Swine flu information

Arthritis Care has compiled the latest information on the risks to people with inflammatory arthritis, what you should do to minimise the risk, and what you should do if you think you have caught it.

The information is from the (now closed) NHS national flu service and the British Society for Rheumatology

1.    What are the symptoms?

The symptoms of swine flu typically consist of a fever or a high temperature (over 38°C / 100.4°F) plus two or more of the following symptoms – unusual tiredness, headache, runny nose, sore throat, shortness of breath or cough, loss of appetite, aching muscles, diarrhoea or vomiting.

2.    Am I more at risk if I am taking methotrexate and other drugs, and will the symptoms be worse if I catch it?

Although these drugs affect your immune system, you are likely to be more at risk if your arthritis is not controlled with them. As far as is known, the risk of contacting swine flu and the time symptoms will last is no more than for normal flu. However, you may be a higher risk of developing a secondary bacterial infection so you should report any worsening of flu symptoms to your GP.

3.    What should I do if I am exposed to someone who has symptoms of swine flu?

If you have been in direct contact (within one metre) of someone with definite swine flu you should stop DMARD and biologic treatment for a week and restart if you have not developed symptoms – unless your rheumatologist has recommended that you do not stop treatment.

Oseltamivir (Tamiflu) will generally only be given to people who have been diagnosed with swine flu, but contact your GP if you are concerned you are developing symptoms. If you have severe underlying disease you could have a higher risk of flu-related complications, so it might be possible to get anti-flu drugs like oseltamivir (Tamiflu) or Zanamivir (Relenza) before symptoms appear.

4.    What should I do if I think I have swine flu?

Now that the National Swine Flu Service has closed, everyone who thinks they might have swine flu should contact their GP. If you have inflammatory arthritis, it's important you do this quickly, even if your symptoms are milder than normal for swine flu. Some drugs for inflammatory arthritis, including steroids and biologics, can mask the symptoms. Tell them that you are taking drugs that suppressed your immune system.

If you don’t have anyone who can get anti-flu drugs for you, mention this because there should be help available locally through your primary care trust or health board. It is important to take anti-flu drugs as soon as possible after symptoms start because they need to be taken within 48 hours to be effective.

5.    Can I take my regular medications if I have swine flu?

If you are on steroids it is important to keep taking them as advised by your doctor. You should stop DMARD and biologic treatment until the symptoms have gone away and restart once symptoms of swine flu have disappeared – unless your rheumatologist has recommended that you do not stop treatment. Contact your rheumatology department for advice.

If your flu symptoms are very severe or deteriorating and you feel unwell it is important to seek advice from your GP.

6.    Can I take Tamiflu with my regular painkillers and NSAIDs?

Yes, these medicines are safe to take with Tamiflu. But contact your GP if your symptoms are severe or suddenly become worse.

7.    What should I do if my partner or carer has symptoms?

It is important to avoid as much contact as is practically possible with a spouse or carer. If possible, try to avoid close contact (1.5-2 metres) with them until five days from when their symptoms started. Sleep in a spare room if possible. Strict hygiene should be observed with frequent hand washing and wiping down of hard surfaces.

They should always cover their mouth and nose when they cough or sneeze, and regularly wash their hands with soap and water. If possible, you could ask a friend or relative to collect medicines and groceries for you, order any repeat prescriptions, help with basic household tasks like cooking and generally care for you. Plan ahead by arranging for friends or relatives to help you, if you fall ill.

8.    How can I get a sick note if I can't go to the doctors surgery – can I get one retrospectively?

Yes, as long as you notify your GP when you first develop symptoms.

9.    Can I get swine flu twice?

Yes, because the virus can change, although you may have some protection from having had a similar virus previously.

10.    What about vaccines?

People taking medication for arthritis to suppress the immune system are among those most at risk, and are being offered an immunisation by their GP. Those living with people with a weakened immune system are also recommended to have the vaccination.

The vaccine does not carry a 'live' virus, so it cannot give you swine flu. Some people may experience a mild fever and flu-like symptoms for a day or two after immunisation, but this will NOT be flu. Unless you know for sure that you have had swine flu, it is suggested you have the vaccination.

People with a weakened immune system will need a booster jab after at least three weeks. Children from six months to nine years will also need a booster after at least three weeks.  

Seasonal flu is a different virus from swine flu so if you normally have a seasonal flu jab, it is really important that you have one this year too. You can normally have both vaccines at the same time if you choose to.

Where can I get more information?

NHS Choices

British Society of Rheumatology