What You Need to Know About the Pandemic (H1N1) 2009 Dr. Esther Tan Medical Services Division

1. What You Need to Know About the Pandemic (H1N1) 2009 Dr. Esther TanMedical Services Division

2. What is the Influenza A (H1N1) Virus? • 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

3. So What? • 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 3

4. 1847 42yrs 1889 29yrs 1918 39yrs 1957 11yrs 1968 Past Influenza Pandemics Pandemic usually occur every 30 – 40years 1850 1900 1950 Last Pandemic was ≈ 40 yrs ago, in 1968.... 2000

5. WHO Pandemic Phase 6

6. 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

7. 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)

8. 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 In March 2006, the Secretary-General directed all UN offices to prepare for a pandemic 8

9. 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 home 9

10. CDC: Pandemic Severity Index (PSI) 10

11. CDC: Community Mitigation Intervention by Pandemic Severity 11

12. So What Can You Do About It?

13. Wash hands often Cover coughs and sneezes 1. Practice Personal Hygiene

14. Value of Proper Handwashing Unwashed hand Washed hand

15. Avoid close contact will ill persons Stay home if ill 2. Practice Social Distancing

16. No Travel Restrictions Seek medical care if you feel sick during travel After return from travel, monitor your health for 7 days 3. Heed Travel Advice • Practice personal hygiene • Wash hands and cover coughs and sneezes

17. Know how to care for yourself or others at home Know the symptoms of mild and severe influenza 4. Have Self Care Knowledge

18. What Are the Symptoms of Flu? • 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

19. What Should I Do If I have Mild Symptoms? • 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.

20. When To Seek Emergency Care? • 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

21. Getting Prepared: Choosing A Local Health Care Provider • 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

22. Comprehensive Pandemic Booklet http://www.un.org/staff/pandemic/

23. 5. Stockpile 6 Weeks of Supplies

24. 6. Vaccinate Against The Flu

25. Antiviral Medication (e.g. oseltamivir) • 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 25

26. When To Use A Surgical Mask? • 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 26

27. What Can You Do? 27

28. Thank you flupandemic@un.org