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1
Pandemic H1N1Stop the Spread
Public Health Services – Disease Control Department
2
Pandemic H1N1
Disease Control DepartmentPublic Health Services
Saskatoon Health Region
#101 – 310 Idylwyld Drive
Saskatoon, SK
655-4612
3
When We Are Finished You Will:• Know What Influenza Is (Section 1, Page 5)
• Know How Influenza is Spread, Tested &Treated (Section 2, Page 13)
• Be Aware of How to Stop the Spread ofInfluenza & Protect Yourself(Section 3, Page 25)
• Know How to Protect Employees in theWorkplace-Plan Ahead (Section 4, Page 42)
• Be Aware of Influenza Resources(Section 5, Page 48)
4
Information Overloadon Influenza
H1N1
Influenza
FlushotSeasonal
influenza
HumanSwine
FluH1N1
PandemicInfluenzaImmunization
for seasonalinfluenza andH1N1
5
Section 1
Know What Influenza Is
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Knowledge Can BeYour Best Defense
• All colds and flu, including the H1N1flu virus are spread the same way
• Understanding how they are spread= Understanding how to stop thespread
• Knowledge can be your bestdefense
7
What is the Seasonal Influenza?
Respiratory illness caused by a virus thatchanges in a minor way each year
Different strains of virus cause varyingdegrees of illness that range from mild tosevere
Normally have seasonal influenzaNovember to March in North America
8
What is Pandemic Influenza?
Occurs when virus has majorchanges and most people will haveno immunity to the virus
Spreads easily
Causes a widespread epidemic orpandemic – involving manycountries
9
ReassortmentLeads to Pandemic H1N1
Migratory waterbirds (Avian)
“Mixing vessel”
Source: WHO/WPRO(Swine)
(Human)
•Avian + Swine + Human=Pandemic H1N1
•New strain that humans are not immune to
•New strain appeared spring 2009
•Spread rapidly around the world
(pandemic)
10
Influenza Pandemics –20th Century
Credit: US National Museum of Health and Medicine
1918: “Spanish Flu”
20-40 million deaths
A(H1N1)
1957: “Asian Flu”
1-4 million deaths
A(H2N2)
1968: “Hong Kong Flu”
1-4 million deaths
A(H3N2)
11
A Different Influenza Year
This year a new strain of influenzavirus has developed and iscirculating
New virus is Pandemic H1N1
2nd wave of the pandemicexpected to occur in fall 2009
1st wave of illness was spring 2009
12
Influenza Symptoms Sudden onset of fever and cough May also have some or all of following:
• Fatigue• Muscle aches joint pain• Sore throat• Headache• Decreased appetite• Runny nose• Nausea• Vomiting• Diarrhea• Weakness• Chills• Most severe symptoms 4 – 6 days, but cough and fatigue
may be much longer
13
Section 2
Know How Influenza isSpread, Tested for and
Treated
14
How is Influenza Spread?
Droplets filled with virus forced frommouth/nose with coughing/sneezing– travel 2 meters
Droplets get into your eyes, nose ormouth and cause illness
15
How Does Influenza Spread?
Direct person to person contact
(cough/sneeze droplets enter eyes,nose, mouth)
Contact with contaminated object• Hard surface lives 24 - 48 hours
• Cloth/paper lives 8 -12 hours
• Warm hands lives 5 minutes
16
Pandemic H1N1
What Do We Know?
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About the Illness
Research is constantly being done on thisnew virus. To date believed to:
• Be infectious 1 day before onset of symptomsand for 7 days after onset of symptoms
• Be most infectious in first few days of illness
• Take 2-7 days to develop symptoms afterexposure to the virus
• Cause most severe symptoms for 4 – 6 days,but cough and fatigue may be much longer
18
How Serious is Pandemic H1N1?
Most illness in Saskatchewan andCanada mild to moderate
Severity can range from mild tosevere
19
How Serious is H1N1 Influenza?
People with the following medicalconditions may be at risk for more severeillness and complications:
• Chronic lung disease
• Heart disease
• Diabetes
• Asthma
• Immune deficiency
• Pregnancy – 2nd and 3rd trimester
20
Treatment
You do not necessarily need to seea doctor if:
• your influenza-like symptoms are mild tomoderate with no complications
• you are otherwise healthy (nounderlying medical conditions)
21
Treatment
You should see a doctor if you areexperiencing:
• Difficulty breathing
• Shortness of breath
• Chest pain
• Severe or persistent vomiting or diarrhea
• Fever (may not be prominent)
• Children: Severe tiredness
• Confusion or difficulty waking
22
Treatment
You should see a a doctor if youhave influenza-like illness and thefollowing medical conditions:• Chronic heart or lung conditions• Diabetes• Asthma• Immune deficiency• Pregnancy
23
Antiviral Medication Free of charge if prescribed
Reduces symptoms, shortens length ofillness, and reduces risk of complications
To be started within 48 hours of onset ofsymptoms
Your doctor will determine if you needantiviral medication. Those at increasedmedical risk are more likely to needantiviral medication
24
Testing
You may not be tested as physicians andlab have guidelines as to who should gettested
Need to avoid lab being overwhelmed
If tested, it is a nasopharyngeal swabtaken from the nose and back of throat
25
Section 3
Be Aware of How to Stopthe Spread of Influenza
and Protect Yourself
26
What Can I Do to Stopthe Spread of Influenza?
Protect yourself and others!
1. Wash hands frequently or use analcohol-based sanitizer
2. Cough or sneeze into your sleeve oruse each tissue once only
3. Stay home if you are ill
4. Clean surfaces often
5. Get immunized
27
Hand Washing
28
Hand Washing
A simple and effective way to prevent illness
Key to preventing spread of infection
Washes away germs that can make you ill
Soap loosens dirt that can harbour germs, waterwashes them away
If hand washing not readily available use:– alcohol hand gel – at least 60% alcohol.
Hand gel does not work when hands are obviouslysoiled.
29
Hand Washing
Do it often and correctly especially:
• After coughing, sneezing or blowing your nose
• After touching your eyes, nose or mouth
• After smoking or touching anything with salivaon it
• After using the washroom
• After being in contact with an ill person
• More often when someone in your home is ill
• After coming home from a public place
30
Most Effective Ways toWash Hands
• Remove jewellery (jewellery harbours germs)• Wet hands with warm water• Use liquid soap if possible and build lather• Scrub all surfaces of hands including backs of hands, wrists,
between fingers and under fingernails• Scrub for 15- 20 seconds (the time it takes to sing Happy
Birthday song))• Rinse hands in warm, running water• Dry with paper towel• Turn off tap with towel• Avoid use of common towels• Avoid use of standing basin of water• If soap and water are not available, use hand gel containing
60% alcohol
31
32
Cough Etiquette
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Cough Etiquette –Protect Yourself and Others
Coughs
And
Sneezes
Spread
Diseases
34
Cough Etiquette –Protect Yourself and Others
35
Cough Etiquette –Protect Yourself and Others
Avoid ill people - Stay more than 2 meters away
36
Stay Home IfYou Are ill
37
Stay Home If You Are ill Stay home if having influenza-like
symptoms
Stay home until symptoms are gone or 7days from onset of illness
Most contagious during first few days ofobvious influenza-like illness, but mayspread influenza until symptoms areresolved
38
Surface Cleaning
39
Surface Cleaning
Virus can survive for 48 hours on hardsurfaces
Clean and disinfect frequentlytouched surfaces twice daily
Regular cleaning products can beused
40
Immunization
41
Immunization
Immunization for H1N1 InfluenzaVaccine will begin as soon asvaccine arrives
Refer to: www.4FLU.ca
or call
655-4FLU (4358)
For clinic dates and locations
42
Section 4
Protecting Employees inthe Workplace –
Plan Ahead
43
Early Identification of Influenza-Like Illness (ILI)
Provide staff with information on recognizingsymptoms
Establish means to track and report ILI illness
Report absenteeism from ILI more than10% toMedical Health Officer at 655-4612
Ensure that infection control measures are inplace
44
Isolation of People with ILIFrom Workplace
Anyone with ILI symptoms should beencouraged to self isolate at homeand limit contact with others untilsymptoms resolve or until 7 days afteronset of illness
Provide staff with information on howto take care of themselves, visit:
www.fightflu.ca
45
Cough/Sneeze Etiquetteand Hand Hygiene
Encourage cough etiquette and handhygiene in the workplace
Post signs as reminders
Ensure wash stations are well supplied
Ensure tissues and waste baskets areavailable
Consider alcohol-based hand sanitizer fortimes when hand washing is not available
46
Surface Cleaning
Clean and disinfect commonlytouched surfaces at least twice daily
• Focus on surfaces such as door knobs,light switches, sink taps, hand rails andkeyboards
47
Stop the Spread of H1N1
1. Wash hands frequently or use analcohol-based sanitizer
2. Cough or sneeze into your sleeve oruse each tissue once only
3. Stay home if you are ill
4. Clean surfaces often
5. Get immunized
48
Section 5
Be Aware of
Influenza Resources
49
For further information,visit the following websites
www.health.gov.sk.ca (Saskatchewan Ministry of Health)
• Up-to-date guidance for community settings
(e.g. workplace, childcare, schools)
www.phac.gc.ca (Public Health Agency of Canada)
www.fightflu.ca (Health Canada)
www.4flu.ca (Saskatoon Health region)
www.saskatoonhealthregion.ca (Saskatoon HealthRegion)
www.health.gov.ca/healthline-online (Health Line)
Websites are updated frequently
as new information becomes available