James R. Ginder, MS, WEMT,PI, CHES Health Education Specialist Hamilton County Health Department www.co.hamilton.in.us

1. Flu And You James R. Ginder, MS, WEMT,PI, CHES Health Education Specialist Hamilton County Health Department www.co.hamilton.in.us

2. The Student Will Be Able To… • list three ways to prevent the flu. • describe how flu is transmitted. • recall who needs to receive a flu vaccine.

3. What Is The Flu… • Influenza (the flu) is a contagious respiratory illness caused by influenza virus. • It can cause mild to severe illness, and at times can lead to death. • Every year in the United States, on average 5% to 20% of the population develops the flu; more than 200,000 people are hospitalized from flu complications, and; about 36,000 people die from flu.

4. How Flu Spreads… • The main way that influenza viruses are spread is from person to person in respiratory droplets of coughs and sneezes. • This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. • The virus may be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

5. The Influenza (Flu) Viruses… • There are two main types of influenza (flu) virus: ●Types A and B. Influenza • Types A and B viruses are responsible for seasonal flu epidemics each year. • Over the course of a flu season, different types (A & B) and subtypes of influenza A viruses can circulate and cause illness. • In addition, influenza viruses are constantly changing through a process called "antigenic drift." Influenza A & B

6. Antigenic Drift… • These are small changes in the virus that happen continually over time. • Antigenic drift produces new virus strains that may not be recognized by the body's immune system. • This process works as follows: a person infected with a particular flu virus strain develops antibody against that virus. • As newer virus strains appear, the antibodies against the older strains no longer recognize the "newer" virus, and re-infection can occur. • This is one of the main reasons why people can get the flu more than one time.

7. Antigenic Shift… • Antigenic shift is an abrupt, major change in the influenza A viruses, resulting in new proteins in viruses that infect humans. • Shift results in a new influenza A subtype. • When shift happens, most people have little or no protection against the new virus. • While influenza viruses are changing by antigenic drift all the time, antigenic shift happens only occasionally. • Type A viruses undergo both kinds of changes; influenza type B viruses change only by the more gradual process of antigenic drift.

8. Flu Season… • In the Northern hemisphere, winter is the time for flu. • The timing and duration of flu seasons vary. • While flu outbreaks can happen as early as October, most of the time influenza activity peaks in January or later. • During the past 26 flu seasons, months with the heaviest flu activity (peak months) occurred in November one season, December four seasons, January five seasons, February 12 seasons, and March four seasons.

9. The Flu Is Contagious… • Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 days after becoming sick. • Children may pass the virus for longer than seven days. Symptoms start one to four days after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.   • Some persons can be infected with the flu virus but have no symptoms. During this time, those persons can still spread the virus to others.

10. Things To Think About… • Avoid close contact:Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too. • Stay home when you are sick:If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness. • Cover your mouth and nose:Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.

11. Things To Think About Cont.. • Clean your hands. Washing your hands often will help protect you from germs. • Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. • Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

12. Hand washing…

13. How To Use Alcohol-Based Hand Sanitizer…

14. Alcohol-BasedHand Sanitizer … • Apply product to the palm of one hand (size of a quarter) • Rub hands together • Rub the product over all surfaces of hands and fingers until hands are dry

15. Cover Your Cough… • Cover your mouth and nose with a tissue when you cough or sneeze. • If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands. • Put your used tissue in the waste basket. • Clean your hands after coughing or sneezing. • Wash with soap and water or alcohol-based hand cleaner.

16. Symptoms Of The Flu… • Symptoms of flu include: ● Fever (usually high) ● Headache ● Extreme tiredness ● Dry cough ● Sore throat ● Runny or stuffy nose ● Muscle aches

17. If You Get Sick… • Get lots of rest, drink plenty of liquids, and avoid using alcohol and tobacco. • There are over-the-counter (OTC) medications to relieve the symptoms of the flu (but never give aspirin to children or teenagers who have flu-like symptoms, particularly fever). • Remember that serious illness from the flu is more likely in certain groups of people including people 65 and older, pregnant women, people with certain chronic medical conditions and young children. • Consult your doctor early on for the best treatment, but also be aware of emergency warning signs that require urgent medical attention.

18. Flu Emergencies In Children… • Fast breathing or trouble breathing • Bluish skin color • Not drinking enough fluids • Not waking up or not interacting • Being so irritable that the child does not want to be held • Flu-like symptoms improve but then return with fever and worse cough • Fever with a rash

19. Adult Flu Emergencies… • Difficulty breathing or shortness of breath • Pain or pressure in the chest or abdomen • Sudden dizziness • Confusion • Severe or persistent vomiting

20. The Protected Stains For 2008-2009… ●A/Brisbane/59/2007(H1N1)-like virus ● A/Brisbane/10/2007 (H3N2)-like virus ●B/Florida/4/2006-like virus.

21. Flu Shot… • The single best way to protect against the flu is to get vaccinated each year. • The "flu shot"— an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. • The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.

22. FluMist®… • The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “live attenuated influenza vaccine” or FluMist®). • LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.

23. How Long Does The Vaccine Last… • The vaccine lasts about a year, so vaccination in August or September provides protection for the duration of the United States flu season, which can last until April or May. • Getting vaccinated as soon as vaccine is available may be most important for children being vaccinated against flu for the first time, who need to get two doses of flu vaccine at least 4 weeks apart.

24. Who Needs Vaccinated… • Children aged 6 months up to their 19th birthday • Pregnant women • People 50 years of age and older • People of any age with certain chronic medical conditions • People who live in nursing homes and other long-term care facilities • People who live with or care for those at high risk for complications from flu, including: a.   Health care workersb.   Household contacts of persons at high risk for complications from the fluc.   Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

25. Who Should NOT Get Vaccinated… • People who have a severe allergy to chicken eggs. • People who have had a severe reaction to an influenza vaccination. • People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine. • Children less than 6 months of age (influenza vaccine is not approved for this age group), and • People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.)

26. Flu Shot Side Effects… • The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. • Some minor side effects that could occur are: ● Soreness, redness, or swelling where the shot was given ● Fever (low grade) ● Aches • If these problems occur, they begin soon after the shot and usually last 1 to 2 days. • Almost all people who receive influenza vaccine have no serious problems from it.

27. FluMist® Side Effects… • LAIV (FluMist®) The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. • In adults and children, side effects from LAIV (FluMist®) can include ● Runny nose ● Wheezing ● Headache ● Vomiting ● Muscle aches ● Fever ● Cough ● Sore Throat

28. When To Receive A Flu Vaccine… • Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. • This is because the timing and duration of influenza seasons vary.  • While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later.  

30. Antiviral Drugs And Flu… • Antiviral drugs are an important second line of defense in the prevention and treatment of flu. • Antiviral drugs are important in the treatment and prevention influenza. • Influenza antiviral drugs can be used to treat the flu or to prevent infection with flu viruses. • Treatment with antivirals should begin within 48 hours of getting sick, and can reduce your symptoms and shorten the time you are sick. • When used for prevention, antivirals are 70% to 90% effective in preventing infection with influenza viruses. • Antiviral drugs are effective across all age and risk groups.

31. Tamiflu® & Relenza®… • Two antiviral drugs (oseltamivir, brand name Tamiflu®, and zanamivir, brand name Relenza®)are approved for treatment of the flu. • Oseltamivir is approved to treat flu in people one year of age and older. • Zanamivir is approved to treat flu in people 7 years and older. • These are prescription medications, and a doctor should be consulted before the drugs are used. • Antiviral treatment lasts for 5 days and should be started within 2 days of illness, so if you get flu-like symptoms, seek medical care early on.

32. Source… • Advisory Committee on Immunization Practices (ACIP) http://www.cdc.gov/vaccines/recs/acip/ • Center For Disease Control and Prevention www.cdc.gov • World Health Organization www.who.org