SWINE FLU
A Pandemic Is Declared= June 11, 2009,
On June 11, 2009, the World
Health Organization (WHO) raised the worldwide pandemic alert level to Phase
6 in response to the ongoing global spread of the novel influenza A
(H1N1) virus. A Phase 6 designation indicates that a global pandemic is
underway.
More than 70 countries are now reporting cases of human infection with
novel H1N1 flu. This number has been increasing over the past few weeks, but
many of the cases reportedly had links to travel or were localized outbreaks
without community spread. The WHO designation of a pandemic alert Phase 6
reflects the fact that there are now ongoing community level outbreaks in
multiple parts of world.
WHO’s decision to raise the pandemic alert level to Phase 6 is a
reflection of the spread of the virus, not the severity of illness caused by
the virus. It’s uncertain at this time how serious or severe this novel
H1N1 pandemic will be in terms of how many people infected will develop
serious complications or die from novel H1N1 infection. Experience with this
virus so far is limited and influenza is unpredictable. However, because
novel H1N1 is a new virus, many people may have little or no immunity
against it, and illness may be more severe and widespread as a result. In
addition, currently there is no vaccine to protect against novel H1N1 virus.
In the United States, most people who have become ill with the newly
declared pandemic virus have recovered without requiring medical treatment,
however, CDC anticipates that there will be more cases, more
hospitalizations and more deaths associated with this pandemic in the coming
days and weeks. In addition, this virus could cause significant illness with
associated hospitalizations and deaths in the fall and winter during the
U.S. influenza season.
Background
Novel influenza A (H1N1) is a new flu virus of swine origin that first
caused illness in Mexico and the United States in March and April, 2009.
It’s thought that novel influenza A (H1N1) flu spreads in the same way
that regular seasonal influenza viruses spread, mainly through the coughs
and sneezes of people who are sick with the virus, but it may also be spread
by touching infected objects and then touching your nose or mouth. Novel
H1N1 infection has been reported to cause a wide range of flu-like symptoms,
including fever, cough, sore throat, body aches, headache, chills and
fatigue. In addition, many people also have reported nausea, vomiting and/or
diarrhea.
The first novel H1N1 patient in the United States was confirmed by
laboratory testing at CDC on April 15, 2009. The second patient was
confirmed on April 17, 2009. It was quickly determined that the virus was
spreading from person-to-person. On April 22, CDC activated its Emergency
Operations Center to better coordinate the public health response. On April
26, 2009, the United States Government declared a public health emergency
and has been actively and aggressively implementing the nation’s pandemic
response plan.
Since the outbreak was first detected, an increasing number of U.S. states
have reported cases of novel H1N1 influenza with associated hospitalizations
and deaths. By June 3, 2009, all 50 states in the United States and the
District of Columbia and Puerto Rico were reporting cases of novel H1N1
infection. While nationwide U.S. influenza surveillance systems indicate
that overall influenza activity is decreasing in the country at this time,
novel H1N1 outbreaks are ongoing in parts of the U.S., in some cases with
intense activity.
CDC is continuing to watch the situation carefully, to support the public
health response and to gather information about this virus and its
characteristics. The Southern Hemisphere is just beginning its influenza
season and the experience there may provide valuable clues about what may
occur in the Northern Hemisphere this fall and winter.
CDC Response
CDC continues to take aggressive action to respond to the outbreak.
CDC’s response goals are to reduce the spread and severity of illness, and
to provide information to help health care providers, public health
officials and the public address the challenges posed by this new public
health threat.
CDC is issuing updated interim
guidance in response to the rapidly evolving situation.
Clinician Guidance
CDC has issued interim guidance for clinicians on identifying
and caring for patients with novel H1N1, in addition to providing
interim guidance on
the use of antiviral drugs. Influenza antiviral drugs are prescription
medicines (pills, liquid or an inhaled powder) with activity against
influenza viruses, including novel influenza H1N1 viruses. The priority use
for influenza antiviral drugs during this outbreak is to treat people
hospitalized with influenza illness, and to treat people at increased risk
of severe illness, including pregnant women, young children, and people with
chronic health conditions like asthma, diabetes and other metabolic
diseases, heart or lung disease, kidney disease, weakened immune systems,
and persons with neurologic or neuromuscular disease.
Public Guidance
CDC has provided guidance for the public on what
to do if they become sick with flu-like symptoms, including infection
with novel H1N1. CDC also has issued instructions on taking
care of a sick person at home and the use of facemasks
and respirators to reduce novel influenza A (H1n1) transmission.
Everyone should take everyday preventive actions to stop the spread of
germs, including frequent hand washing and people who are sick should stay
home and avoid contact with others in order to limit further spread of the
disease.
Testing
CDC has developed a PCR diagnostic test kit to detect this novel H1N1
virus and has now distributed test kits to all states in the U.S. and the
District of Columbia and Puerto Rico. The test kits are being shipped
internationally as well. This will allow states and other countries to test
for this new virus.
Vaccine
Vaccines are a very important part of a response to pandemic influenza
and the U.S. Government is aggressively taking early steps in the process to
manufacture a novel H1N1 vaccine, working closely with manufacturers. CDC
has isolated the new H1N1 virus, made a candidate vaccine virus that can be
used to create vaccine, and has provided this virus to industry so they can
begin scaling up for production of a vaccine, if necessary. Making vaccine
is a long multi-step process requiring several months to complete.
Stockpile Deployment
CDC has deployed 25 percent of the supplies in the Strategic National
Stockpile (SNS) to all states in the continental United States and U.S.
territories. This included antiviral drugs, personal protective equipment,
and respiratory protection devices. The influenza A (H1N1) virus is
susceptible to the prescription antiviral drugs oseltamivir and zanamivir.
These supplies and medicines will help states and U.S. territories respond
to novel H1N1 virus.
Surveillance
Novel influenza A (H1N1) activity is now being detected through CDC’s routine
influenza surveillance systems and reported weekly in FluView. CDC
tracks U.S. influenza activity through multiple systems across five
categories. While our influenza surveillance systems indicate that overall
influenza activity is decreasing in the United States, novel H1N1 outbreaks
are ongoing in different parts of the U.S., in some cases with intense
influenza-like activity. Most of the influenza viruses being detected now
are novel H1N1 viruses.
Shared Responsibility
Individuals have an important role in protecting themselves and their
families.
- Stay informed. Health officials will provide additional information as
it becomes available.
- Everyone should take these everyday steps to protect your health and
lessen the spread of this new virus:
- Cover your nose and mouth with a tissue when you cough or sneeze.
Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you
cough or sneeze. Alcohol-based hand cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread this way.
- Try to avoid close contact with sick people.
- If you are sick with a flu-like illness, stay home for 7 days
after your symptoms begin or until you have been symptom-free for 24
hours, whichever is longer. This is to keep from infecting others
and spreading the virus further.
- Follow public health advice regarding school closures, avoiding
crowds and other social distancing measures.
More on the WHO Pandemic Declaration
More on the Situation
Site
last updated May 13, 2009, 11:00 AM ET
A New Virus Emerges
Novel influenza A (H1N1) is a new flu virus of
swine origin that was first detected in April, 2009. The virus is
infecting people and is spreading from person-to-person, and has
sparked a growing outbreak of illness in the United States with an
increasing number of cases being reported internationally as well.
CDC anticipates that there will be more cases,
more hospitalizations and more deaths associated with this new
virus in the coming days and weeks because the population has
little to no immunity against it. Novel influenza A (H1N1)
activity is now being detected in two of CDC’s routine influenza
surveillance systems as reported in the May
8, 2009 FluView. FluView is a weekly report
that tracks U.S. influenza activity through multiple systems
across five categories.
The May 8 FluView found that the number
of people visiting their doctors with influenza-like-illness is
higher than expected in the United States for this time of year.
Second, laboratory data shows that regular seasonal influenza A
(H1N1), (H3N2) and influenza B viruses are still circulating in
the United States, but novel influenza A (H1N1) and
“unsubtypable”* viruses now account for a significant number
of the viruses detected in the United States.
It’s thought that novel influenza A (H1N1) flu
spreads in the same way that regular seasonal influenza viruses
spread; mainly through the coughs and sneezes of people who are
sick with the virus.
CDC continues to take aggressive action to
respond to the outbreak. CDC’s response goals are to reduce the
spread and severity of illness, and to provide information to help
health care providers, public health officials and the public
address the challenges posed by this new public health threat.
Increased Testing
CDC has developed a PCR diagnostic test kit to
detect this novel H1N1 virus and has now distributed test kits to
all states in the U.S. and the District of Columbia and Puerto
Rico. The test kits are being shipped internationally as well.
This will allow states and other countries to test for this new
virus. This increase in testing will likely result in an increase
in the number of confirmed cases of illness reported. This,
combined with ongoing monitoring through Flu View should
provide a fuller picture of the burden of disease in the United
States over time.
CDC is issuing updated interim
guidance daily in response to the rapidly evolving situation.
Clinician Guidance
CDC has issued interim guidance for clinicians
on identifying and caring for patients with novel H1N1, in
addition to providing interim guidance
on the use of antiviral drugs. Influenza antiviral drugs are
prescription medicines (pills, liquid or an inhaler) with activity
against influenza viruses, including novel influenza H1N1 viruses.
The priority use for influenza antiviral drugs during this
outbreak is to treat severe influenza illness, including people
who are hospitalized or sick people who are considered at high
risk of serious influenza-related complications.
Public Guidance
In addition, CDC has provided guidance for the
public on what to do
if they become sick with flu-like symptoms, including
infection with novel H1N1. CDC also has issued instructions on taking
care of a sick person at home. Novel H1N1 infection has been
reported to cause a wide range of symptoms, including fever,
cough, sore throat, body aches, headache, chills and fatigue. In
addition, a significant number of people also have reported
nausea, vomiting or diarrhea. Everyone should take everyday
preventive actions to stop the spread of germs, including frequent
hand washing and people who are sick should stay home and avoid
contact with others in order to limit further spread of the
disease.
*Unsubtypable viruses are viruses that
through normal testing cannot be subtyped as regularly occurring
human seasonal influenza viruses. In the context of the current
outbreak, it’s likely that most of these unsubtypable viruses
are novel H1N1.
Citizen Corps News:
What You Can Do to Plan and Prepare for a Possible Pandemic
Flu
The Departments of Homeland Security (DHS) and Health and
Human Services (HHS), including the HHS Centers for Disease Control and
Prevention (CDC) have the lead roles for the nation’s response to the H1N1 flu
outbreak. For more information on the H1N1, visit www.dhs.gov; www.hhs.gov;
and www.cdc.gov.
As health officials combat the new influenza virus known as
H1N1 or swine flu with detection, diagnosis, and treatment protocols, it’s
important to realize that managing a major disease outbreak requires
participation from everyone. This recent flu outbreak reminds us how important
it is to be prepared and how we all need to take the time now to get ready for a
possible pandemic flu.
The federal government and each state/territory are required
to have a Pandemic Flu plan in place which goes into effect in the event a
pandemic flu. These plans are to ensure government services continue and to
manage public communications and guidance on the possible need for social
distancing, to include school closings and telework options. But the government
alone can’t prepare the nation for a possible pandemic flu; this challenge
requires your help.
Everyone in America needs to prepare themselves and their
family to be safe from the spread of disease or from any other possible disaster
or crisis situation. Below are some of the recommended actions to take when
preparing for a possible pandemic disease outbreak.
•
Practice good hygiene.
Ensure you and
your family members always practice flu prevention principles, such as:
o
Use
good cough etiquette. Cough and sneeze into your sleeve or a tissue, not your
hands.
o
Wash
your hands often with soap and water, especially after you cough or sneeze.
Alcohol-based hand cleaners are also effective.
o
Avoid
touching your eyes, nose or mouth. Germs spread this way.
o
Try
to avoid close contact with sick people.
o
If
you get sick with influenza, the Centers for Disease Control and Prevention
(CDC) recommend that you stay home from work or school and limit contact with
others to keep from infecting them.
•
Stay informed.
The U.S.
Department of Health and Human Services maintains a website, www.PandemicFlu.gov,
that provides guidance, including checklists, for individuals, families,
businesses and all sectors on what to do before, during, and after a pandemic
flu. View the following HHS Webcast to learn more about Individual Pandemic
Preparedness: www.pandemicflu.gov/news/panflu_webinar6.html. The Centers
for Disease for Control and Prevention website, www.cdc.gov/h1n1flu,
includes up-to-date information on the H1N1 flu outbreak.
•
Get local information. Call
or visit the website for your local health department to learn their plans and
recommendations for a potential disease outbreak in your community. Ask how you
can receive updated information on local outbreaks, how you learn about
prevention safety measures (including hand-washing, social-distancing,
anti-viral medications), and who to contact if you become ill or have questions.
•
Review your family plan. Ensure
that your family disaster plan is up-to-date and that family members know what
to do both for a disease outbreak and for other emergency situations, including
what to do at home, work, school or other locations and what to do if your means
of transportation is disrupted, such as if public transit services are not
available. Think about measures you can take to protect your family and
property. And be sure to address what additional precautions should be taken for
those family members with special needs.
•
Think about all likely
emergencies. Take
this opportunity to make sure your family plan includes contingencies for
different types of hazards and ensure all family members understand and practice
the plan. Consider the possibility of more than one hazard occurring at the same
time, such as a disease outbreak and a power outage. More information on
creating a family disaster plan can be found on the following websites:
www.pandemicflu.gov/plan/individual/index.html and www.fema.gov/areyouready.
•
Prepare supplies for possible
social distancing measures. Social
distancing, or limited personal interaction, is an important preventative
measure to reduce the spread of disease. If a pandemic situation occurs, you may
be asked to stay in your home, with limited access to outside sources of food or
services. Prepare to reduce your need to go public places by store a two-week
supply of water and non-perishable food for the entire family, including pets.
Have two weeks of your regular prescription drugs at home and keep other health
supplies on hand, including pain relievers and cold medicines. Be sure to check
expiration dates on prescription and nonprescription drugs. The following
website provides a list of recommended items to sustain your family during a
pandemic flu: www.pandemicflu.gov/plan/pdf/individuals.pdf.
•
Learn how to care for someone who
gets sick. Learn
what to do if you or your family members become sick with the flu. Visit
www.cdc.gov/h1n1flu/guidance_homecare.htm for current information on how to care
for sick family members and prevent the spread of the flu. In addition,
up-to-date flu outbreak information is available in English and Spanish, 24
hours a day, 7 days a week at the CDC Hotline (1-800-CDC-INFO).
•
Update medical records. Ensure
you have current medical records and other official documents on all family
members. Create a summary sheet on Family Emergency Health Information. Visit
the following website for a template: www.pandemicflu.gov/plan/individual/familyhealthinfo.html.
•
Update emergency contacts. Update
your emergency contacts and ensure that all family members have this
information. Choose an out-of-town contact and teach your children how to call
that person. Teach your children when and how to dial 9-1-1. The following
websites provide sample emergency contact lists that can be handed out to all
family members: www.ready.gov/america/_downloads/familyemergencyplan.pdf and
www.pandemicflu.gov/plan/individual/emergencycontacts.html.
•
Talk to your employer. Ask
your employer about its business plan during a pandemic flu. It will be
important to know if you can work from home and what the policies are for
extended absences and other office protocols. If you commute to work with
others, be sure to discuss contingency plans if participants become ill or if
their working hours change.
•
Talk to your children. Parents
should talk to their children about the flu virus and how it is impacting your
family and community. Your children may need extra attention from you and may
want to talk about their concerns and questions. Explain why it is important to
practice good hygiene habits, why schools may close, and any new rules in your
home. In the absence of factual information, children often imagine situations
far worse than reality. Don’t ignore their concerns, but rather explain that
at the present moment the vast majority of people, even those who are sick, will
be okay. The interactive website, www.scrubclub.org, provides information and
interactive games to teach children ages 3-8 about germs and the proper way to
wash their hands. For more information about talking to your children about the
H1N1 flu outbreak, visit the following Centers for Disease Control and
Prevention webpage: www.cdc.gov/h1n1flu/talkingtokids.htm.
•
Check with school and childcare
facilities. Talk
to your schools, including childcare service providers and colleges, about their
pandemic flu plan. Find out the steps your school will take to prevent the
spread of flu, including hygiene lessons/enforcement, identification and removal
of sick children, and closings. If classes or school activities are cancelled
for an extended period of time, be sure to establish a back-up child care plan
or confirm telework or leave options with your employer. It is important to
remember that the purpose of closing schools is to stop the spread of disease.
If schools are closed, children will be expected to stay home rather then go to
the mall, to a movie, or meet up with friends. If your children rely on
nutrition programs while at school, identify alternative options to receive
food. Visit the following site for school-related mitigation strategies and
checklists: www.pandemicflu.gov/plan/school/index.html.
•
Discuss policies with elder care
providers. Talk
to your family’s elderly care service providers and nursing homes about their
pandemic flu plan to ensure you are familiar with any changes in care. Hygiene
enforcement and visitation procedures are likely to change during a pandemic.
•
Consider impacts on faith and
social group activities. If
you participate in regular group activities, such as worship services, sports
teams, book clubs, service groups, or volunteer programs, discuss how a possible
pandemic flu might affect your meeting frequency and location, routine
practices, and planned activities. Also consider what your group can do to help
your community during disease outbreaks or other emergencies, such as collecting
donations of supplies, checking on people who may need help, and providing
child-care support.
•
Help others prepare. Assist
neighbors, family, friends, and co-workers in preparing for a possible pandemic
disease outbreak, to include how you will share information during periods of
limited access or social distancing. Be especially aware of those in your family
and community with special needs who might need additional attention and
assistance.
•
Follow travel advisories. Follow
CDC and local travel recommendations during a pandemic. Visit the following
website for up-to-date information on travel notices: wwwn.cdc.gov/travel.
•
Contact your local Citizen Corps
Council. Citizen
Corps Councils are leadership councils made up of government and community
leaders from all sectors that work towards involving everyone in the community
for greater community safety, preparedness, and resilience. Your local Citizen
Corps Council will have information on local community emergency response plans,
personal preparedness, and ways you can get involved and volunteer for community
preparedness and response activities. Visit the following website to find the
Citizen Corps Council nearest you: www.citizencorps.gov.
Citizen Corps News: Pandemic Flu Preparedness –
Updated 11:00pm 5/7/09
Update on Situation
The ongoing outbreak of novel influenza A (H1N1) continues
to expand in the United States. CDC expects that more cases, more
hospitalizations and more deaths from this outbreak will occur over the coming
days and weeks.
CDC continues to take aggressive action to respond to the
expanding outbreak. CDC’s response goals are to reduce spread and illness
severity, and provide information to help health care providers, public health
officials and the public address the challenges posed by this emergency.
CDC is issuing updated interim
guidance daily in response to the rapidly evolving situation.
Antiviral Guidance
CDC has issued guidance
for health care providers on the use of antiviral medications during the
current outbreak. The priority use for influenza antiviral drugs is to treat
severe influenza illness and people who are at high risk of serious
influenza-related conditions.
School Guidance
At this time, CDC recommends the primary means to reduce
spread of influenza in schools focus on early identification of ill students
and staff, staying home when sick, and good cough etiquette and frequent hand
washing. Decisions about school closure should be at the discretion of local
authorities based on local considerations. (See the School
Guidance.)
Increased Testing
CDC has developed a PCR
diagnostic test kit to detect this novel H1N1 virus and has now
distributed test kits to all states in the U.S. and Puerto Rico. The test kits
are being shipped internationally as well. This will allow states and other
countries to test for this new virus. This increase in testing capacity is
likely to result in an increase in the number of reported confirmed cases in
this country, which should provide a more accurate picture of the burden of
disease in the United States.
U.S. Human Cases of H1N1 Flu
Infection
As of 11:00 AM ET on May 7, 2009, CDC has confirmed 896
human cases and 2 deaths in 41 states:
NOTE: Because of daily reporting deadlines,
the state totals reported by CDC may not always be consistent with those
reported by state health departments. If there is a discrepancy between these
two counts, data from the state health departments should be used as the most
accurate number.
For more information, see the CDC
H1N1 Flu website.
International Human Cases of H1N1
Flu Infection
For information about the global situation, see the World
Health Organization website.
What You Can Do to Stay Healthy
-
Stay informed. This website will be
updated regularly as information becomes available.
-
Influenza is thought to spread mainly
person-to-person through coughing or sneezing of infected people.
-
Take everyday actions to stay healthy.
-
Cover your nose and mouth with a tissue when you
cough or sneeze. Throw the tissue in the trash after you use it.
-
Wash your hands often with soap and water,
especially after you cough or sneeze. Alcohol-based hands cleaners are
also effective.
-
Avoid touching your eyes, nose or mouth. Germs
spread that way.
-
Stay home if you get sick. CDC recommends that you
stay home from work or school and limit contact with others to keep
from infecting them.
-
Follow public health advice regarding
school closures, avoiding crowds and other social distancing measures.
-
Call 1-800-CDC-INFO for more information.
For more information on what you can to stay safe and
healthy, check the CDC
H1N1 Flu website.
Updated 11:00pm 5/4/09
Update on Situation
CDC continues to take aggressive action to respond to an
expanding outbreak caused by novel H1N1 flu.
CDC’s response 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 this
emergency.
CDC continues to issue and update interim
guidance daily in response to the rapidly evolving situation. CDC will issue
updated interim guidance for clinicians on how to identify and care for people
who are sick with novel H1N1 flu illness. This guidance will provide priorities
for testing and treatment for novel H1N1 flu infection. The priority use for
influenza antiviral drugs during this outbreak will be to treat people with
severe flu illness.
CDC has completed deployment of 25 percent of the supplies in
the Strategic National Stockpile (SNS) to all states in the continental United
States. These supplies and medicines will help states and U.S. territories
respond to the outbreak. In addition, the Federal Government and manufacturers
have begun the process of developing a vaccine against the novel H1N1 flu virus.
Response actions are aggressive, but they may vary across
states and communities depending on local circumstances. Communities,
businesses, places of worship, schools and individuals can all take action to
slow the spread of this outbreak. People who are sick are urged to stay home
from work or school and to avoid contact with others, except to seek medical
care. This action can avoid spreading illness further.
U.S. Human Cases of H1N1 Flu Infection
As of 11:00 AM ET on May 4, 2009, CDC has confirmed 279 human
cases and 1 death in 36 states:
For more information, see the CDC
H1N1 Flu website.
International Human Cases of H1N1
Flu Infection
For information about the global situation, see the World
Health Organization website.
What You Can Do to Stay Healthy
-
Stay informed. This website will be
updated regularly as information becomes available.
-
Influenza is thought to spread mainly
person-to-person through coughing or sneezing of infected people.
-
Take everyday actions to stay healthy.
-
Cover your nose and mouth with a tissue when you cough
or sneeze. Throw the tissue in the trash after you use it.
-
Wash your hands often with soap and water, especially
after you cough or sneeze. Alcohol-based hands cleaners are also
effective.
-
Avoid touching your eyes, nose or mouth. Germs spread
that way.
-
Stay home if you get sick. CDC recommends that you
stay home from work or school and limit contact with others to keep from
infecting them.
-
Follow public health advice regarding
school closures, avoiding crowds and other social distancing measures.
-
Call 1-800-CDC-INFO for more information.
Updated 11:00am 5/3/09
Update on Situation
CDC continues to take aggressive action to respond to an
expanding outbreak caused by H1N1 (swine flu).
CDC’s response 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 this
emergency.
CDC continues to issue and update interim
guidance daily in response to the rapidly evolving situation. This includes
guidance on when to close schools and how to care for someone who is sick at
home. Supplies from CDC’s Division of the Strategic National Stockpile (SNS)
are being sent to all 50 states and U.S. territories to help them respond to the
outbreak. In addition, the Federal Government and manufacturers have begun the
process of developing a vaccine against this new virus.
Response actions are aggressive, but they may vary across
states and communities depending on local circumstances. Communities,
businesses, places of worship, schools and individuals can all take action to
slow the spread of this outbreak. People who are sick are urged to stay home
from work or school and to avoid contact with others, except to seek medical
care. This action can avoid spreading illness further.
U.S. Human Cases of H1N1 Flu Infection
As of 11:30 AM ET on May 2, 2009, CDC has confirmed 160 human
cases and 1 death in 21 states:
For more information, see the CDC
H1N1 Flu website.
International Human Cases of H1N1
Flu Infection
For information about the global situation, see the World
Health Organization website.
What You Can Do to Stay Healthy
-
-
Stay informed. This website will be
updated regularly as information becomes available.
-
Influenza is thought to spread mainly
person-to-person through coughing or sneezing of infected
people.
-
Take everyday actions to stay healthy.
-
Cover your nose and mouth with a tissue when you
cough or sneeze. Throw the tissue in the trash after you use it.
-
Wash your hands often with soap and water,
especially after you cough or sneeze. Alcohol-based hands cleaners
are also effective.
-
Avoid touching your eyes, nose or mouth. Germs
spread that way.
-
Stay home if you get sick. CDC recommends that
you stay home from work or school and limit contact with others to
keep from infecting them.
-
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.
-
Call 1-800-CDC-INFO for more information.
Updates posted to the website in the past 24 hours include the
following:
And more...
To learn about other updates made to the CDC H1N1 Flu Website
in the past 24 hours, please check the "What's New" page on the CDC
H1N1 Flu website.
Updated 9am 5/2/09
Influenza A H1N1 (Swine Origin) (SO) is a novel virus and
there is an ongoing intensive
investigation of its clinical and epidemiologic features.
Providers should monitor the New York
City Department of Health and Mental Hygiene (DOHMH) Health
Alerts and check
www.nyc.gov/heatlh
and www.cdc.gov
for updates as they become available. Please
note that
infection control recommendations may change as this situation
evolves and more knowledge of
the transmission, clinical and epidemiologic features of this
virus is gained.
Infection Control Guidelines for Medical Facilities (Hospitals
and Clinics) with Suspected,
Probable, or Confirmed Cases of H1N1 (SO)
At this time, DOHMH recommends more stringent infection
control measures (described below) for
suspected, probable or confirmed swine flu cases (See H1N1
(SO) case definitions at the end of this
document) than are required for seasonal influenza. Many of
the recommendations will be the same for
inpatient and outpatient facilities; differences by facilities
will be indicated.
As of today’s date, community transmission of H1N1 (SO)
appears to be occurring in New York City.
Epidemiologic risk factors can no longer be used to
distinguish between patients with a high likelihood of
having H1N1 (SO) infection from those who have acute
respiratory illness due to other causes. Specific
diagnostic testing for H1N1 (SO) is not recommended for
patients with mild illness; therefore most patients
seen in outpatient settings will not meet the probable or
confirmed case definition.
For these reasons, and out of an abundance of caution, DOHMH
is recommending that the infection
control recommendations provided below be applied to ALL
patients who present to medical facilities or
offices with acute febrile respiratory illness, including mild
illness or severe unexplained acute febrile
respiratory illness (e.g., pneumonia, ARDS or respiratory
distress), or probable or confirmed H1N1 (SO).
What should outpatient providers do to alert hospitals of
potential cases being referred to the
emergency department?
Outpatient medical providers who are referring suspected,
probable or confirmed cases of H1N1 (SO) to
emergency departments or other medical facilities should call
ahead to alert the facility that the patient is
arriving, and have the patient wear a surgical mask when
entering the hospital. The patient should also be
instructed to notify the receptionist or triage nurse
immediately upon arrival that he or she has respiratory
symptoms.
Infection Control Guidelines for Medical Facilities (Hospitals
and
Outpatient Clinics) with Suspected, Probable, or Confirmed
Cases
of Influenza A H1N1 (Swine Origin)
Last updated 05/01/09
2
What should ALL medical facilities (e.g., hospitals,
outpatient clinics) do to prepare for suspected
cases arriving at their facility?
•
All medical
facilities should institute their screening and isolation protocols. For more
information on
medical facility screening and isolation protocols, please
refer to:
http://www.nyc.gov/html/doh/downloads/word/bhpp/bhpp-train-emergency-guidance-01.doc
•
Outpatient
clinics where patients typically call ahead to schedule an appointment should
try to group
patients with acute febrile respiratory illness towards the
end of the day, to avoid exposure to other
patients
.
•
Signs in
appropriate languages to the community should be posted at all entrances.
Messages that
should be stressed include:
o
“If you have
symptoms of fever and cough, please don a surgical mask, perform hand hygiene
and notify staff as soon as possible.”
o
“Cover your
nose/mouth when coughing or sneezing.”
o
“Cough or
sneeze into a tissue or your sleeve.”
o
“Dispose of
tissues in the nearest waste receptacle after use and perform hand hygiene after
contact with respiratory secretions.”
•
Masks, tissues,
and alcohol hand rub products should be easily available for staff and patient
use.
o
Provide tissues
and no-touch receptacles (e.g., waste containers with pedal operated lid or
uncovered waste container) for used tissue disposal.
o
Provide soap and
disposable towels for hand washing where sinks are available.
•
Enhanced
environmental cleaning of high touch areas should be done frequently (e.g.,
doorknobs,
elevator buttons, chair arms, handrails, etc.)
If a patient identifies him/herself as symptomatic with acute
febrile respiratory illness:
•
Give the
patient a surgical mask and instruct him/her on how to put it on; have the
patient perform
hand hygiene and place symptomatic patients in a separate room
with the door closed as soon as
possible to limit their time in the common waiting area.
There
is no longer a need to place the patients
in an Airborne Infection Isolation room (AIIR) unless
performing aerosol generating procedures (see
below).
o
If necessary,
designate separate waiting areas for patients with acute febrile respiratory
illness
where they can sit at least three to six feet away from
others.
•
Surgical masks
should be worn by patients and changed if there is obvious soilage or
tears/damage to
the mask. Instruct patients that whenever they don or remove
their masks, they should perform hand
hygiene.
Infection Control Procedures and Healthcare Worker Personal
Protective Equipment for Patient
Care
Isolation precautions:
Recommendations
below based on Interim Guidance for
Infection Control for
Care of Patients with Confirmed or Suspected Swine Influenza A
(H1N1) Virus Suspected in a Healthcare
Setting
Last
updated 04/29/09. See http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm.
•
Standard and
contact precautions plus eye protection should be used for all patient care
activities and
maintained for 7 days after illness onset or until 24 hours
after symptoms have resolved, whichever is
longer.
•
Place
symptomatic patients in a separate room with the door closed as soon as possible
to limit their
time in the common waiting area.
There
is no longer a need to place these patients in an Airborne
Infection Isolation room (AIIR) unless performing aerosol
generating procedures (See examples below)
•
Healthcare
workers evaluating, treating, or collecting specimens from a patient with acute
febrile
respiratory illness should don maximal personal protective
equipment (PPE) whenever in the patient’s
room. This includes:
3
o
Gloves, face
shield or goggles, and gowns
o
N95 respirator or
equivalent, when available
NOTE: This recommendation differs from current infection
control guidance for seasonal
influenza, which recommends that healthcare personnel wear
surgical masks for patient
care. The rationale for the use of respiratory protection is
that a more conservative approach
is needed until more is known about the specific transmission
characteristics and virulence of
the new virus.
o
If N95
respirators are unavailable, a surgical mask should be used
o
Because N95
respirator supply may become more limited if this outbreak continues, practices
may elect to reserve their use for aerosol-generating
procedures (nebulizer treatments,
suctioning, intubation, sputum and nasopharyngeal swab
collection, and bronchoscopy)
•
PPE should be
removed and disposed of in a receptacle prior to or upon exiting a patient room
and hand
hygiene performed immediately. Disposal of PPE should be
performed according to your hospital’s
infection control policy.
•
Aerosol-generating
procedures should be performed in an AIIR. If
an AIIR is not available, use clinical
judgment to decide whether the procedure can be performed in a
private room with the door closed.
•
Healthcare
providers should review the order of donning and removing PPE:
o
Donning PPE
order: Gown, mask or respirator,
goggles or face shields, gloves
o
Removing PPE
order: Gloves, goggles or face
shields, gown, mask or respirator
•
The patient
should wear a surgical mask when outside his or her own room, including when
sent for
procedures in other departments of the hospital or outpatient
clinic. Limiting unnecessary patient
movement is recommended.
•
Visitors should
be limited only to those persons who are necessary for the emotional well-being
and
care of the patient.
•
Visitors may be
offered a gown, glove, eye protection and respiratory protection (i.e., N95
respirator)
and should be instructed by healthcare personnel on their use
as well as hand hygiene before entering
the patient’s room.
•
The patient may
be discharged when medically indicated. However, if the patient is discharged to
home
before symptoms are resolved, guidance on home isolation
should be provided. This guidance is
available at
http://www.nyc.gov/html/doh/downloads/pdf/cd/cd-swineflu-homeisolation-new.pdf.
•
More
information can be found at: http://www.cdc.gov/ncidod/dhqp/gl_environinfection.html
New York City Case Definitions for Swine-Origin Influenza A
(H1N1) (H1N1 (SO)) Infection
A
confirmed case of
H1N1 (SO) infection is defined as a person with an acute febrile respiratory
illness with
laboratory confirmed H1N1 (SO) infection by one or more of the
following tests:
•
real-time
RT-PCR, or
•
viral culture
A
probable case of
H1N1 (SO) infection is defined as a person with an acute febrile respiratory
illness who is
positive for influenza A, but negative for H1 and H3 by
influenza RT-PCR
A
suspected case of
H1N1 (SO) infection is defined as a person with unexplained acute febrile
respiratory
illness.
(Patients with an acute febrile respiratory illness who have a
negative PCR test for influenza A can be
considered non-cases of H1N1 [SO]).
Dear Patient,
You are suspected of having or were diagnosed recently with
swine influenza (swine flu). Influenza can be
transmitted when an infected person coughs or sneezes. It is
also possible to become infected by touching
surfaces contaminated with the virus, and then touching your
own nose or mouth. Covering coughs and sneezes
and washing hands with soap and water or with an alcohol‐based
hand rub are essential in stopping the spread of
influenza.
During the period that you have symptoms, especially fever, it
is possible for you to transmit this virus to those
who have close contact with you (for example, someone living
with or caring for you). To help prevent transmission
of influenza virus to your close contacts, the Health
Department is asking you to
stay at
home for 7 days after the
day you developed a fever or 24‐48 hours after all
symptoms resolve, whichever is longer.
During
that time,
please follow these guidelines:
HOME ISOLATION
Instructions for Suspected, Probable and Confirmed Swine
Influenza Cases
YOU SHOULD:
Stay at home for 7 days after the first day of fever or at
least 24‐48 hours after all symptoms resolve,
whichever is longer.
Limit contact
with others; avoid close contact such as kissing, do not share toothbrushes,
cigarettes or drinks
with non‐infected persons. Persons living in the home
with you should limit contact with you to the extent
possible. Consider designating one person (not someone who is
pregnant) as the primary person who will
care for you while you’re sick.
If possible,
stay in a room separate from the common areas of the house. (For example, a
spare bedroom, if
that’s possible.).
ALWAYS cover
your mouth and nose with a tissue when sneezing, coughing or blowing your nose.
ALWAYS wash your
hands with soap or water or use alcohol‐based hand rubs after coughing or
sneezing or
throwing a used tissue in the garbage. Throw out your used
tissues with your regular garbage. Do not touch
your nose, face or eyes after coughing or sneezing.
While the virus
is likely not spread very well from contact with soiled household surfaces,
cleaning of surfaces
that are frequently touched (such as door knobs or any other
object that you sneeze or cough on) may help
prevent transmission. Clean all hard surfaces such as bedside
tables, bathroom surfaces, doorknobs, and
children’ toys with a standard household disinfectant. If
surfaces are visibly dirty use a household cleaner
first, then a disinfectant. Wash your hands after cleaning the
area.
Dirty dishes and
eating utensils should be washed in a dishwasher or by hand with warm water and
soap.
Laundry can be
washed in a standard washing machine with warm or cold water and detergent.
Linens and
towels should also be tumble dried on a hot setting. It is not
necessary to separate soiled linen and laundry
your laundry from other household laundry.
When close
contact with other people in the home is unavoidable, the sick person should
wear a surgical
mask to help prevent the spread of the virus. Surgical masks
can be purchased in a pharmacy or hardware
store.
2
If your symptoms worsen, (see WHEN TO CONTACT A DOCTOR RIGHT
AWAY), you should call your doctor or seek medical care
immediately.
When going to the doctor’s office or the emergency room,
you
should
have a family member or friend drive you in a private car or
take a taxi. Do
NOT take public transportation (subway or bus).
If
you go to your doctor,
please contact your doctor before you leave your home and tell
the
doctor you have the flu. After arriving, go straight to the
receptionist or
triage nurse so that you can be put in a private room while
you wait to
see the doctor
. You
may be asked to wear a mask and you should sit away
from others as much as possible.
If
you need to call an ambulance to take
you to the hospital, let the 911 operator know that you have
the flu and
a l so l e t the ambulance c rew know when they ar r i ve.
IF I AM SICK DO I NEED TO TAKE MEDICINE?
You should only take medicine if your doctor prescribes it for
you. For people with certain underlying medical
conditions, a medicine called either oseltamivir (Tamiflu®)
or zanamavir (Relenza™) may be recommended. You
should consult with your doctor to see if you need medicine.
You should also rest, drink plenty of liquids, and take
medications that you would normally take to treat your
symptoms, such as acetaminophen or ibuprofen. If you
have other underlying medical conditions, you should consult
with your doctor. You should rest, drink plenty of
liquids, and take medications that you would normally take to
treat your symptoms, such as acetaminophen or
ibuprofen. People who are under 18 years of age should NOT
take aspirin or aspirin‐containing products (e.g.,
Pepto‐Bismol™), as this can cause a rare serious
illness called Reye’s Syndrome in young people with the flu.
WHAT TO DO IF YOUR SYMPTOMS WORSEN
SHOULD PERSONS I LIVE WITH OR OTHER CLOSE CONTACTS TAKE
MEDICINE TO PREVENT SWINE FLU?
The Health Department is recommending preventive medication
for household or other close contacts who have
an underlying condition (such as certain chronic medical
conditions, being immunocompromised, being <2 or > 65
years old) that may put them at risk for more severe illness.
To find out whether preventive medication such as
oseltamivir (Tamiflu®) or zanamavir (Relenza™) is
recommended, call a doctor.
WHERE TO GET MORE INFORMATION
For more information, call your doctor or visit the following
websites that have information about swine flu:
www.cdc.gov
/ www.who.int
/ www.nyc.gov/health
or call 718-767-1000
Created on 4/30/2009 9:58:00 AM
INSTRUCTIONS FOR CLOSE CONTACTS:
Other household
members should monitor themselves closely for the development of influenza‐like
symptoms. If they get sick with fever, cough, or sore throat,
they should stay at home and take the same
precautions listed above.
Sick persons
should not have visitors while they are ill with influenza or an influenza‐like
illness. If anyone
who does not live with the patient must enter the home, they
should avoid contact with the sick person.
All persons in
the household, especially those who must come in close contact with the sick
person should
clean their hands with soap and water or an alcohol‐based
hand rub frequently and after every contact with
the sick person.
If someone else is doing laundry
for the sick person, they should avoid “hugging” laundry prior to washing it
to prevent self‐contamination and clean hands with soap
and water or alcohol‐based hand rub right after
handling dirty laundry.
Close contacts may consider
using a facemask (e.g. surgical mask) or an N95 respirator. These can be
purchased at a pharmacy or hardware store. If a reusable
fabric facemask is used, it should be laundered
with normal laundry detergent and tumble‐dried in a hot
dryer.
HOME ISOLATION ‐ Instructions for Suspect, Probable and
Confirmed Swine Influenza Cases (cont)
WHEN TO CONTACT A DOCTOR
RIGHT AWAY
Children:
‐Fast breathing or trouble breathing
‐Bluish skin color
‐Not drinking enough fluids
‐Lethargic or not interacting
‐Increasing irritability
‐Flu‐like symptoms improve but return
with fever and worse cough
Adults
‐Difficulty breathing
‐Shortness of breath
‐Pain or pressure in the chest or abdomen
‐Sudden dizziness
‐Confusion
Dear Patient,
If you are suspected of having or were diagnosed recently with
swine influenza (swine flu).
Influenza can be transmitted when an infected person coughs or
sneezes. It is also possible to
become infected by touching surfaces contaminated with the
virus, and then touching your
own nose or mouth. Covering coughs and sneezes and washing
hands with soap and water or
with an alcohol-based hand rub are essential in stopping the
spread of influenza.
During the period that you have symptoms, especially fever, it
is possible for you to transmit this
virus to those who have close contact with you (for example,
someone living with or caring for
you). To help prevent transmission of influenza virus to your
close contacts, the Health
Department is asking you to
stay
at home for 7 days after the day you developed a fever or 24-
48 hours after all symptoms resolve, whichever is longer.
During
that time, please follow these
guidelines:
HOME ISOLATION
Instructions for Suspected, Probable and Confirmed Swine
Influenza Cases
YOU SHOULD:
Stay at home for 7 days after the first day of fever or at
least 24-48 hours after all symptoms
resolve, whichever is longer.
Limit contact with others;
avoid close contact such as kissing, do not share toothbrushes,
cigarettes or drinks with non-infected persons. Persons living
in the home with you should limit
contact with you to the extent possible. Consider designating
one person (not someone who is
pregnant) as the primary person who will care for you while
you’re sick.
If possible, stay in a
room separate from the common areas of the house. (For example, a spare
bedroom, if that’s possible.).
ALWAYS cover your mouth
and nose with a tissue when sneezing, coughing or blowing your
nose.
ALWAYS wash your hands
with soap or water or use alcohol-based hand rubs after coughing or
sneezing or throwing a used tissue in the garbage. Throw out
your used tissues with your regular
garbage. Do not touch your nose, face or eyes after coughing
or sneezing.
While the virus is likely
not spread very well from contact with soiled household surfaces, cleaning
of surfaces that are frequently touched (such as door knobs or
any other object that you sneeze
or cough on) may help prevent transmission. Clean all hard
surfaces such as bedside tables,
bathroom surfaces, doorknobs, and children’ toys with a
standard household disinfectant. If
surfaces are visibly dirty use a household cleaner first, then
a disinfectant. Wash your hands after
cleaning the area.
Dirty dishes and eating
utensils should be washed in a dishwasher or by hand with warm water
and soap.
Laundry can be washed in a
standard washing machine with warm or cold water and
detergent. Linens and towels should also be tumble dried on a
hot setting. It is not necessary to
separate soiled linen and laundry your laundry from other
household laundry
INSTRUCTIONS FOR CLOSE CONTACTS:
Other household members should monitor themselves closely for
the development of
influenza-like symptoms. If they get sick with fever, cough,
or sore throat, they should stay
at home and take the same precautions listed above.
Sick persons should not have visitors while they are ill with
influenza or an influenza-like
illness. If anyone who does not live with the patient must
enter the home, they should
avoid contact with the sick person.
All persons in the household, especially those who must come
in close contact with the
sick person, should clean their hands with soap and water or
an alcohol-based hand rub
frequently and after every contact with the sick person.
If someone else is doing
laundry for the sick person, they should avoid “hugging” laundry
prior to washing it to prevent self-contamination and clean
hands with soap and water or
alcohol-based hand rub right after handling dirty laundry.
Close contacts may
consider using a facemask (e.g. surgical mask) or an N95 respirator.
These can be purchased at a pharmacy or hardware store. If a
reusable fabric facemask
is used, it should be laundered with normal laundry detergent
and tumble-dried in a hot
2
IF I AM SICK DO I NEED TO TAKE MEDICINE?
You should only take medicine if your doctor prescribes it for
you. For people with certain
underlying medical conditions, a medicine called either
Tamiflu™ or Relenza™ may be
recommended. You should consult with your doctor to see if you
need medicine. You should
also rest, drink plenty of liquids, and take medications that
you would normally take to treat
your symptoms, such as acetaminophen or ibuprofen. People who
are under 18 years of age
should NOT take aspirin or aspirin-containing products (e.g.,
Pepto-Bismol™), as this can cause
a rare serious illness called Reye’s Syndrome in young
people with the flu.
WHAT TO DO IF YOUR SYMPTOMS WORSEN
If your symptoms worsen, especially if you begin to have
trouble breathing, you should call your
doctor or seek help at an emergency room. When going to the
doctor’s office or the
emergency room,
you
should have a family member or friend drive you in a private car or take
a taxi. Do NOT take public transportation (subway or bus).
If you go to your doctor, please contact your doctor before
you leave your home and tell the
doctor you have influenza-like symptoms. After arriving, go
straight to the receptionist or triage
nurse so that you can be put in a private room while you wait
to see the doctor
. You may be
asked to wear a mask and you should sit away from others as
much as possible.
If you call an
ambulance to take you to the hospital, let the operator know
that you have influenza-like
symptoms when you call 911, and let the ambulance crew know
when they arrive.
SHOULD PERSONS I LIVE WITH OR OTHER CLOSE CONTACTS TAKE
MEDICINE TO PREVENT SWINE FLU?
The Health Department is recommending preventive medication
for household or other close
contacts who have an underlying condition (such as certain
chronic medical conditions, being
immunocompromised, being <2 or > 65 years old) that may
put them at risk for more severe
illness. To find out whether preventive medication such as
oseltamivir (Tamiflu®) is
recommended, call a doctor.
CALL WHITESTONE AMBULANCE AT 718-767100 0R THE CITY FOR
ADDITIONAL INFORMATION
info@wvac11357.com
