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Influenza A H1 N1

Influenza A H1 N1. Prepared by Dr Alissar Rady, WHO Lebanon. Influenza Virus Types A and B. Circulating Influenza Strains and Pandemics in The 20 th Century. 1968: “Hong Kong Flu”. 1918: “Spanish Flu”. 1957: “Asian Flu”. 20-40 million deaths. 1-4 million deaths.

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Influenza A H1 N1

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  1. Influenza A H1 N1 Prepared by Dr Alissar Rady, WHO Lebanon

  2. Influenza VirusTypes A and B

  3. Circulating Influenza Strains and Pandemics in The 20thCentury 1968: “Hong Kong Flu” 1918: “Spanish Flu” 1957: “Asian Flu” 20-40 million deaths 1-4 million deaths 1-4 milliondeaths H3N2 H2N2 H1N1 1920 1940 1960 1980 2000

  4. Pandemic Waves (1918-1919)

  5. Seasonal Epidemics vs. Pandemics Influenza Pandemics Appear in the human population rarely and unpredictably Human population lacks any immunity All age groups, including healthy young adults Seasonal Influenza A public health problem each year Usually some immunity built up from previous exposures to the same subtype Infants and elderly most at risk

  6. Prerequisites for pandemic influenza A new influenza virus emerges to which the general population has little/no immunity The new virus must be able to replicate in humans and cause disease The new virus must be efficiently transmitted from one human to another

  7. The InfluenzaVirus

  8. A H1N1 :new virus • The 2009 H1N1 virus is a hybrid of swine, avian and human strains Influenza A (H1N1)

  9. Viral Re-assortment Reassortment in humans Reassortment in pigs Pandemic Influenza Virus

  10. WHO Pandemic Phases

  11. Big droplets fall on people surfaces bed clothes Courtesy of CDC

  12. Signs and Symptoms

  13. Swine flu • "The entire purpose is to limit exposure“ • The Centers for Disease Control and Prevention hopes to have a vaccine to manufacturers within 6 months (??)

  14. #1 Pandemic outbreak: No intervention #2 Daily Cases Pandemic outbreak: With intervention #3 Days since First Case Non-pharmaceutical Interventions 1. Delay disease transmission and outbreak peak 2. Decompress peak burden on healthcare infrastructure 3. Diminish overall cases and health impacts

  15. Cough etiquette • Respiratory etiquette • Cover nose / mouth when coughing or sneezing • Hand washing!

  16. Voluntary Isolation • Separation and restricted movement of illpersons with contagious disease (often in a hospital setting and Primarily individual level) • Isolate severe and mild cases • Location of isolation (home, hospital) depends on several factors (severity of illness, the number of affected persons, the domestic setting) • Do not wait for lab confirmation • Plan for large number of severe cases • Provide medical and social care

  17. Voluntary Quarantine • Separation and restricted movement of wellpersons presumed exposed • Identification of contacts • Often at home, but may be designated residential facility or hospital • Applied at the individual or community level • Regular health monitoring is essential part of quarantine • Self-health monitoring and reporting

  18. Hand Washing Method • Wet hands with clean (not hot) water • Apply soap • Rub hands together for at least 20 seconds • Rinse with clean water • Dry with disposable towel or air dry • Use towel to turn off faucet

  19. Alcohol-based Hand Rubs • Effective if hands not visibly soiled • More costly than soap & water Method • Apply appropriate (3ml) amount to palms • Rub hands together, covering all surfaces until dry

  20. Patients Cared for at Home • Potential for transmission • Must educate family caregivers • Fever / symptom monitoring • Infection control measures • Hand washing • Use of available material as mask …

  21. Isolation Precautions

  22. Droplet precautions: Surgical Masks Source: Rosie Sokas, MD MOH UIL at Chicago

  23. N-95 Filtering Masks

  24. Personal Protective Equipment (PPE)

  25. Antivirals- Oseltamivir Treatment is 75 mg twice a day for 5 days. Prophylaxis is 75 mg once a day for 7 days after last exposure. Prophylaxis: High risk exposure (household contacts) Moderate risk (unprotected very close exposure to sick animals; HCW with unprotected exposure to patients) Low risk exposure: no need for prophylaxis unless activation of exceptional measures.

  26. Importance of the Early Treatment

  27. Thank you

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