S WINE F LU (H1N1) Preparing for the second wave

NCH is a leading global provider of industrial hygiene and maintenance solutions… Operating in over 50 countries Serving over 500,000 customers each year Developing, manufacturing and distributing over 100,000 products Generating $900 million annual sales, over $350 million of which in hygiene products and services With leading expertise in disinfection for over 90 years… About NCH

Specialising in disinfection since 1919

What is the swine flu (H1N1 influenza) pandemic? Sporadic : occasional, isolated incidences in a population Endemic: prevalent but expected level of infection in a population Outbreak: a sudden expansion of infection in a population Epidemic: infection spreading very widely and rapidly in a population Pandemic: An epidemic that spreads worldwide H1N1 is the world’s first pandemic flu since the “Hong Kong Flu” in 1968 H1N1 was first detected in in Mexico in February. By July it had spread through much of the northern hemisphere. The World Health Organisation (WHO) believes a more severe wave will return this autumn.

H1N1 spread rapidly in major population centers during the first wave Outbreaks Deaths Legend (size = quantity)

Number of H1N1 cases over 15 weeks 1 billion+ 2 nd Wave 1 st Wave The World Health Organization is advising governments to prepare for a larger second wave Fact: The second wave will be spread more rapidly in autumn due to reduced sunlight (sunlight kills the virus) Fact: The second wave will be spread more rapidly in autumn due to reduced sunlight (sunlight kills the virus) 2 nd wave impact: 83% of infected people will recover in 7 to 10 days 17% will suffer complications Of which, 1% will die 2 nd wave impact: 83% of infected people will recover in 7 to 10 days 17% will suffer complications Of which, 1% will die

How do you know if you are infected? People infected with H1N1 develop symptoms 2 to 4 days after becoming infected The illness lasts for 7 to 10 days Up to 30% of people who become infected will not become ill For the other 70%, symptoms typically include: −sore throat −coughing and sneezing −Fever over 38 o C −headaches −muscular pain −diarrhoea and vomiting −weakness and immobility Fact: H1N1 is most likely to infect people under the age of 50 Fact: H1N1 is most likely to infect people under the age of 50

There is no cure for H1N1, so what should you do if you become infected? Personal quarantine “Presenteeism” is a major risk to your business Stay at home – this is recommended by the US government Minimise contact with other people Fluids and pain relief Stay hydrated by drinking lots of water Rest as much as possible Take over the counter pain relief – aspirin and paracetamol Antiviral medication Relieves symptoms Shortens recovery by 1 to 2 days Most effective if taken within 48 hours of developing symptoms Masks Not effective for prevention if worn by people who are not infected Can prevent H1N1 spreading if worn by people who are infected Only CDC approved masks are effective – not paper masks

What about the H1N1 vaccine? Scientists have developed a vaccine for H1N1 The vaccine was developed using eggs from chickens Fast track testing was used to get the product to people quickly The vaccine is expected to be available this autumn The vaccine will be given to high risk people first Pregnant women are the main priority group Children under the age of 5 are the next in line Governments hope everybody will eventually be vaccinated What about side effects Season flu vaccines do not typically have significant side effects Vaccination against H1N1 in the US in 1976 coincided with an increase in the autoimmune disease Guillain-Barre Syndrome Governments believe the risk of side effects is very low for the H1N1 vaccine

But...this is also an opportunity to demonstrate care and protection for employees What does H1N1 mean for you? Global predictions on business impact: 20%+ of workforce will become ill 15%+ of workforce absent to care for family Average absence will be 5+ working days Absences are likely to happen all at once Significant supply interruption What this means for down time and cost: 20% of a work force of _____ means _____ people 15% of a workforce of _____ means _____ people Average cost per working day of €_____ With a 5-day absence, there is a cost to your company of €______ For your family, H1N1 means: Risk of complications Spread to other family members Interruption of all other events—work, social, etc. For your family, H1N1 means: Risk of complications Spread to other family members Interruption of all other events—work, social, etc.

How does H1N1 spread? Surface transmission H1N1 remains contagious on hard surfaces for up to 24 hours Personal transmission H1N1 infects through the mouth, nose, ears and eyes, often through hand contact Airborne transmission H1N1 spreads through moisture from coughs and sneezes, which can travel over 3 metres

Surface transmission: typical points of contact

Surface transmission: minimizing the risk Sanitise hard surfaces daily Fact: The H1N1 virus can remain infectious on hard surfaces for over 24 hours! Fact: The H1N1 virus can remain infectious on hard surfaces for over 24 hours! Sanitise common contact areas frequently coffee machines and kettles shared telephones and keyboards fax machines and photocopiers handles on doors and drawers Fact: Reception desks and counters are high risk points for infection Fact: Reception desks and counters are high risk points for infection Clean internal glass regularly

Regularly sanitise hands at work Before shaking hands Before touching eyes (the most common infection entry point) Before and after visiting the toilet After touching shared contact areas (e.g. coffee machine, keyboard, phone) Regularly sanitise hands outside of work Public areas can be transmission points for H1N1 Risks areas include shopping carts, ATMs, stair rails, etc. Encourage “social distance” Minimise interpersonal physical contact Use alternatives to meetings ( , telephone, video) Personal transmission: minimizing the risk Fact: The French government has advised to avoid “la bise” (the kiss of greeting) Fact: The French government has advised to avoid “la bise” (the kiss of greeting) Fact: neckties Neck ties ‘catch’ lots of respiratory droplets. The UK government told doctors to not wear neck ties Fact: neckties Neck ties ‘catch’ lots of respiratory droplets. The UK government told doctors to not wear neck ties

Good basic hygiene begins with washing hands frequently and correctly with soap and water Step 1: palm to palm Step 2: right palm over left dorsum and left palm over right dorsum Step 3: palm to palm with fingers interlaced Step 5: Rotational rubbing of right thumb clasped in left palm and vice versa Step 6: Rotational rubbing backwards and forwards with clasped fingers of right hand in left palm and vice versa Step 4: Backs of fingers to opposing palms with fingers interlocked Personal transmission: minimizing the risk

Sneezing etiquette prevents H1N1 Sneeze away from the body/clothing Always sneeze into a tissue This captures the swine flu droplets Dispose of tissues immediately after use (single use only) Sanitise hands after sneezing Disinfecting open spaces prevents H1N1 Air can be disinfected using sprays and fogs This can be effective in spaces with high occupancy Only disinfect air when no people are present Fact: Sneezing is the most common way to spread H1N1. The droplets in a sneeze can travel at over 150Km per hour! Fact: Sneezing is the most common way to spread H1N1. The droplets in a sneeze can travel at over 150Km per hour! Airborne transmission: minimizing the risk

Everbrite Super Hospital grade liquid, effective up to 1:100 dilution Powerful, sanitising cleaner with food grade certification Eliminates odours and controls mould and mildew Everbrite Wet Wipes Hospital grade Hard wearing disposal wipes impregnated with Everbrite Super Convenient portable packs of 80 wipes Promine-A Hospital grade aerosol Surface sanitiser that also eliminates odours Flash General purpose surface aerosol Sanitises, cleans and eliminates odours Surface Sanitisers Surface transmission: prevention with NCH

Blue Sheen Liquid cleaner that attacks germs as it cleans Streak free finish on any non porous, reflective surface Phosphate free but effective up to 1:4 dilution Glisten Aerosol cleaner that attacks germs as it cleans Foaming action clings to glass, preventing run off Streak free finish Surface transmission: prevention with NCH Glass Cleaners

Portable hand sanitisers Healthy Hands Hospital grade Clear, anti bacterial gel with aloe vera Unscented, rinse free formula 70% alcohol in 250ml containers Sanifoam Hospital grade Clear, anti bacterial liquid with aloe vera Unscented, rinse free formula in foaming 50ml container Alcohol free for very frequent use Personal transmission: prevention with NCH

Fixed point hand sanitisers Hand sanitiser Hospital grade Clear, anti microbial, neutral pH liquid Non-irritating, unscented and rinse free formula No-touch pouch prevents cross infection Touchless dispenser Designed for hospitals Electronic, automatic dispensing Ideal for use at common contact areas Can be used with all NCH hand sanitising products Personal transmission: prevention with NCH

Washroom soaps and sanitisers Claro II Hospital grade Cleans as well as sanitises Non-irritating, citrus scented formula Thick lather ensures skin contact during washing Aloe Derm Soothes as well as cleans Silicone free formula is ideal for use around electrical equipment Abrasive and lanolin free with lavender scent Personal transmission: prevention with NCH

Small and medium sized spaces Aeroshot aerosol Automatic dispensing allows for overnight use Single application disinfects an entire room Penetrates the smallest crevices to prevent infection Free from chlorinated or butylated solvents Large spaces Tri-Gly fights airborne micro-organisms Deodorises whilst decontaminating Dispensed through Aerofog Generator Adjustable settings to control particulate release Tri-Gly can also be directly applied to surfaces Airborne transmission: prevention with NCH Air sanitisers

Dosing for large facilities Accudose II Complies with latest EU water regulations Precise control over dilution Adjustable flow and dilution options Dosing for small and medium sized facilities [insert name of manual dosing system] Xxxxxxxxx Professional equipment: prevention with NCH Dosing equipment

Small and medium scale cleaning and spraying Manual and pressurised spraying systems Colour coded for safety Wide range of sizes Large scale cleaning and spraying Industrial grade pressure washers Deep cleaning capabilities Wide range of options Professional equipment: prevention with NCH Cleaning equipment

Surface Cleaning Based on the information from our Active Ingredient supplier, we can confirm that: Everbrite Extra 1% dilution (1:100) passed EN 14476:2005 with 5 minutes contact time (clean conditions) and 15 minutes contact time (dirty conditions) producing a 4 log reduction against Influenza virus A H3N8 Everbrite Super 1% dilution (1:100) Passed EN 14476:2005 with 5 minutes contact time (clean conditions) and 10 minutes contact time (dirty conditions) producing a 4 log reduction against Influenza virus A H3N8. The NCH Solution: verified effectiveness

What about H1N1 mutation? Influenza viruses can mutate This means that their key characteristics of the virus can change Which means that the impact on humans can also change Mutation has an impact on vaccines Vaccines are developed for specific viruses Mutation means that the vaccines stop being effective This is why scientists develop new seasonal vaccines each year What does this mean for H1N1? Scientists are concerned that H1N1 could mutate with Avian Flu (H5N1) H1N1 is faster spreading and H5N1 has more severe symptoms So far, H1N1 has not mutated