FACTS ABOUT NOVEL FACTS ABOUT NOVEL H1N1 FLUH1N1 FLU

Information Provided by: NYSDOH and CDCInformation Provided by: NYSDOH and CDC

Chautauqua County Health Chautauqua County Health DepartmentDepartment

Novel H1N1 FluNovel H1N1 Flu

Novel H1N1 influenza is a new flu virus Novel H1N1 influenza is a new flu virus that is spreading from person-to-person.that is spreading from person-to-person.

The The virus has spread rapidly.virus has spread rapidly. The government has declared a public The government has declared a public

health emergency in the U.S. in response health emergency in the U.S. in response to the H1N1 outbreak. to the H1N1 outbreak.

The first cases of human infection were The first cases of human infection were detected in April 2009 in San Diego and detected in April 2009 in San Diego and Imperial County, California and in Imperial County, California and in Guadalupe County, Texas. Guadalupe County, Texas.

Novel H1N1 FluNovel H1N1 Flu

At this time, H1N1 flu is widespread in the At this time, H1N1 flu is widespread in the United States and has been detected United States and has been detected internationally as well.internationally as well.

The CDC expects that more cases, more The CDC expects that more cases, more hospitalizations, and more deaths from this hospitalizations, and more deaths from this outbreak will occur over the and months.outbreak will occur over the and months.

Because this is a new virus, most people will Because this is a new virus, most people will not have immunity to it, and illness may be not have immunity to it, and illness may be more severe and widespread as a result.more severe and widespread as a result.

Seasonal Flu Facts

“Routine” seasonal flu can be severe Each year in the United States:

– more than 200,000 people are hospitalized

– 36,000 people die from seasonal flu-related causes

In comparison as of August 28, 2009 there have been 8,843 total H1N1 hospitalizations, and only 556 deaths reported to the CDC

Chautauqua County Health Chautauqua County Health Department role:Department role:

Lessen the spread of Novel H1N1 Lessen the spread of Novel H1N1 influenzainfluenza

Monitor and reduce illness severityMonitor and reduce illness severity Provide information to help the public Provide information to help the public

address the challenges of this address the challenges of this emergencyemergency

Community Mitigation Measures Goals

Slow the spread of the disease in the community

Decrease exposure to both seasonal flu and H1N1 flu

Delay peak of disease to “buy” time for production and distribution of vaccine

Reduce the total number of people who get sick

Reduce the “surge” demand on healthcare systems resulting from those who are sick

Novel H1N1 Flu VaccinationNovel H1N1 Flu Vaccination With the new H1N1 virus continuing to With the new H1N1 virus continuing to

spread in the United States, the CDC has spread in the United States, the CDC has taken important steps preparing for a taken important steps preparing for a voluntary novel H1N1 vaccination effort.voluntary novel H1N1 vaccination effort.

CDC is concerned that the new H1N1 flu CDC is concerned that the new H1N1 flu virus could result in a particularly severe flu virus could result in a particularly severe flu season this year.season this year.

Vaccines are the best tool to prevent Vaccines are the best tool to prevent influenza influenza

Priority populations should get vaccinated Priority populations should get vaccinated as soon as vaccines become available at as soon as vaccines become available at their doctor’s offices and in their their doctor’s offices and in their communities.communities.

Priority Populations for H1N1 Vaccination

Pregnant women Household contacts and caregivers for

children less than 6 months of age Health care and emergency services

personnel Persons 6 months through 24 years of

age Persons age 25 through 64 years who

have medical conditions associated with a higher risk of influenza complications.

Seasonal Influenza Vaccine

H1N1 vaccine is not intended to replace the seasonal flu vaccine.

Those 65 and older, health care workers, and those with underlying medical conditions should receive seasonal flu shot as soon as possible.

How does Novel H1N1 flu How does Novel H1N1 flu spread?spread?

This virus is thought to spread the This virus is thought to spread the same way that seasonal flu spreads:same way that seasonal flu spreads:

Primarily through Primarily through respiratory dropletsrespiratory droplets – CoughingCoughing– SneezingSneezing– Touching respiratory droplets on yourself, Touching respiratory droplets on yourself,

another person, or an object, then touching another person, or an object, then touching mucus membranes (e.g., mouth, nose, eyes) mucus membranes (e.g., mouth, nose, eyes) without washing handswithout washing hands

Fever Fever ≥ 100≥ 100o o FF CoughCough Sore throatSore throat Runny or stuffy noseRunny or stuffy nose Body achesBody aches HeadacheHeadache ChillsChills FatigueFatigue In addition, vomiting (25%) and diarrhea (25%) In addition, vomiting (25%) and diarrhea (25%)

have been reportedhave been reported

SEEK MEDICAL CARE FROM YOUR DOCTOR IF YOU ARE AT RISK OF SEEK MEDICAL CARE FROM YOUR DOCTOR IF YOU ARE AT RISK OF COMPLICATIONS OF THE FLU OR IS YOUR SYMPTOMS ARE SEVERE OR COMPLICATIONS OF THE FLU OR IS YOUR SYMPTOMS ARE SEVERE OR

PERSIST!PERSIST!

Signs and Symptoms of Novel Signs and Symptoms of Novel H1N1 FluH1N1 Flu

What are emergency warning What are emergency warning signs to watch for?signs to watch for?

In adults:– Difficulty breathing or shortness of breath– Pain or pressure in the chest or abdomen– Sudden dizziness – Confusion – Severe or persistent vomiting – Flu-like symptoms improve but then return

with fever and worse cough

SEEK EMERGENCY MEDICAL CARE!SEEK EMERGENCY MEDICAL CARE!

What are emergency warning What are emergency warning signs to watch for?signs to watch for?

In In childrenchildren::– Fast breathing or trouble breathingFast breathing or trouble breathing– Bluish or gray skin color Bluish or gray skin color – Not drinking enough fluids Not drinking enough fluids – Severe or persistent vomiting Severe or persistent vomiting – Not waking up or not interacting Not waking up or not interacting – Irritable, the child does not want to be held Irritable, the child does not want to be held – Flu-like symptoms improve but then return Flu-like symptoms improve but then return

with fever and worse cough with fever and worse cough

SEEK EMERGENCY MEDICAL CARE!SEEK EMERGENCY MEDICAL CARE!

What is MRSA?What is MRSA?

Known as Methicillin-Resistant Known as Methicillin-Resistant Staphylococcus AureusStaphylococcus Aureus

A potentially dangerous type of staph A potentially dangerous type of staph bacteria that is resistant to certain bacteria that is resistant to certain antibiotics and may cause skin and antibiotics and may cause skin and other infections other infections

How is MRSA transmitted?How is MRSA transmitted?

MRSA is usually transmitted by direct MRSA is usually transmitted by direct skin-to-skin contact or contact with skin-to-skin contact or contact with shared items or surfaces that have shared items or surfaces that have come into contact with someone come into contact with someone else's infection (e.g., towels, used else's infection (e.g., towels, used bandages). bandages).

What are the signs and What are the signs and symptoms of MRSA skin symptoms of MRSA skin

infections? infections? MRSA appears as a bump or infected MRSA appears as a bump or infected

area on the skin that may be: area on the skin that may be: – Red Red – Swollen Swollen – Painful Painful – Warm to the touch Warm to the touch – Full of pus or other drainage Full of pus or other drainage – Accompanied by a feverAccompanied by a fever

NYSED/NYSDOH H1N1 School NYSED/NYSDOH H1N1 School GuidanceGuidance

Latest issued on August 31, 2009Latest issued on August 31, 2009 Focus on early identification and Focus on early identification and

exclusion of ill students and staff.exclusion of ill students and staff. Exclusion period: 24 hours after free of Exclusion period: 24 hours after free of

fever (100F) or signs of a fever without fever (100F) or signs of a fever without the use of fever-reducing medication.the use of fever-reducing medication.

Decisions related to measures taken in Decisions related to measures taken in response to H1N1 are at the discretion response to H1N1 are at the discretion of local education and health officials.of local education and health officials.

Schools are strongly urged to closely monitor ILI activity and work with their local health dept to report absenteeism and staffing shortages.

Reactive school dismissal is not recommended unless absenteeism of students or staff makes it impossible to maintain a normal functioning and safe environment.

This guidance is subject to change based on what the H1N1 virus does related to virulence, severity, and impact.

How to protect yourself from How to protect yourself from MRSAMRSA

Practice good hygiene:Practice good hygiene:– Keep your hands clean by washing with soap and Keep your hands clean by washing with soap and

water or using an alcohol-based hand sanitizer.water or using an alcohol-based hand sanitizer.– Shower immediately after participating in exercise.Shower immediately after participating in exercise.

Cover skin trauma such as abrasions or cuts Cover skin trauma such as abrasions or cuts with a clean dry bandage until healedwith a clean dry bandage until healed

Avoid sharing personal items (ie. towels/ razors) Avoid sharing personal items (ie. towels/ razors) Maintain a clean environment by establishing Maintain a clean environment by establishing

cleaning procedures for surfaces that come into cleaning procedures for surfaces that come into direct contact with people's skin. direct contact with people's skin.

What can your school do to What can your school do to fight H1N1 and MRSA?fight H1N1 and MRSA?

Students and staff should stay home when sick. Students and staff should stay home when sick. This includes extracurricular and social activities.This includes extracurricular and social activities.

Separate ill students and staff.Separate ill students and staff. Hand hygiene and respiratory etiquetteHand hygiene and respiratory etiquette

– Traditional hand washing: soap and warm water, Traditional hand washing: soap and warm water, lathering for a minimum of 20 seconds)lathering for a minimum of 20 seconds)

– Provide hand sanitizer for all classrooms, especially in Provide hand sanitizer for all classrooms, especially in the cafeteriathe cafeteria

– Consider hand wash “breaks” for elementary studentsConsider hand wash “breaks” for elementary students– Provide tissues for all classroomsProvide tissues for all classrooms– Cover coughs and sneezes with tissue or inside of elbow Cover coughs and sneezes with tissue or inside of elbow

(shirt sleeve)(shirt sleeve) Discourage the sharing of personal itemsDiscourage the sharing of personal items

– water bottles, chap sticks, etcwater bottles, chap sticks, etc

In In general general it is it is notnot necessary to close schools to necessary to close schools to "disinfect" "disinfect"

Cleaning and disinfectionCleaning and disinfection should be performed daily should be performed daily on surfaces that are likely touched by students, on surfaces that are likely touched by students, teachers, and staff. teachers, and staff. – Door handles, table tops, desk tops, faucets, handrails, entrances, school Door handles, table tops, desk tops, faucets, handrails, entrances, school

buses, bookshelves, filing cabinets, bathroon stall doors, keyboards, buses, bookshelves, filing cabinets, bathroon stall doors, keyboards, phones, etc… phones, etc…

– Focus on surfaces touched frequently be hands.Focus on surfaces touched frequently be hands.– Clean bathroom surfaces on a regular basis. Air sanitizers have not been Clean bathroom surfaces on a regular basis. Air sanitizers have not been

shown to disinfect airborne influenza and are not recommended.shown to disinfect airborne influenza and are not recommended.– Utilize detergent-based cleaners or Environmental Protection Agency Utilize detergent-based cleaners or Environmental Protection Agency

(EPA)-registered disinfectants is effective at removing Influenza and MRSA (EPA)-registered disinfectants is effective at removing Influenza and MRSA from the environment. from the environment.

The EPA provides a list of registered products effective against The EPA provides a list of registered products effective against Influenza: http://www.epa.gov/oppad001/influenza-a-product-list.pdfInfluenza: http://www.epa.gov/oppad001/influenza-a-product-list.pdf

The EPA provides a list of registered products effective against MRSA: The EPA provides a list of registered products effective against MRSA: http://epa.gov/oppad001/chemregindex.htm

Selective school dismissals may be considered Selective school dismissals may be considered based on the population of an individual school, based on the population of an individual school, such as those serving medically fragile or pregnant such as those serving medically fragile or pregnant students.students.

Novel H1N1 Flu Novel H1N1 Flu Educational MaterialsEducational Materials

NY State DOH: NY State DOH: www.nyhealth.gov/diseases/communicablewww.nyhealth.gov/diseases/communicable/influenza/h1n1educational_materials.html/influenza/h1n1educational_materials.html

CDC Flu Materials: CDC Flu Materials: www.cdc.gov/flu/professionals/flugallery/inwww.cdc.gov/flu/professionals/flugallery/index.htmdex.htm

CDC Stop the Spread of germs: CDC Stop the Spread of germs: www.cdc.gov/flu/professionals/flugallery/inwww.cdc.gov/flu/professionals/flugallery/index.htmdex.htm

American Society for Microbiology:American Society for Microbiology:www.washup.org/page01.htmlwww.washup.org/page01.html

Additional ResourcesAdditional Resources

www.cdc.gov/h1n1flu (CDC)www.cdc.gov/h1n1flu (CDC) www.flu.gov (CDC)www.flu.gov (CDC) www.health.state.ny.us (NYSDOH)www.health.state.ny.us (NYSDOH) www.who.int (WHO)www.who.int (WHO) www.nih.gov (NIH)www.nih.gov (NIH) www.cdc.gov/mrsa (CDC)www.cdc.gov/mrsa (CDC)

Questions/CommentsQuestions/Comments