Ministry of Public Health
Public Health Advice No. 8
Subject: Pandemic H1N1 2009
9 July 2009
-------------------------At present, Pandemic (H1N1) 2009, formerly called “Influenza A(H1N1)”, has been spreading
so rapidly while the severity of the disease is moderate. In Thailand, there have been many
reported cases of the pandemic among schoolchildren, university students, and working-age
people in Bangkok and its vicinity as well as more than 60 other provinces.
Advice for the general public
The public are advised not to get into a panic about the disease. Meanwhile, they are
recommended to acquire knowledge about it in order to seek ways to protect themselves
against the virus by means of monitoring the Ministry of Public Health’s advice;
maintaining good health; regularly exercising; eating nutritious food like vegetables, fruit,
eggs, milk, etc.; having enough sleep; often washing their hands; avoiding closely mixing
with patients with influenza-like symptoms; and fostering a habit of not using their fingers or
hands to pick their nose, rub their eyes, or even touch their face. To be safe from the viral
infection, tissue paper should be used, if necessary. Moreover, people are able to look after
themselves or their family members as well as prevent the viral transmission by
suspending studying or working, covering their nose and mouth with a tissue when coughing
or sneezing, wearing surgical masks while socializing with other people, and often washing
their hands. This will help keep the epidemic under control as well as reduce other impacts as
much as possible.
Patients with pandemic H1N1 2009 usually have symptoms of illness that are similar to
those of seasonal influenza which include fever, headaches, body aches, fatigue, cough, sore
throat, nasal congestion, runny nose, loss of appetite, and, probably in some cases, vomiting
as well as diarrhoea. Very few (4–5) cases have been reported with symptoms of encephalitis.
A majority of the patients (95%) develop mild symptoms and will gradually get better
(declining temperature, less coughing, and eating more). Finally, they will recover in 5–7
days without a need to be hospitalized.
A minority of the patients (5%) have severe symptoms and are vulnerable to death. Their
symptoms include high fever which does not gradually decline within two days,
drowsiness or exhaustion, do not eat food, a lot of vomiting, a lot of coughing and chest pain,
and pneumonia (rapid breath and exhausted). Most (70%) of such cases have been found to
have risk factors such as those with chronic diseases (pulmonary diseases, asthma, heart
diseases, haematological diseases, kidney disease, diabetes, etc.), low immunity (cancer, HIV
etc.), and obesity, pregnant women, people aged 65 years or over, and children under 5. Some
(30%) of the minority cases, however, have severe symptoms but their fatal risk factors
cannot be detected. As a result, such patients need to seek medical care at a large government
or private hospital immediately.
Home care for patients with mild symptoms
A patient with mild symptoms of illness (low grade fever, non-lethargy or exhaustion, and
being able to eat some food) can look after him/herself at home by acting in accordance with
the following advice:
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
The patient is advised to suspend studying or working and rest at home or his/her
dormitory for at least seven days after falling ill or at least one day after getting well
to pass the viral transmission period.

The patient is required to notify his/her educational institution or workplace of the
illness in order to keep Pandemic (H1N1) 2009 under surveillance and take the
disease prevention and control actions in time.

The patient has to take some antipyretic such as paracetamol (aspirin is forbidden)
and some symptomatic treatment drugs like an expectorant and a decongestant as
recommended by a pharmacist or medical clinic, or as prescribed by a physician.

As influenza is caused by a virus, it is unnecessary to take antibiotics except
that a bacterial complication is detected. If so, all antibiotics must be taken as
prescribed by a doctor.
The patient needs to be given a rub with a towel damped with tepid clean water
to lower fever. It is advisable to initially rub from the limbs to trunk; rubbing the
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
forehead, armpits, groins, elbow folds, and knee folds is particularly needed. While
rubbing, the patient should be covered up with a blanket on his/her chest to prevent
the risk for pneumonia. In case the patient is chilled, the rubbing must be stopped and
he/she needs to be covered up with a blanket.
The patient should drink a lot of tepid clean water and fruit juice, avoid very cold
water.

The patient should adequately eat less-spicy soft dishes like rice soup, boiled rice,
eggs, vegetables and fruit.

The patient needs to get a lot of rest and sleep in a well-ventilated room that is not too
cold.

In case his/her symptoms become more severe such as having high fever that
does not decline within two days, being lethargic or exhausted, being unable to eat
food, a lot of vomiting or diarrhoea, a lot of coughing and chest pain, rapid breath and
being exhausted, the patient has to go to a hospital immediately.
Prevention of viral transmission to other family members

The patient is advised to stay in a separate room all the time until he/she has been
fully recovered for at least one day in order to pass the viral transmission period.

The patient is required to have meals separately. If his/her symptoms become less
severe, he/she may possibly eat food with other people. It is, however, necessary for
him/her to use serving spoons to scoop food.

The patient must not use personal effects such as handkerchiefs, towels, glasses,
straws, etc. together with other people.

The patient needs to cover his/her nose and mouth with tissue paper when coughing
or sneezing, and discard the used paper into a garbage bin. After that he/she has to
clean his/her hands with alcohol gel or water and soap often.

The patient is required to wear a surgical mask to prevent the viral transmission to
other people.

The patient’s caretaker is advised to wear a surgical mask as well and wash hands
with soap and water or alcohol gel often.

Other family members are advised to be about 1–2 metres or at least an arm’s length
away from the patient.
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Sources of information: Local public health agencies

In Bangkok: Disease Control Division, Department of Health, Bangkok Metropolitan
Administration: Tel 0 2245 8106, 0 2246 0358, 0 2354 1836

In other provinces: Provincial Public Health Office in each of the provinces
For more information, please visit the Ministry of Public Health’s website: www.moph.go.th
and for questions, call the Department of Disease Control’s Operations Centre at 0 2590 3333
or MOPH’s Hotline Centre at 0 2590 1994 around the clock.
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