Situation Update: H1N1 Influenza A

2. Situation Update:H1N1 Influenza A Taney County Health Department August 2009

3. Overview • Define “the flu.” • Describe the unique features of influenza viruses • Describe the illness caused by influenza • Explain how influenza spreads • Discuss epidemics vs. pandemics • Discuss the H1N1 virus • Describe ways to reduce risk of disease

4. Influenza Virus Strains • Type A • moderate to severe illness • all age groups • humans and other animals • Type B • changes less rapidly than type A • milder epidemics • humans only • primarily affects children

5. H N Influenza Type A Subtypes Subtypes of type A determined by hemagglutinin (H) and neuraminidase (N) Recent Viruses in the News: H5N1 H1N1 H3N2

6. Signs and Symptoms • Symptoms of novel H1N1 flu are similar to those of seasonal flu. • Fever • Cough • Sore throat • Runny or stuffy nose • Body aches • Headache • Chills • Fatigue • In addition, vomiting (25%) and diarrhea (25%) have been reported. (Higher rate than for seasonal flu.)

7. How does H1N1 Influenza spread? • This virus spreads the same way seasonal flu • Primarily through droplets (Not Airborne) • Coughing • Sneezing • Touching respiratory droplets on yourself, another person, or an object, then touching mucus membranes (e.g., mouth, nose, eyes) without washing hands

8. Infectious and Incubation Period • Infected persons are assumed to be contagious from one day prior to illness onset until at least 24 hours after fever is gone. • Fever should be gone without the use of fever-reducing medicine. • Incubation period: 1-4 days could be as long as 7 days, 2 days average (similar to seasonal flu)

9. What is the difference between Pandemic Flu and Seasonal Flu? Seasonal Flu Pandemic Flu • Respiratory illness caused by a flu virus. • Some local outbreaks or epidemics • Some immunity among people in the community • About 20% of population ill during flu season • Global flu outbreak • Occurs when new influenza A virus emerges • Little or no immunity in people • Large numbers of people become ill and many die • Approximately 30-50% of population ill.

10. Credit: US National Museum of Health and Medicine Past Influenza Pandemics 1918: “Spanish Flu” 1957: “Asian Flu” 1968: “Hong Kong Flu” A(H1N1) A(H2N2) A(H3N2) 20-40 m deaths 675,000 US deaths 1-4 m deaths 34,000 US deaths 1-4 m deaths 70,000 US deaths

11. August 13, 2009: 1,799 deaths

12. August 20, 2009: 7,983 Hospitalizations, 522 deaths

13. H1N1 Influenza • CDC estimated >1 million cases had already occurred. • CDC expects that more cases, more hospitalizations, and more deaths from this outbreak will continue to occur. • Seasonal influenza results in approx. 36,000 deaths and more than 200,000 hospitalizations. • Because this is a new virus, most people will not have immunity to it. • The H1N1 vaccine is currently in clinical trials…..

14. Public Health Actions • Implemented the emergency response plan • Information Dissemination • CDC’s Division of the Strategic National Stockpile (SNS) has sent 25% of the SNS stockpile of antiviral drugs to local jurisdictions • Meetings with response partners and community organizations • Inventory of PPE and local needs • Epidemiology and Planning Activities (surveillance, disease investigation, antiviral distribution planning, mass vaccination clinic planning, etc.)

15. Prevention Messages • Hand washing and use of hand gels • Avoid touching your Eyes, Nose and Mouth • Stay home if you are ill and keep children home if they are ill. • Cough Etiquette • Vaccination • Family Preparedness

16. Family Preparedness • What are the signs and symptoms of the flu? • What are warning signs that require evaluation by healthcare provider? • What is social distancing and why it is important? • What can families do to prevent the spread of flu?

17. Get medical care right away if the sick person at home: • has difficulty breathing or chest pain • has purple or blue discoloration of the lips • is vomiting and unable to keep liquids down • has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry • has seizures (for example, uncontrolled convulsions) • is less responsive than normal or becomes confused

18. Take these everyday steps to protect your health • Cover your nose and mouth with a tissue or the crook of your elbow when you cough or sneeze. Throw the tissue in the trash after you use it. • Avoid touching your eyes, nose or mouth. Germs spread this way. • Hand washing • Avoid contact with sick people.

19. If you get sick… • Stay home if you’re sick. • Until you’ve been free from a fever for 24 hours, without the use of fever reducing medications. • If you are sick, limit your contact with other people as much as possible.

20. Social Distancing • Social distancing measures include: • Closing schools • Canceling public gatherings or events • Planning for work leave policies • Working from home • Staying home if sick • Some or all of these may be recommended for the public depending on the situation.

21. Personal Preparedness For Pandemic • Plan • How will ill family members be cared for, identify needed supplies, unemployment? • Prepare items for an extended stay at home • Food, medications, medical supplies • Preventing the spread of illness • Knowledge (Hand washing, social distancing, etc) • Personal protection equipment (masks) • Cleaners/disinfectant • Plan for social distancing measures • Listen for information.

22. Summary • For the most current information on the H1N1 influenza outbreak, visit http://www.cdc.gov/h1n1flu/and www.taneycohealth.org • Missouri, CDC, WHO, and public health officials worldwide are carefully monitoring the situation. • Follow all recommendations for preventing the spread of influenza.

23. Resources • http://www.cdc.gov/h1n1flu/ • http://www.cdc.gov/h1n1flu/espanol/ • 1-800-CDC-INFO (1-800-232-4636) • http://www.who.int/csr/disease/swineflu/en/index.html • http://www.cdc.gov/h1n1flu/guidance_homecare.htm • http://www.epa.gov/oppad001/influenza-disinfectants.html