H₁N₁: What You Need to Know Q&A Session

1. H₁N₁ What you Need to Know Q & A Session Ozark’s Technical Community College Michelle Howard, RN, BSN

2. Don’t Let the swine flu myths get out of hand!

3. What is H₁N₁? • History: • Identified in 1930 after research from 1918 Flu Pandemic • Isolated virus from pigs and humans and labeled H₁N₁ • Originally called the “swine flu” • Determined to be a sub-unit-- “1st cousin” to Seasonal Flu (H₃N₂)

4. 2009 H₁N₁ • Now termed “Novel Flu” • Spreading worldwide • Different than seasonal flu • No antibodies/immunity • Very unpredictable • Suspected that it could be worse than years past • CDC preparing for massive flu outbreak • Seasonal flu (H3N2) and novel flu (H1N1)

5. How Does it Spread? • Still under investigation as new cases present • Available data suggests the following: • Person-to-person contact via: • Droplet -“airborne” transmission • Coughing, sneezing • Contaminated surfaces • Virus lands on surface and then transported to eyes or mouth

6. When do Symptoms Begin? • Incubation period is 1-7 days • From exposure to onset of symptoms is typically 1-4 days • The Problem: Infected person can spread 1 day before and 7 days after getting sick

7. What are the Symptoms? Range May be Mild to Severe • Fever • Some cases may NOT have fever • Cough • Sore throat • Runny/stuffy nose • Body aches • Headache • Chills • Fatigue • Vomiting and/or diarrhea

8. Who is at Risk? • All ages are at risk • However like the 1918 Flu Pandemic, H₁N₁ seems to affect the following: • More younger populations • Highest risk 6 months- 24 years old • Those 65 years and older • At least risk • Cases of proven immunity

9. What are the Complications? • Complications include: • Exacerbation of any underlying chronic conditions • Respiratory (asthma, bronchioloitis, pneumonia & croup) • Cardiac (myocarditis & pericarditis) • Musculoskeletal (myositis & rhabdomyolysis) • Neurological (encephalopathy, febrile seizures, & status epilepticus) • Sepsis

10. Who is at highest risk for complications? • Although more of the younger population may get the illness, there are several groups identified as high risk for severe complications: • Children less than 5 years of age • Especially those less than 2 years old • Elderly older than 65 years of age • Persons with chronic conditions • Pregnant women • Immunosuppressed individuals

11. How is H₁N₁ Tested? • If your PCP suspects novel influenza • Nasal swab or aspirate for Influenza A • Some clinicians may defer testing • CDC states “Not all people with suspected novel flu need to have confirmed diagnosis.” • Positive novel flu in community • Illness is mild

12. How is H₁N₁ Treated? • Treatment is based on severity of symptoms • Per CDC guidelines: Not all positive cases are treated • High-risk groups or serious ill • Most cases of H₁N₁ are NOT treated • Less risk of side effects from antivirals • Less chance of antiviral resistance

13. How is H₁N₁ Treated? • Antivirals are available • Help lessen symptoms • Prevent serious complications • Include the following: • Tamiflu (oseltamivir) • Relenza (zanamivir) • Antibiotics • PCP suspects you have a bacterial infection

14. What about Prevention? • CDC recommends: • Personal responsibility • Vaccination

15. How can I fight against H₁N₁ ? • Take Action and Be Responsible! • Cover your mouth and nose when you sneeze • Use a tissue or your sleeve • Wash Your hands with soap and water or use alcohol-based hand sanitizer • Avoid touching your eyes, nose, and mouth • Avoid close contact with sick people • Stay home if you are ill • CDC recommends you stay home for 24 hours after you are fever free with no medications

16. Use Your Sleeve When you Sneeze! • http://www.youtube.com/watch?v=zXXgRvdq7fg.

17. How can I fight against H₁N₁ ? • Get the H₁N₁ Vaccine • A new 2009 vaccine • Different than “Seasonal Flu” vaccine • Provides protection from H₁N₁ • Recommended for the following: • Anyone 6 months-24 years old • Anyone 25-64 years old who are at the highest risk for complications • Pregnant women • Those in contact with young children • All healthcare professionals

18. H₁N₁ Vaccine • This target group makes up 159 million people in U.S. • Will NOT protect against “seasonal flu” • Will need additional vaccine • Manufactured the same as “seasonal flu” vaccine • As safe and effective • Inactivated vaccine or intranasal dose • Injection form recommended for adults > 10 years

19. H₁N₁ Vaccine • Injectable H₁N₁ may be given at the same time as other vaccines including seasonal flu • Simultaneous dosing of intranasal flu is NOT recommended with seasonal flu administration • Dosing: • One dose if 10 years and older • Two doses for 6 month- 9 years(1 month apart)

20. H₁N₁ Vaccine • Contraindicated for: • Anyone who has an allergy to eggs • Anyone with severe allergic reactions to the flu or any vaccine in the past • Anyone with a fever • Notify the person giving the vaccine if: • You have ever had Guillain Barré Syndrome • Have had a fever in last 24 hours

21. H₁N₁ Vaccine • Reactions • All vaccines pose a risk of reaction • Mild: • Redness, soreness swelling at injection site • Headache • Low-grade fever • Severe • Allergic reaction • The 1976 H₁N₁ Vaccine was linked to GuillainBarré Syndrome. Since then, there has not been a clear link.

22. What is OTC doing to help? • OTC is on the frontlines for our community • Concerned for the safety of our students • Campus-wide vaccination campaign initiated • For students • Faculty, staff and their immediate family

23. What is OTC doing to help? • Vaccination Day is coming • Stay tuned: • OTC website • Blackboard • Email announcement • Flyers

24. Let’s see what you know about H₁N₁!

25. True or False? The H1N1 Vaccine can give you the ‘Swine” flu….

26. FALSE

27. True or False? The “Stomach Flu” and influenza(H₁N₁) are the same virus….

28. FALSE

29. True or False? The influenza virus is constantly changing, which requires a new vaccine to be created every year…..

30. TRUE

31. True or False? Handwashing is the BEST method for decreasing the transmission of the swine flu…

32. TRUE

33. True or False? If I get a “seasonal flu” vaccine, I will not need to get the H1N1 vaccine….

34. FALSE