What You Need to Know About the Pandemic (H1N1) 2009

Dr. Esther TanMedical Services Division 1

What is the Influenza A (H1N1) Virus?

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• H1N1 is a completely new strain of influenza or “flu” virus

• Genetic material from pig, bird and human combined to form this new strain

• Can spread from person-to-person through coughing or sneezing of ill persons

• Despite term “swine flu”: Infections not associated with contact with pigs or pork meat

So What?

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• This new influenza virus has already sparked a pandemic

• A pandemic is world-wide epidemic

• Results from emergence of a new virus in which overall population has that no immunity

• Severity can vary

Past Influenza Pandemics

1900

1850

1950

2000

1847

1889

1918

19571968

42 yrs

29 yrs

39 yrs

11 yrs

Pandemic usually occur every 30 – 40 years

Last Pandemic was ≈ 40 yrs ago, in 1968....

Last Pandemic was ≈ 40 yrs ago, in 1968....

WHO Pandemic Phase 6

“Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5.

Designation of this phase will indicate that a global pandemic is under way.” - WHO

WHO Pandemic Phase 6

What We Know About Pandemics

• More than one pandemic wave likely• Can be weeks or months between waves• Severity of waves unpredictable: subsequent

wave could be worse than first• Typically affects young, healthy adults (unlike

regular seasonal flu)

Why Must the UN Prepare?

• A severe pandemic can have great impact on the organization

• Social disruption due to fear and panic in community

• Routine life may be affected

• High absenteeism everywhere – staff focus on own families’ health

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In March 2006, the Secretary-General directed all UN offices to

prepare for a pandemic

In March 2006, the Secretary-General directed all UN offices to

prepare for a pandemic

But We Don’t Act Alone….

• The UN works closely with the national, state and city health and emergency authorities

• Some of the public health responses by host country/city authorities may include:– Distribution of medical supplies– Some restrictions on transportation– School/child care closures– Cancelling of public gatherings – Isolation / quarantine of

persons at home9

CDC: Pandemic Severity Index (PSI)

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CDC: Community Mitigation Intervention by Pandemic Severity

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So What Can You Do About It?

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1. Practice Personal Hygiene

Wash hands often Cover coughs and sneezes

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Value of Proper Handwashing

Unwashed hand

Washed hand

2. Practice Social Distancing

Avoid close contact will ill persons

Stay home if ill

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3. Heed Travel Advice

• No Travel Restrictions– Seek medical care if you

feel sick during travel – After return from travel,

monitor your health for 7 days

• Practice personal hygiene

• Wash hands and cover coughs and sneezes

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4. Have Self Care Knowledge

Know how to care for yourself or others at home

Know the symptoms of mild and

severe influenza

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• Similar to regular seasonal flu symptoms

• Fever (often >101oF), chills, dry cough, sore throat, body aches, headache, extreme tiredness, runny nose/nasal congestion

• For H1N1, may get nausea, vomiting, diarrhea

What Are the Symptoms of Flu?

• Current outbreak: Majority of mild cases recovered without any treatment

• Current recommendation from NYC DOH:– If no underlying conditions: Rest at home– If at higher risk of severe disease: See a doctor

• People at higher risk of severe disease:– Those > 65 years, or < 5 years of age– Anyone with lung, heart, kidney, liver or blood disorders, or diabetes– Anyone with a weak immune system, possibly due to illness or medication – Pregnant women– Those on long-term aspirin therapy.

What Should I Do If I have Mild Symptoms?

• Anyone who:– Has difficulty breathing or chest pain– Has purple or blue discoloration of the lips– Is vomiting and unable to keep liquids down– Has seizures (uncontrolled fits)– Is less responsive than normal or becomes

confused– Has signs of dehydration:

• dizziness when standing, absence of urination, or in infants a lack of tears when crying

When To Seek Emergency Care?

• Search for and contact a local health care provider near where you live:

• Use network of participating physicians under your health insurance plan to identify your doctor (http://www.un.org/Depts/oppba/accounts/insurance/healthPlans.htm ).

• Staff with no health insurance can look up the New York City Health and Hospitals Corporation (HHC) directory  (http://www.nyc.gov/html/hhc/html/facilities/directory.shtml

Getting Prepared: Choosing A Local Health Care Provider

Comprehensive Pandemic Booklet

http://www.un.org/staff/pandemic/

5. Stockpile 6 Weeks of Supplies

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6. Vaccinate Against The Flu

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Antiviral Medication (e.g. oseltamivir)

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• Can reduce severe symptoms of flu

• Currently not recommended for mild illness, unless are at “higher risk” of severe symptoms

• Have confirmed with NYC DOH that they have stockpiled enough to treat all expected to be ill

• UN has stockpiled additional amount

• Due to limited medical resources in MSD, Staff should contact your local health provider for first line health services

When To Use A Surgical Mask?

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• WHO: No evidence that wearing masks in community setting is effective

• Currently recommended only for ill persons and in health care settings and medical staff caring for suspected patients

• Nevertheless, individuals may wish to wear it – but must remember it should be combined with other public health measures

What Can You Do?

6. FluVaccination

5. StockpileSupplies

4. Self CareKnowledge

3. Heed Travel Advice

2. SocialDistancing

1. PersonalHygiene

CORE STRATEGIES

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Thank you

flupandemic@un.org

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