This travel health notice is being provided by the Public Health Agency of Canada (PHAC) in response to the 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 information about the H1N1 influenza virus, and is subject to review and change as new information becomes available.

Global H1N1 flu virus

This travel health notice is NO LONGER IN EFFECT. Click here for a list of current travel health notices.

Updated: January 21, 2010

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

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Travel Health Notice

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 Public Health Agency of Canada recommends that individuals get vaccinated with the H1N1 flu shot before leaving Canada.

Anyone who becomes sick with 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 into place screening measures to check for symptoms of the flu among arriving passengers. You should consult the Department of Foreign Affairs and International Trade (DFAIT) for further information on whether the country you are travelling to/from has established screening measures.

About H1N1 Flu Virus

• H1N1 flu virus is a new strain of the influenza A (H1N1) virus and is different from the regular seasonal flu.
• This is a new strain of influenza that can cause serious and widespread illness as humans have little to no natural immunity to this virus.

Symptoms

• Usually includes those similar to seasonal influenza (flu) including sudden onset of cough and fever.
• Commonly includes fatigue, muscle aches, sore throat, headache, loss of appetite, and runny nose.
• Sometimes includes nausea, vomiting and diarrhea.
• In more severe cases, shortness of breath, chest pain and complications such as pneumonia may develop.
• Severe illnesses and deaths have occurred.

Transmission

• Spread through droplets that have been coughed or sneezed into the air by someone who is infected.

Where is H1N1 Flu Virus a Concern

H1N1 continues to spread around the globe. The World Health Organization (WHO) reports the following international activity:

• Globally, central, eastern, southeastern Europe, North Africa, and South Asia are showing the most H1N1 flu activity.
• In the Americas, including the South, the Caribbean, Mexico, and the United States, influenza-like illness and flu activity have declined.
• Western and northern Europe have also peaked and continue to decline. Some countries have returned to seasonal averages. Eastern Europe is still experiencing high rates of the flu.
• Although there is limited information available, reports indicate that H1N1 transmission is still high in North Africa and the Middle East, although declining in some countries that already experienced a peak in activity prior to December 2009.
• South Asia has reported increasing activity in northern areas, East Asia appears to be declining overall, and Southeast Asia continues to have pockets of transmission with generally low activity.

For more global H1N1 information, please refer to the WHO Pandemic H1N1 updates.

For more information on H1N1 in Europe, please refer to the website of the European Centre for Disease Prevention and Control (ECDC).

For more information on H1N1 in the US, please consult the Centre for Disease Control and Prevention (CDC).

Recommendations to Travellers

1. Get vaccinated with the H1N1 flu shot
   1. Adults and children six months of age and older should get vaccinated to protect themselves and their families from the H1N1 flu virus.
   2. Information about where you can get vaccinated is available from each province and territory.
2. Avoid getting the flu or spreading it to others
   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 sanitizer 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. If you do sneeze or cough in your hand, wash your hands immediately or use a hand sanitizer.
   3. Avoid contact with people who appear to be sick.
   4. 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. Where the H1N1 flu vaccine is available in your province or territory.
      3. What you should do if you are at risk of severe illness from H1N1 flu virus. At risk groups include children less than five years of age (especially those less than two years old), pregnant women and people with chronic conditions such as diabetes, asthma and lung disease.
   5. Individuals who have an underlying illness that puts them at risk for severe illness or complications may wish to consider not attending mass gatherings because of their own personal risk.
   6. If you are currently travelling or living abroad:
      1. The Government of Canada does not provide Canadians travelling or living abroad with vaccines or medication.
      2. Consult the local health authority in your destination to see whether the H1N1 flu vaccine will be available to non-residents and how to obtain the vaccine.
3. Be Aware and Prepared
   1. Find out what the H1N1 flu virus situation is in your destination and inquire about available health care in the area.
   2. Monitor this website and the World Health Organization website frequently for updates on the situation and recommendations.
   3. Pay attention to local government and public health announcements regarding movement restrictions and prevention recommendations.
4. What to do if you get sick
   1. If you are ill with the flu before you leave Canada or while abroad you should delay your travel.
   2. 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.
   3. If you are sick and must go out, consider wearing a mask if one is available. This will reduce the risk of spreading the virus in the community.
   4. Remember that access to adequate medical care abroad may be limited.
   5. Be aware of the possibility, in certain countries, of isolation and quarantine. 
   6. A list of physicians can be obtained through the nearest Canadian Embassy or consulate.  Consult the website of the Department of Foreign Affairs and International Trade for further information.
   7. If you are travelling in, or return from a country where malaria is present and you develop flu-like symptoms, seek medical help immediately.
   8. If your symptoms get worse :

      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)