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Pandemic Influenza (Flu) Guide for Individuals and Families
Developed by the Johns Hopkins Office of Critical Event Preparedness and Response

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An influenza (flu) pandemic is a widespread outbreak of disease that occurs when a new flu virus appears that people have not been exposed to before. Pandemics are different from seasonal outbreaks of influenza. Seasonal flu outbreaks are caused by viruses that people have already been exposed to; flu shots are available to help prevent widespread illness, and impacts on society are less severe. Pandemic flu spreads easily from person to person and can cause serious illness because people do not have immunity to the new virus.

A pandemic may come and go in waves, each of which can last for months at a time. Everyday life could be disrupted due to people in communities across the country becoming ill at the same time. These disruptions could include everything from school and business closings to interruption of basic services such as public transportation and health care. An especially severe influenza pandemic could lead to high levels of illness, death, social disruption, and economic loss.

This guide is designed to help you understand the threat of a pandemic flu outbreak in our country and your community. It describes common sense actions that you can take in preparing for a pandemic. As you plan, it is important to think about the challenges that you might face, particularly if a pandemic is severe. It may take time to find the answers to these challenges so it’s important to start getting ready now. 


It is important to start getting ready now for the challenges that you might face if a pandemic occurs.

Schools and day care centers may be closed for an extended period of time.

  • Make sure you have a back-up plan if schools and day care centers are closed.

Other businesses may be closed.

  • Banking and credit services may be interrupted. You may have to pay for goods and services with cash.

Transportation services may be disrupted.

  • Consider other ways to get to work if you usually rely on the bus or subway.

Families may find it hard to keep in touch.

  • Create a family communication plan.

Shortages of food, supplies and water may occur.

  • Consider stocking at least a two week supply (preferably more) of water and non-perishable food, which is refreshed, according to expiration date. This can be helpful in power outages and disasters.
  • Gather emergency and other supplies. See for details.

General Disaster Supplies



  • Get your seasonal flu shot to keep you baseline healthy. (NOTE: A seasonal flu shot will not protect you from a new virus strain like the avian flu, but can keep you healthier.)
  • Eat a balanced diet, exercise in moderation and get plenty of rest.
  • Wash your hands frequently with soap and water or use an alcohol-based hand cleaner, like Purell®.
  • Cover your mouth and nose with a tissue when you cough or sneeze.
  • Put used tissues in a waste basket, not in your purse or pocket.
  • Use a surgical mask if you are instructed to do so, especially when taking care of others who are sick.
  • Practice “social distancing” by limiting the amount of face-to-face contact you have with people. (Use the telephone or email and avoid places where crowds may gather such as cafeterias, restaurants, public transportation, etc.)
  • Frequently clean commonly used surfaces such as counters, railings, washbasins/toilets, telephones, computer mouse, grocery cart handles with disinfectant. 
To make water drinkable: Bring water to a rolling boil for 4-5 minutes.
To avoid dehydration drink Gatorade® or make your own electrolyte drink: 1 quart or litre of water; 1 level tsp. of table salt; 2 level tbs. sugar (do not use artificial sweetners). Mix well until sugar is dissolved. Solution may be served at room temperature but do not boil.
Make your own disinfectant: Mix 1 gallon water with 1/4 cup of bleach. Store in a labeled and closed container.


  • Provide plenty of fluids. Avoid alcohol and beverages with caffeine, as these dehydrate people.
  • Keep patient clean, dry, warm and isolated from others in the house.
  • Reassure patient that you will take care of him/her.
  • Take the patient’s temperature morning and evening and keep a record. Give fever–reducing medication such as acetaminophen (e.g., Tylenol™) or ibuprofen (e.g., Advil™, Motrin™ or other). Aspirin may be used but must be avoided by anyone under age 20.
  • Consider a lukewarm water sponge bath or tub bath to help reduce fever.
  • Encourage gargling with warm salt water or using throat lozenges to help reduce throat pain.
  • To ease sore throat pain, offer ice cream, sherbet, popsicles or sorbets.
  • Every 2 – 3 hours, help patient change position in bed and take brief walks around the room to avoid chest congestion. In addition, have patient take 4-5 slow, deep breaths and try to cough.
  • For nausea, vomiting and diarrhea, offer clear liquid diet and small sips of fluids with electrolytes. Give ice chips, liquids, and avoid acidic drinks such as citrus or cranberry juice.
  • Call a health care provider if patient has: confusion or extreme irritability; difficulty breathing or chest pain with each breath; cough producing frothy or red saliva; bluish skin; stiff neck; inability to move arm or leg or first-time seizure.
  • See a health care provider if high or worrisome fever develops. Guidelines for fever are:
    - Infants under 3 months – a fever of 100.4ºF or above taken rectally
    - Children from 3 months to 2 years – a fever of 103ºF or above
    - Children over 2 years to adults – a fever of 104ºF or above

    Sources: U.S. Department of Health and Human Services, “Now is the time to prepare. Your Guide to Pandemic Flu Care in the Home” Howard County General Hospital, Howard County Health Department and the Horizon Foundation, U.S. National Security Agency

    References: For additional information, please see and


Symptoms of the flu include fever, headache, muscle aches/pains, intense fatigue, inflammation of the respiratory tract, sore throat and cough, nausea, vomiting. Some flu-like symptoms may not always be present in the elderly or in young children. If you are sick, call your Supervisor or Manager and then stay home! Seek medical attention if your symptoms are severe.

Sources: U.S. Department of Health and Human Services, U.S. National Security Agency.

References: For additional information, please see the CEPAR website and

Public Affairs media contacts for the Johns Hopkins Bloomberg School of Public Health: Tim Parsons at 410-955-7619 or

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