H1N1 INFLUENZA (Swine Flu): What employers and employees need to know
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Transcript of H1N1 INFLUENZA (Swine Flu): What employers and employees need to know
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H1N1 Influenza is the new name for the 2009 Swine Flu.
Started in Mexico, and now is worldwide – 40 countries 9,830 cases 79 deaths
As of May 19, 2009
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U.S. 48 states, including Hawai`i 5,469 cases 6 deaths
HAWAI`I 26 cases
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Phases of Pandemic Alert - WHO
Phase 1 No flu viruses of concern
Phase 2 Animal virus capable of causing human infection
Phase 3 Animal virus has caused some infection, but does not spread easily
Phase 4 Virus can cause sustained outbreaks and is adapting itself to human spread
Phase 5 The virus has spread to two (2) countries and is causing even bigger outbreaks.
Phase 6 Full-blown pandemic – outbreaks in at least two (2) regions of the world.
Bird Flu
H1N1 Flu
WHO declared Phase 5 status on 4/29/09
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H1N1 does not appear to be as virulent as Avian Flu (H5N1)
Similar to Spanish Influenza of 1918 – affected healthy young adults
SARS – Toronto – affected healthy health care workers
As of 5/19/09, with 5,469 confirmed & probable cases in the U.S., only 6 deaths
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As of May 19, 2009
U.S. Mexico Worldwide
Confirmed Cases 5,469 3,648 9,830
Fatalities 6 72 79
Fatality Rate 0.11% 2.0% 0.8%
On May 1, Mexico’s fatality rate was 6-7%
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Kills ~ 36,000 Hospitalizations ~ 200,000 Infection Rate: 5 – 20% of population
(15 – 61 million people each year) Fatality Rate: ~ 0.09% on average Severity Rate: ~ 0.5% on average
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Severe Acute Respiratory Syndrome November 2002 – July 2003 8,096 cases worldwide 774 deaths In Canada – mostly healthcare workers
(healthy young adults) Fatality rate: 9.6% More than 100x more fatal than Seasonal
Flu
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H5N1 2005 – 2006 mostly Similar to Spanish Influenza of 1918 –
healthy young adults Confirmed cases: 208 No. of Deaths: 115 Fatality Rate: 55% More than 5x more virulent than SARS,
500x more virulent than seasonal flu
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H5N1 Avian Influenza Situation Update Humans
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHOCumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO
12-May-0612-May-06
CountryCountry
20032003 20042004 20052005 20062006 TotalTotal
casescases deathsdeaths casescases deathsdeaths casescases deathsdeaths casescases deathsdeaths casescases deathsdeaths
AzerbaijanAzerbaijan 00 00 00 00 00 00 88 55 88 55
CambodiaCambodia 00 00 00 00 44 44 22 22 66 66
ChinaChina 00 00 00 00 88 55 1010 77 1818 1212
DjiboutiDjibouti 11 00 11 00
EgyptEgypt 00 00 00 00 00 00 1313 55 1313 55
IndonesiaIndonesia 00 00 00 00 1717 1111 1616 1414 3333 2525
IraqIraq 00 00 00 00 00 00 22 22 22 22
ThailandThailand 00 00 1717 1212 55 22 00 00 2222 1414
TurkeyTurkey 00 00 00 00 00 00 1212 44 1212 44
Viet NamViet Nam 33 33 2929 2020 6161 1919 00 00 9393 4242
TotalTotal 33 33 4646 3232 9595 4141 6464 3939 208208 115115
WHO reports only laboratory-confirmed cases.WHO reports only laboratory-confirmed cases.55%!
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H1N1 Flu2009 – (US)
Seasonal Flu (US)
SARS(2003)
H5N1(Avian) (2006)
No. of Confirmed Cases
5,123 40,000,000 8,096 208
No. of Fatalities 5 36,000 744 115
Fatality Rate .10% .09% 9.6% 55.0%
In U.S. appears to be similar in severity to seasonal flu
But it’s not the same as seasonal flu!
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Never-before seen combination of human, swine, and avian influenza viruses.
Most affected are healthy, young adults More contagious than seasonal flu
22-33% versus 5-15% for seasonal Virus may continue to evolve
No human immunity May become more virulent Major impact on society
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Viruses mutate quickly The 1918 Spanish
influenza was originally a mild flu in the spring
Came back in November as a killer
Different from seasonal flu in viral composition
Leads to uncertainty
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Credit: US National Museum of Health and Medicine
A(H1N1) A(H2N2) A(H3N2)1918: “Spanish Influenza” 1957: “Asian Flu” 1968: “Hong Kong Flu”
20-40 m deaths
675,000 US deaths
1-4 m deaths
70,000 US deaths
1-4 m deaths
34,000 US deaths
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1889, 1918, 1957, 1968
First wave in spring was mild
Second wave in fall – much more virulent.
Time to Prepare -- 3 months!
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This is a MUST for all businesses!!!!
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Continuity of Operations (COOP) Worker Protection - OSHA/HIOSH Law“Every employer shall furnish to each of the
employer’s employees employment and a place of employment which are safe as well as free from recognized hazards.”
Section 6(a) of the Hawai`i Occupational Safety and Health Law, Chapter 396, Hawai`i Revised Statutes
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Common knowledge to the industry Employer genuinely desirous of
protecting workers.
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Risk Level depends on whether or not jobs require: Close Proximity Repeated or Extended
Contact
To people: Potentially infected, or Known or suspected sources
http://www.osha.gov/Publications/influenza_pandemic.html
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Healthcare workers performing aerosol generating procedures on known or suspected patients Cough Induction
procedures Bronchoscopies Some Dental
procedures Invasive specimen
collection
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Healthcare and delivery support staff Doctors, nurses,
others that must enter patients rooms
Medical Transport EMTs
Autopsy Morgue and mortuary
employees
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High frequency contact with general population Schools High population
density work High volume retail
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Employees with minimal contact with the general public and other coworkers Office employees
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For workers exposed to hazards for which respiratory protection is required Only NIOSH approved N95 or higher Full program – no waivers for medical
evaluations or fit testing. Where hazard assessments have
determined that respirators are NOT required - Voluntary filtering face-pieces – Training as
per Appendix D.
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Guidance on Preparing Workplaces for an Influenza Pandemic (OSHA Publication 3327-02N)(2007) (http://www.osha.gov/Publications/influenza_pandemic.html)
Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers. (OSHA Publication 3328-05 (2007). (http://www.osha.gov/Publications/3328-05-2007-English.html)
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Frequently Asked Questions on Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers. OSHA, Office of Occupational Health Nursing (OOHN). (http://www.osha.gov/SLTC/pandemicinfluenza/pandemic_health.html)
Proposed Guidance on Workplace Stockpiling of Respirators and Facemasks for Pandemic Influenza. OSHA. (http://www.osha.gov/dsg/guidance/stockpiling-facemasks-respirators.html)
Workplace Preparation. PandemicFlu.gov. (http://pandemicflu.gov/news/panflu_webinar4.html)
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Lead State Agency is the Hawai`i State Department of Health (HDOH) Issue advisories, warnings to public Recommends actions Can require quarantine and isolation
Governor can issue Emergency Declarations
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Training – Cough Etiquette Hand Washing
Posters in Public Areas Hand Sanitizers Sick leave policy
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Tiny droplets from coughing or sneezing
Spreads 3 – 6 feet Can survive on
surfaces up to 1-2 days
Transferred from hands to mouth, nose, eyes.
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Cover your cough/sneeze
Wash hands (Use waterless/ alcohol-based hand cleaners if water/soap not available)
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Stay Home When Sick
Keep Self and Family Healthy
Sanitize Work Stations of Co-Workers Who Become Ill
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NO H1N1 (Swine Flu) is not spread by food.
You cannot get H1N1 by eating pork or pork products. Eating properly handled and cooked pork products is safe.
Reason for change in name is to separate pigs from the human H1N1 flu.
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Hygiene and Distancing are more effective Purpose is to prevent the transmission of
droplets and fomites from the ill person. Limited protection for the non-ill person
trying to avoid getting sick In the workplace, when respirators are
necessary for the type of work, only NIOSH approved N95 respirators are allowed.
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There is NO vaccine for H1N1 yet. Earliest would be fall of 2009.
CDC has NOT recommended that the general public take anti-viral drugs such as Tamiflu or A viruses.
They are most effective if taken 48 hours after exposure.
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Hawai`i State Department of Health website:
http://hawaii.gov/health H1N1 Flu Information Hot Line (Hawai`i
State Department of Health) (866) 767-5044
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Centers for Disease Control:http://www.pandemicflu.gov/
World Health Organization (WHO)http://www.who.int/csr/disease/swineflu/en/
index.html OSHA
www.osha.gov
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Implement good hygiene and infection control practices.
Stay healthy (Keep your family healthy)
Wash your hands frequently – soap and water or alcohol based hand sanitizer
Cover your mouth and nose when coughing or sneezing
Go to your doctor if you suspect you have the flu! (Don’t wait)
Don’t Panic!