TANEY COUNTY HEALTH DEPARTMENT

AUGUST 2009

Situation Update:H1N1 Influenza A

Overview

Define “the flu.”Describe the unique features of influenza virusesDescribe the illness caused by influenzaExplain how influenza spreadsDiscuss epidemics vs. pandemicsDiscuss the H1N1 virusDescribe ways to reduce risk of disease

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

NN

H

Subtypes of type A determined by Subtypes of type A determined by hemagglutinin (H) and neuraminidase (N)hemagglutinin (H) and neuraminidase (N)

Subtypes of type A determined by Subtypes of type A determined by hemagglutinin (H) and neuraminidase (N)hemagglutinin (H) and neuraminidase (N)

Influenza Type A SubtypesInfluenza Type A Subtypes

RecentViruses in the

News:

H5N1H1N1H3N2

Signs and SymptomsSymptoms 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.)

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

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)

Seasonal FluSeasonal Flu Pandemic FluPandemic 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.

What is the difference between Pandemic Flu and Seasonal Flu?

Past Influenza Pandemics

A(H1N1) A(H2N2) A(H3N2)1918: “Spanish Flu” 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

Credit: US National Museum of Health and Medicine

August 13, 2009: 1,799 deaths

August 20, 2009: 7,983 Hospitalizations, 522 deaths

H1N1 Influenza

CDC estimated >1 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…..

Public Health Actions

Implemented the emergency response plan

Information Dissemination

CDC’s 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.)

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 EtiquetteVaccination Family Preparedness

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?

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

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.

If you get sick…

Stay home if you’re sick. Until you’ve 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.

Social Distancing

Social distancing measures include:Closing schoolsCanceling public gatherings or eventsPlanning for work leave policiesWorking from homeStaying home if sick

Some or all of these may be recommended for the public depending on the situation.

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 suppliesPreventing the spread of illness

Knowledge (Hand washing, social distancing, etc) Personal protection equipment (masks) Cleaners/disinfectant Plan for social distancing measures

Listen for information.

Summary

For the most current information on the H1N1 influenza outbreak, visit http://www.cdc.gov/h1n1flu/ 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.

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.html

http://www.cdc.gov/h1n1flu/guidance_homecare.htm http://www.epa.gov/oppad001/influenza-

disinfectants.html

Resources