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, and the H1N1 strain has established itself all over the world.

As that wave of the disease eventually peaked and passed, we learned that particular strain 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 also unfortunately learned that while the H1N1 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. 

 Photo by  Kyle Simourd  via Flickr, CC 2.0 license

Photo by Kyle Simourd via Flickr, CC 2.0 license

In case your area is closed off

Enforced quarantines against entire airplanes or hotels were shown to not be effective in 2009, 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 a Westerner. (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 tour guide'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. 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 a multi-strain flu vaccine each year as soon it is available to the general public in your area; the H1N1 strain is covered for the 2015-2016 season. If you are traveling in the fall or winter, and vaccines are limited, ask your travel clinic or family doctor if you can be on a priority list, as your child will certainly be at high risk.

  • Talk with your doctor or travel clinic about obtaining a supply of Tamiflu for emergency use.

  • 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 and aren't sneezing, there's no need to wear a face mask.

 Photo by  Tony Hisgett  via Flickr, CC 2.0 license

Photo by Tony Hisgett via Flickr, CC 2.0 license

In case you do get sick on the trip

  • If you are part of a group tour, talk with your representative 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 – the onset of symptoms happens almost instantly: a rush of fever, nausea, and lack of appetite.
  • If you do have a supply of Tamiflu, follow the directions and use it as soon as symptoms appear.

  • 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 or cold, damp conditions, 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, Japan, and Korea 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.