H1N1 Update October 2009 Patricia Lynn Meyer, BSN, MPH, CIC

Objectives Discuss current status of disease Identify patients at high risk Identify symptoms of H1N1 Discuss isolation/segregation Define restriction of visitors and staff with H1N1 or exposed to H1N1

Spread is via droplets

Current Status Approximately 48,000 cases in U.S. 500 adult deaths and 76 pediatric deaths with 11 pediatric deaths in week 38 (9/20-9/26) 99% of influenza A are H1N1 Tamiflu indicated for treatment H1N1 Vaccine now available

The Big Picture

2009 H1N1 Confirmed and Probable Case Rate in the United States, By Age Group

2009 H1N1 U.S. Hospitalization Rate per 100,000 Population, By Age Group

What Should You Look For? Seasonal Influenza Temp (101 or above) Cough Sore Throat Runny Nose Extreme Tiredness Muscle Aches Headaches Chills H1N1 Temp (100 or above) Cough Sore Throat Runny Nose Extreme Tiredness Muscle Aches Headaches Chill Nausea, vomiting, diarrhea

When to Call the Doctor Children Fast breathing or trouble breathing Bluish or grey skin color Not drinking enough fluids Severe or ongoing vomiting Not waking up or interacting So irritable child does not want to be held Symptoms improve then fever and cough return Adults Difficulty breathing or trouble catching their breath Pain or pressure in the chest or abdomen Sudden dizziness Severe or ongoing vomiting Symptoms improve then return with fever and cough

Isolation/Segregation Confine to room Droplet precautions with surgical/procedure mask Good hand hygiene Extra cleaning/disinfection of high touch areas Look for other cases Keep line list Notify health department

Care of the H1N1 Resident Hydrate Fever control Patient safety Pain medication Nutrition Continued assessment

Control Measures Educate everyone Good hand hygiene Extra cleaning Social Distancing Screening for new cases

Employee/Visitor Restriction Restrict individuals with symptoms from working or entering your building (CDC-7 days) Screen visitors and staff for history of exposure and restrict from work or entry or mask Educate regarding policies (written or oral communication)

How Prepared Are You For Infectious Diseases?

Websites Available for Monitoring a Pandemic and for General Health Information cdc.gov WHO.org MoDHSS.gov