Pandemic H1N1

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Pandemic (H1N1)
County Of San Diego Health and Human Services
Agency Division of Public Health Services Oct,
2009
Plan. Prepare. Prevent. Protect.
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Objectives

• Influenza 101
• H1N1 Update
• What is the County Doing?
• What Can You Do?
• Review Plan Prepare.. Prevent. Protect.

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Influenza is a Virus

• Pandemic H1N1 is transmitted the same way as
  seasonal flu
• Respiratory droplets
• Coughs and sneezes
• Touching objects touched by an infectious person,
  then touching your nose or mouth
• Droplets arent able to travel long distances
  through the air
• 3-6 feet maximum
• Virus generally survive up to 2 hours on most
  surfaces in ideal conditions of moisture it may
  survive longer

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Seasonal vs. Pandemic Influenza

• Seasonal Influenza
• Circulating virus each year
• Usually some immunity built up from previous
  exposures to the same virus
• Infants and elderly most at risk

• Pandemic Influenza
• New Virus for humans
• Human population lacks any immunity
• All age groups, including healthy young adults

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Pandemic Prerequiste
Pandemic Prerequiste

• A NEW VIRUS Emerges

• A NEW VIRUS Emerges

• It causes illness in Humans

• Able to infect humans

• It is passes easily person to person

• Outbreaks appear worldwide

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Pandemics of the 20th Century
1918 Spanish Flu
1968 Hong Kong Flu
1957 Asian Flu
20-40 million deaths
1-4 million deaths
1-4 million deaths
H3N2
H2N2
H1N1

• 1920 1940 1960 1980 2000

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Pandemic (H1N1)
H1N1 Update
Plan. Prepare. Protect.
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San Diego County H1N1 Spring Outbreak

• Occurred very late in flu season April 2009
• Affected young people disproportionately
• Caused widespread illness some severe or fatal

Adapted from CDC
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First Pandemic of the 21st Century

• On June 11, 2009
• Community-level outbreaks in multiple parts of
  the world
• Declaration was reflection of the spread of the
  virus not of the severity of the disease it
  causes

World Health Organization, Retrieved July 7,
2009, form http//www.who.int/csr/disease/avian_i
nfluenza/phase/en/index.html
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Novel A H1N1so far Sept. 2009

• A mild Pandemicso far.
• person to person spread
• human trials on H1N1 vaccine ongoing
• FDA approval with vaccine due in Oct.

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Clinical Picture so far..

• Symptoms like other flu infections
• Abrupt fever, gt100 F
• Cough, sore throat, runny nose
• Aches, chills, fatigue
• Sometimes diarrhea and vomiting (children)
• Majority of cases recover fully
• Hospitalization rate higher than expected in
  comparison to seasonal flu rate
• The virus is affecting younger populations than
  seasonal flu

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Pandemic (H1N1)
HHSA Public Health Services Duties
Surveillance Community Mitigation Vaccination Comm
unication
Plan. Prepare. Protect.
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Surveillance

• Sentinel sites
• Reporting to State
• Investigation of clusters
• Laboratory Capacity

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Community Mitigation

• Non-pharmaceutical prevention Messages
• Wash hands
• Cover coughs sneezes
• Stay home when ill
• Social distancing
• recommendations

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Community Mitigation

• Pharmaceutical measures
• Anti-virals may be useful to
• limit duration of illness
• County assists with securing
• national stockpile supplies
• if needed

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Vaccinations for 2009

• Regular seasonal flu vaccine
• 6 months thru 8 years, if not had prior flu shot
  ever, will need to get two shots 4 weeks apart
• All others get one flu shot
• PLUS
• Pandemic H1N1 flu vaccine
• Using tiered target groups
• May need two shots 3-4 weeks apart

Image source Retrieved July 24, 2009
fromhttp//flushots2009.com/images/flu_vaccine_200
9.jpg,
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1st Tier Target Group
Vaccinations for 2009

• Pregnant women
• Persons 6 months to 24 years of age
• Household and caregiver contacts for infants 6
  months old and younger
• Health care and emergency personnel
• Persons with medical conditions
• Heart disease, asthma, cancer, autoimmune
  disorders

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2nd Tier Target Groups
Vaccinations for 2009

• Persons aged 25 through 64 years who DO NOT have
  medical conditions associated with a higher risk
  of influenza complications

3rd Tier Target Groups

• Persons aged 65 years and older

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Communication

• Communication
• Press releases
• Press conferences
• Communication Documents
• Letters
• Video Messages
• Toolkits
• Social Networking strategies
• County Television Network
• County website

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Know About.

• Influenza prevention
• Influenza symptoms
• How to care for ill loved ones
• When to stay home
• When to contact your medical provider
• When to seek emergency care

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Influenza Prevention

• Obtain vaccinations when available
• Stay home when ill
• Avoid contact with ill people
• Clean hands with soap and water or alcohol gel
• Cover coughs sneezes

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Pandemic (H1N1)
What Can You Do?
Plan. Prepare. Protect.
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(No Transcript)
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Influenza Symptoms

• Stay Home with influenza like illness if
• You have a fever at 100 degrees F
• AND have onset of cough and/or sore throat

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When to Contact Your Provider

• If pregnant-
• Ask MD about vaccination and treatment
• Consult your MD as soon as symptoms begin
• If have certain health conditions -
• Diabetes, Heart Disease, Asthma, Lung, Autoimmune
  
• Ask MD about vaccination and prevention
• Consult your MD as soon as symptoms begin
• All ages
• If you have influenza symptoms that are not
  resolving with at home care or you start to have
  respiratory distress. Call your medical provider
  and follow up with the screening or appointment
  advice.

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When to Seek Emergency Care

• Get medical care right away if patient
• has difficulty breathing or chest pain
• has blue discoloration of the lips
• is vomiting or is unable to keep liquids down
• has signs of dehydration
• has seizures
• is less responsive or becomes confused

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PREVENTHealthy Habits to Reduce Risk
Vaccinate against disease
Cover your cough
Breastfeed your baby
Eat healthy and get rest
Prevent and manage chronic disease
Wash hands often and use alcohol-based hand
sanitizer
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PLAN Take Time to Plan
Vulnerable populations
Family and community
Schools, universities and child care
Work, business and government
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PLAN Take Time to Plan

• Monthly Tribal Pandemic Workgroup May 2006 to
  Oct. 2008 Hosted by La Jolla Band of Luiseno
  Indians Members from La Jolla, Los Coyotes,
  Rincon, Pala, Pechanga, NAEPC, local community
  and Public Health Services

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PLANGoals of Tribal Pandemic Workgroup
Create Tribal Pandemic Work Plan
Template for Tribal Councils
Choose emergency contact coordinator
Maintaining reservation functions
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Tribal Pandemic Work Plan
Pandemic PeriodResponse Leadership Tasks
Activate Security Plan ECC Tasks Monitor
press releases for Tribe All Member Tasks
Practice infection controlPlanning Leadership
Tasks ECC Tasks All Member
TasksCommunication Leadership Tasks ECC
Tasks All Member Tasks
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Tribal Concerns
Maintaining Reservation Function Services
provided to members that are dependant on
outside suppliers power, water, energy, food
Security Plans Possible refugee influx,
increased facility use simultaneously possible
short staff situationReservation Returnee
Services Need to educate all members about
limitations, if any, around return to
reservation scenario
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PREPARECaring for Self, Family and Community
School closing arrangements
Medications and health supplies
Alternative child care arrangements
Non-perishable foods and water
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PROTECTResponding to Influenza
Know symptoms of flu
Know when to see doctor
Follow Public Health Requests
Protect vulnerable people
Be patient and care for one another
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STAY HOME YOU CAN REDUCE THE SPREAD AND RISK
Keep kids home when ill
You stay home when ill
Ask others to stay home when ill
Use the 24 hour rule Remain home for 24 hours
after fever has gone and without taking fever
reducing medication for 24 hours
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Resources for Seasonal Flu and Novel Influenza A
(H1N1)

• Local Resources
• San Diego Immunization Branch Website
• www.sdiz.org
• http//www.sdix.org/Home/H1N1-Resources.html
• County of San Diego Website
• http//www.sdcounty.ca.gov/Portal/News/swineflu.ht
  ml
• Press conferences
• Communication Documents
• Letters
• Video Messages
• Toolkits
• County Television Network
• 2-1-1, toll free General Community and Health
  Information Line includes H1N1 information (24
  hours, 7 days per week.)
• 211 Website
• http//www.211sandiego.org

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Resources for Seasonal Flu and Novel Influenza A
(H1N1)
State of California California Department of
Public Health (CDPH) website http//www.cdph.ca.g
ov/HealthInfo/discond/pages/swineinfluenza.aspx C
DPH Pandemic Influenza A (H1N1) virus (Swine
Flu) Hotline [phone] toll-free from
800am to 500pm daily CDPH EZ-IZ Vaccines for
Children Program website http//www.eziz.org/ htt
p//www.eziz.org/resources/materials_h1n1.html CA
H1N1 vaccine ordering site http//www.calpanflu.
org/ California Immunization Coalition
(CIC) www.ImmunizeCa.org Twitter
http//twitter.com/ImmunizeCa
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Resources for Seasonal Flu and Novel Influenza
A (H1N1)
National and International Resources Federal
Centers for Disease Control and Prevention
(CDC) http//www.cdc.gov/flu/ http//www.cdc.gov/
h1n1flu/ CDC General Information Phone
Numbers Includes H1N1 information (24 hours, 7
days per week) Toll Free 1-800-CDC-INFO
(1-800-232-4636) 1-888-232-6348 (TTY) World
Health Organization (WHO) http//www.who.int/csr/d
isease/swineflu/en/
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Questions???
Prevent . Protect. Prepare. Plan.