The novel H1N1 virus has spread globally since March 2009. It is a new subtype of influenza A virus containing genes of swine, avian, and human influenza viruses. Symptoms are similar to seasonal flu but it can potentially lead to pneumonia or respiratory failure. Transmission is mainly through airborne droplets from coughing/sneezing or surfaces. Treatment involves antiviral drugs but self-medication should be avoided. Prevention focuses on handwashing, covering coughs/sneezes, and limiting contact with infected individuals. Governments are monitoring the spread, procuring medical supplies and raising public awareness.

1. The Novel Virus

2. Current situation Since March 2009, a novel strain of influenza A (H1N1) virus has been identified, which is being described as a new subtype of the Influenza virus A, not previously detected in swine or humans.

3. A Mongrel virus! Pigs, birds and human beings are infected with many types of influenza viruses, but usually these viruses infect only one species. Sometimes these viruses swap genes, creating new viruses that can infect more than one species. This novel strain of influenza virus contains a combination of swine, avian, and human influenza virus genes.

4. Geographical distribution

5. 1 5 2 3 4 6 1 No viruses circulating among animals reported to cause infection in humans 2 Animal influenza virus known to have caused infection in humans, 3 Animal influenza virus has caused infection in small clusters of people, but no human to human transmission has occurred 4 Verified human-to-human transmission of the animal flu virus able to cause “community-level outbreaks.” 5 Human-to-human spread of the virus into at least two countries in one WHO region. A strong signal that a pandemic is imminent 6 A global pandemic is under way The World Health Organization uses a six-phased approach as an indication of risk to global health.

6. Are similar to the symptoms of regular human flu Runny nose Sore throat Cough Fever (≥ 38 C) Body ache Vomiting & diarrhoea Difficulty in breathing Pneumonia Symptoms

7. Transmission Mainly through the air by coughing or sneezing, which generates droplets in the surrounding air.

8. Transmission These respiratory droplets can also get deposited on surfaces,or on to objects by contaminated hands. A person touching these objects collects the viruses and can get infected if the mouth, nose, or eyes are touched without washing hands.

9. Transmission There is no risk of infection from this virus by consuming well-cooked pork and pork products.

10. Incubation period : the time interval between invasion of the body by the virus and the appearance of the first symptom. Usually 1 to 4 days. Infectious period : the time during which an infected person can spread the disease to another person. Up to 7 days following onset of illness, or until all symptoms have resolved.

11. Treatment Antivirals for the treatment of infection : • Oseltamivir (Tamiflu) or • Zanamivir (Relenza) Use of anti-virals can make illness milder and recovery faster They may also prevent serious flu complications For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms)

12. HOWEVER….. Antivirals will be used as per guidelines laid down in the National Preparedness Plan. Self medication is strongly discouraged. Misuse of antivirals can lead to drug resistance. Will be needed for preempting the initial stage of the epidemic

13. Prevention Those who have influenza Cover the nose and mouth when coughing or sneezing, with a tissue if possible, then dispose the tissue in the trash after use. Wash hands immediately after coughing or sneezing to reduce the spread of the virus from the hands to other people. Limit contact with others to prevent spread of infection. Environmental cleaning. Seek advice from a health professional.

14. Prevention Those who are well Avoid close contact with people who appear unwell and have fever and cough Wash hands frequently with soap and water Avoid touching eyes, nose or mouth with unwashed hands Clean hard surfaces such as table tops, door handles and taps regularly using a normal cleaning product. Reduce as much as possible the time spent in crowded settings Ensure good ventilation in your living space by opening windows as much as possible.

15. Palm to palm The back of the hands In between the fingers The back of the fingers The thumbs The tips of the fingers Six steps of Handwashing

16. What is being done at the MOHQL Surveillance of incoming passengers from high risk countries has been reinforced at the Port and the Airport, including the airport at Plaine Corail and the harbor in Port Mathurin in Rodrigues.

17. What is being done at the MOHQL All passengers from countries with confirmed cases of Influenza A H1N1 are being followed up for a period of seven days after their arrival in Mauritius. isolation facilities have been provided in each hospital to cater for suspected cases of Avian Flu. In addition, fully equipped isolation wards have been set up at Souillac Hospital and in Rodrigues.

18. What is being done at the MOHQL Presently, enough stock of Oseltamivir [Tamiflu] is available to cater for 13% of the population, and arrangements are under way to procure more stock so that this coverage is extended to 25% of the population. A Polymerase Chain Reaction [PCR] machine required for diagnosis of Influenza A virus, is being purchased. This will enable analysis of specimens from suspected Influenza cases. In the meantime, specimens for confirmatory tests will be referred to the WHO Influenza Reference Laboratory in London for identification of strain. Arrangements are being made for the procurement of a stock of personal protective equipment and other consumables.

19. What is being done at the MOHQL An extensive Communication Strategy is being carried out to sensitise the population and to make them aware about the actions being taken by the MoHQL. Partnerships have been established with key stakeholders to enlist their support in the campaign against this new disease

20. How can you help? Spread the message to all staff and employees in your organisation. Help the Ministry in its communication strategy. Arrange for training sessions for employees. Resource persons from the Ministry of Health & Quality of Life are at your disposal. Put in place a preparedness plan for your organisation. Stock some amounts of antivirals and masks.

21. THANK YOU