1. Swine Influenza 4/30/09

2. Background Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza virus –Regularly causes outbreaks of influenza in pigs Like all influenza viruses, swine flu viruses change constantly –Pigs can be infected by avian influenza and human influenza viruses as well as swine influenza viruses. When influenza viruses from different species (birds, pigs, humans) infect pigs, the viruses can reassort (i.e. swap genes) Sporadic human infections with swine flu have occurred

3. Swine Flu – Symptoms The symptoms of swine flu in people are expected to be similar to the symptoms of regular human season influenza and include fever, cough, rhinorrhea, sore throat, malaise, fatigue, lack of appetite. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea.

4. Swine Flu – Transmission Thought to occur in the same way as seasonal flu occurs in people –Person-to-person transmission through coughing or sneezing of people infected with the influenza virus –People may become infected by touching something with flu viruses on it and then touching their eyes, mouth or nose.

5. Current Swine Flu Epidemic International – WHO Stage 5 (Pandemic Imminent) Nationally (CDC 5/01 6AM) 109 cases in 11 states (AZ, CA, IN, KS, MA, MI, NV, NY, OH, SC,TX) 1 fatality Locally –6 probable cases

6. Swine Flu Prevention at JHH Incident Command Center in the Smith Room (410-955-3333) Departmental Command Centers A daily briefing occurs in the Hurd Hall at 12N For updated information [Hospital Epidemiology and Infection Control (HEIC) website] –http://www.hopkinsmedicine.org/heic WASH HANDS, RESPIRATORY ETIQUETTE, STAY HOME IF YOU HAVE FEBRILE URI http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

7. Swine Flu Prevention at JHH http://www.hopkinsmedicine.org/heic Swine Flu Q&A Swine Flu Respiratory Screening Card Swine Flu Procedures for Screening Patients Swine Flu Employee Screening (algorithm) –Updated daily - source of all current information from the CDC and the status of our prevention and screening activities. http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

8. Swine Flu Prevention at JHH Staging Screening –Patients –Employees Fit testing http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

9. JHH EPRI Response Plan Format Type of Transmission Location of Cases Are there cases at JHH? Stages Person-to-person transmission Anywhere in the worldNo 1 Person-to-person transmission Anywhere in North AmericaNo 2 Person-to-person transmission In region: MD,PA,VA,DC,DE,NJ,WV or close to borders Possibility exists 3 AnyAt JHH Yes, but no nosocomial transmission 4 Person-to-Person transmission At JHH Yes, nosocomial transmission from known sources only 5 Person-to-Person transmission At JHH Yes, nosocomial transmission from unclear sources 6

10. Current Screening at JHH This may change daily –Patients (Respiratory Report Card on HEIC website) http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

12. Screening at JHH This may change daily –Patients (Respiratory Report Card on HEIC website) Screening at reception Phone screening & triage –Employees (Respiratory Report Card) Screening of all staff with symptoms Screening of staff returning from areas with infection OHS maintain list of staff under surveillance http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

13. Screening at JHH If a patients or employee meets the case definition –Place mask on patient/employee –Isolate on droplet –Healthcare workers must wear N-95 with eye protection or PAPR –Call HEIC (pager 3-3426) –Refer or perform NP aspirate Obtain in negative pressure setting (airborne precaution room or portable HEPA in room, N95 or PAPR for HCW) http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

14. Fit Testing JHH All employees need to be fit tested for an N- 95 respirator A priority list has been determined by the Incident Command Team Please call Gai Cole (410-935-0668) http://www.hopkinsmedicine.org/heic/SwineFlu/index.html