Swine Flu / H1N1

Note: excerpted from a more complete article at our home site, weninchina.com.  Check out our new content - packing lists, tipping advice, essential Mandarin phrases, and more!

Easy to get, easy to spread. Be careful.

The Spring 2009 outbreak of the H1N1 flu strain sent Asian countries into crisis mode immediately. Initial efforts in China and Japan focused on isolating people believed to be carrying the disease, especially those traveling from Mexico. It is now clear the virus had already spread around the world before governments were broadly aware.

Now that the initial wave of the disease has passed, we have learned that the virus passes more easily than the typical flu, over a longer period of time. You can infect other people before you even start feeling symptoms yourself, and for a few days after you start feeling better.

We have also unfortunately learned that while this strain seems no worse than typical flu among adults, and that the elderly seem to have some degree of immunity, children are affected with severe symptoms far more than the normal rate.

Asian countries, having borne the tremendous cost of the 2006 SARS epidemic, are especially sensitive to the potential of mass disease. Their governments are under immense public pressure to take rapid, concrete action at the first sign of trouble, even if later on such action looks far out of proportion to the actual threat. 

In case your area is closed off

With H1N1 now widespread, enforced quarantines against entire airplanes or hotels are not effective, and there have not been recent news articles about these tactics being used against the flu. (But, there was a town in western China shut down in Summer 2009 due to a plague outbreak, so that is an option for authorities to use if they feel they need to.) 

However, in the event that an outbreak does become severe enough that local or national governments do have to close off the area you are in – which could be just your hotel, or even your city – do not expect special treatment just because you are working with the government on your adoption. (Local officials are likely going to be stuck in their apartments, too.) As a foreigner, you’re going to want to keep a low profile and stick to your hotel. Comply with any directions you are given by Public Security or hotel staff, and rely on your local adoption agency representative’s advice.

If the delay is several days, get in touch with your airline to let them know you’ll need to make changes for your trip out of Guangzhou. They will understand your situation and help as best they can; carriers in Asia have had to become flexible about dealing with these kinds of events.

What you can do to prevent getting sick – and to protect your child

• Be immunized with the H1N1 vaccine as soon it is available to the general public in your area. If you are traveling in Fall 2009 – Winter 2010, ask your travel clinic or family doctor if you can be on a priority list, as your child will certainly be at high risk.
• Also get the standard flu shot, if you have not already done so.
• Wash your hands often, and use hand sanitizer (gel or wipes) liberally. Be sure to include sanitizer as you pack for the trip.
• Maintain a healthy distance from family or coworkers who show flu symptoms. You cannot tell from symptoms alone which strain a person is infected with; not that you want the “regular” flu, either.)
• Get plenty of rest, exercise, take fresh air, and eat a healthy diet. Adequate sleep has also been found to boost the effectiveness of the flu vaccine.
• If you feel fine, there’s no need to wear a face mask.

In case you do get sick on the trip

• Talk with your agency rep as soon as you start feeling symptoms (fever, runny nose, coughing, sore throat.) He or she will determine if you need medical intervention.  From personal experience – my daughter and I both caught it in October 2009 – I can tell you that the onset of symptoms happens almost instantly: a rush of fever, nausea, and lack of appetite. 
• Try to isolate yourself as much as possible. If the weather is nice, fresh air and sunshine will help you mood as well as your immune system. In case of smog, definitely keep inside.
• Sneeze into your sleeve, or keep plenty of tissues around. Face masks help somewhat in this case to keep you from spraying more virus into the air.
• Get plenty of sleep and fluids. (The soups in China are exactly what the doctor ordered…) Use ibuprofen (Advil) or acetominofen (Tylenol) to keep your fever under control.
• Only travel if absolutely essential, such as for signing paperwork, and use a mask in public for such trips. Skip the sightseeing, not that you’ll feel well enough to do it. 
• With luck, the fever will break in a couple days, but if your condition worsens, call the hotel front desk and ask for medical attention.

Physical preparation for your trip

Making sure your body is ready for two weeks in China should involve more than merely getting shots at the travel clinic. (But by all means, go to your travel clinic! Great article about it in this weekend's Denver Post here.) You’re not running a marathon, but there are times when your strength will be tested:

• Sixteen hours in an airplane each way - not in business class
• Standing for possibly hours in line, often holding your toddler, for passport checks, security screenings, baggage, and at the consulate
• Climbing the Great Wall - while you’ll go to the “tourist area,” that doesn’t mean it’s flat or easy
• Walking all the way through Tiananmen Square and the Forbidden City
• Thick smog, extreme heat, tropical humidity, intense sun
• Extended periods without access to modern toilet facilities
• Getting sick from - something - whether food poisoning or the flu
• Lifting and carrying your new 20-pound child, especially if she is your first child...

The conditioning you’ll want to do depends on your current fitness level, of course, and talk with your physician about your goals and any special considerations you may have.

Some activities that worked well for us, and other travelers, included:

• Hiking at the park for 40 minutes every night
• Wearing a backpack or kelpie to get used to the feeling, then adding a small amount of weight every day or two (such as a paperback novel) to build endurance
• Stair-climbing or crossing rugged terrain
• Losing weight, but keeping well-hydrated
• Stretching and exercises to promote flexibility (very useful for keeping comfortable in the airplane)
• Plenty of sleep in general. China’s time zone is too far out of sync with North America to try re-setting your internal clock ahead of the trip, however.

We wish we could say that doing these things allowed us to scale the Great Wall for miles without losing our breath, or to trek through the alleyways of Guangzhou without noticing the heat, but that wouldn’t be true. But the conditioning did help - we wouldn’t have gotten as far as we did, or enjoyed the trip nearly as much, if we hadn’t prepared.

With the current worries about the H1N1 "swine flu", these activities are also beneficial to helping your body ward off the virus, or help you recover should you be infected.

Another benefit of the physical training was that it helped us pass the time between referral and travel more quickly. We felt like we were accomplishing measurable progress toward our goal with each step, and taking control of something when so much was out of our hands.

The time we spent together gave us the chance, too, to talk about our hopes, expectations, fears, and plans.

Finally, the conditioning we did before the trip was the last real extended run we’ve had of proper exercise - our lives with a toddler since then just haven’t given us that kind of flexibility!