Updated 13 August 2010

Pandemic (H1N1) 2009 influenza: Advice for travellers

There are no travel restrictions to any country. The world is now in the post pandemic phase, indicating that influenza (H1N1) 2009 activity worldwide is transitioning to seasonal patterns of transmission.

Travellers should be aware, however, that some countries have put into place health screening of arriving passengers. Screening may consist of:

• passing through a device that checks your temperature
• directly checking your temperature with a thermometer
• completing forms about your health
• providing details about your travel itinerary

If you are ill with an influenza-like illness (ILI) (fever plus two or more symptoms of cough, sore throat, runny nose, body aches or headache), you may be isolated, have a medical examination, tested for flu virus, or hospitalised and given treatment. If a travelling companion or someone on your flight is ill or found to have pandemic flu, you may be quarantined for a period of time.

Before you travel

• If you are ill with a respiratory illness you should delay travel.
• Check to see if your destination is reporting cases of pandemic flu. View countries reporting cases of pandemic flu on the NaTHNaC Outbreak Surveillance Search. 
• Check the country pages of the Foreign and Commonwealth Office or the International Air Transport Association (IATA) to see if health screening is being carried out at your destination.
• You should consider:

• whether you need to travel to an area know to be affected with pandemic influenza
• the risk of getting pandemic influenza at your destination
• the level of medical care at your destination including access to anti-viral medications in the event you need treatment for an ILI.

• You should receive appropriate vaccines and other preventive measures for your destination. This includes seasonal flu vaccine if you come under the recommended risk groups (see NaTHNaC Health Information Sheet on Influenza). It is not expected that seasonal flu vaccine will protect against pandemic flu.

• You should obtain comprehensive travel health insurance that includes coverage for trip cancellation and any potential disruptions to your trip such as quarantine. Clarify if there are any exclusions to coverage.

During travel

Influenza is transmitted via the respiratory route and you should exercise sensible precautions:

• follow public health guidance at your destination
• avoid crowding or mass gatherings
• avoid close contact (within 2 metres) with persons who are ill with an ILI
• wash hands with soap and water; use waterless alcohol-based hand gels when soap and water is not available
• avoid touching your nose, mouth or eyes, to prevent the spread of germs
• cover your nose and mouth with a tissue when you cough or sneeze and dispose of the tissue promptly
• keep hard surfaces (e.g. door handles, countertops) clean using a normal cleaning solution
• assure that children follow similar advice
• pandemic flu is not passed through properly handled and prepared pork; the virus is killed by cooking to temperatures of 70°C
• there is little evidence of the effectiveness of wearing masks at a mass level, however, properly fitted, special grade masks can be worn in situations such as healthcare settings

After you travel

Travellers who have visited affected areas should monitor their health for seven days after the visit. If you develop a febrile illness with cough, sore throat, runny nose, headache or muscle aches, within seven days you should:

• check your symptoms on the National Pandemic Flu Service website (www.direct.gov.uk/pandemicflu), or on NHS Choices (www.nhs.uk). If you live in England, you can also call a national pandemic flu information service: 0800 1 513 513. You should contact your GP directly if you have a serious underlying illness, are pregnant, or your condition suddenly gets much worse.
• if you speak to the national pandemic flu information service or your GP, inform them of your travel history
• limit contact with other people
• cover your nose and mouth with a tissue when you cough or sneeze and dispose of the tissue promptly
• wash hands with soap and water
• keep hard surfaces (e.g. door handles, countertops) clean using a normal cleaning solution
• There is guidance for health professionals who evaluate persons with suspected pandemic flu on the Health Protection Agency website, listed below.

Further information is available at the following sources:

NaTHNaC Country Information pages: http://www.nathnac.org/ds/map_world.aspx

NaTHNaC Outbreak Surveillance Search:

http://www.nathnac.org/countrysearch.aspx

Centers for Disease Control and Prevention, H1N1 Flu (Swine flu): http://www.cdc.gov/h1n1flu/

European Centre for Disease Prevention and Control: http://ecdc.europa.eu/

Foreign and Commonwealth Office. Swine flu outbreak: http://www.fco.gov.uk/en/travelling-and-living-overseas/swine-flu

Health Protection Agency, Swine Influenza: http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAuto

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National Pandemic Flu Service: http://www.direct.gov.uk/pandemicflu

WHO, pandemic (H1N1) 2009: http://www.who.int/csr/disease/swineflu/en/index.html