading to a quick recovery. The median age of hospitalized individuals with swine flu is 15.

The two U.S. deaths linked to swine flu occurred in individuals with multiple underlying health problems, according to a CDC report released early by the New England Journal of Medicine on Thursday. The first victim — a Mexican toddler named Miguel Tejada Vazquez who had been treated at a Texas hospital — suffered from a chronic muscle disorder called myasthenia gravis, and also had a heart defect, low oxygen, and problems swallowing.

The second case involved 33-year-old schoolteacher Judy Trunnell, who suffered from asthma and rheumatoid arthritis and who was 35 weeks’ pregnant and in a coma when she died in a Texas hospital on Tuesday. Doctors delivered her baby girl via Cesarean section.

On Friday, the CBC reported that Canadian officials are investigating the first suspected death linked to swine flu in that country, an elderly woman in northern Alberta.

At the Thursday press conference, Besser said the CDC plans to stop concentrating on reporting numbers of cases and start concentrating on where flu activity is most pronounced in the country. “At some point reporting on individual cases no longer has value from a public health perspective, but knowing where in the country we are seeing large amounts of flu activity does remain important,” he added.

Besser also addressed two other significant topics at the teleconference:

The H1N1 swine flu, thought to be a new virus, shows similarities to strains that first infected people in the United States back in 2005.
People may be holding “swine flu parties,” where individuals knowingly expose themselves to someone with the flu, in the belief that gaining some immunity now may offer greater protection next winter if the swine flu returns in a more virulent form. Besser dismissed the idea as a “big mistake.”

On Thursday, the New England Journal of Medicine released early a study by CDC researchers that said 11 cases of infection with a swine flu virus similar to that involved in the current outbreak have been recorded in the United States since 2005. These viral strains were so-called “triple-reassortant” viruses, meaning that — like the current H1N1 strain — they contained genes from bird, pig and human viruses.

All but two of the cases involved people who had direct or indirect contact with pigs, but “in another patient, human-to-human transmission was suspected,” wrote a team led by Dr. Lyn Finelli of the CDC’s Influenza Division. The patients were typically young — with an average age of 10 years — and four of the 11 cases were severe enough to require hospitalization, with two needing invasive mechanical ventilation. Four patients were given the antiviral medication Tamiflu and all eventually recovered, according to the report.

Cases of this type of influenza H1 virus appeared to pick up more recently, with eight of the 11 cases being reported by the CDC after June 2007, the researchers noted. The cases were spotted via the CDC’s routine “passive” flu surveillance systems and additional but unidentified cases may have occurred, the experts said.

The findings suggest that “all human infections with influenza viruses of animal origin, even those that appear to be clinically mild, warrant a thorough public health investigation to assess the epidemiological risk to humans,” the researchers said.

At the teleconference, Besser also discussed reports of so-called swine flu parties.

“Having swine flu H1N1 parties is a big mistake,” he said. “This is a new emerging infection and we are learning more each day, but how an individual person will be impacted by the infection is not something we know. It is a big mistake. It is putting individuals and children at risk and CDC does not recommend that people follow that course.”

As the outbreak continues, the CDC continues to study various aspects of the health threat to gain a better understanding of the virus, how it is spread, as well as better ways to test for it, Besser said. The research under way includes: finding a rapid diagnostic test; understanding “viral shedding” (how long people can pass the virus to others); determining how the virus is transmitted in households; and learning how well antiviral drugs work, he said.

Testing has found that the swine flu virus remains susceptible to two common antiviral drugs, Tamiflu and Relenza, according to the CDC.

On Tuesday, U.S. health officials said the outbreak of swine flu appears similar to the seasonal flu in its severity, so schools across the nation should remain open and any schools that did close should reopen.

On Thursday, the World Health Organization (WHO) warned that as many as 2 billion people around the globe could become infected by swine flu, if the current outbreak turns into a pandemic.

On Friday, the World Health Organization was reporting almost 2,400 confirmed cases of swine flu in 24 countries, with Canada, Spain and the United Kingdom having the most cases outside of Mexico and the United States.

There were 1,112 laboratory-confirmed cases in Mexico, the source of the outbreak, including 42 deaths. The United States had reported 896 confirmed cases, including two deaths, the WHO said.

On Friday, reports emerged that the swine flu has extended its spread in the Southern hemisphere, where flu season is just beginning. According to the Associated Press, Argentina and Brazil have now confirmed their first cases of swine flu, joining Colombia as South American nations reporting infections.

U.S. Human Cases of H1N1 Flu Infection
(As of May 8, 2009, 11:00 AM ET)
States # of
laboratory
confirmed
cases Deaths
Alabama 4
Arizona 131
California 107
Colorado 25
Connecticut 4
Delaware 39
Florida 6
Georgia 3
Hawaii 5
Idaho 1
Illinois 392
Indiana 29
Iowa 5
Kansas 12
Kentucky** 3
Louisiana 7
Maine 4
Maryland 4
Massachusetts 83
Michigan 49
Minnesota 1
Missouri 9
Nebraska 4
Nevada 8
New Hampshire 3
New Jersey 7
New Mexico 8
New York 174
North Carolina 7
Ohio 6
Oklahoma 4
Oregon 15
Pennsylvania 2
Rhode Island 7
South Carolina 29
South Dakota 1
Tennessee 36
Texas 93 2
Utah 24
Virginia 14
Washington 33
Washington, D.C. 1
Wisconsin 240
TOTAL*(43) 1639 cases 2 deaths

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First U.S. resident with Swine Flu to die

Wednesday, May 6th, 2009

HARLINGEN, Texas – This week should have been a joyous time for Judy Trunnell, a 33-year-old schoolteacher who had just given birth to a healthy baby girl.

But the friends and relatives whose cars lined the quiet street in front of her home in a quiet subdivision Tuesday instead were mourning her, the first American with swine flu to die.

“We’re grieving now,” said a woman with tear-streaked eyes who declined to give her name.

In Maryland, her cousin told WMAR-TV in Baltimore that Trunnell had died after spending two weeks in the hospital. She slipped into a coma, and her baby was delivered by Cesarean section, Mario Zamora said.

“She was just a beautiful person, warm at heart. She worked with disabled children as a teacher,” Zamora said. “Those that knew her will always remember her.”

Texas health officials stopped short of saying that swine flu caused Trunnell’s death. State health department spokeswoman Carrie Williams said the schoolteacher had “chronic underlying health conditions” but wouldn’t give any more details.

She died early Tuesday after being hospitalized since April 19, said Leonel Lopez, Cameron County epidemiologist.

Trunnell’s death came as life in the areas hardest hit by the outbreak began returning to normal. In Mexico, where the current strain is thought to have originated, stores, restaurants and factories were officially allowed to reopen Tuesday. And U.S. health officials withdrew their recommendation that schools with suspected swine flu cases shut down for two weeks.

The only other swine flu death in the U.S. was that of a Mexico City toddler who also had other health problems and had been visiting relatives in Brownsville, near Harlingen. He died last week at a Houston children’s hospital.

There have been 29 other confirmed swine flu deaths, all in Mexico. Hundreds of cases of the disease have been confirmed in several countries, but mostly in Mexico and the U.S.

Trunnell was from Harlingen, a city of about 63,000 near the U.S.-Mexico border, and taught in the Mercedes Independent School District about 15 miles west of her hometown.

She was first seen by a physician April 14 and was hospitalized on the April 19. Zamora said she had complained of difficulty breathing and was put on life support.

Doctors knew she had a flu when she came in, but did not know what kind, Lopez said. The area is undergoing a Type A influenza epidemic right now, and swine flu is one variety of that, he said. She was confirmed to have swine flu shortly before she died, he said.

Dr. Joseph McCormick, regional dean of the University of Texas School of Public Health’s Brownsville campus, said the woman was extremely ill when she was hospitalized.

Mercedes school district officials announced that it would close its schools for the rest of the week and reopen Monday.

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Novel H1N1 Flu

Tuesday, May 5th, 2009

What is H1N1 (swine flu)?
H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

Why is this new H1N1 virus sometimes called “swine flu”?
This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a “quadruple reassortant” virus.

Novel H1N1 Flu in Humans

Are there human infections with this H1N1 virus in the U.S.?
Yes. Cases of human infection with this H1N1 influenza virus were first confirmed in the U.S. in Southern California and near Guadalupe County, Texas. The outbreak intensified rapidly from that time and more and more states have been reporting cases of illness from this virus. An updated case count of confirmed novel H1N1 flu infections in the United States is kept at http://www.cdc.gov/h1n1flu/investigation.htm. CDC and local and state health agencies are working together to investigate this situation.

Is this new H1N1 virus contagious?
CDC has determined that this new H1N1 virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of this virus in people?
The symptoms of this new H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Also, like seasonal flu, severe illnesses and death has occurred as a result of illness associated with this virus.

How severe is illness associated with this new H1N1 virus?
It’s not known at this time how severe this virus will be in the general population. CDC is studying the medical histories of people who have been infected with this virus to determine whether some people may be at greater risk from infection, serious illness or hospitalization from the virus. In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions. It’s unknown at this time whether certain groups of people are at greater risk of serious flu-related complications from infection with this new virus. CDC also is conducting laboratory studies to see if certain people might have natural immunity to this virus, depending on their age.

How does this new H1N1 virus spread?
Spread of this H1N1 virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How long can an infected person spread this virus to others?
At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. CDC is studying the virus and its capabilities to try to learn more and will provide more information as it becomes available.

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Novel H1N1 Flu

Tuesday, May 5th, 2009

What is H1N1 (swine flu)?
H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

Why is this new H1N1 virus sometimes called “swine flu”?
This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a “quadruple reassortant” virus.

Novel H1N1 Flu in Humans

Are there human infections with this H1N1 virus in the U.S.?
Yes. Cases of human infection with this H1N1 influenza virus were first confirmed in the U.S. in Southern California and near Guadalupe County, Texas. The outbreak intensified rapidly from that time and more and more states have been reporting cases of illness from this virus. An updated case count of confirmed novel H1N1 flu infections in the United States is kept at http://www.cdc.gov/h1n1flu/investigation.htm. CDC and local and state health agencies are working together to investigate this situation.

Is this new H1N1 virus contagious?
CDC has determined that this new H1N1 virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of this virus in people?
The symptoms of this new H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Also, like seasonal flu, severe illnesses and death has occurred as a result of illness associated with this virus.

How severe is illness associated with this new H1N1 virus?
It’s not known at this time how severe this virus will be in the general population. CDC is studying the medical histories of people who have been infected with this virus to determine whether some people may be at greater risk from infection, serious illness or hospitalization from the virus. In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions. It’s unknown at this time whether certain groups of people are at greater risk of serious flu-related complications from infection with this new virus. CDC also is conducting laboratory studies to see if certain people might have natural immunity to this virus, depending on their age.

How does this new H1N1 virus spread?
Spread of this H1N1 virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How long can an infected person spread this virus to others?
At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. CDC is studying the virus and its capabilities to try to learn more and will provide more information as it becomes available.

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Swine Flu Latest Headlines

Wednesday, April 29th, 2009


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Preventing the Flu: Good Health Habits Can Help Stop Germs

Wednesday, April 29th, 2009

The single best way to prevent seasonal flu is to get vaccinated each year, but good health habits like covering your cough and washing your hands often can help stop the spread of germs and prevent respiratory illnesses like the flu. There also are flu antiviral drugs that can be used to treat and prevent the flu.

Avoid close contact.
Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.

Stay home when you are sick.
If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.

Cover your mouth and nose.
Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.

Clean your hands.
Washing your hands often will help protect you from germs.

Avoid touching your eyes, nose or mouth.
Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Practice other good health habits.
Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

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Swine Flu Official CDC Video Information

Tuesday, April 28th, 2009

Prevention and Simptoms Information
Official Video from CDC
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Mexico Travel Alert

Tuesday, April 28th, 2009

April 28, 2009

The Department of State alerts U.S. citizens of the health risks of travel to Mexico at this time due to an outbreak of H1N1 influenza(“swine flu).”  The U.S. Centers for Disease Control and Prevention (CDC) on April 27 issued a notice recommending that American citizens avoid all nonessential travel to Mexico at this time.  CDC’s notice also suggests precautions that travelers and U.S. citizen residents in Mexico can take to reduce their risk of infection while in Mexico, provides recommendations for those who must travel to an area where cases of H1N1 influenza have been reported, and recommends measures travelers should take following their return from an area that has reported cases of H1N1 influenza.  The complete CDC notice can be found at the following link: http://www.cdc.gov/travel/.  Please check this site frequently for updates.  This Travel Alert replaces the Travel Alert dated April 27, 2009 and provides updated information on closings of schools and commercial venues in Mexico and U.S. consular operations throughout Mexico.  This Travel Alert will be reviewed and updated as necessary, and is valid until further notice.

The World Health Organization (WHO), the Global Alert and Response Network (GOARN), and the Centers for Disease Control and Prevention (CDC) have sent experts to Mexico to work with health authorities.

The Government of Mexico has announced that as a precautionary measure, all schools throughout Mexico from kindergarten through university level will remain closed until May 6.  All government-sponsored events involving large crowds have also been canceled, and museums and most tourist attractions are closed.  During an April 28 press conference, the Mayor of Mexico City announced that all establishments where large numbers of the public gather will be closed, including restaurants, bars, discos, night clubs, movie theaters, gyms, and convention centers. The Archdiocese of Mexico City has also closed Catholic churches for services.        

Effective April 28, all nonimmigrant visa operations at all consular posts in Mexico will be suspended until May 6.  American citizen services are restricted to passports and Consular Reports of Birth Abroad and emergency services.  Please refer to Embassy Mexico’s web page at http://mexico.usembassy.gov/eng/main.html for the latest information on closings and service reductions.  Immigrant visa appointments in Ciudad Juarez will be cancelled for the week of May 4th.  Further information on rescheduling visa appointments is available on Ciudad Juarez’s web page at http://ciudadjuarez.usconsulate.gov/.
  

The U.S. Embassy reminds U.S. citizens in Mexico that most cases of influenza are not H1N1 influenza.  Any specific questions or concerns about flu or other illnesses should be directed to a medical professional.  Mexico City medical authorities are urging people to avoid hospitals and clinics unless they have a medical emergency, since hospitals can be centers of infection; instead, those with health concerns are encouraged to stay home and call their physicians to avoid potential exposure.  Although the U.S. Embassy cannot give medical advice or provide medical services to the public, a list of hospitals and doctors can be found on our website at the following links:  http://mexico.usembassy.gov/sacs_medical_info.html  (Spanish) http://mexico.usembassy.gov/eng/eacs_medical_info.html  (English)

For additional information, please consult the State Department’s website at www.travel.state.gov, the CDC website at www.cdc.gov, or the website of the World Health Organization at www.who.int.  The U.S.-based call center for U.S. citizens can be reached at 1-888-407-4747 from 8:00 am – 8:00 pm Eastern Daylight Time, Monday through Friday, , or if calling from outside the U.S., at (202)-501-4444.  The U.S. Embassy will post additional information as it becomes available at: www.usembassy-mexico.gov.  American citizens traveling or residing overseas are encouraged to register with the appropriate U.S. Embassy or Consulate on the State Department’s travel registration website at https://travelregistration.state.gov/.

For any emergencies involving U.S. citizens in Mexico, please contact the closest U.S. Embassy or Consulate.  The U.S. Embassy is located in Mexico City at Paseo de la Reforma 305, Colonia Cuauhtemoc, telephone from the United States: 011-52-55-5080-2000; telephone within Mexico City: 5080-2000; telephone long distance within Mexico 01-55-5080-2000.  You may also contact the Embassy by e-mail at: ccs@usembassy.net.mx.  The Embassy’s internet address is http://www.usembassy-mexico.gov/.

More Information HERE http://travel.state.gov/travel/cis_pa_tw/pa/pa_3028.html

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