H1N1 (Swine Flu) Pandemic Influenza Gordon C. Manin, MD, MPH Medical Director.

Slides:



Advertisements
Similar presentations
H1N1 Flu and YOU….
Advertisements

Novel H1N1 Influenza A Current Knowledge and Recommendations June
C E N T R A L P I E D M O N T C O M M U N I T Y C O L L E G E Pandemic and Influenza: A Guide to Understanding.
Swine flu.
2009 Pandemic Influenza Preparation Presented by Midland ISD Health Services.
2009 H1N1 Flu (Swine Flu) Information
Dr S Aboobakar Regional Public Health Superintendent.
Influenza A, H1N1 “Swine Flu” The Facts and How to Protect Yourself.
Influenza Prevention We anticipate that there will be two types of influenza illness and influenza vaccines this year Seasonal influenza – the usual flu.
Influenza A, H1N1 “Swine Flu”
NH Department of Health and Human Services Division of Public Health Services Influenza Seasonal and H1N1 Patricia Ingraham, MPH Communicable Disease Control.
Swine Flu H1N1.
SWINE INFLUENZA. WHO raises pandemic flu alert level to phase 5  April 29, 2009 — GENEVA – The World Health Organization has raised its pandemic alert.
Swine Influenza (pig flu) is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of influenza in pigs. Swine.
Influenza A (H1N1) Virus & Pandemic Preparedness Generic H1N1 presentation developed for UN staff by Dr. Esther Tan, MSD, UNNY (Please customize.
Maryland Department of Health and Mental Hygiene.
SISD School Nurses are following DSHS and CDC guidelines in sending these type of students home……. Send sick students, teachers, and staff home and advise.
Influenza Annual Training Health, healing and hope.
INFLUENZA (FLU) Management Presentation
Puja A. Sehgal, MD Kelsey-Seybold Clinic
Get the Facts About Novel H1N1 Influenza
H1N1.
Influenza Outbreaks and Cruise Ships Laura Martin 25 April 2002.
Influenza Prevention We anticipate that there will be two types of influenza illness and two different types of influenza vaccine this year Seasonal influenza.
Influenza (The Flu).
Understanding Novel Flu H1N1 Formerly “Swine Flu”
Information source: Swine Flu What is Swine Influenza? Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza.
Tina Kitchin Department of Human Services, SPD 9/24/09
About Swine Flu Dr.Kedar Karki. What is Swine Influenza? Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza virus.
Plate 85 Viral Diseases of the Respiratory System.
The 411 on H1N1 Marcia Nickle Emergency Preparedness Coordinator Campus and Public Safety.
Pandemic Influenza (H1N1) Carol Franklin, MSN Ed, RN Public Health Doctoral Student Walden University.
Seasonal Influenza and Swine-Origin Influenza A (H1N1) Virus
INFLUENZA Caring for our Caregivers AND Our Patients ~ Our Community
Between the extremes of panic and complacency lies the solid ground of vigilance. Margaret Chen Director General of WHO.
H ₁N₁ What you Need to Know Q & A Session Ozark’s Technical Community College Michelle Howard, RN, BSN.
George A. Ralls M.D. Dave Freeman Health Services Department September 1st, 2009 INFLUENZA UPDATE.
U. S. Centers for Disease Control and Prevention
Influenza Vaccination
Flu Prevention Awareness Campaign
Influenza Annual Training
By: Sharee Windish, Haley Bradley & Jordan North
ESRD Network 6 5 Diamond Patient Safety Program
Health Care Personnel Influenza Vaccination [ORGANIZATION NAME] [ORGANIZATION LOGO]
Influenza (Flu)
20 Answers About Influenza
DR.KHEYRKHAH MD-MPH. What is novel H1N1 (swine flu)? Novel H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people.
TANEY COUNTY HEALTH DEPARTMENT AUGUST 2009 Situation Update: H1N1 Influenza A.
UNIVERSITY POLICE OFFICE OF EMERGENCY MANAGEMENT H1N1 Presentation.
Seasonal and H1N1 Flu Guidance on helping Child Care and Early Childhood Programs respond to Influenza Season September 17, 2009 Presented by: Leona Davis.
Swine Flu:/ Leslie Cepeda:). About Virus What is the disease: The swine flu is a new influenza virus causing illness in people. This new virus was first.
H1N1 VIRUS SWINE FLU. What is the H1N1 Virus? It is a new virus that is spread from person to person first detected in people in the United States in.
H1N1 Update Marty White October 12, H1N1 Information  Pandemic declared by World Health Organization in June 2009  The symptoms include fever,
Influenza of 1918 Danielle Albin Dane van Loon Matthew Litch.
Pandemic Flu Brief Unit Name Rank / Name Unit logo.
It’s Just Not the Flu Anymore Rick Hong, MD Associate Chairman CCHS EMC Medical Director, PHPS.
- 1 - H1N1 Influenza What we know What is H1N1 Flu? A new, or novel, flu for which humans have little or no natural immunity H1N1 has been declared.
Swine Flu H1N1. What is swine flu (Influenza A)? Swine Influenza (swine flu) is a respiratory disease of pigs caused by Type A influenza viruses that.
SWINE INFLUENZA. What is Swine Influenza? What is Swine Influenza? Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza.
Agilent Restricted Influenza H1N1 A (Swine Influenza) Information for Agilent’s Employees.
Influenza A, H1N1 “Swine Flu” The Facts and How to Protect Yourself.
Update: Novel Influenza A H1N1 Jeffrey S. Duchin, M.D., FACP, FIDSA Public Health- Seattle & King County Division of Allergy & Infectious Diseases University.
What is influenza? Influenza (also called "the flu") is a viral infection in the nose, throat and lungs. About 10% to 20% of Americans get the flu each.
Influenza A (H1N1). What is Influenza A (H1N1)? Influenza A(H1N1) is caused by a novel virus that resulted from the reassortment of 4 viruses from pigs,
Influenza A, H1N1 “Swine Flu”
PHARMACOTHERAPY III PHCY 510
H1N1 Swine Flu Overview by ziffi.com Symptoms, Causes, Prevention, Tests, Test & Vaccination Centers.
Influenza Presentation for Health Care Workers
Rich Feifer, MD, MPH, FACP April 27, 2009
Presentation transcript:

H1N1 (Swine Flu) Pandemic Influenza Gordon C. Manin, MD, MPH Medical Director

Overview  Definitions/Background  Annual/Seasonal Influenza  H1N1 (Swine Flu)  Prevention & Treatment

Definitions  Influenza (Flu): three types of Flu in humans (A, B, C); only type A further classified by subtypes that differ based on different surface proteins (HA, NA)  H1N1 (Swine Flu A), Avian Flu A (H5N1)  Influenza Epidemic: caused by subtypes of virus already circulating among humans, “seasonal outbreaks”  Antigenic Shift: abrupt/sudden major change in influenza A virus  Influenza Pandemic: new influenza A virus effecting humans, global outbreak, causes serious illness, easily spread from person to person

Pandemic Influenza History DateSubtype Worldwide deaths Highest mortality Waves/ duration H1N150,000, – 50 year olds 3 waves 2 years 1957H2N22,000,000Elderly 2 waves 2 years 1968H3N21,000,000Elderly ? 2 waves 3 years 2009-?H1N1? 25 – 45 Year olds ?

Perspective from Seasonal Influenza Outbreaks  Usually Occur Dec-March  Primarily Spread Person to Person by Respiratory Droplets from Coughs and Sneezes  Complications Include: –Bacterial Pneumonia –Dehydration –Worsening of Chronic Medical Conditions

Perspective from Seasonal Influenza Outbreaks  Incubation Time 1-5 Days (Average 2 Days)  Typically Contagious 1 Day before Symptoms to 5 Days after Symptoms develop  5-20% Get the Flu Each Year in USA  200,000 Hospitalized Each Year in USA  36,000 Americans Die Annually

Awareness Phases  W.H.O.* created 6 phases of awareness 1 Low risk to humans 4 Small clusters human-human spread 2 High risk to humans 5 Large clusters human-human spread 3 Human disease, no spread 6 Sustained transmission in humans**  Level of risk/preparation increases as levels increase –Over time, levels may go up and down –Geographic regions may be at different phases simultaneously –Unclear how much publicity will be given to Phase changes * World Health Organization ** As of June 11 th, 2009

International Co-circulation of 2009 H1N1 and Seasonal Influenza (As of September 20, 2009)

International Co-circulation of 2009 H1N1 and Seasonal Influenza (As of October 16, 2009)

Weekly influenza activity estimates reported by state and territorial epidemiologists (activity levels indicate geographic spread of both seasonal and 2009 influenza A (H1N1) viruses, September 19, 2009

Weekly influenza activity estimates reported by state and territorial epidemiologists (activity levels indicate geographic spread of both seasonal and 2009 influenza A (H1N1) viruses, October 10, 2009

Current H1N1 Situation  H1N1 a novel influenza virus, isolated April 2009  Incubation period unknown (Could range 1-7 days, more likely 1-4 days)  Infectious period for a Confirmed case of H1N1, 1 day before symptoms to 7 days after onset  As of July 31 st, 2009, median age was 12 years, with highest infection incidence among those between 25 and 45 years of age  Lowest incidence of infection among persons age ≥ 65 years  WHO Declared Worldwide Pandemic June 11, 2009

Current H1N1 Situation  Relatively Few Severe Cases in Older Persons  As of July 31 st, 2009, Median Age of Hospitalized Persons was 20 years, with highest Incidence in those < 4years  Highest Hospitalization Rates Among Persons < 65 years  Median Age Among Persons who Died with Novel H1N1 was 37 Years  Signs and Symptoms Similar to Seasonal Influenza  Specific Diagnostic Testing Required to Distinguish H1N1 from Seasonal Influenza

Symptoms Seasonal Influenza Seasonal Influenza  Fever  Headache  Extreme Tiredness  Dry Cough  Sore Throat  Runny or Stuffy Nose  Muscle Aches *Children may also experience nausea, vomiting, or diarrhea nausea, vomiting, or diarrhea Swine/H1N1 Influenza Swine/H1N1 Influenza  All symptoms of Typical Influenza  Diarrhea and Vomiting

High Risk Patients  High risk for seasonal influenza (Patterns are emerging for H1N1) complications include: –Children < 5 years old; –Persons aged 50 years or older; –Children and adolescents (aged 6 months to 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after an influenza infection; –Pregnant women; –Adults and children who have chronic pulmonary, cardiovascular, hepatic, hematological, neurologic, or metabolic disorders

Prevention  Cover your nose and mouth with a tissue when you cough or sneeze, dispose of tissue  Wash your hands often with soap and water (alcohol-based hand cleaners are also effective)  Avoid close contact with people: –Stay home if you are sick for 7 days after your symptoms begin or until you have been fever (100 o F) free for 24 hours, whichever is longer vs. 24 hours free of fever

Current Seasonal Influenza Vaccination Recommendations Should Get Vaccinated  People at High Risk  All Children 6 months- 18 years  People over 50  People Who Can Transmit to Others at High Risk  Residents of Chronic- Care Facilities  Pregnant in Flu Season  Anyone Who Wants to Reduce their Risk Should not Get Vaccinated  Severe Allergy to Eggs  Severe Reaction to Flu Vaccine in Past  GBS within 6 Weeks of Getting Flu Vaccine in Past  Children < 6 Months of Age  People with Moderate or Severe Illness Should Wait

H1N1 Vaccination  Sept. 15 th, 2009, FDA Approved Four H1N1 Vaccine Manufacturers  State Health Departments Received First Shipments September 30 th, 2009  Immune Response in Most Healthy Adults 8-10 Days After a Single Dose  Manufactured with and without Thimerosal  Same Contraindications and Side Effects as Seasonal Influenza Vaccine

Current ACIP H1N1 Influenza Vaccination Recommendations  Initial Target Groups (order of target groups does not indicate priority): –Pregnant women –Persons who live with or provide care for infants aged < 6 months (i.e. parents, siblings, and daycare providers) –Health-care and emergency medical services personnel –Persons aged 6 months to 24 years, and –Persons aged years who have medical conditions that put them at higher risk for influenza-related complications

Current ACIP H1N1 Influenza Vaccination Recommendations  Subset of Target Groups During Limited Vaccine Availability: –Pregnant women, –Persons who live with or provide care for infants aged < 6 months (i.e. parents, siblings, and daycare providers), –Health-care and emergency medical services personnel who have direct contact with patients or infectious material, –Children aged 6 months to 4 years, and –Children and adolescents aged years who have medical conditions that put them at higher risk for influenza-related complications

What Should I Do If I Get Sick?  Contact a Health Care Provider if: –You live in areas where cases have been identified and you develop influenza-like symptoms –You are a high risk patient and develop influenza- like symptoms –You are worried about your symptoms  CALL BEFORE GOING TO PHYSICIAN’S OFFICE!! –Not everyone needs to be seen, tested, or treated –Medical providers need to be prepared –Should patient be seen by personal physician or company physician

Current Antiviral Oral Medications  Amantadine: Swine (H1N1) Flu Currently Resistant  Rimantadine: Swine (H1N1) Flu Currently Resistant  Oseltamivir (Tamiflu)  Zanamivir (Relenza) *Avoid Aspirin if 18 years or younger

Other Recommendations  Dietary Restrictions  Contact with Pigs  Travel  Vaccination for Seasonal Flu  Oral Medications  Masks

Possible Scenarios  If pandemic occurs: –High absentee rate  Employee illness (30 – 40%)  Family illness/death  “Precautionary absence” –Likely to occur in waves of 3-6 months over total duration of 1-2 years –Medical care system will be severely tested

Issues Disaster Preparedness Teams Must Consider  Relapsing high absentee/death rates in employees  Protective measures (masks, gloves, surface disinfectants) for those at work  Virtual Office  Pay policies for “precautionary absence”  Insufficient vaccine/medication  Federal/state/local coordination  Employee communications  Other …

Resources  Occupational Health Disaster Expert Network  Department of Health and Human Services  Centers for Disease Control  World Health Organization  Pennsylvania Department of Health

Conclusions  Pandemic H1N1 Influenza is Upon Us  Experts have been Predicting that Pandemic Influenza will Return at Some Point  Base Actions on Best Available Evidence  Communicate with Your Providers, Employees, and Stakeholders  Organizations Should Take the Time Now to Gather Accurate Information and Plan for How Your Organization will Respond to any Disaster (Intentional, Unintentional, or Natural)