1. Pandemic Influenza Be Informed…….. Be Prepared………… Grampians Region Infection Control Group Swine Influenza – April 2009

2. What is an influenza pandemic? An influenza (flu) pandemic is a flu outbreak that occurs worldwide when: 1. A new strain of flu virus emerges, to which no-one is immune 2. The virus causes disease in humans 3. The virus is easily spread between humans. A new influenza strain can spread rapidly across the globe with high numbers of cases and deaths New influenza viruses may originate from influenza viruses that cause illness in pigs or birds

3. Why are authorities worried? The World Health Organisation is worried that this swine influenza virus has resulted in a new strain of influenza virus that can be easily passed from person to person This might trigger an ‘influenza pandemic’ where the virus spreads rapidly around the world, infecting many people

4. Swine influenza Swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs, caused by one of several swine influenza A viruses. Outbreaks in pigs occur year round with increased incidence in autumn & winter in temperate zones. Morbidity tends to be high and mortality low (1- 4%). Many countries routinely vaccinate swine populations against swine influenza. The virus is spread among pigs by aerosols, direct and indirect contact, and asymptomatic carrier pigs.

5. Swine flu in humans Since 2007, WHO have been notified of swine influenza cases in humans in the United States and Spain. High morbidity (that is, it infects a large proportion of an area's population) but low mortality (less than 5% of infected patients die of the disease). Mild or asymptomatic cases may have escaped from recognition; therefore the true extent of this disease among humans is unknown.

6. Reservoir People usually get swine influenza from infected pigs, however, some human cases lack contact history with pigs or environments where pigs have been located. Until recently human-to-human transmission has occurred in some instances but was limited to close contacts and closed groups of people.

7. Modes of transmission Most people are infected through prolonged, close contact with infected pigs. Good hygiene practices are essential in all contact with animals and are especially important during slaughter and post- slaughter handling to prevent exposure to disease agents. It is believed to be spread between humans through coughing or sneezing of infected people and touching something with the virus on it and then touching their own nose or mouth.

8. Eating pork It has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. The swine influenza virus is killed by cooking temperatures of 70 o C corresponding to the general guidance for the preparation of pork and other meat.

9. How is swine influenza spread? Influenza is very contagious and is spread by:  Breathing in virus when around people who have the flu and have been coughing, sneezing or talking  Touching those who are ill (shaking hands, kissing) or their articles soiled by infected nasal or throat discharges  Contact with surfaces or objects on which virus may be present – telephone, keyboard, door knobs etc. – then touching your mouth or nose

10. When can you pass on the flu? Time it takes to feel sick – 1 to 3 days Time you are able to spread virus – from 1 day prior to onset of symptoms until 7 days or more after becoming sick. Children, especially younger children, can potentially spread the virus for longer periods

11. How is influenza diagnosed A sample of nose or throat mucous is collected using a swab Sample sent off by doctor for testing

12. What should I do if I get sick? Very Important:- Stay home from work when unwell, and encourage colleagues to do so Try and keep well and sick people apart

13. Body/muscle aches, head aches, chills - Can vary from mild to severe illness

14. Seek medical assistance if: Adults  Difficulty breathing or shortness of breath  Pain or pressure in the chest or abdomen  Sudden dizziness  Confusion  Severe or persistent vomiting

15. Seek medical assistance if: Children  Fast breathing or trouble breathing  Bluish skin colour  Not drinking enough fluids  Not waking up or not interacting  Being so irritable that child does not want to be held  Flu-like symptoms improve but then return with fever and worse cough  Fever with rash

16. What treatment is effective? Have someone around to care for a person who has influenza Ensure adequate fluids and bed rest Take medications to help with fever and pain, such as aspirin (not in children) and paracetamol. Antiviral treatment – give within 24 hours of onset of illness

17. Antiviral medication The viruses obtained from the recent human cases with swine influenza were sensitive to oselatmivir (Tamiflu) and zanamivir (Relenza) but resistant to other flu antiviral medications. Speak to your doctor about antiviral medication

18. Antiviral medication Antiviral drugs keep the flu virus from reproducing in your body  If you get sick they can make your illness milder and recovery quicker  They may prevent serious flu complications Start within 2 days of becoming sick

19. How can you protect against swine flu? There is no vaccination available right now to protect against swine flu - 1. Attention to hygiene 2. Do not share eating utensils or drinks 3. Don’t visit people who have the flu unless absolutely necessary 4. Avoid large crowds or gatherings

20. Especially easy to spread in crowds: The virus can survive for up to 2 days on hard surfaces like tables, doorknobs and desks Frequent handwashing will help reduce your chances of getting contamination for these common surfaces Work, school, church ……..

22. What Might Happen? Some workplaces and schools might close Normal health and other services may not be available for several weeks You might need to care for yourself and others at home There will be public announcements on TV radio and other media about the pandemic

23. WHAT CAN I DO?

24. How can I protect myself and others from pandemic flu? Short of a vaccine, there are many simple ways people can substantially reduce their risk of being infected by or spreading the influenza virus.

25. Good hygiene – always important Regardless of whether an influenza pandemic is occurring Get into good habits now Or cough or sneeze into your upper sleeve, not your hands.

26. Maintain general good health

27. Have an annual seasonal flu shot Not a vaccine against pandemic flu but will help protect against seasonal influenza

28. Disinfect common touch surfaces in your home and at work

29. Don’t Kiss Me ( or anyone else) If You Have A Cold, Flu, or Fever! Avoid close contact with others  No kissing  No hugging  No sharing of food  No sharing of drinks Greater than one metre

30. Avoid crowed public areas

31. If not possible – wear a mask

32. Be prepared to have to stay home for several days/weeks …….

33. Plan ahead – Have an emergency supply of food and essentials

34. Emergency Kit: First aid kit Extra supplies of paracetamol or ibuprofen - for aches, pains and fever Tissues and plastic bags for used tissues Torches, spare batteries Radio, spare batteries Can opener Gas BBQ – don’t forget the gas bottle

35. Emergency food and water Enough for at least 7 days  Ready to eat canned and dried food  Dried and long life milk  Snack food  Supplies for babies and small children  3 litres of water per person per day  Toilet rolls  Soap

36. Personal Protective Equipment Masks worn by sick people can help stop the spread of germs. You can buy masks from a pharmacy. If there is a pandemic, people will be told how and when to use their masks. A mask can be worn only for a short time, and needs changing when wet from sneezing and coughing.

37. Keeping Busy at Home Think about things to do if you and your family have to stay home for a couple of weeks (e.g., books, games and videos)

38. DON’T PANIC BUT BE PREPARED

40. Where to get help - Call the Swine Influenza Hotline Tel. 180 2007 – for the general public and people returning from the Americas with flu-like symptoms Nurse-on-Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)

41. Further Information: DHS website http://www.health.vic.gov.au/ideas/diseases/s wine-influenza WHO website http://www.who.int/csr/disease/swineflu/en/ind ex.html