1. Pandemic Preparedness Influenza: Protecting Your Employees 1PPT-130-01 Bureau of Workers’ Compensation PA Training for Health & Safety (PATHS)

2. Seasonal Influenza Pandemic Flu History/Past Pandemics Treatment & Prevention Preparation/Personal Planning PPT-130-012 Overview

3. PPT-130-013 Seasonal Influenza Illness caused by the influenza virus Extremely contagious and spreads quickly to others. Symptoms vary from person to person Occurs every year, usually in the fall and winter killing 36,000 people in U.S.

4. PPT-130-014 Cause The influenza virus, commonly known as the flu, is an infectious disease of birds and mammals caused by RNA viruses. Commonly confused with a cold, the flu is a much more severe disease and caused by a different virus.

5. PPT-130-015 Infection The flu virus binds onto sugars on the surfaces of epithelial cells such as nose, throat, and lungs of mammals and intestines of birds.

6. PPT-130-016 Symptoms & Diagnosis of Seasonal Flu Chills Body aches, especially throat and joints Coughing and sneezing Extreme fever Fatigue, headache, and nasal congestion Though similar symptoms occur with a cold, they are much more severe with the flu!

7. PPT-130-017 Flu Virus Incubation Symptomatic (Sick) Recovering Work, etc.Work/Home/HospitalBack to work, etc Day 0Day 11Day 4Day 15 DANGER OF INFECTION Day 2 Infectious (Shedding Virus)

8. PPT-130-018 Flu Prevention Get the flu vaccine each year due to high mutation rate of the virus. Practice good hygiene and personal health habits. Cover your mouth when sneezing and wash your hands regularly as the virus spreads through aerosols. Stay at home when sick.

9. PPT-130-019 Flu Treatment Bed rest Hydration-with eight ounces of fluid every hour Acetaminophen, ibuprofen, naproxen Avoid aspirin when dealing with children Since the flu is a virus, antibiotics won’t work unless there is a secondary bacterial infection.

10. PPT-130-0110 Medical Treatment Persistent fever Productive cough Increasing difficulty breathing Improvement, followed by relapse

11. PPT-130-0111 What is Pandemic Flu? Epidemic: serious outbreak in a single community, population or region Pandemic: an epidemic spreading around the world affecting hundreds of thousands of people, across many countries Pandemic flu: a pandemic that results from an influenza virus strain that humans have not been previously exposed to

12. A disease outbreak that spreads rapidly and affects many people world wide Characteristics - New virus that spreads easily as most people are susceptible (no natural resistance or immunity) - Effective human to human transmission is necessary - Measured by how fast the virus spreads - Wide geographic spread Not predictable Outbreaks lasting 8-12 weeks with 1-3 week wave cycles PPT-130-0112 Pandemic Influenza

13. Pandemics occur in multiple waves of disease outbreaks The first wave in a local area is likely to last six to eight weeks The time between pandemic waves varies and can not be easily predicted. Anticipate 1-3 waves PPT-130-0113 Pandemic Waves

14. PPT-130-0114 History Name of pandemic Date Deaths Asiatic Flu1889-18901 million Spanish Flu1918-192040 -100 million Asian Flu1957-19581 - 1.5 million Hong Kong Flu1968-19690.75 - 1 million Information taken from en.wikipedia.org/wiki/influenza

15. PPT-130-0115 Past Pandemics Occurs unpredictably, not always in winter Variations in: – Case fatality rates (number of people diagnosed with a disease that die from that disease) – Severity of illness – Pattern of illness (ages most severely affected) Rapid surge in number of cases over brief period of time Tend to occur in waves - May only be one wave

16. PPT-130-0116 Today vs 1918 Today Modern travel Many areas more densely populated Population exceeds 6 billion 1918 World War I (civilian and military overcrowding) Public information withheld Population approximately 1.8 billion

17. PPT-130-0117 Perspective 2001 terrorist attack with anthrax - killed five people 2002 outbreak of West Nile Virus - killed 284 people nationally in six months 2003 SARS outbreak - killed over 800 people world wide - froze Asian economies - frightened millions of people into wearing masks on the streets

18. PPT-130-0118 Becoming a Pandemic For pandemic influenza to occur, three conditions must be met: 1.A new virus which humans are not immune emerges 2.The virus causes severe human illness or death in humans 3.The virus spreads easily from person to person worldwide H5N1 has two of the three today.

19. PPT-130-0119 H5N1 Status Interpandemic Larger clusters, localized Limited spread among humans PandemicPandemic alert Phase 1Phase 2Phase 3 Phase 4 Phase 5Phase 6 New virus in humans Little/no spread among humans Small clusters, localized Limited spread among humans Increased and sustained spread in general human population No new virus in humans Animal viruses low risk to humans No new virus in humans Animal viruses low risk to humans Current H5N1 status

20. Crisis for extended period of time in multiple locations Daily routines will be affected from personal, community, and professional changes - Isolation/quarantine guidelines or requirements? - Cancellation of public events and schools? - Non-essential work activities limited? - Commerce Patterns changed? PPT-130-0120 Expectations of Pandemics

21. Elements of personal action will be required Absenteeism from pandemic flu expected to be 40-60% Lost availability for those who are ill (or caring for ill family) is projected at 2-4 weeks PPT-130-0121 Expectations of Pandemics

22. PPT-130-0122 Pandemic Possibility World Health Organization assures us that there will be another influenza pandemic. Unknown when it will occur/how severe the next pandemic will be Unknown what the organism will be

23. A vaccine to protect people from pandemic flu is not available now. A vaccine may not be available at the start of a flu pandemic (~ 6-8 months after start). The best protection is to practice healthy hygiene to stay well now and during a flu pandemic. PPT-130-0123 Vaccination?

24. PPT-130-0124 Medications During Pandemic Flu Antiviral Medications Can prevent complications if taken within first 48 hours of illness May not be effective against a pandemic flu virus Extremely limited supply now Would be prioritized Initial use probably only for treatment, not prophylaxis Antiviral Medications Amatadine (Symmetrel) Rimantadine (Flumadine) Zanamivir (Relenza) Oseltamivir (Tamiflu)

25. PPT-130-0125 Pandemic Disruptions Significant disruption of infrastructure Transportation Schools Businesses Medical care Utilities Police and fire protection Communications Limited to no assistance from State and Federal Governments due to nation-wide impact

26. PPT-130-0126 Infection Control Hand Hygiene Wash hands regularly with soap & water If no water available: 60%-95% alcohol- based sanitizer Cover your cough strategy Environmental cleaning 1:10 bleach solution EPA registered disinfectant Gloves & surgical masks

27. PPT-130-0127 Personal Planning Stockpiling up to 30 days of water, food, supplies, medicines Social distancing Practice all the same behaviors to prevent seasonal flu Stay at Home Toolkits

28. PPT-130-0128 Preparedness P repare yourself – disaster training & volunteerism. R emember to get enough sleep. E xercise regularly. P revent the spread of infection – wash hands regularly, cough/sneeze into tissue, keep your hands away from your nose/mouth. P ut out cigarettes. A nnual flu shots. N utritious eating. F amily plan and kit. L ook for information about pandemic flu. U tensils, food and beverages should not be shared.

29. PPT-130-0129 Health & Safety Training Specialists 1171 South Cameron Street, Room 324 Harrisburg, PA 17104-2501 (717) 772-1635 RA-LI-BWC-PATHS@pa.gov Like us on Facebook! - https://www.facebook.com/BWCPATHS https://www.facebook.com/BWCPATHS Contact Information

30. PPT-130-0130 Questions

31. PPT-130-0131 Bibliography Influenza (flu), Mayo Clinic http://www.mayoclinic.org/diseases- conditions/flu/basics/definitions en.wikipedia.org/wiki/influenza