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Interim Guidance for special situation (H1N1 Flu) By Dr. AMAL FATHY A. Prof. of pulmonary medicine Thoracic Medicine Department - Mansoura University Interim.

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Presentation on theme: "Interim Guidance for special situation (H1N1 Flu) By Dr. AMAL FATHY A. Prof. of pulmonary medicine Thoracic Medicine Department - Mansoura University Interim."— Presentation transcript:

1 Interim Guidance for special situation (H1N1 Flu) By Dr. AMAL FATHY A. Prof. of pulmonary medicine Thoracic Medicine Department - Mansoura University Interim Guidance for special situation (H1N1 Flu) By Dr. AMAL FATHY A. Prof. of pulmonary medicine Thoracic Medicine Department - Mansoura University

2 The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can remain contagious for up to ten days. The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can remain contagious for up to ten days. Germs Spread when droplets from a cough or sneeze of an infected person move through the air and are deposited on the mouth or nose of people nearby. Germs Spread when droplets from a cough or sneeze of an infected person move through the air and are deposited on the mouth or nose of people nearby. We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Recommendations to prevent spread of the virus among humans include using standard infection control against influenza. Recommendations to prevent spread of the virus among humans include using standard infection control against influenza.infection control against influenzainfection control against influenza

3 CDC has implemented its emergency response. The agency ’ s goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by the new virus. CDC has implemented its emergency response. The agency ’ s goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by the new virus.emergency responseemergency response The World Health Organization has raised the worldwide pandemic alert level. The World Health Organization has raised the worldwide pandemic alert level. In response to these developments, CDC is recommending that states, communities, institutions and individuals assess their emergency response plans and capacities. In response to these developments, CDC is recommending that states, communities, institutions and individuals assess their emergency response plans and capacities.

4 Experts agree that hand-washing can help prevent viral infections, including ordinary influenza and the swine flu virus. Experts agree that hand-washing can help prevent viral infections, including ordinary influenza and the swine flu virus. Influenza can spread in coughs or sneezes, but an increasing body of evidence shows small droplets containing the virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes. Influenza can spread in coughs or sneezes, but an increasing body of evidence shows small droplets containing the virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes. Alcohol-based gel or foam hand sanitizers work well to destroy viruses and bacteria. Alcohol-based gel or foam hand sanitizers work well to destroy viruses and bacteria. Anyone with flu-like symptoms such as a sudden fever, cough or muscle aches should stay away from work or public transportation and should contact a doctor to be tested. Anyone with flu-like symptoms such as a sudden fever, cough or muscle aches should stay away from work or public transportation and should contact a doctor to be tested.

5 Social distancing is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community. Social distancing is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community. Social distancing Social distancing Public health and other responsible authorities have action plans which may request or require social distancing actions depending on the severity of the outbreak. Public health and other responsible authorities have action plans which may request or require social distancing actions depending on the severity of the outbreak.Public healthPublic health

6 CDC recommendations for post secondary institutions of higher education Review your institutions plans for responding to a Review your institutions plans for responding to a public health emergency and make sure they are up public health emergency and make sure they are up to date. to date. Know local/state plans for institutions of higher Know local/state plans for institutions of higher education in the event of a mild or severe disease education in the event of a mild or severe disease outbreak. outbreak. Ask your campus health center to develop and Ask your campus health center to develop and implement a system to track and report (to the local implement a system to track and report (to the local health department)influenza-like illness among health department)influenza-like illness among students. students.

7 CDC recommendations for post secondary institutions of higher education (cont.) Persons with influenza-like-illness should consult their physician and the institution should consult with their local or state health department for recommendations on identifying persons with H1N1 flu and ways to prevent spread of this virus. Persons with influenza-like-illness should consult their physician and the institution should consult with their local or state health department for recommendations on identifying persons with H1N1 flu and ways to prevent spread of this virus. Institutions of higher education should promote everyday preventive actions for students and staff: Institutions of higher education should promote everyday preventive actions for students and staff:

8 CDC recommendations for post secondary institutions of higher education (Cont.) 1.Cover your nose and mouth with a tissue when you cough or sneeze. 2.Throw the tissue in the trash after you use it. 3.Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol- based hand cleaners are also effective. 4.Avoid close contact with sick people. 5.Avoid touching your eyes, nose or mouth. Germs spread this way. 6.If you get influenza-like illness symptoms, stay home from work or school except to seek medical care and limit contact with others to keep from infecting them.

9 Recommendations When H1N Virus is Confirmed in a School, School District, or Community Schools play a critical role in protecting the health of their students, staff, and the community from contagious diseases such as H1N1 influenza. Schools play a critical role in protecting the health of their students, staff, and the community from contagious diseases such as H1N1 influenza. Children are very susceptible to getting this new virus and schools may serve as amplification point for spread of this new virus in a community. Children are very susceptible to getting this new virus and schools may serve as amplification point for spread of this new virus in a community. The reason for closing schools during this H1N1 outbreak is to try to reduce the spread of the virus. However, little information is available on what the effectiveness of a school closure might be in preventing further community spread of this new virus. The reason for closing schools during this H1N1 outbreak is to try to reduce the spread of the virus. However, little information is available on what the effectiveness of a school closure might be in preventing further community spread of this new virus.

10 Decisions to dismiss students and close childcare facilities and subsequent implementation of those measures should be made based on the extent and severity of illness. Decisions to dismiss students and close childcare facilities and subsequent implementation of those measures should be made based on the extent and severity of illness. That local authorities decide whether or not to dismiss schools or close childcare facilities. That local authorities decide whether or not to dismiss schools or close childcare facilities. Authority for decision-making may reside in multiple sectors and local government; these entities must be well coordinated Authority for decision-making may reside in multiple sectors and local government; these entities must be well coordinated

11 Sick people (students, faculty and staff) should stay home unless they need to seek medical care and stay away from schools regardless of whether schools and childcare facilities are operating normally or have dismissed students or closed, respectively. Sick people (students, faculty and staff) should stay home unless they need to seek medical care and stay away from schools regardless of whether schools and childcare facilities are operating normally or have dismissed students or closed, respectively. Dismissal of students in a school and closure of childcare facilities should be considered in schools with one or more laboratory-confirmed or non-subtypable influenza A case among students, faculty or staff. Dismissal of students in a school and closure of childcare facilities should be considered in schools with one or more laboratory-confirmed or non-subtypable influenza A case among students, faculty or staff.

12 Closure of childcare facilities should be considered for not-yet-affected schools and childcare facilities in the same area if more than one school or childcare facility in that area has confirmed or non- subtypable influenza A cases among their students, faculty, or staff. Closure of childcare facilities should be considered for not-yet-affected schools and childcare facilities in the same area if more than one school or childcare facility in that area has confirmed or non- subtypable influenza A cases among their students, faculty, or staff. Neighboring schools to those that dismiss students should also closed. According to the geographic proximity and extent of mixing of student populations among area. Neighboring schools to those that dismiss students should also closed. According to the geographic proximity and extent of mixing of student populations among area. School or childcare-related gatherings should be canceled School or childcare-related gatherings should be canceled Parents and students should be encouraged to avoid congregating in large numbers outside of the school setting. Parents and students should be encouraged to avoid congregating in large numbers outside of the school setting.

13 Considerations for Pregnant Women who are More likely to be Exposed to Novel H1N1 Flu (Swine Flu) Considerations for Pregnant Women who are More likely to be Exposed to Novel H1N1 Flu (Swine Flu)

14 Evidence that influenza can be more severe in pregnant women comes from observations during previous pandemics and from studies among pregnant women who had seasonal influenza. Evidence that influenza can be more severe in pregnant women comes from observations during previous pandemics and from studies among pregnant women who had seasonal influenza. An excess of influenza-associated excess deaths among pregnant women were reported during the pandemics of 1918 – 1919 and 1957 – An excess of influenza-associated excess deaths among pregnant women were reported during the pandemics of 1918 – 1919 and 1957 – Adverse pregnancy outcomes have been reported following previous influenza pandemics, with increased rates of spontaneous abortion and preterm birth reported, especially among women with pneumonia. Adverse pregnancy outcomes have been reported following previous influenza pandemics, with increased rates of spontaneous abortion and preterm birth reported, especially among women with pneumonia.

15 What if I get this new virus and I am pregnant? Case reports and several epidemiologic studies conducted during interpandemic periods also indicate that pregnancy increases the risk for influenza complications for the mother and might increase the risk for adverse perinatal outcomes or delivery complications. Case reports and several epidemiologic studies conducted during interpandemic periods also indicate that pregnancy increases the risk for influenza complications for the mother and might increase the risk for adverse perinatal outcomes or delivery complications. We don ’ t know if this virus will do the same, but it should be taken very seriously. We don ’ t know if this virus will do the same, but it should be taken very seriously. Pregnant women who have suspected swine influenza A (H1N1) virus infection should be tested, and specimens from women who have un-subtypeable influenza A virus infections should have specimens sent to the state public health laboratory for additional testing to identify swine influenza A (H1N1). Pregnant women who have suspected swine influenza A (H1N1) virus infection should be tested, and specimens from women who have un-subtypeable influenza A virus infections should have specimens sent to the state public health laboratory for additional testing to identify swine influenza A (H1N1).specimens

16 Take these everyday steps to help prevent the spread of germs and protect your health Take these everyday steps to help prevent the spread of germs and protect your health Have a plan to care for sick family members. Have a plan to care for sick family members. Stock up on household, health, and emergency supplies, such as medication, non-perishable foods. Stock up on household, health, and emergency supplies, such as medication, non-perishable foods. Pregnant women who will likely be in direct contact with patients with confirmed, probable, or suspected influenza A (H1N1) (e.g., a nurse, physician, or respiratory therapist caring for hospitalized patients), should consider reassignment to lower-risk activities, such as telephone triage Pregnant women who will likely be in direct contact with patients with confirmed, probable, or suspected influenza A (H1N1) (e.g., a nurse, physician, or respiratory therapist caring for hospitalized patients), should consider reassignment to lower-risk activities, such as telephone triage

17 If reassignment is not possible, pregnant women should avoid participating in procedures that may generate increased small-particle aerosols of respiratory secretions in patients with known or suspected influenza, including the following procedures: If reassignment is not possible, pregnant women should avoid participating in procedures that may generate increased small-particle aerosols of respiratory secretions in patients with known or suspected influenza, including the following procedures: Endotracheal intubation Endotracheal intubation Aerosolized or nebulized medication administration Aerosolized or nebulized medication administration Diagnostic sputum induction Diagnostic sputum induction Bronchoscopy Bronchoscopy Airway suctioning Airway suctioning Positive pressure ventilation via face mask (e.g., BiPAP and CPAP) Positive pressure ventilation via face mask (e.g., BiPAP and CPAP) High-frequency oscillatory ventilation High-frequency oscillatory ventilation

18 Breastfeeding considerations Breastfeeding considerations A mother ’ s milk is made to fight diseases in her baby. This is really important in young babies when their immune system is still growing. A mother ’ s milk is made to fight diseases in her baby. This is really important in young babies when their immune system is still growing. Do not stop breastfeeding if you are ill. Breastfeed early and often. Limit formula feeds if you can. This will help protect your baby from infection. Do not stop breastfeeding if you are ill. Breastfeed early and often. Limit formula feeds if you can. This will help protect your baby from infection. If you are too sick to breastfeed, pump and have someone give the expressed milk to your baby. If you are too sick to breastfeed, pump and have someone give the expressed milk to your baby. Antiviral medication treatment or prophylaxis is not a contraindication for breastfeeding. Antiviral medication treatment or prophylaxis is not a contraindication for breastfeeding. The risk for swine influenza transmission through breast milk is unknown. However, reports of viremia with seasonal influenza infection are rare. The risk for swine influenza transmission through breast milk is unknown. However, reports of viremia with seasonal influenza infection are rare.

19 H1N1 Flu (Swine Flu) and Travel During the swine influenza outbreak, extra vigilance is required to identify and report passengers with respiratory symptoms or fever. Any passenger who appears ill, or who reports not feeling well, should be observed or queried for the following signs or symptoms: During the swine influenza outbreak, extra vigilance is required to identify and report passengers with respiratory symptoms or fever. Any passenger who appears ill, or who reports not feeling well, should be observed or queried for the following signs or symptoms: Feeling feverish or temperature greater than 100°F (37.8°C) if measured. For children, feeling warm by parent ’ s report. Feeling feverish or temperature greater than 100°F (37.8°C) if measured. For children, feeling warm by parent ’ s report. Sore throat Sore throat Cough Cough Stuffy or runny nose Stuffy or runny nose Any passengers observed to have or who report having two or more of these symptoms should be reported immediately to the CDC Quarantine Station in the jurisdiction of the airport where the plane is expected to land. Any passengers observed to have or who report having two or more of these symptoms should be reported immediately to the CDC Quarantine Station in the jurisdiction of the airport where the plane is expected to land.CDC Quarantine StationCDC Quarantine Station

20 Preventing the Flu: Good Health Habits Can Help Stop Germs The single best way to prevent seasonal flu is to get vaccinated each year, but good health habits may also help protect you against the flu. The single best way to prevent seasonal flu is to get vaccinated each year, but good health habits may also help protect you against the flu.vaccinated Although the current trivalent influenza vaccine is unlikely to provide protection against the new 2009 H1N1 strain, vaccines against the new strain are being developed and could be ready as early as June Although the current trivalent influenza vaccine is unlikely to provide protection against the new 2009 H1N1 strain, vaccines against the new strain are being developed and could be ready as early as June There also are flu antiviral drugs that can be used to treat and prevent the flu. There also are flu antiviral drugs that can be used to treat and prevent the flu.flu antiviral drugsflu antiviral drugs

21 Avoid close contact. Avoid close contact. Stay home when you are sick. Stay home when you are sick. Cover your mouth and nose. Cover your mouth and nose. Clean your hands. Clean your hands. Avoid touching your eyes, nose or mouth. Avoid touching your eyes, nose or mouth. Practice other good health habits. Practice other good health habits.

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