The H1N1 flu virus, or swine flu, caused a worldwide pandemic in 2009-2010. It is now considered a seasonal flu, which continues to circulate seasonally worldwide. Spread of the H1N1 virus occurs in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching items – such as a surface or object – with flu viruses on it and then touching their mouth or nose.