This travel health notice is being provided by the Public Health Agency of Canada (PHAC) in response to the recent outbreak of H1N1 flu virus. This document has been developed to protect the health of Canadian travellers. This travel health notice is based on current available scientific evidence about this emerging disease, and is subject to review and change as new information becomes available.

Global H1N1 flu virus

Updated: September 14, 2009

• Travel Health Notice
• About H1N1 Flu Virus
• Where is H1N1 Flu Virus a Concern
• Recommendations to Travellers
• Monitor your Health
• Don't Forget...
• Other Related Information

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Travel Health Notice

A new strain of the H1N1 influenza virus was identified in the spring of 2009.  Referred to as H1N1 flu virus, this virus has never previously been identified in humans and has now been reported in many countries. The Public Health Agency of Canada, along with the World Health Organization and public health authorities around the world, continue to monitor the spread of cases of H1N1 flu virus globally.

The World Health Organization raised the pandemic alert level to Phase 6 on June 11, 2009.  This was in response to continued spread of the H1N1 flu virus around the world. This means that H1N1 flu virus is being transmitted easily among humans in more than one continental region and that the outbreak is now global.  It is important to note that it does not reflect the severity of the illness, just the spread of the virus.

Individuals who have an acute respiratory illness either before leaving Canada or while abroad should delay travel to reduce the risk of spreading the virus.

Some countries have put quarantine measures in place for people travelling from countries reporting cases of H1N1, such as Canada.  Information and assistance for Canadians travelling abroad, who may be subjected to quarantine measures, are provided by the Department of Foreign Affairs and International Trade (DFAIT).

About H1N1 Flu Virus

• H1N1 flu virus is a new strain of the influenza A H1N1 virus.
• It is a virus with a combination of genes from pig (swine), bird (avian) and human flu viruses that has never been previously detected in either human or swine.
• This virus is being detected among humans in many countries around the world and is currently being spread from person-to-person within communities.

Where is H1N1 Flu Virus a Concern

• H1N1 is being reported in many countries around the world.  Up-to-date information on the number of cases can be found at the following:
  • United States: Centres for Disease Control and Prevention (CDC)
  • Mexico: Secretaria de Salud / Secretary of Health, Mexico (webpage in Spanish)
  • Countries in the European Union and European Free Trade Association
  • Other countries: World Health Organization
    and Pan American Health Organization
• Countries in the Southern Hemisphere have reported cases consistent with a normal influenza season (April to September); however, the peaks in illness seem to have already occurred in many of these regions.

Recommendations to Travellers

1. Wash your hands frequently
   1. By washing your hands with soap under warm running water, you will reduce your chance of getting the flu.
   2. Alcohol-based hand gel can also be used if soap and water are not readily available. It's a good idea to keep some with you in your pocket or purse when you travel.
2. Practice proper cough and sneeze etiquette .
   1. Cover your mouth and nose with your arm, not your hand, to reduce the spread of germs. Remember to wash your hands afterwards.
3. Avoid contact with people who appear to be sick.
4. Monitor this website and World Health Organization website frequently for updates on the situation and recommendations.
5. Pay attention to local government and public health announcements regarding movement restrictions and prevention recommendations.
6. If you are ill with the flu either before you leave Canada or while abroad, you should delay your travel.
7. See your health care provider before you travel to discuss:
   1. Whether you are up-to-date with your routine vaccinations and what vaccines you need for your destination.
   2. The H1N1 flu virus situation in your destination and available health care in the area.
   3. Whether you are at risk of severe illness from influenza (for example, persons with chronic conditions such as diabetes, lung disease, heart disease, elderly or children under 2 years of age).
   4. If you should get a seasonal flu shot particularly if travelling to the southern hemisphere where it is currently flu season.
8. Travelers returning to Canada, who develop symptoms of flu, are advised to follow recommendations in the Monitor Your Health section.

Monitor your Health

While travelling or back in Canada,

1. If you develop symptoms of flu
   1. Stay in your accommodations or hotel (while travelling) or at home (if back in Canada) and avoid contact with others until you are symptom free and able to participate fully in regular activities.
   2. If you are travelling in, or return from a country where malaria is present and you develop flu-like symptoms, seek medical help immediately.
   3. Wash your hands frequently.
   4. Cough and sneeze into your arm and not your hand.
   5. If you are sick and must go out, consider wearing a mask if one is available, to reduce the risk of spreading the virus in the community.
   6. Be aware of the possibility, in certain countries, of isolation and quarantine.
   7. A list of physicians can be obtained through the nearest Canadian Embassy or consulate.  A listing of these establishments can be accessed through the web site of the Department of Foreign Affairs and International Trade (DFAIT).
2. Should your symptoms worsen
   Before seeking medical attention, it is recommended that you call ahead to your health care provider or urgent care facility to inform them of your symptoms and your recent travel history.

Don't Forget …

1. Consult a doctor, nurse or health care provider, or visit a travel health clinic at least six weeks before you travel.
2. What to do if you get sick when you are travelling.
3. What to do if you get sick after you return to Canada.
4. Know what vaccines you need and when to get them.

Other Related Information

• Fightflu.ca 
• Public Health Agency of Canada – Human H1N1 Flu Virus
• PHAC - Seasonal Influenza (Flu) and Travel: Fact Sheet
• Department of Foreign Affairs and International Trade (DFAIT) - Information for Canadian travellers in foreign countries
• World Health Organization - Influenza A (H1N1)