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H1N1 Update. September 11, 2009 Savannah Chatham School Nurses. What exactly is H1N1?. Novel Influenza A (H1N1) is a new flu virus of swine origin that was first detected in April 2009. It continues to infect people and spread from person to person.

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H1n1 update

H1N1 Update

September 11, 2009

Savannah Chatham School Nurses


What exactly is h1n1
What exactly is H1N1?

  • Novel Influenza A (H1N1) is a new flu virus of swine origin that was first detected in April 2009. It continues to infect people and spread from person to person.

  • This new H1N1 flu virus is a reminder of the ever-changing and unpredictable nature of influenza


What is a pandemic
What is a pandemic?

  • A pandemic means:

  • There is a new strain of influenza A virus and

  • humans have little or no immunity to it

  • The virus spreads from person-to-person

  • There is a global outbreak with sustained

  • person- to-person transmission


Pandemic timeline
Pandemic Timeline

  •  Major pandemic

1918

Pandemic“Spanish flu” H1N1The most devastating flu pandemic in recent history, killing more than 500,000 people in the United States, and 20 million to 50 million people worldwide.


How contagious is h1n1
How Contagious is H1N1?

Novel H1N1 influenza shares characteristics

with seasonal flu, and studies have shown

that with seasonal flu people may be

contagious from one day before they

develop symptoms to up to 7 days after they

get sick.


H1n1 symptoms
H1N1 symptoms

  • Fever

  • Cough

  • Lethargy

  • Lack of appetite

  • Runny Nose

  • Sore Throat

  • Some report nausea, vomiting and diarrhea

    Basically, no different than seasonal influenza


How h1n1 virus spreads

The transmission of novel H1N1 is similar to seasonal flu -

Spreads through coughing or sneezing of infected people

Some people may become infected by touching something with flu viruses on it and then touching their mouth, nose or eyes.

How H1N1 virus spreads


Percentage of Visits for Influenza-like Illness (ILI) Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

National Summary 2008-2009 and Previous Two Seasons


Novel h1n1 confirmed and probable case rate in the us by age group
Novel H1N1 Confirmed and Probable Case Rate Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet), in the US, By Age Group


Novel h1n1 u s hospitalization rate per 100 000 population by age group
Novel H1N1 U.S. Hospitalization Rate per 100,000 Population, Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet), By Age Group


Novel h1n1 u s deaths by age group
Novel H1N1 U.S. Deaths, By Age Group Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),


Pediatric complications from h1n1
Pediatric Complications from H1N1 Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

  • Of 477 deaths with confirmed H1N1 flu in the Us as of 8/8/09, 36 were in children < 18 y.o.

  • 67% of children who died had at least one high risk medical condition

  • Among high risk medical conditions, more than 90% had neurodevelopmental conditions, such as developmental delay and cerebral palsy


Recommendations
Recommendations Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

  • Wash frequently with soap and water (use alcohol-based hand sanitizer if soap is not available)

  • Cough into your elbow

  • Cover mouth and nose when sneezing and throw away the tissue

  • Avoid touching mouth, nose, and eyes


Recommendations1
Recommendations Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

  • Stay home if you are sick with influenza like illness (at least 24 hours fever free)

  • Keep sick children home from school, daycare, camp, etc.

  • Avoid contact with sick people

  • Stay informed!


For schools
For Schools Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

  • Separate/Isolate students who appear to ILI at arrival or become ill during the day; recommended 6 ft distance between the ill person and others

  • Limit # of persons designated to care for ill persons

  • If severity increases, consider active fever and respiratory infection screening of students and staff when they arrive

  • Provide parents with written information; encourage parents of children with ILI to contact health care provider


Signs symptoms requiring more urgent medical attention
Signs/Symptoms Requiring More Urgent Medical Attention Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

  • Fast breathing or difficulty breathing

  • Bluish or gray skin color

  • Severe or persistent vomiting

  • Not drinking enough fluids

  • Not waking up or not interacting

  • Flu-like symptoms improve but then return with fever and worse cough


Testing
Testing Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

  • Confirmatory testing for H1N1 available through the GA State Public Health Laboratory for hospitalized patients primarily and for surveillance purposes (NOT diagnostic)

  • Rapid Influenza Tests are generally not very specific or sensitive; sensitivity ranges from 10-70%

  • Most influenza like illness (ILI) circulating NOW is likely H1N1; but cannot distinguish clinically from other respiratory viruses (e.g. parainfluenza, RSV in infants/toddlers, seasonal flu)


Treatment
Treatment Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

  • Decision based on guidelines and clinical assessment by providers

  • Recommended antivirals that appear to be effective are oseltamivir (TamiFlu) and zanamivir (Relenza)

  • Rx recommended for persons with suspected influenza at higher risk for complications: children < 5 y.o.

    pregnant women

    persons with chronic medical and immuno-

    suppressive conditions

    adults > 64 y.o.


Exclusion guidelines
Exclusion Guidelines Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

  • Staff/students should stay at home for at least 24 hours after fever has resolved without the use for fever reducing medicines like tylenol or ibuprofen

  • Certain circumstances may dictate longer periods of exclusion

  • Should severity of influenza increase, the recommendations for exclusion are likely to be revised


Importance of vaccination
Importance of Vaccination Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

When it comes to protecting people from influenza, vaccines are an important tool!

Seasonal vaccine still important but will not protect from H1N1


Acip target groups for h1n1 vaccination
ACIP Target Groups for H1N1 Vaccination Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),

  • Pregnant Women

  • Household Contacts/caregivers of children < 6 months

  • Health care workers and Emergency Service Personnel

  • Persons ages 6 months through 24 years of age

  • Non-elderly adults (25-64) with underlying medical conditions


Coastal health district chatham county health department activities
Coastal Health District/Chatham County Health Department Activities

Ongoing Surveillance Activities

Vaccination (Seasonal and H1N1)/Mass Vaccination Planning

Community Education and Preparedness


Pandemic preparedness resources
Pandemic Preparedness Resources Activities

  • www.gachd.org

  • www.cdc.gov/h1n1flu/

  • www.pandemicflu.gov

  • www.health.state.ga.us/h1n1fl

  • Questions????


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