Swine or H1N1

Flu
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 Background

Swine Influenza (H1N1)

 First
Remember, Keep Things in Perspective:

• Influenza is a normal part of our lives but is always

potentially dangerous, especially to the young, the
elderly, or people with compromised immune systems
• The more common Influenza (the flu) is a contagious
respiratory illness caused by influenza viruses. It can
cause mild to severe illness, and at times can lead to
death
• There are currently three strains of influenza circulating
in NYS (two seasonal)
• Every year in the United States, on average 5% to 20%
of the population gets the flu
• This outbreak, so far, appears to be a mild strain

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 What is Swine Influenza?
• Swine Influenza (formally H1N1) is a respiratory
disease of pigs caused by type A influenza virus
that regularly causes outbreaks of influenza in
pigs.
• Swine flu viruses cause high levels of illness and
low death rates in pigs. Swine influenza viruses
may circulate among swine throughout the year,
but most outbreaks occur during the late fall and
winter months similar to outbreaks in humans.
• The classical swine flu virus (an influenza type A
H1N1 virus) was first isolated from a pig in 1930.
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• The 2009 flu outbreak in humans is due to a new
strain of influenza
• The origins of this new strain are unknown, and
the World Organization for Animal Health (OIE)
reports that this strain has not been isolated in
swine
• It passes with apparent ease from human to
human, an ability attributed to an as-yet
unidentified mutation
• The strain in most cases causes only mild
symptoms and the infected person makes a full
recovery without requiring medical attention and
without the use of antiviral medicines
• The World Health Organization has stated that
symptoms may even be less severe than
seasonal influenza symptoms.
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 How serious is it?
• At this time it appears this strain is a mild
virus
• It may mutate eventually and become
more serious
• NYSDOH recommends treating this like
seasonal influenza

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 Will my regular flu shot help?
• No, this is a different strain and influenza
vaccine will not help
• However, there are currently two seasonal
strains of influenza circulating and
NYSDOH is recommending, to help avoid
confusion, that you receive a vaccination
for those if you have not yet been
immunized

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 How do you catch Swine Flu?
• The same way you would catch any other
cold or flu virus – transmission appears to
be same as seasonal flu
– When an infected person coughs or sneezes
around another person
– Touching something with the flu virus on it
then touching your mouth, nose, or eyes.
– An infected person can pass the virus to
another before any symptoms develop and
after symptoms subside
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 Symptoms of Swine Flu
• Very similar to regular flu
• Typically happens after regular flu season is
over
• Upper respiratory symptoms, may have
nausea, vomiting, diarrhea
• Some incidents of sudden dizziness
• If feverish or have other flu-like symptoms,
call your doctor or occupational health nurse!
Try to avoid the emergency room or doctor’s
office.
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 Can people catch swine flu from
eating pork?

• No. Swine influenza viruses are not transmitted

by food.
• You can not get swine influenza from eating pork
or pork products.
• Eating properly handled and cooked pork and
pork products is safe.
• Cooking pork to an internal temperature of
160°F kills the swine flu virus as it does other
bacteria and viruses
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 Primary Prevention
Policies Needed by Providers
• Screening for symptoms
• Employees should not travel or work if ill:
temp greater than 100 degrees combined
with recent onset of cough, sore throat,
nasal congestion
• Have policies for primary prevention
methods
• Sick leave policies so ill employees can
stay home

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Preventing Spread of H1N1 Flu
•Hand washing with soap and water or
alcohol-based hand cleaner
•Avoid touching your mouth, eyes and
nose as much as possible
•Use cough etiquette
•If you are sick, stay home and avoid
close contact to others
•Avoid crowds
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 What about travelers returning
from Mexico?
• Monitor for signs of flu
• Incubation period is 1-7 days
• Treat accordingly

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 What Does Pandemic Mean?

• A pandemic is a global disease outbreak.

• An influenza pandemic occurs when a
new influenza A virus emerges for which
there is little or no immunity in the human
population, begins to cause serious illness
and then spreads easily person-to-person
worldwide.
• We are currently in Pandemic Phase 5

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 Pandemic Phases
Phase 5 is characterized by human-to-human spread of the virus
into at least two countries in one WHO region. While most
countries will not be affected at this stage, the declaration of
Phase 5 is a strong signal that a pandemic is imminent and that
the time to finalize the organization, communication, and
implementation of the planned mitigation measures is short

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 How long can viruses live on
surfaces?
• Some viruses and bacteria can live two
hours or longer on surfaces such as
ATMs, doorknobs, money, computer
keyboards, etc.
• Find out about infection control measures
for laptops, bags, or anything you carry
with you.
• Keep your waterless hand sanitizer with
you at all times.
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 How long are people
contagious?
• 7 days after symptoms start

• Children are considered to be contagious

longer than adults – possibly up to 14
days

• Tamiflu can reduce symptoms – refer to

NYSDOH guidance/advisory
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 Home Care Visits
• Call ahead to screen for symptoms if possible
• Carry PPE – fit tested N95 if available or tight
fitting surgical masks; keep sealed until needed
• Monitor patients
• Communicate with other providers serving same
patients
• Family and patient education
• Hand hygiene
• Cases should be reported to Local Health
Department

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 Enhanced PPE
• Despite saying this is transmitted through
droplets, NYSDOH recommends
enhanced PPE for symptomatic home
care patients until more is known about
transmission
• No evidence of long distance transmission
• In presence of Febrile Respiratory illness
only
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 Transport to Hospital
• Should be based on severity of patient-
specific illness per physician
recommendation
• Patient should wear mask during transport
• Notify EMS of reason for transport

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 What you can do
• Stay informed
• Take everyday actions to stay healthy
• Use cough etiquette
• Wash your hands often with soap and
water or alcohol-based hands cleaners
• Avoid touching your eyes, nose or
mouth.
• Stay home if you get sick. Call your
supervisor or occupational health office if
you are exhibiting flu like symptoms

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 What you can do
• Follow public health advice regarding
school closures, avoiding crowds and
other social distancing measures.
• Develop a family emergency plan as a
precaution. This should include storing a
supply of food, medicines, facemasks,
alcohol-based hand rubs and other
essential supplies.
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 What should you do if you become
sick?
• If you live in areas where swine influenza cases
have been identified and become ill with
influenza-like symptoms, including fever, body
aches, runny nose, sore throat, nausea, or
vomiting or diarrhea, contact your health care
provider or occupational health nurse
• Your health care provider will determine whether
influenza testing or treatment is needed
• If you are sick, you should stay home and avoid
contact with other people as much as possible to
keep from spreading your illness to others
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 Questions

• Resources
• CDC: http://www.cdc.gov/swineflu/
• NYSDOH: http://www.health.state.ny.us/
• HCA’s Home Care Prepare:
www.homecareprepare.org
• Email with infection control questions:
icp@health.state.ny.us
• Email with general questions:
swineflu@health.state.ny.us
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Mini Drill
 There are many cases of suspected, probable
and confirmed flu in NYS, but most related to
one cluster in Queens
•Monitor all patients for symptoms of swine
flu – call ahead to check for symptoms if
possible
•Facilitate communication or transport to
their physician for evaluation if suspected
•Oversee their treatment at home since they
won’t be eligible for admission to a hospital
and will be in quarantine
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 Your Assignment
•List things that you need to educate staff
about to prevent infection of staff members
or others
•Plan process of care for one patient who is
identified with Swine flu, including frequency
of visits, what to monitor for, and who you
would report which things to
•Develop strategies for educating aides who
will be caring for patients with H1N1
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 Your assignment
• Review your role in your agency’s
emergency plan, including the pandemic
plan
• Discuss appropriate infection control
standards based on information available
at this time.

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