How to Set Up a Swine-Flu Sickroom

With the H1N1 vaccine delays, using social distancing to stop the spread of swine flu is more important than ever.

October 22, 2009

Isolate the swine flu afflicted from the rest of the family. But you can leave the door open.

RODALE NEWS, EMMAUS, PA—The current swine flu outbreak is raising some interesting questions regarding the use of social distancing to prevent sickness, not only in public places, but even within your own home. Although the U.S. Centers for Disease Control and Prevention (CDC) hasn't issued formal guidelines on social distancing for small gatherings or house parties, infectious-disease experts suggest nixing these affairs if someone in the family is sick. "There aren't any published recommendations, but we can make some suggestions based on principals," says William Schaffner, MD, chair of the department of preventive medicine at Vanderbilt University in Nashville, and president-elect of the National Foundation for Infectious Diseases. "The general theme is to try to do things that are reasonable and practical."

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THE DETAILS: Nonmedicinal forms of prevention are key right now, particularly because distribution of the swine-flu vaccine is delayed. "The H1N1 vaccine is not out there freely yet," says Dr. Schaffner. "More will come out, but it won't come out in huge truckloads. It will keep dribbling out for awhile."

WHAT IT MEANS: If you or someone in your family is sick with the swine flu, you are hardly alone. At least 2 million people (and that's a conservative estimate) have been infected with swine flu so far in the U.S. The good news is, most people recover in a week or so without taking medicine or experiencing serious complications. But the virus has been shown to pose a greater risk to people with underlying medical conditions like asthma, heart disease, or diabetes, pregnant women, young adults, and small children. So it's important to take the illness very seriously and incorporate methods to reduce swine-flu transmission in your home, too.

Here's how to handle swine flu in your house:

• Call your doctor at the onset of illness. If someone in your family is sick with swine-flu symptoms, including fever (not everyone with the flu has a fever), cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue, and sometimes diarrhea and vomiting, call your doctor. He or she will decide if the patient should take prescribed antivirals or come in for a doctor's visit; taken soon enough, the meds can reduce the amount of virus shed by someone who's infected. Your doctor can also recommend safe over-the-counter treatments to help the sick person feel better. (Children and teens should not take aspirin.)

Learn how to treat swine flu, and watch for symptoms that warrant immediate attention, such as difficulty breathing, chest pain, bluish discoloration, persistent vomiting, seizures, or appearing to be less responsive or more confused, warns infection preventionist Pat Rosenbaum, RN, CIC, spokesperson for the Association for Professionals in Infection Control and Epidemiology. If a patient appears to be improving and then suddenly falls ill again, call your physician or visit the emergency room—a secondary bacterial infection like pneumonia could be setting in.

• Create a sickroom. The next step in preventing the transmission of swine flu in your home involves setting up a sickroom where the ill person spends most of his or her time. If possible, designate one person to be the caretaker who checks on the patient, delivers meals, and most important, monitors symptoms and makes sure the patient is hydrated. People more at risk for swine-flu complications (see list above) should avoid being the caretaker.

Since a person is most contagious the day before symptoms show through the first several days of the disease, it's important to keep the patient inside the room as much as possible. Flu is primarily spread through droplets sprayed when a person sneezes or coughs, so caregivers should try to stay at least six feet away as much as possible, or can even wear a paper surgical mask for extra protection. Stock the sickroom with plenty of tissues and fresh fluids like water, Gatorade, and fruit juice. And be sure to urge the sick person to sneeze into a tissue to prevent contamination in the room, and to practice proper hand washing or use of a hand cleanser often. In fact, everyone in the home should be washing his or her hands frequently.

After a few days, as symptoms ease, the patient can become a bit more mobile. "As the sick start to get better, particularly if they're not coughing, they can come out," says Dr. Schaffner. "But it's important that other family members initially keep their distance and wash their hands frequently."

• Don't make the sickroom a dungeon. It's important that the sick person stays in isolation most of the time, but as long as family members are steering clear of the room, you don't need to shut the door. "It's not airborne transmission, it's droplet. If you leave the door open, you can watch the person more readily," says Dr. Schaffner. If the door's always closed, it's harder for the patient to let you know when he or she needs something.

• Keep the infection contained. If you have more than one bathroom in your house, designate the one closest to the sickroom as the sick person's sole bathroom, and have everyone else in the home use another. If the patient has to leave the room, he or she could also wear a surgical mask to keep the droplets contained. As a general rule, people sickened with swine flu should wait a minimum of 24 hours after their fever subsides without fever-lowering medicine before returning to school or work.

• Keep it clean. You don't have to be obsessive about cleaning, wiping down doorknobs and light switches every two minutes, but because the CDC says this virus can live on some inanimate objects for two to eight hours, it is a good idea to wipe down areas in the sickroom and bathrooms. The CDC says using warm, soapy water is sufficient, but if you do want to use cleaners, avoid ones with harsh ingredients and strong fragrances that can irritate the lungs.

And remember, your greatest risk isn't from contaminated objects, it's being within the same breathing—or sneezing—zone of a sick person, generally four to 10 feet.

• Avoid hosting visitors. So a symptomatic person is quarantined, is it OK to have visitors over? "Not when you've got sickness in the home," says Dr. Schaffner. That's because others in the household who appear to be healthy could actually be infected—and in the most contagious stage—a day before they actually start showing symptoms. Other experts agree that you should shy away from hosting visitors: "I wouldn't encourage that. At this point in time, everybody is trying to prevent the spread of illness. There's limited vaccine, and you don't want to spread this any more than is necessary," says Rosenbaum.

• Find out what's happening in your area. What if people in your house are healthy, but there's an H1N1 outbreak in your community? The best way to know if there actually is an outbreak in your area is to find out if many school kids are sick, or if schools are actually temporarily closing due to illness. If that's the case, you're better off renting a movie rather than going to the movies, Dr. Schaffner suggests. He also says uninfected people—particularly ones with underlying medical conditions, or young children and pregnant women—may want to avoid going to parties, concerts, or other public places to lower their risk of being infected. "Some people have decided not to go to religious services, too, figuring they have 50 other weeks in the year when they can attend," he adds.