Influenza Prevention We anticipate that there will be two types of influenza illness and two different types of influenza vaccine this year Seasonal influenza – the usual flu that causes illness in fall and winter every year Seasonal influenza – the usual flu that causes illness in fall and winter every year H1N1 Influenza – a novel flu virus that began causing illness for the first time in April 2009 H1N1 Influenza – a novel flu virus that began causing illness for the first time in April 2009 Do you plan to or have you already received seasonal flu vaccine this year ? Do you plan to or have you already received seasonal flu vaccine this year ? NO YES

The following presentation will take approximately 5 minutes to view The following presentation will take approximately 5 minutes to view You will be asked to answer a question at the end of the presentation You will be asked to answer a question at the end of the presentation

Seasonal Influenza Basics and Mode of Spread Influenza is a viral infection Symptoms include: abrupt onset of fever, body aches, tiredness, cough and sore throat. Influenza is easily spread from person to person by coughing or sneezing Influenza is easily spread from person to person by coughing or sneezing People with influenza can spread it to others starting 1 day before and up to 5-7 days after they feel sick People with influenza can spread it to others starting 1 day before and up to 5-7 days after they feel sick You can spread influenza to others even if you don’t feel sick yourself

Burden of Influenza In an average year in the US, seasonal influenza results in 30 million people getting sick 30 million people getting sick 11 million out patient visits 11 million out patient visits 200,000 hospital admissions 200,000 hospital admissions 36,000 deaths 36,000 deaths

Importance of Seasonal Flu Vaccine for Healthcare workers Importance of Seasonal Flu Vaccine for Healthcare workers Because you work in health care, you are twice as likely to get influenza compared to the general population If you get influenza you can spread it to your patients, family and co-workers The single best way to prevent influenza is to get the flu vaccine each year

Effectiveness of Vaccine How well the flu vaccine works each year depends on a) the match between the vaccine strains and circulating strains and b) the age and health status of the person getting the vaccine The vaccine works best in young, healthy adults where it is 70-90% effective in preventing influenza. In those who get influenza despite vaccine, the illness is usually less severe. The vaccine is less effective in older people and those with health problems. Thus it is doubly important that people around them (family members and healthcare workers) get the flu vaccine AgeStatusVaccine effectiveness* 6mo- 64 yrs Healthy70-90% against infection >65 yrsCommunity dwelling 30-70% against hospitalization >65 yrsNursing home or long term care 30-40% against infection 50-60% against hospitalization 80% against death *When vaccine well matched to circulating Influenza virus strains

Flu vaccine side-effects Two types of seasonal flu vaccine will be available at Mayo Flu shot: An inactivated vaccine given as an injection An inactivated vaccine given as an injection Side-effects include: Soreness at the vaccine site and muscle pain Side-effects include: Soreness at the vaccine site and muscle painFluMist: A live vaccine given as a. You cannot receive FluMist if you are 50 years or older, have chronic health problems or if you are pregnant A live vaccine given as a nasal spray. You cannot receive FluMist if you are 50 years or older, have chronic health problems or if you are pregnant Side-effects include: Cough, runny nose, headache Side-effects include: Cough, runny nose, headache Side-effects with both types of vaccine are mild and generally last less than 48 hours

TOP REASONS why you should get the flu vaccine   You are at higher risk of influenza because you work in healthcare   If you get influenza you can spread it to patients and others even though you may not feel sick   The flu vaccine is safe and effective and free   By getting the flu vaccine you protect your patients, family, co- workers and community Protect our patients, protect yourself !

After viewing this presentation, if you still DO NOT plan to get the SEASONAL FLU vaccine, please let us know why. Pick the choice that best explains your reason  I don’t think I need the vaccine  The flu vaccine makes me sick  The flu vaccine doesn’t really work  The vaccine side effects are worse than the flu  I don’t think employee flu vaccination protects patients  I am allergic to the vaccine. Consider Allergy Clinic consult All answers are CONFIDENTIAL Individual responses will not be shared, only aggregate data will be analyzed to find ways to improve the employee flu vaccination program

Other Influenza Prevention Measures   Cover your mouth and nose while coughing or sneezing and encourage others to do the same.   Make sure the Respiratory Etiquette Signs are displayed in outpatient areas   Use a droplet mask when you evaluate patients with a fever/ new cough   Perform hand hygiene using soap and water or alcohol hand rub   Place hospital patients with fever and new cough in Droplet Plus isolation, comply with the instructions on the Isolation door cardsDroplet Plus

If you think you have Influenza….  Do not come in to work if you have fever and new cough.  If you are diagnosed with seasonal influenza, you must stay home until fever resolves  Talk to your primary provider, about antivirals. Antivirals may be useful if started soon after you develop symptoms. This is especially important you have heart or lung problems or are immunosuppressed  Remember the flu vaccine is not 100% effective. So you can still get the flu even if you have had the flu vaccine.

H1N1 Influenza H1N1 flu virus is a novel flu virus that began causing flu-like illness in April of 2009 H1N1 flu virus is a novel flu virus that began causing flu-like illness in April of 2009 Over 7000 cases and 500 deaths due to H1N1 have been reported in the US as of August 2009 Over 7000 cases and 500 deaths due to H1N1 have been reported in the US as of August 2009 Increased numbers of H1N1 infection are predicted this fall Increased numbers of H1N1 infection are predicted this fall H1N1 illness is similar to seasonal flu – main symptoms are fever, muscle aches, cough, sore throat H1N1 illness is similar to seasonal flu – main symptoms are fever, muscle aches, cough, sore throat Unlike seasonal influenza, the majority of cases of H1N1 have occurred in younger people, especially those between the age of 5 and 24 years Unlike seasonal influenza, the majority of cases of H1N1 have occurred in younger people, especially those between the age of 5 and 24 years

H1N1 Vaccine The The seasonal flu vaccine will not protect against H1N1 An H1N1 vaccine will be available later this year Groups with highest priority for H1N1 vaccination include: Groups with highest priority for H1N1 vaccination include: Pregnant women Pregnant women People who care for children younger than 6 months People who care for children younger than 6 months Health care workers who have direct patient contact Health care workers who have direct patient contact Children 6 months - 4 years Children 6 months - 4 years Children years with chronic medical conditions Children years with chronic medical conditions It is likely that 2 doses of H1N1 vaccine separated by 3 weeks will be needed. It is likely that 2 doses of H1N1 vaccine separated by 3 weeks will be needed.

Other measures to prevent H1N1 H1N1 is spread in the same ways as seasonal influenza H1N1 is spread in the same ways as seasonal influenza Hand hygiene, respiratory etiquette and appropriate isolation prevent spread of both seasonal and H1N1 influenza Hand hygiene, respiratory etiquette and appropriate isolation prevent spread of both seasonal and H1N1 influenza Stay home if you have fever and new cough. Stay home if you have fever and new cough. If you are diagnosed with H1N1 infection you must stay home for 7 days from onset of symptoms or until fever resolves – whichever is longer If you are diagnosed with H1N1 infection you must stay home for 7 days from onset of symptoms or until fever resolves – whichever is longer H1N1 information changes rapidly. H1N1 information changes rapidly.

AOEC thanks William Buchta, MD of the Mayo Clinic System for donating this set of slides. August 2009 AOEC thanks William Buchta, MD of the Mayo Clinic System for donating this set of slides. August 2009