Health Care Workers Safety in Influenza

8/2/2019 Health Care Workers Safety in Influenza

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Circulating Influenza Strains and

Pandemics in The 20th Century

1920 1940 1960 1980 2000

H1N1

H2N2H3N2

1918: Spanish Flu1957: Asian Flu1968: Hong Kong Flu20-40 million deaths 1-4 million deaths 1-4 milliondeaths

Dr.T.V.Rao MD 2
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What is Swine Flu?

Swine flu (also called swine influenza) is outbreaksin pigs.

People do not normally get swine flu, but humaninfections can and do happen. Swine flu viruses have

been reported to spread from person-to-person, butin the past, this transmission was limited and notsustained beyond three people.

The 2009 swine fluoutbreak (began in April) in

humans is due to a new strain of influenza A virussubtype H1N1 that derives in part from humaninfluenza, avian influenza, and two separate strains ofswine influenza.

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HOW DOES SWINE FLU SPREAD?

Coughing orsneezing of people

with influenza

Touching somethingwith flu viruses to

yourmouth ornose

Spqeadof theswineinfluenza A(H1N1)viqus[the same as seasonal fluspreads]

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Viral Re-assortment

Reassortment in pigs

Reassortment in

humans

Pandemic InfluenzaVirus

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PIG THE CREATOR

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EPIDEMIOLOGY

Incubation period- 1-7 days Transmission

PRIMARY CASEdirect contact with pigs

SECONDARY CASESsneezing, coughing

respiratory droplets

body fluids(diarroeal stool)contact surfaces

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Transmission

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Spread of Influenza Virus

This virus is not transmitted from eating porkor pork products

Contagiousness:

1 day onset of symptoms

7 days

Children are contagious for longer periods.

. Majority of patients were previously healthy.

Clinical course mild in PCR negative influenza.

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EARTH LIVING SPACE FOR ALL

Including Influenza Virus

n Epidemic: An increase in disease above what is normally expected

n Pandemic: A worldwide epidemic

A pandemic begins when: there is person-to-person

sustained transmission on multiple continents

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Signs and Symptoms

Human Influenza

Type of infection Upper and lower respiratory

Fever Yes

Headache Yes

Cough Yes

Respiratory symptoms Varies; sore throat to difficulty breathing

Gastrointestinal symptoms Uncommon, except children, elderly

Recovery 2-7 daysDr.T.V.Rao MD 13


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Swine flu

A Acute respiratory infection Swine flu is an infection caused by a virus. It's

named for a virus that pigs can get. People donot normally get swine flu, but human

infections can and do happen. The virus iscontagious and can spread from human tohuman. Symptoms of swine flu in people aresimilar to the symptoms of regular human flu

and include fever, cough, sore throat, bodyaches, headache, chills and fatigue.

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Swine flu spreads through

Respiratory route

The main way that

influenza viruses

are thought tospread is from

person to person

in respiratorydroplets of coughs

and sneezes.

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Swine flu can begin with

Fever

with Sudden

symptoms of Aches

Chills Tiredness

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May Preset with more severe

Symptoms Fever (usually high) Headache Muscle aches Chills Extreme tiredness Dry cough Runny nose may also occur but is more common in

children than adults

Stomach symptoms, such as nausea, vomiting, anddiarrhea, may also occur but are more common inchildren than adults

Donot self Diagnose Visit a Health Centre

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Collection of Specimens

Nasopharyngeal swab, nasal swab, throatswab, combined oropharyngeal/

nasopharyngeal swab, or nasal aspirate

Swabs with a synthetic tip (eg, polyester orDacron) and an aluminum or plastic shaft

should be used. Swabs with cotton tips and

wooden shafts are not recommended. The collection vial in which the swab is placed

should contain 1 to 3 mL of viral transport

media. Dr.T.V.Rao MD 18


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Collection and Transportation

Respiratory specimen should be collected

within 4 to 5 days of illness or at the

earliest Specimens should be placed in viral

transport media and placed on ice (4C)

or refrigerated immediately fortransportation to the laboratory

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Whom to test

Testing for pandemic H1N1 influenza A

should be considered in individuals with

an acute febrile respiratory illness( temperature of 100F or higher and

recent onset of at least one of the

following: rhinorrhea, nasal congestion,sore throat, or cough) or sepsis-like

syndrome

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Priority and Recommendations in

Testing

Priority for testing should be given to :

Those who require hospitalization and

Those who are at high risk for severecomplications

No testing if illness is mild or the personresides in an area with confirmed cases

Recommended test for suspected cases is real-time reverse transcriptase (RT)-PCR forinfluenza A, B, H1, and H3

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Diagnosis To diagnose swine influenza A

infection, a respiratory specimenwould generally need to be

collected within the first 4 to 5 daysof illness (when an infected personis most likely to be shedding virus).

However, some persons, especiallychildren, may shed virus for 10 daysor longer. Identification as a swine

flu influenza A virusDr.T.V.Rao MD 23


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Rapid Diagnosis

RT PCR can

make rapid

Diagnosis

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Frequent hand washing Covering coughs and sneezes

Avoidance of crowded settings when possible

advising ill persons to stay home (except toseek medical care) and minimize contact

with others in household

voluntary home quarantine of members ofhouseholds with confirmed or probable swine

influenza cases

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Hand Washing

Method Wet hands with clean (not hot) water

Apply soap

Rub hands together for at least 20seconds

Rinse with clean water

Dry with disposable towel or air dry

Use towel to turn off faucetDr.T.V.Rao MD 26


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Isolation Precautions

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Care for common materials used by

Swine flu patients

Linens, eatingutensils, and dishesbelonging to those

who are sick do notneed to be cleanedseparately, butimportantly these

items should not beshared withoutwashing thoroughlyfirst.

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Antivirals- Oseltamivir Treatment is 75 mg twice a day for 5 days.

Prophylaxis is 75 mg once a day for 7 days

after last exposure. Prophylaxis:

High risk exposure (household contacts)

Moderate risk (unprotected very close exposure tosick animals; HCW with unprotected exposure topatients)

Low risk exposure: no need for prophylaxis unless

activation of exceptional measures.Dr.T.V.Rao MD 32


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* household close contacts (of confirmed, probable, or

suspected case) at high-risk for complications of influenza

+ chronic medical conditions

+ aged 65 years

+ aged 5 years+ pregnant women

* school children or children in daycare at high-risk for

complications of influenza (certain chronic medicalconditions) who had close contact (face-to-face) with

confirmed, probable, or suspected case

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*Any healthcare worker at high-risk for

complications of influenza (persons with certain

chronic medical conditions, elderly) working in area

with confirmed swine influenza A (H1N1) cases, orwho is caring for patients with any acute febrile

respiratory illness

* Non-high risk travelers to Mexico, first

responders, or border workers who are working in

areas with confirmed cases of swine influenza A

(H1N1) virus infection Dr.T.V.Rao MD 34


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Pre-exposure

Treat during exposure period and for 10 days

after last known exposure to ill confirmed

case of swine influenza A (H1N1) virus

infection

Post-exposure

Treat for 10 days after last known exposure

to ill confirmed case of swine influenza A(H1N1) virus infection

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Can the Mask Prevent the Spread

of Flu ???

However, no studies

have definitively

shown that mask

use by eitherinfectious patients

or health-care

personnel preventsinfluenza

transmission

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Prevention is best option

Covering your

nose and mouth

with a tissue

when you cough

or sneeze. Throw

the tissue in thetrash after you

use it.

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Using N95 mask reduces the Risk

You can cut your risk of

contracting the flu or

other respiratory

viruses by as much as80 percent by wearing a

mask over your nose

and mouth, according

to a new study.Emerging Infectious Diseases, the

journal of the Centres for Disease

Control and Prevention (CDC) .

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Why do we need vaccine

COST EFFECTIVETARGET AT RISK

PEOPLE

VACCINE

WINTER SEASON

TO COME(LOW

HUMIDITY,TEMP)

RAPID GLOBAL

SPREAD

SEASONAL

VACCINE

PROTECTION?

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"flu shot

The "flu shot" aninactivated vaccine(containing killed virus)that is given with a

needle, usually in thearm. The flu shot isapproved for use inpeople older than 6

months, includinghealthy people andpeople with chronicmedical conditions.

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Nasal Vaccination

The nasal-spray flu

vaccine a vaccine made

with live, weakened flu

viruses that do not causethe flu (sometimes called

LAIV for "live attenuated

influenza vaccine" or

FluMist). LAIV

(FluMist) is approved

for use in healthy*

people 2-49 years of age

who are not re nant.Dr.T.V.Rao MD 43

How to Keep Away from Swine Flu?


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How to Keep Away from Swine Flu?

A,B,C,D of Prevention

A. Wash your hands with soap or hand cleaners.B. Avoid touching your eyes, nose or mouth.C. Drink plenty of fluids and eat nutritious food.D. Cover your nose and mouth with a tissue.

E. Try to stay in good general health.F. Get plenty of sleep to be physically active.G. Manage your stress.H. Try not touch surfaces that may be contaminated

with the flu virus.I. Avoid close contact with people who are sick.J. Get treatment and/or prevention of the infection

with antiviral drugs.

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Transport of deceased persons in a transport bag.

Hand hygiene should be performed after

completing transport.

For deceased persons with confirmed, probable, orsuspect novel influenza A (H1N1):

o limit contact with the body in health care

settings to close family memberso Direct contact with the body is discouraged

o Necessary contact may occur as long as hands

are washed immediately with soap and water.

Dealing with the Deceased

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Stop Spreading Virus


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Stop Spreading Virus

Promote Prevention

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d hi i b


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Your Hand Washing Practices are best

contribution to Hospital Safety

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The Programme Created by Dr.T.V.Rao MD as

Public Health Message on Prevention and

Control of Swine Flu among the Health Care

Workers

Email

[email protected]

Documents

Health Care Workers Safety in Influenza