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Situation UpdateH1N1 Influenza A

• Taney County Health Department
• August 2009

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Overview

• Define the flu.
• Describe the unique features of influenza viruses
• Describe the illness caused by influenza
• Explain how influenza spreads
• Discuss epidemics vs. pandemics
• Discuss the H1N1 virus
• Describe ways to reduce risk of disease

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Influenza Virus Strains

• Type A
• moderate to severe illness
• all age groups
• humans and other animals
• Type B
• changes less rapidly than type A
• milder epidemics
• humans only
• primarily affects children

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Influenza Type A Subtypes
Subtypes of type A determined by hemagglutinin
(H) and neuraminidase (N)
Recent Viruses in the News H5N1 H1N1 H3N2
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Signs and Symptoms

• Symptoms of novel H1N1 flu are similar to those
  of seasonal flu.
• Fever
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headache
• Chills
• Fatigue
• In addition, vomiting (25) and diarrhea (25)
  have been reported. (Higher rate than for
  seasonal flu.)

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How does H1N1 Influenza spread?

• This virus spreads the same way seasonal flu
• Primarily through droplets (Not
  Airborne)
• Coughing
• Sneezing
• Touching respiratory droplets on yourself,
  another person, or an object, then touching mucus
  membranes (e.g., mouth, nose, eyes) without
  washing hands

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Infectious and Incubation Period

• Infected persons are assumed to be contagious
  from one day prior to illness onset until at
  least 24 hours after fever is gone.
• Fever should be gone without the use of
  fever-reducing medicine.
• Incubation period 1-4 days could be as long as
  7 days, 2 days average (similar to seasonal flu)

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What is the difference between Pandemic Flu and
Seasonal Flu?

• Seasonal Flu

• Pandemic Flu

• Respiratory illness caused by a flu virus.
• Some local outbreaks or epidemics
• Some immunity among people in the community
• About 20 of population ill during flu season

• Global flu outbreak
• Occurs when new influenza A virus emerges
• Little or no immunity in people
• Large numbers of people become ill and many die
• Approximately 30-50 of population ill.

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Past Influenza Pandemics
1918 Spanish Flu
1957 Asian Flu
1968 Hong Kong Flu
A(H1N1)
A(H2N2)
A(H3N2)
20-40 m deaths 675,000 US deaths
1-4 m deaths 34,000 US deaths
1-4 m deaths 70,000 US deaths
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August 13, 2009 1,799 deaths
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August 20, 2009 7,983 Hospitalizations, 522
deaths
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H1N1 Influenza

• CDC estimated gt1 million cases had already
  occurred.
• CDC expects that more cases, more
  hospitalizations, and more deaths from this
  outbreak will continue to occur.
• Seasonal influenza results in approx. 36,000
  deaths and more than 200,000 hospitalizations.
• Because this is a new virus, most people will not
  have immunity to it.
• The H1N1 vaccine is currently in clinical
  trials..

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Public Health Actions

• Implemented the emergency response plan
• Information Dissemination
• CDCs Division of the Strategic National
  Stockpile (SNS) has sent 25 of the SNS stockpile
  of antiviral drugs to local jurisdictions
• Meetings with response partners and community
  organizations
• Inventory of PPE and local needs
• Epidemiology and Planning Activities
  (surveillance, disease investigation, antiviral
  distribution planning, mass vaccination clinic
  planning, etc.)

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Prevention Messages

• Hand washing and use of hand gels
• Avoid touching your Eyes, Nose and Mouth
• Stay home if you are ill and keep children home
  if they are ill.
• Cough Etiquette
• Vaccination
• Family Preparedness

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Family Preparedness

• What are the signs and symptoms of the flu?
• What are warning signs that require evaluation by
  healthcare provider?
• What is social distancing and why it is
  important?
• What can families do to prevent the spread of flu?

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Get medical care right away if the sick person at
home

• has difficulty breathing or chest pain
• has purple or blue discoloration of the lips
• is vomiting and unable to keep liquids down
• has signs of dehydration such as dizziness when
  standing, absence of urination, or in infants, a
  lack of tears when they cry
• has seizures (for example, uncontrolled
  convulsions)
• is less responsive than normal or becomes confused

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Take these everyday steps to protect your health

• Cover your nose and mouth with a tissue or the
  crook of your elbow when you cough or sneeze.
  Throw the tissue in the trash after you use it.
• Avoid touching your eyes, nose or mouth.
• Germs spread this way.
• Hand washing
• Avoid contact with sick people.

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If you get sick

• Stay home if youre sick.
• Until youve been free from a fever for 24 hours,
  without the use of fever reducing medications.
• If you are sick, limit your contact
• with other people as much as possible.

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Social Distancing

• Social distancing measures include
• Closing schools
• Canceling public gatherings or events
• Planning for work leave policies
• Working from home
• Staying home if sick
• Some or all of these may be recommended for the
  public depending on the situation.

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Personal Preparedness For Pandemic

• Plan
• How will ill family members be cared for,
  identify needed supplies, unemployment?
• Prepare items for an extended stay at home
• Food, medications, medical supplies
• Preventing the spread of illness
• Knowledge (Hand washing, social distancing, etc)
• Personal protection equipment (masks)
• Cleaners/disinfectant
• Plan for social distancing measures
• Listen for information.

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Summary

• For the most current information on the H1N1
  influenza outbreak, visit http//www.cdc.gov/h1n1f
  lu/ and www.taneycohealth.org
• Missouri, CDC, WHO, and public health officials
  worldwide are carefully monitoring the situation.
• Follow all recommendations for preventing the
  spread of influenza.

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Resources

• http//www.cdc.gov/h1n1flu/
• http//www.cdc.gov/h1n1flu/espanol/
• 1-800-CDC-INFO (1-800-232-4636)
• http//www.who.int/csr/disease/swineflu/en/index.h
  tml
• http//www.cdc.gov/h1n1flu/guidance_homecare.htm
• http//www.epa.gov/oppad001/influenza-disinfectant
  s.html