Preparing for the 2009-2010 Seasonal

&Novel H1N1

Influenza

Grant County Health District

Protect yourself, your child & your community from influenza

• Influenza (flu) is caused by a virus that spreads easily by coughing and sneezing.– Close contact within 6 feet. – Can be transmitted by surfaces.

• Can lead to serious illness and death.– especially in babies, young children, pregnant

women, and older adults.

Seasonal flu causes up to 36,000-50,000 deaths per year in the United States. These are often

vaccine preventable.

Influenza is a Respiratory Illness

• People often confuse seasonal flu with what they call “stomach flu”, but they are not the same.

• Influenza causes: – fever (100F or higher), – cough, – sore throat,– muscle aches, headache, runny or stuffy nose,

extreme tiredness; – stomach symptoms, such as nausea, vomiting, and

diarrhea, also can occur but are more common in children than adults.

% of Visits for Influenza-like Illness (ILI) Outpatient Influenza-like Illness Surveillance Network (ILINet),

Who should get the seasonal

flu vaccine? • All children, age 6 months up to the 19th birthday,

especially those with illnesses like asthma, diabetes, or heart disease.

• Anyone (including TEACHERS), living with or caring for children especially babies under 6 months (who are too young to get flu vaccine).

• Pregnant women.• People age 50 and older.• People with certain chronic medical conditions.• People living in long-term care facilities.• Healthcare workers and others near those at high risk for

flu complications.• All others who want to reduce their risks.

VACCINE IS THE BEST WAY TO PREVENT FLU and COMPLICATIONS

• There are 2 types of season flu vaccines.– Flu shot: for anyone 6 months and older.– Nasal spray: for healthy non-pregnant individuals age 2

through 49. • Flu shots do not (and cannot) cause the flu.

– Some may feel slightly feverish or achy for 1– 2 days while their immune system responds.

• All school staff & students should receive flu vaccine as soon as possible. – Children < age 9 may need 2 doses.

Intranasal influenza vaccine LAIV:“live attenuated influenza vaccine”

Intramuscular influenza vaccineTIV:“trivalent inactivated influenza vaccine”

Novel H1N1 Influenza (a.k.a. “Swine Flu” or “SOIV” or PanH1)

• Another, albeit new, type of influenza virus.• Newly born, probably around April 2009 in Mexico from

avian, human, pig flu soup of viruses.• Within days, it had spread to the US. Within weeks, the

virus had spread across the globe.• Health officials were braced for worst case scenario (new

unpredictable virus).• As more was understood about the virus, we learned it is

to a point similar to the seasonal flu.

Novel H1N1 Influenza (Swine Flu)• There are some differences between the novel

H1N1 and the seasonal flu variety: – It is capable of multiplying deep within the lungs.– The immune system does not know it: lung damage more

severe in those severely ill. – Most severe cases and deaths are occurring in people below

50 years of age. – Not enough time to fully understand the virus: it could

possibly mutate /change.– Projected to cause additional 30,000 - 90,000 deaths in 2009-

2010.

Novel H1N1 Influenza Symptoms

• The symptoms include: fever (95%), cough (95%), sore throat, runny or stuffy nose, body aches, headache, chills and fatigue.

• A significant number of people have also reported diarrhea and vomiting.

• Those sick could be ill for a week or more.• People may be contagious from one day before

they develop symptoms to up to 24 hours after the fever is gone (usually 7days).

Help to stop the spread of Influenza viruses in your school!

• Stay home and away from other people when you are sick with flu-like illness (at least 24 hours free of sign of fever - or your temp stays < 100F - without any fever reducing medications).

• Separate ill students and staff.– Those with signs of illness before they enter.– Promptly separate those developing illness during the

school day.– Have a room designated for separating these people until

they can be sent home.

Help to stop the spread of Influenza viruses in your school!

Help to stop the spread of Influenza viruses in your school!

• Wash your hands often with soap and water. – If soap and water are not available, use alcohol-based hand

gel or disposable wipes (attention to fingertips). – Keep your hands away from your eyes, nose, mouth.

• Cover your cough or sneeze with a tissue or you upper sleeve, not your bare hand. – Discard the tissue properly (then wash your hands). – Masks are recommended for those who are ill and those

caring for them (until sent home).

• Clean high contact surfaces (often) with cleaners already in use at your school.– Includes desks, keyboards, door knobs, gym

equipment.

• Treatment of high-risk students and staff early. • VACCINATE AGAINST H1N1 as soon as available.

DO NOT SKIP SEASONAL FLU SHOT.

Help to stop the spread of Influenza viruses in your school!

STEP UP ACTIVITIES WHEN MANY BECOME ILL• Active screening for illness at the entrance /signage;• Not permitting anyone with temp >100F to enter;• Permit high-risk students and staff to stay home;• Students with ill household members stay home

(quarantine);• Increase social distances within the school

environment;• Extended exclusion period OR School dismissals

(either reactive or preemptive).

Help to stop the spread of Influenza viruses in your school!

Novel H1N1 Vaccine Information

Recommended Target Groups (from CDC) • Children and young people between the ages of 6

months and 24 years of age,• Pregnant women, • Household contacts and caregivers of children who are

younger than 6 months of age, • Healthcare workers and emergency medical services

personnel, • Adults 25-64 years of age with underlying risk

conditions or medical conditions that increase their risk for complications from influenza.

Novel H1N1 Vaccine Information• Vaccine should be available BY mid-October or the first part of

November 2009 (195mln doses ordered nationwide for the whole season).

• Studies on children and adults are under way.• Seasonal influenza and H1N1 vaccines can be given together

(most current assumption).• 2 doses are likely to be necessary for children.• Limited cost to the individual vaccinated.• The H1N1 vaccine will reach the county through the Grant

County Health District and possibly your healthcare provider (none available now)

High-Risk Students & StaffPeople at the highest-risk for influenza complications include:

• Pregnant women• Asthmatic persons, and people with lung disease• Diabetic and morbidly obese persons• People with compromised immune systems (HIV)• Those with neuromuscular dss. (i.e. cerebral palsy)If students and/or staff with any of these conditions become

ill, they should contact their health care provider immediately. Early treatment is key to preventing hospitalizations and deaths.

School Dismissal

Scenarios that may result in dismissal or closure:

• Absenteeism levels of staff and students prevents the school from being able to function.

• Virus becomes more severe.If a school is concerned about remaining open,

GCHD will work with them to determine the best course of action.

School Dismissal

Decisions are made by balancing:• How to ensure students continue to learn;• How to provide an emotionally and

physically safe place for students;• How to reduce demands on local health care

services.School Dismissal is reportable to CDC by HO or

school administration.

Important CDC Links• Main guidance

www.cdc.gov/h1n1flu/schools/schoolguidance.htm• Technical report (rationale and research behind some of the

recommendations) www.cdc.gov/h1n1flu/schools/technicalreport.htm

• Communications toolkit (Q&A, factsheets for schools, teachers and parents, flu prevention posters, templates for letters from schools to parents) www.cdc.gov/h1n1flu/schools/toolkit/

• CDC school dismissal reporting systemwww.cdc.gov/h1n1flu/schools/dismissal_form/index.htm

Important Washington State Links• Washington Department of Health (DOH) - Joint Letter to Parents from

Secretary Selecky and OSPI Superintendent Dorn is posted there in 8 languages. http://www.doh.wa.gov/h1n1/h1n1_schools.htm

• August 31 OSPI/DOH video conference “Preparing for H1N1 Swine Influenza.” http://www.k12.wa.us/HealthServices/H1N1Flu.aspx

• OSPI Guidance for School Transportation http://www.k12.wa.us/HealthServices/H1N1Flu.aspx

• The Department of Education has released guidance on continuity of learning during school dismissal. Preparing for the Flu: Department of Education Recommendations to Ensure the Continuity of Learning for Schools (K-12) During Extended Student Absence or School Dismissal: http://www.ed.gov/admins/lead/safety/emergencyplan/pandemic/index.html