Education on the 2009 Seasonal Flu & H1N1 Flu: How it's transmitted, treated, and methods of prevention, including handwashing and vaccination. Up to date info from the CDC.

1. The Flu, What it can do and
How to protect You!
A presentation on the Seasonal and H1N1
Influenzas
By Lisa Hezel, RN WCC

2. About the Speaker
 Been a nurse for 16 years.
 Certified in Wound Care with National
Alliance of Wound Care since 2007.
 Work at St. John’s Mercy Medical
Center in Creve Coeur, MO.
 Wife and mother of 2 children.
 Flu survivor!

3. Where I work
 Nurse Manager of St. John’s
Hyperbaric and Wound Treatment
Center and St. John’s Diabetic Foot
Clinic.
 I love my job!

4. What we will cover today:
 Seasonal Influenza and the Swine Flu.
 How it is spread
 How is it treated
 What you can do to protect yourself
and loved ones.

5. There are 3 types of Flu:
◦ Seasonal (H3N2)
◦ Avian (H5N1)
◦ Swine (H1N1)

6. Quick Question….
 What does the H & N stand for?
◦ It stands for Hemagglutinin and
Neuraminidase. There are 16 types of the H
protein, numbered H1 through H16, and 9
types of the N protein, numbered N1 through
N9. That makes 144 possible combinations
of the virus, a constantly changing challenge
for prevention or treatment

7. Peak months for seasonal
influenza
 Source:
http://www.cdc.gov/flu/professionals/a
cip/clinical.htm

8. How the flu is spread
 Sneezing
 Coughing
 Shaking hands
 Sharing drinks
 Close Contact with sick people
 Going to work or school when you are
sick—should stay home if you have a
fever of 100.8 or more and not return
until you are 24 hours with out fever
(without using Tylenol).

9. The most common symptoms of
the Seasonal Flu are:
 SUDDEN onset
 Chills
 Fever
 Sore throat
 Muscle pains
 Severe headache
 Coughing
 Weakness and general discomfort
 Runny or stuffy nose

10. Why you don’t want to get the flu
 Uncomplicated flu usually resolves after 3—7
days for most people, although cough and
malaise can persist for up to 2 weeks or
more.
 The flu can cause primary influenza viral
pneumonia or a secondary bacterial
pneumonia.
 Exacerbate underlying medical
conditions, i.e. asthma.
 Other possible complications: sinusitis, or
otitis media (ear infection); or contribute to
co-infections with other viral or bacterial
pathogens

11. Who is most at risk for
complications?
 65 years and older
 Young children,
 Pregnant women and women up to 2
weeks from end of pregnancy
 People with certain chronic medical
conditions (such as asthma, heart
failure, chronic lung disease) and people
with a weak immune system (such as
diabetes, HIV)
 People younger than 19 years of age
who are receiving long-term aspirin
therapy

12. How long are you
“contagious?”
 Incubation period: 1—4 days
 Adults: shed influenza virus from the day
before symptoms begin through 5—10
days after illness onset.
 The amount of virus shed, decreases
rapidly by 3—5 days after onset.
 Young children: shed virus several days
before illness onset, and children can be
infectious for 10 or more days after onset
of symptoms.
 Severely immunocompromised persons
can shed virus for weeks or months.

13. Treating the seasonal flu
 Prevention is the best method.
 Anti-viral medications Tamiflu and
Relenza (only helps if taken within the
1st 48 hours)
 Rest and fluids
 Stay Home!

14. The Swine flu (H1N1)
 Swine Influenza (swine flu) is a
respiratory disease of pigs caused by
Type A influenza viruses that causes
regular outbreaks in pigs.
 This is now considered a “moderate”
pandemic by the CDC (Category 2).

15. What is a pandemic?
 A pandemic affects the entire world and
not just a country or continent.
 Pandemic flu is usually more severe than
seasonal flu with a higher death rate.

16. What is a pandemic?
 Pandemic influenza is a virus to which
we have no natural immunity.
 It originates in wild birds and then
jumps to other species, including pigs
and humans.
 “Swine flu” has bird, pig and
human genes, a very
unusual occurrence.

17. Recent Pandemics
 1918-19 - H1N1, "Spanish flu”
Severe: Humans had no immunity to any of
the 8 gene sequences
 1957-58 “Asian flu”
Mild: We had immunity to 5 of 8
gene sequences
 1968-69 "Hong Kong flu”
Milder: We had immunity to 6 of 8
gene sequences
 1997- ? H5N1, “Bird Flu”
Severe: Humans have no immunity
 2009 - ? A/H1N1, “Swine Flu”
Moderate: We have no immunity to any of
the 8 gene sequences, but have modern
medicine to help us this time.

18. What makes the H1N1
Influenza Virus so Strong?
 Adaptability: the ability to survive
different environments.
 This table shows how long 3 different
viruses can survive outside of their
host.
Cold Couple of hours
Flu Up to 8 hours
Small Pox 24 hrs / up to 12 weeks in
a scab

19. What does the Swine Flu Look
Like?

20. What are the symptoms of swine
flu?
 Similar to the symptoms of regular
human flu:
 fever, cough, sore throat, body
aches, headache, chills and fatigue.
 Some people have reported diarrhea and
vomiting associated with swine flu.
 In the past, severe illness (pneumonia and
respiratory failure) and deaths have been reported
with swine flu infection in people.
 Like seasonal flu, swine flu may cause a
worsening of underlying chronic medical
conditions.

21. Fatalities from H1N1
 H1N1 currently has a mortality rate of
around 0.5%, or 5 times the death rate of
seasonal influenza, with prompt, first-rate
medical care.
 Average age of death: 38
 Affects children and young adults
 1/3 have no pre-existing medical
conditions

22. Who is most at risk for
complications?
 Ages 5-50
 Pre-existing conditions:
◦ Asthma
◦ Diabetes
◦ Pregnancy
◦ Heart disease

23. Treating the H1N1 is the same
as the seasonal flu
 Prevention is the best method.
 Anti-viral medications Tamiflu and
Relenza (only help if taken within the
1st 48 hours)
 Rest and fluids
 Stay Home!

24. Adults Children
 Difficulty breathing or • Trouble breathing
shortness of breath • Bluish skin color
• Not drinking enough
 Pain or pressure in the
chest or abdomen • Not waking up or not
interacting
 Sudden dizziness • So irritable-- does not want
 Confusion to be held
• Flu-like symptoms improve
 Severe or persistent
but return with fever and
vomiting worse cough
• Fever with a rash
When to seek emergency
treatment

25. What to do if you become
sick?
 If you live in areas where swine
influenza cases have been identified
and become ill with influenza-like
symptoms, contact your health care
provider.
 Your health care provider will
determine whether influenza testing or
treatment is needed.
 Stay home and avoid contact with
other people as much as possible to
keep from spreading your illness to
others.

26. Preventing illness
 Vaccinations for seasonal flu and
H1N1
◦ Currently the doses of the H1N1 are being
given to populations with the most risk.
◦ Healthcare workers
◦ Pregnant women
◦ Emergency services
◦ “High risk” people—cancer, severe pulmonary
illnesses, etc.

27. Vaccinations
 Both the seasonal and H1N1 vaccines
come in an injectable form and a form
you can inhale (Flu-Mist).
 Persons with asthma or other pulmonary
conditions should not get the flu mist.

28. Contraindications to the Flu
Vaccine
 Allergies to eggs
 Sick with a fever
 Mercury allergy (preservative )
 History of Guillain-Barre syndrome
 Less than 14 weeks pregnant.
 In years past, pregnancy was also a
contraindication to flu vaccine but, today, the
Advisory Committee on Immunization Practices
(ACIP) of the Centers for Disease Control (CDC)
recommends flu vaccine for women more than 14
weeks pregnant.

29. The Seasonal Influenza (H3N2) Vaccine
 Each year, many laboratories throughout the
world, including in the United States, collect flu viruses.
 World Health Organization (WHO) reference
laboratories, do detailed testing on these viruses.
 WHO also test how well antibodies made to the current
vaccine react to the circulating virus and new flu viruses.
 This information, along with information about flu
activity, is summarized and presented to the U.S. Food
and Drug Administration (FDA) and at a WHO meeting.
 Three viruses (two subtypes of influenza A viruses and
one influenza B virus) to go into flu vaccines for the
following fall and winter.
 Usually, one or two of the three virus strains in the
vaccine are changed each year.

30. Is the vaccine for H1N1 safe?

31. Is the vaccine for H1N1 safe?
 The A/H1N1 flu vaccine is safe
◦ According to the CDC in a report
released on Wednesday 11/25/09.
 22 million Americans have already
been inoculated.
 3,200 reports of possible side effects.
◦ Mostly minor:
 soreness or swelling from the shot

32. Why should I get it?
 As of November 20, 2009 there have
been 4008 deaths from Pandemic
Swine Flu in the US.
 98,000 Americans have been
Hospitalized with the H1N1 Swine
Flu.
 22 million Americans have gotten ill
from it.
 Of those, here’s the number for
children:
◦ 36,000 have been hospitalized .

33. Other ways to protect yourself
 Cover your nose and mouth when you
cough or sneeze.
 Wash your hands often with soap and
water, especially after you cough or
sneeze.
 Alcohol-based hand cleaners are also
effective.
 Avoid touching your eyes, nose or
mouth.
 Try to avoid close contact with sick
people.

34. Sneeze Cough
 Droplets of whatever is in  Coughs come out very
the nose and mouth fast and can propel
come zipping out at germs and moisture up
about 100 miles an hour. to about 30 feet when
you cough.
Did you know?

35. Proper Etiquette for coughing &
sneezing
 Cover your mouth and nose with a
tissue when coughing or sneezing.
 Put your used tissue in the waste
basket.
 Cover your cough or sneeze in your
arm.
 If you cough or sneeze on your
hands, wash them!

36. Wash your hands!
 Viruses and bacteria can live 2 hours
or longer on surfaces like cafeteria
tables, doorknobs, and desks.
 Frequent hand washing will reduce the
chance of contamination from these
common surfaces.

37. Best hand washing practices
 Get your paper towel ready
 Turn on faucet, wet your hand and lather
well with soap.
 Rub your hands vigorously for at least 20
seconds. Remember to scrub all
surfaces.
 Rinse well.
 Dry your hands with a clean or
disposable towel.
 If possible, use your towel to turn off the
faucet.

38. When to wash your hands:
Before After
Preparing food Preparing food, especially
raw meat or poultry
Eating Using the toilet/changing a
diaper
Treating wounds or giving Blowing your nose,
medicine coughing or sneezing into
your hands
Touching a sick or injured Touching a sick or injured
person person
Inserting or removing Treating wounds
contact lenses
Handling garbage or
something that could be
contaminated, such as a
cleaning cloth or soiled
shoes

39. One more Question: Can you
get the Swine flu from eating
pork?

40. Can you get the Swine flu from
eating pork?
 No! Eating properly handled and
cooked pork and pork products is
safe.
 Cooking pork to an internal
temperature of 160°F (72°C) kills the
swine flu virus as it does other
bacteria and viruses.
 Enjoy your bacon!

41. Sources
 http://www.cdc.gov/flu/weekly/
 http://www.nydailynews.com/lifestyle/hea
lth/2009/04/23/2009-04-
23_should_we_be_concerned_about_sw
ine_flu_two_new_cases_pop_up_in_calif
ornia.html
 http://www.menshealth.com/cda/article.d
o?site=MensHealth&channel=health&cat
egory=colds.flu&conitem=2111fdf3fed34
210VgnVCM10000030281eac____
 http://www.vaccineinfo.net/immunization/
vaccine/influenza/flu_vaccine_facts.shtm
l

42. More sources!
 http://blogs.abcnews.com/theworldne
wser/2009/11/98000-americans-have-
been-hospitalized-because-of-swine-
flu.html
 http://www.cdc.gov/Flu/about/qa/fluvac
cine.htm
 http://news.xinhuanet.com/english/200
9-11/26/content_12541662.htm