Novel H1N1 Influenza A Virus

1. Novel H1N1 Influenza AVirus Presented by: Marsha Pierce, RN,BSN School Health Liaison Coastal Health District 9-1

2. June, 2009World Health OrganizationDeclares Phase 6: Global pandemic

3. What is a pandemic? • A pandemic means: • There is a new strain of influenza A virus and • humans have little or no immunity to it • The virus spreads from person-to-person • There is a global outbreak with sustained • person- to-person transmission

4. Pandemic Timeline  Major pandemic 1918 Pandemic“Spanish flu” H1N1The most devastating flu pandemic in recent history, killing more than 500,000 people in the United States, and 20 million to 50 million people worldwide.

5. What exactly is H1N1? Novel Influenza A (H1N1) is a new flu virus of swine origin that was first detected in April 2009. It continues to infect people and spread from person to person. This new H1N1 flu virus is a reminder of the ever-changing and unpredictable nature of influenza.

6. Updated Timeline – H1N1 Story March 2009 – H1N1 confirmed in Mexico April 15th - 1st confirmed case of H1N1 in US April 30th - 1st confirmed case of H1N1 in GA June 11th – WHO Pandemic Alert to Phase 6 July 10th - 1st H1N1 Death in Georgia July 24th - Confirmed and probable case counts discontinued by CDC, Georgia and Coastal Health District adopting same policy

7. The transmission of novel H1N1 is similar to seasonal flu - Spreads through coughing or sneezing of infected people Some people may become infected by touching something with flu viruses on it and then touching their mouth, nose or eyes. How H1N1 virus spreads

8. H1N1 symptoms • Fever • Cough • Lethargy • Lack of appetite Some people with H1N1 flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea.

9. How Contagious is H1N1? Novel H1N1 influenza shares characteristics with seasonal flu, and studies have shown that with seasonal flu people may be contagious from one day before they develop symptoms to up to 7 days after they get sick.

10. Novel H1N1 Case Rates, Hospitalizations and Deaths in the US • Approximately 50% of all confirmed and probably cases in the US in those ages 24 years and younger • The highest incidence of hospitalizations in the US are in those birth through 4 yrs of age • The highest rate of deaths in the US are in those 25-49 y.o., the great majority with underlying risk factors

11. Recommendations • Wash frequently with soap and water (use alcohol-based hand sanitizer if soap is not available) • Cough into your elbow • Cover mouth and nose when sneezing and throw away the tissue • Avoid touching mouth, nose, and eyes

12. Recommendations • Stay home if you are sick with influenza like illness • Keep sick children home from school, daycare, camp, etc. • Avoid contact with sick people • Stay informed!

13. Emergency Symptoms • Fast breathing or trouble breathing, • Bluish or gray skin color, • Persistent vomiting, • Not waking up, OR • Symptoms improve but return with fever and worse cough. Any of these symptoms – call 9-1-1!

14. Importance of Vaccination When it comes to protecting people from influenza, vaccines are an important tool! Seasonal vaccine still important but will not protect from H1N1

15. Target groups for H1N1 Vaccination • Pregnant Women • Household Contacts of children < 6 months old • Health care workers and Emergency Service Personnel • Persons ages 6 months through 24 years of age • Non-elderly adults (25-64) with underlying medical conditions

16. Preparation You should always be prepared for any kind of emergency. Part of that preparation includes having a disaster supply kit that includes: • At least a 3-day supply of water (1/2 gallon per person for each day). Consider storing a two-week supply of water. Remember to have extra on hand for cooking, washing, etc. • A two-week supply of non-perishable food • Items for infants (formula, diapers, etc.) and pets (food, medication, etc.) • A battery-powered flashlight and radio along with extra batteries • A first-aid kit • Sleeping bag and extra blankets • Changes of clothes and footwear for all family members • Sanitation and hygiene items

17. What are we doing? • Seasonal flu for our employees • Tool Kit for employees and community partners • Talks to groups • COOP updates and planning • Meetings, Meetings, Meetings…

18. Coastal Health District/Chatham County Health Department Activities Ongoing Surveillance Activities Vaccination (Seasonal and H1N1)/Mass Vaccination Planning Community Education and Preparedness

19. Priorities for Vaccination Pregnant Women Household contacts of children < 6 months HCWs and ESP with direct patient contact Children ages 6 months through 4 years Persons ages 5-18 with underlying medical conditions

20. Challenges for H1N1 Vaccination Demands and Workforce Simultaneously providing seasonal and H1N1 vaccinations Ability to sustain other clinic efforts/multiple sites – STD, Family Planning, TB, environmental services, WIC Increased demand for data entry (Billing system and GRITS) Currently have no contract nursing staff to expand nursing workforce to meet increased demands of H1N1 Financial Ability to bill for administration, but cannot turn away for inability to pay School based mass vaccination clinics pose unique billing challenges Diversion of clinical staff to H1N1 vaccination, estimate over $300,000 loss in revenues for a two week campaign

21. Key Messages to the Public • Importance of cough and hand hygiene • Stay home if sick with ILI • Recommendation for seasonal flu shot when available; when available and in those for whom it is recommended, importance of H1N1 vaccination • Recommendation to create an emergency supply list (at a minimum, a 2 week supply) • H1N1 flu virus is a reminder of the ever-changing and unpredictable nature of influenza

22. Pandemic preparedness resources • Your county health department • www.gachd.org • www.cdc.gov/h1n1flu/ • www.pandemicflu.gov • www.health.state.ga.us/h1n1fl

23. QUESTIONS???