Home Care Association of NYS Swine or H1N1 Flu 9/19/2018 9/19/2018 Home Care Association of NYS 1

Background Swine Influenza (H1N1) 9/19/2018

First Remember, Keep Things in Perspective: Influenza is a normal part of our lives but is always potentially dangerous, especially to the young, the elderly, or people with compromised immune systems The more common Influenza (the flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death There are currently three strains of influenza circulating in NYS (two seasonal) Every year in the United States, on average 5% to 20% of the population gets the flu This outbreak, so far, appears to be a mild strain 9/19/2018 Home Care Association of NYS 3

What is Swine Influenza? Swine Influenza (formally H1N1) is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of influenza in pigs. Swine flu viruses cause high levels of illness and low death rates in pigs. Swine influenza viruses may circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months similar to outbreaks in humans. The classical swine flu virus (an influenza type A H1N1 virus) was first isolated from a pig in 1930. 9/19/2018 9/19/2018 Home Care Association of NYS 4

Home Care Association of NYS The 2009 flu outbreak in humans is due to a new strain of influenza The origins of this new strain are unknown, and the World Organization for Animal Health (OIE) reports that this strain has not been isolated in swine It passes with apparent ease from human to human, an ability attributed to an as-yet unidentified mutation The strain in most cases causes only mild symptoms and the infected person makes a full recovery without requiring medical attention and without the use of antiviral medicines The World Health Organization has stated that symptoms may even be less severe than seasonal influenza symptoms. 9/19/2018 9/19/2018 Home Care Association of NYS 5

Home Care Association of NYS How serious is it? At this time it appears this strain is a mild virus It may mutate eventually and become more serious NYSDOH recommends treating this like seasonal influenza 9/19/2018 9/19/2018 Home Care Association of NYS 6

Will my regular flu shot help? No, this is a different strain and influenza vaccine will not help However, there are currently two seasonal strains of influenza circulating and NYSDOH is recommending, to help avoid confusion, that you receive a vaccination for those if you have not yet been immunized 9/19/2018 9/19/2018 Home Care Association of NYS 7

How do you catch Swine Flu? The same way you would catch any other cold or flu virus – transmission appears to be same as seasonal flu When an infected person coughs or sneezes around another person Touching something with the flu virus on it then touching your mouth, nose, or eyes. An infected person can pass the virus to another before any symptoms develop and after symptoms subside 9/19/2018 9/19/2018 Home Care Association of NYS 8

Home Care Association of NYS Symptoms of Swine Flu Very similar to regular flu Typically happens after regular flu season is over Upper respiratory symptoms, may have nausea, vomiting, diarrhea Some incidents of sudden dizziness If feverish or have other flu-like symptoms, call your doctor or occupational health nurse! Try to avoid the emergency room or doctor’s office. 9/19/2018 9/19/2018 Home Care Association of NYS 9

Can people catch swine flu from eating pork? No. Swine influenza viruses are not transmitted by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 160°F kills the swine flu virus as it does other bacteria and viruses 9/19/2018 9/19/2018 Home Care Association of NYS 10

Primary Prevention Policies Needed by Providers Screening for symptoms Employees should not travel or work if ill: temp greater than 100 degrees combined with recent onset of cough, sore throat, nasal congestion Have policies for primary prevention methods Sick leave policies so ill employees can stay home 9/19/2018 9/19/2018 Home Care Association of NYS 11

Preventing Spread of H1N1 Flu Hand washing with soap and water or alcohol-based hand cleaner Avoid touching your mouth, eyes and nose as much as possible Use cough etiquette If you are sick, stay home and avoid close contact to others Avoid crowds 9/19/2018 9/19/2018 Home Care Association of NYS 12

What about travelers returning from Mexico? Monitor for signs of flu Incubation period is 1-7 days Treat accordingly 9/19/2018 9/19/2018 Home Care Association of NYS 13

What Does Pandemic Mean? A pandemic is a global disease outbreak. An influenza pandemic occurs when a new influenza A virus emerges for which there is little or no immunity in the human population, begins to cause serious illness and then spreads easily person-to-person worldwide. We are currently in Pandemic Phase 5 9/19/2018 9/19/2018 Home Care Association of NYS 14

Home Care Association of NYS Pandemic Phases Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short 9/19/2018 9/19/2018 Home Care Association of NYS 15

How long can viruses live on surfaces? Some viruses and bacteria can live two hours or longer on surfaces such as ATMs, doorknobs, money, computer keyboards, etc. Find out about infection control measures for laptops, bags, or anything you carry with you. Keep your waterless hand sanitizer with you at all times. 9/19/2018 9/19/2018 Home Care Association of NYS 16

How long are people contagious? 7 days after symptoms start Children are considered to be contagious longer than adults – possibly up to 14 days Tamiflu can reduce symptoms – refer to NYSDOH guidance/advisory 9/19/2018 9/19/2018 Home Care Association of NYS 17

Home Care Association of NYS Home Care Visits Call ahead to screen for symptoms if possible Carry PPE – fit tested N95 if available or tight fitting surgical masks; keep sealed until needed Monitor patients Communicate with other providers serving same patients Family and patient education Hand hygiene Cases should be reported to Local Health Department 9/19/2018 9/19/2018 Home Care Association of NYS 18

Home Care Association of NYS Enhanced PPE Despite saying this is transmitted through droplets, NYSDOH recommends enhanced PPE for symptomatic home care patients until more is known about transmission No evidence of long distance transmission In presence of Febrile Respiratory illness only 9/19/2018 9/19/2018 Home Care Association of NYS 19

Home Care Association of NYS Transport to Hospital Should be based on severity of patient-specific illness per physician recommendation Patient should wear mask during transport Notify EMS of reason for transport 9/19/2018 9/19/2018 Home Care Association of NYS 20

Home Care Association of NYS What you can do • Stay informed • Take everyday actions to stay healthy • Use cough etiquette • Wash your hands often with soap and water or alcohol-based hands cleaners • Avoid touching your eyes, nose or mouth. • Stay home if you get sick. Call your supervisor or occupational health office if you are exhibiting flu like symptoms 9/19/2018 9/19/2018 Home Care Association of NYS 21

Home Care Association of NYS What you can do Follow public health advice regarding school closures, avoiding crowds and other social distancing measures. • Develop a family emergency plan as a precaution. This should include storing a supply of food, medicines, facemasks, alcohol-based hand rubs and other essential supplies. 9/19/2018 9/19/2018 Home Care Association of NYS 22

What should you do if you become sick? If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, contact your health care provider or occupational health nurse Your health care provider will determine whether influenza testing or treatment is needed If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others 9/19/2018 9/19/2018 Home Care Association of NYS 23

Home Care Association of NYS Questions Resources CDC: http://www.cdc.gov/swineflu/ NYSDOH: http://www.health.state.ny.us/ HCA’s Home Care Prepare: www.homecareprepare.org Email with infection control questions: icp@health.state.ny.us Email with general questions: swineflu@health.state.ny.us 9/19/2018 9/19/2018 Home Care Association of NYS 24

Mini Drill 9/19/2018

Home Care Association of NYS There are many cases of suspected, probable and confirmed flu in NYS, but most related to one cluster in Queens Monitor all patients for symptoms of swine flu – call ahead to check for symptoms if possible Facilitate communication or transport to their physician for evaluation if suspected Oversee their treatment at home since they won’t be eligible for admission to a hospital and will be in quarantine 9/19/2018 9/19/2018 Home Care Association of NYS 26

Home Care Association of NYS Your Assignment List things that you need to educate staff about to prevent infection of staff members or others Plan process of care for one patient who is identified with Swine flu, including frequency of visits, what to monitor for, and who you would report which things to Develop strategies for educating aides who will be caring for patients with H1N1 9/19/2018 9/19/2018 Home Care Association of NYS 27

Home Care Association of NYS Your assignment Review your role in your agency’s emergency plan, including the pandemic plan Discuss appropriate infection control standards based on information available at this time. 9/19/2018 9/19/2018 Home Care Association of NYS 28