H1N1 Basics


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Basic information on H1N1 flu; geared mostly for Beijing expats but valuable for all.

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H1N1 Basics

  1. 1. Influenza A (H1N1) Virus & Pandemic Preparedness Dr Richard Saint Cyr June 25, 2009 [email_address] http://www.myhealthbeijing.com
  2. 3. First, What is a Pandemic? <ul><ul><li>An epidemic is a disease that is more widespread than expected </li></ul></ul><ul><ul><li>A pandemic is a world-wide epidemic (but not necessarily more severe!) </li></ul></ul><ul><ul><li>Usually is new virus -- population has no immunity </li></ul></ul><ul><ul><li>Severity can vary </li></ul></ul>
  3. 4. What We Know About Pandemics <ul><ul><li>More than one pandemic wave likely </li></ul></ul><ul><ul><li>Can be weeks or months between waves </li></ul></ul><ul><ul><li>Severity is unpredictable </li></ul></ul><ul><ul><li>F uture waves could be worse than first </li></ul></ul><ul><ul><li>Typically affects young, healthy adults (unlike regular seasonal flu) </li></ul></ul>
  4. 5. Past Influenza Pandemics 1900 1850 1950 2000 1847 1889 1918 1957 1968 42 yrs 29 yrs 39 yrs 11 yrs Pandemics usually occur every 30 – 40 years Last Pandemic was ≈ 40 yrs ago, in 1968....
  5. 6. WHO Pandemic Phases
  6. 7. The Latest Numbers (June 19) Death rate: 0.4% Seasonal flu in US: 36,000 deaths each year 0 deaths 55 cases Beijing: 0 deaths 519 cases China: 180 deaths 44,287 cases Worldwide:
  7. 8. <ul><li>Phase 6 = pandemic phase </li></ul><ul><li>Community level outbreaks in at least one other country in two different WHO regions </li></ul>Now: WHO Pandemic Phase 6
  8. 9. <ul><li>Three WHO levels: Mild/Moderate/Severe </li></ul><ul><li>WHO Severity level: Moderate </li></ul><ul><ul><li>Most recover without hospitalization or medical care. </li></ul></ul><ul><ul><li>Levels of severe illness similar to seasonal influenza periods </li></ul></ul><ul><ul><li>Hospitals and health care systems coping well </li></ul></ul><ul><ul><li>But: </li></ul></ul><ul><ul><ul><li>affecting more young & healthy </li></ul></ul></ul><ul><ul><ul><li>severity may change </li></ul></ul></ul>What About Severity?
  9. 10. What is the Influenza A (H1N1) Virus? <ul><ul><li>H1N1 is a completely new strain of influenza or “flu” virus </li></ul></ul><ul><ul><li>Genetic material from pig, bird and human combined to form this new strain </li></ul></ul><ul><ul><li>Can spread just like the annual flu -- from person-to-person through coughing & sneezing </li></ul></ul><ul><ul><li>Despite term “swine flu”: Infections not associated with contact with pigs or pork meat </li></ul></ul>
  10. 11. Speaking of pork…
  11. 12. Is Pork Safe? <ul><ul><li>YES! </li></ul></ul><ul><ul><li>Despite term “swine flu”: Infections not associated with contact with pigs or pork meat </li></ul></ul><ul><ul><li>This A(H1N1) is a mutated pork virus </li></ul></ul><ul><ul><li>Always cook pork well </li></ul></ul>
  12. 13. How Does H1N1 Spread? <ul><li>In the same way that seasonal flu spreads. </li></ul><ul><li>Not from pork! </li></ul><ul><li>Person to person -- coughing or sneezing </li></ul><ul><li>Touching something with flu viruses on it and then touching their mouth or nose. </li></ul><ul><li>Droplets -- talking, spitting, coughing, sneezing. </li></ul><ul><li>Droplets spread 1 meter (3 ft) </li></ul><ul><li>Can live for several hours on hard surfaces, cloth, paper. </li></ul><ul><li>Sometimes through the air. </li></ul>
  13. 14. Who is at risk of Infection? <ul><li>Everyone </li></ul><ul><li>Higher risk: Diabetes; age>65 or <2; pregnant; major chronic illness; immunosupressed </li></ul><ul><li>New virus = no immunity = more infections </li></ul><ul><li>Even young and healthy people may develop serious complications and die. </li></ul><ul><li>The vast majority of people have a mild, normal flu-like syndrome and recover </li></ul>
  14. 15. What Can You Do?
  15. 16. Practice Personal Hygiene Wash hands often Cover coughs and sneezes
  16. 17. Value of Proper Handwashing Unwashed hand Washed hand
  17. 18. Use Soap or Alcohol-gel
  18. 19. And Please…
  19. 20. Practice Social Distancing Avoid close contact will ill persons Stay home if ill
  20. 21. <ul><ul><li>Similar to regular seasonal flu symptoms </li></ul></ul><ul><ul><li>Fever (often >101 o F), chills, dry cough, sore throat, body aches, headache, extreme tiredness, runny nose/nasal congestion </li></ul></ul><ul><ul><li>For H1N1, may get nausea, vomiting, diarrhea </li></ul></ul>Know The H1N1 Symptoms
  21. 22. Flu vs. Cold
  22. 23. When Should You Stay Home? <ul><li>FEVER + any cold/flu type symptoms </li></ul><ul><li>Family member has or is suspected to have influenza </li></ul><ul><li>Recent contact (<48 hours) with someone now known to have pandemic influenza. </li></ul><ul><li>If you become ill, stay at home for 7 days from the onset of symptoms, and not return until 2 days after the symptoms end </li></ul><ul><li>Wear a simple surgical mask when meeting other people. </li></ul>
  23. 24. Heed Travel Advice <ul><ul><li>Monitor Travel Restrictions (office, government) </li></ul></ul><ul><ul><ul><li>Seek medical care if you feel sick during travel </li></ul></ul></ul><ul><ul><ul><li>After return from travel, monitor your health for 7 days </li></ul></ul></ul><ul><ul><li>Practice personal hygiene </li></ul></ul><ul><ul><li>Wash hands and cover coughs and sneezes </li></ul></ul>
  24. 25. What If You May Have Been Exposed? <ul><li>Go to work </li></ul><ul><li>Monitor your health for 7 days </li></ul><ul><li>If you become ill during this 7-day period, stay home; take OTC Rx; consult physician if severe symptoms </li></ul><ul><li>Limit contact with others </li></ul>
  25. 26. How Do You Care For Yourself? <ul><li>Measure your temperature </li></ul><ul><li>Rest </li></ul><ul><li>Avoid contact with others </li></ul><ul><li>Stay at home </li></ul><ul><li>Drink plenty of fluids </li></ul><ul><li>Fever/pain Rx: paracetamol (Tylenol) </li></ul><ul><li>Sore throat Rx: Salt gargle; lemon & honey tea </li></ul><ul><li>Stuffed nose Rx: Use saline (salt) solution nose drops; OTC sprays; OTC Tylenol Cold /Bufferin Cold </li></ul><ul><li>Don't smoke. </li></ul>
  26. 27. How To Take Care of Others <ul><li>A separate room </li></ul><ul><li>Extra bedding supplies </li></ul><ul><li>Ventilate well </li></ul><ul><li>Wash hands </li></ul><ul><li>Mask </li></ul>
  27. 28. <ul><ul><li>Children or adults: </li></ul></ul><ul><ul><ul><li>difficulty breathing or chest pain </li></ul></ul></ul><ul><ul><ul><li>purple or blue discoloration of the lips </li></ul></ul></ul><ul><ul><ul><li>vomiting and unable to keep liquids down </li></ul></ul></ul><ul><ul><ul><li>seizures (uncontrolled fits) </li></ul></ul></ul><ul><ul><ul><li>less responsive than normal or becomes confused </li></ul></ul></ul><ul><ul><ul><li>signs of dehydration : </li></ul></ul></ul><ul><ul><ul><ul><li>dizziness when standing, absence of urination, or in infants a lack of tears when crying </li></ul></ul></ul></ul>When To Seek Emergency Care?
  28. 29. What Will Happen At The Local Clinic? <ul><li>Temperatures checked at the door </li></ul><ul><li>If you have fever + flu-like symptoms or travel exposure: </li></ul><ul><ul><li>Isolation room </li></ul></ul><ul><ul><li>Beijing Public Health evaluation </li></ul></ul><ul><ul><li>Possible escort to local hospital for rapid H1N1 test </li></ul></ul>
  29. 30. What If You Are Quarantined?
  30. 31. What If You Are Quarantined? <ul><li>Don’t resist – it’s China law </li></ul><ul><li>Relax – China’s doing a good job treating patients – and releasing them </li></ul><ul><li>You can get food delivered </li></ul>
  31. 32. Tamiflu - Antiviral Rx <ul><ul><li>Can reduce severe symptoms of flu </li></ul></ul><ul><ul><li>Currently not recommended for mild illness, unless are at “higher risk” of severe symptoms </li></ul></ul><ul><ul><li>Sick staff should visit your local doctor </li></ul></ul>
  32. 33. Is There A Vaccine? <ul><ul><li>Available starting late summer – probably not for general public at first (supplies for 1-5%) </li></ul></ul><ul><ul><li>Seasonal influenza vaccine not helpful for the pandemic influenza </li></ul></ul><ul><ul><li>May not even be needed for healthy persons </li></ul></ul><ul><ul><ul><li>Pandemic H1N1 is not severe </li></ul></ul></ul><ul><ul><ul><li>New vaccine may cause more deaths than prevent </li></ul></ul></ul><ul><ul><ul><li>Stay tuned </li></ul></ul></ul>
  33. 34. When To Use A Mask? <ul><ul><li>WHO: No evidence that wearing masks in community setting is effective </li></ul></ul><ul><ul><li>Currently recommended only for ill persons, caretakers, medical staff </li></ul></ul><ul><ul><li>Throw away disposables </li></ul></ul><ul><ul><li>Put on and take off carefully </li></ul></ul>
  34. 35. What Can You Do At Home?
  35. 36. Stockpile 6 Weeks of Supplies
  36. 37. What medical items should be stored? <ul><li>Thermometer for each family member </li></ul><ul><li>Prescription Rx - 6 weeks </li></ul><ul><li>OTC cold/flu Rx </li></ul><ul><li>First aid kit </li></ul><ul><li>Check expiration dates </li></ul>
  37. 38. Websites <ul><li>WHO H1N1 Center </li></ul><ul><ul><li>www.who.int/csr/disease/swineflu/ (English & Chinese) </li></ul></ul><ul><li>China Ministry of Health </li></ul><ul><ul><li>www.moh.gov.cn/ (chinese) </li></ul></ul>
  38. 39. Hotlines <ul><li>China CDC  (Center for Diease Control and Prevention) 010-63022935 </li></ul><ul><li>Beijing CDC 010-64407014 </li></ul>