Transcript H1N1 Flu (Swine Flu) Infections Alert for Institutions of

Interim Guidance for special
situation (H1N1 Flu)
By
Dr. AMAL FATHY
A. Prof. of pulmonary medicine
Thoracic Medicine Department - Mansoura University
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The swine flu in humans is most contagious
during the first five days of the illness although
some people, most commonly children, can remain
contagious for up to ten days.
Germs Spread when droplets from a cough or
sneeze of an infected person move through the air
and are deposited on the mouth or nose of people
nearby.
We know that some viruses and bacteria can live 2
hours or longer on surfaces like cafeteria tables,
doorknobs, and desks.
Recommendations to prevent spread of the virus
among humans include using standard infection
control against influenza .
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CDC has implemented its emergency response.
The agency’s goals are to reduce transmission and
illness severity, and provide information to help
health care providers, public health officials and
the public address the challenges posed by the new
virus .
The World Health Organization has raised the
worldwide pandemic alert level.
In response to these developments, CDC is
recommending
that
states,
communities,
institutions and individuals assess their emergency
response plans and capacities .
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Experts agree that hand-washing can help prevent
viral infections, including ordinary influenza and
the swine flu virus.
Influenza can spread in coughs or sneezes, but an
increasing body of evidence shows small droplets
containing the virus can linger on tabletops,
telephones and other surfaces and be transferred
via the fingers to the mouth, nose or eyes .
Alcohol-based gel or foam hand sanitizers work
well to destroy viruses and bacteria .
Anyone with flu-like symptoms such as a sudden
fever, cough or muscle aches should stay away
from work or public transportation and should
contact a doctor to be tested.
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Social distancing is another tactic. It means
staying away from other people who might
be infected and can include avoiding large
gatherings, spreading out a little at work, or
perhaps staying home and lying low if an
infection is spreading in a community.
Public health and other responsible
authorities have action plans which may
request or require social distancing actions
depending on the severity of the outbreak.
CDC recommendations for post secondary
institutions of higher education
Review your institutions plans for responding to a
public health emergency and make sure they are up
to date .
 Know local/state plans for institutions of higher
education in the event of a mild or severe disease
outbreak.
 Ask your campus health center to develop and
implement a system to track and report (to the local
health department)influenza-like illness among
students .
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CDC recommendations for post secondary
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institutions of higher education
Persons with influenza-like-illness should
consult their physician and the institution
should consult with their local or state
health department for recommendations on
identifying persons with H1N1 flu and ways
to prevent spread of this virus .
Institutions of higher education should
promote everyday preventive actions for
students and staff:
CDC recommendations for post secondary
institutions of higher education (Cont.)
1. Cover your nose and mouth with a tissue when
you cough or sneeze .
2. Throw the tissue in the trash after you use it .
3. Wash your hands often with soap and water,
especially after you cough or sneeze. Alcoholbased hand cleaners are also effective .
4. Avoid close contact with sick people .
5. Avoid touching your eyes, nose or mouth. Germs
spread this way .
6. If you get influenza-like illness symptoms, stay
home from work or school except to seek medical
care and limit contact with others to keep from
infecting them .
Recommendations When H1N1 2009 Virus is
Confirmed in a School, School District, or Community
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Schools play a critical role in protecting the health
of their students, staff, and the community from
contagious diseases such as H1N1 influenza .
Children are very susceptible to getting this new
virus and schools may serve as amplification point
for spread of this new virus in a community .
The reason for closing schools during this H1N1
outbreak is to try to reduce the spread of the
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Decisions to dismiss students and close
childcare
facilities
and
subsequent
implementation of those measures should be
made based on the extent and severity of
illness .
That local authorities decide whether or not
to dismiss schools or close childcare
facilities.
Authority for decision-making may reside in
multiple sectors and local government; these
entities must be well coordinated
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Sick people (students, faculty and staff)
should stay home unless they need to seek
medical care and stay away from schools
regardless of whether schools and childcare
facilities are operating normally or have
dismissed students or closed, respectively .
Dismissal of students in a school and
closure of childcare facilities should be
considered in schools with one or more
laboratory-confirmed or non-subtypable
influenza A case among students, faculty or
staff .
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Closure of childcare facilities should be considered
for not-yet-affected schools and childcare facilities
in the same area if more than one school or
childcare facility in that area has confirmed or nonsubtypable influenza A cases among their
students, faculty, or staff .
Neighboring schools to those that dismiss
students should also closed. According to the
geographic proximity and extent of mixing of
student populations among area .
School or childcare-related gatherings should be
canceled
Parents and students should be encouraged to
avoid congregating in large numbers outside of the
school setting .
Considerations for Pregnant Women
who are More likely to be Exposed to
Novel H1N1 Flu (Swine Flu)
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Evidence that influenza can be more severe in
pregnant women comes from observations during
previous pandemics and from studies among
pregnant women who had seasonal influenza.
An excess of influenza-associated excess deaths
among pregnant women were reported during the
pandemics of 1918–1919 and 1957–1958.
Adverse pregnancy outcomes have been reported
following previous influenza pandemics, with
increased rates of spontaneous abortion and
preterm birth reported, especially among women
with pneumonia.
What if I get this new virus and I am
?pregnant
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Case reports and several epidemiologic studies conducted
during interpandemic periods also indicate that pregnancy
increases the risk for influenza complications for the
mother and might increase the risk for adverse perinatal
outcomes or delivery complications.
We don’t know if this virus will do the same, but it should
be taken very seriously.
Pregnant women who have suspected swine influenza A
(H1N1) virus infection should be tested , and specimens
from women who have un-subtypeable influenza A virus
infections should have specimens sent to the state public
health laboratory for additional testing to identify swine
influenza A (H1N1).
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Take these everyday steps to help prevent the
spread of germs and protect your health
Have a plan to care for sick family members .
Stock up on household, health, and emergency
supplies, such as medication, non-perishable
foods.
Pregnant women who will likely be in direct
contact with patients with confirmed, probable, or
suspected influenza A (H1N1) (e.g., a nurse,
physician, or respiratory therapist caring for
hospitalized patients), should consider
reassignment to lower-risk activities, such as
telephone triage
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If reassignment is not possible, pregnant women
should avoid participating in procedures that may
generate increased small-particle aerosols of
respiratory secretions in patients with known or
suspected influenza, including the following
procedures:
Endotracheal intubation
Aerosolized or nebulized medication administration
Diagnostic sputum induction
Bronchoscopy
Airway suctioning
Positive pressure ventilation via face mask (e.g.,
BiPAP and CPAP)
High-frequency oscillatory ventilation
Breastfeeding considerations
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A mother’s milk is made to fight diseases in her
baby. This is really important in young babies
when their immune system is still growing .
Do not stop breastfeeding if you are ill. Breastfeed
early and often. Limit formula feeds if you can.
This will help protect your baby from infection .
If you are too sick to breastfeed, pump and have
someone give the expressed milk to your baby .
Antiviral medication treatment or prophylaxis is
not a contraindication for breastfeeding.
The risk for swine influenza transmission through
breast milk is unknown. However, reports of
viremia with seasonal influenza infection are rare.
H1N1 Flu (Swine Flu) and Travel
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During the swine influenza outbreak, extra vigilance is
required to identify and report passengers with respiratory
symptoms or fever. Any passenger who appears ill, or who
reports not feeling well, should be observed or queried for
the following signs or symptoms:
Feeling feverish or temperature greater than 100°F (37.8°C)
if measured. For children, feeling warm by parent’s report.
Sore throat
Cough
Stuffy or runny nose
Any passengers observed to have or who report having two
or more of these symptoms should be reported immediately
to the CDC Quarantine Station in the jurisdiction of the
airport where the plane is expected to land.
Preventing the Flu: Good Health
Habits Can Help Stop Germs
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The single best way to prevent seasonal flu is to
get vaccinated each year, but good health habits
may also help protect you against the flu.
Although the current trivalent influenza vaccine is
unlikely to provide protection against the new 2009
H1N1 strain, vaccines against the new strain are
being developed and could be ready as early as
June 2009.
There also are flu antiviral drugs that can be used
to treat and prevent the flu .
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Avoid close contact.
Stay home when you are sick .
Cover your mouth and nose.
Clean your hands.
Avoid touching your eyes, nose or mouth.
Practice other good health habits.