H1n1 Swine Fluppt

Swine or H1N1 Flu 08/19/09

Home Care Association of NYS

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Background Swine Influenza (H1N1)

First Remember, Keep Things in Perspective: • Influenza is a normal part of our lives but is always potentially dangerous, especially to the young, the elderly, or people with compromised immune systems • The more common Influenza (the flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death • There are currently three strains of influenza circulating in NYS (two seasonal) • Every year in the United States, on average 5% to 20% of the population gets the flu • This outbreak, so far, appears to be a mild strain 08/19/09

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What is Swine Influenza? • Swine Influenza (formally H1N1) is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of influenza in pigs. • Swine flu viruses cause high levels of illness and low death rates in pigs. Swine influenza viruses may circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months similar to outbreaks in humans. • The classical swine flu virus (an influenza type A H1N1 virus) was first isolated from a pig in 1930. 08/19/09

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• The 2009 flu outbreak in humans is due to a new strain of influenza • The origins of this new strain are unknown, and the World Organization for Animal Health (OIE) reports that this strain has not been isolated in swine • It passes with apparent ease from human to human, an ability attributed to an as-yet unidentified mutation • The strain in most cases causes only mild symptoms and the infected person makes a full recovery without requiring medical attention and without the use of antiviral medicines • The World Health Organization has stated that symptoms may even be less severe than seasonal influenza symptoms. 08/19/09

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How serious is it? • At this time it appears this strain is a mild virus • It may mutate eventually and become more serious • NYSDOH recommends treating this like seasonal influenza

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Will my regular flu shot help? • No, this is a different strain and influenza vaccine will not help • However, there are currently two seasonal strains of influenza circulating and NYSDOH is recommending, to help avoid confusion, that you receive a vaccination for those if you have not yet been immunized 08/19/09

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How do you catch Swine Flu? • The same way you would catch any other cold or flu virus – transmission appears to be same as seasonal flu – When an infected person coughs or sneezes around another person – Touching something with the flu virus on it then touching your mouth, nose, or eyes. – An infected person can pass the virus to another before any symptoms develop and after symptoms subside

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Symptoms of Swine Flu • Very similar to regular flu • Typically happens after regular flu season is over • Upper respiratory symptoms, may have nausea, vomiting, diarrhea • Some incidents of sudden dizziness • If feverish or have other flu-like symptoms, call your doctor or occupational health nurse! Try to avoid the emergency room or doctor’s office. 08/19/09 Home Care Association of NYS 9

Can people catch swine flu from eating pork? • No. Swine influenza viruses are not transmitted by food. • You can not get swine influenza from eating pork or pork products. • Eating properly handled and cooked pork and pork products is safe. • Cooking pork to an internal temperature of 160°F kills the swine flu virus as it does other bacteria and viruses 08/19/09

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Primary Prevention Policies Needed by Providers

• Screening for symptoms • Employees should not travel or work if ill: temp greater than 100 degrees combined with recent onset of cough, sore throat, nasal congestion • Have policies for primary prevention methods • Sick leave policies so ill employees can stay home 08/19/09

Home Care Association of NYS

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Preventing Spread of H1N1 Flu •Hand washing with soap and water or alcohol-based hand cleaner •Avoid touching your mouth, eyes and nose as much as possible •Use cough etiquette •If you are sick, stay home and avoid close contact to others •Avoid crowds 08/19/09

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What about travelers returning from Mexico? • Monitor for signs of flu • Incubation period is 1-7 days • Treat accordingly

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What Does Pandemic Mean? • A pandemic is a global disease outbreak. • An influenza pandemic occurs when a new influenza A virus emerges for which there is little or no immunity in the human population, begins to cause serious illness and then spreads easily person-to-person worldwide. • We are currently in Pandemic Phase 5 08/19/09

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Pandemic Phases

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short

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How long can viruses live on surfaces? • Some viruses and bacteria can live two hours or longer on surfaces such as ATMs, doorknobs, money, computer keyboards, etc. • Find out about infection control measures for laptops, bags, or anything you carry with you. • Keep your waterless hand sanitizer with you at all times. 08/19/09

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How long are people contagious? • 7 days after symptoms start • Children are considered to be contagious longer than adults – possibly up to 14 days • Tamiflu can reduce symptoms – refer to NYSDOH guidance/advisory 08/19/09

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Home Care Visits • Call ahead to screen for symptoms if possible • Carry PPE – fit tested N95 if available or tight fitting surgical masks; keep sealed until needed • Monitor patients • Communicate with other providers serving same patients • Family and patient education • Hand hygiene • Cases should be reported to Local Health Department 08/19/09

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Enhanced PPE • Despite saying this is transmitted through droplets, NYSDOH recommends enhanced PPE for symptomatic home care patients until more is known about transmission • No evidence of long distance transmission • In presence of Febrile Respiratory illness only 08/19/09

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Transport to Hospital • Should be based on severity of patientspecific illness per physician recommendation • Patient should wear mask during transport • Notify EMS of reason for transport

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What you can do • • • •

Stay informed Take everyday actions to stay healthy Use cough etiquette Wash your hands often with soap and water or alcohol-based hands cleaners • Avoid touching your eyes, nose or mouth. • Stay home if you get sick. Call your supervisor or occupational health office if you are exhibiting flu like symptoms 08/19/09

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What you can do • Follow public health advice regarding school closures, avoiding crowds and other social distancing measures. • Develop a family emergency plan as a precaution. This should include storing a supply of food, medicines, facemasks, alcohol-based hand rubs and other essential supplies. 08/19/09

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What should you do if you become sick? • If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, contact your health care provider or occupational health nurse • Your health care provider will determine whether influenza testing or treatment is needed • If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others 08/19/09

Home Care Association of NYS

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Questions • • • •

Resources CDC: http://www.cdc.gov/swineflu/ NYSDOH: http://www.health.state.ny.us/ HCA’s Home Care Prepare: www.homecareprepare.org • Email with infection control questions: [email protected] • Email with general questions: [email protected] 08/19/09

Home Care Association of NYS

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Mini Drill

There are many cases of suspected, probable and confirmed flu in NYS, but most related to one cluster in Queens •Monitor all patients for symptoms of swine flu – call ahead to check for symptoms if possible •Facilitate communication or transport to their physician for evaluation if suspected •Oversee their treatment at home since they won’t be eligible for admission to a hospital and will be in quarantine 08/19/09

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Your Assignment •List things that you need to educate staff about to prevent infection of staff members or others •Plan process of care for one patient who is identified with Swine flu, including frequency of visits, what to monitor for, and who you would report which things to •Develop strategies for educating aides who will be caring for patients with H1N1 08/19/09

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Your assignment • Review your role in your agency’s emergency plan, including the pandemic plan • Discuss appropriate infection control standards based on information available at this time.

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