1. U.S. Department of Health and Human Services Federal Occupational Health H1N1 Pandemic Update Presented by CAPT Mark Delowery, DO, MPH Director, Division of Clinical Services August 11, 2009

2. Federal Occupational Health U.S. Department of Health and Human Services 2 H1N1 Pandemic Update  Current influenza cases in U.S. unusually high for summer  >43,000 confirmed/Estimated 1-2 million cases  Only reporting hospitalizations/deaths  Children & young adults disproportionately affected  Severely ill more likely to have health issues (co morbidity)  Virus strain not mutating  3 cases of antiviral resistance  Monitoring Southern Hemisphere H1N1 activity

3. Federal Occupational Health U.S. Department of Health and Human Services 3 How is H1N1 spread?

4. Federal Occupational Health U.S. Department of Health and Human Services 4 How is H1N1 spread?  Close contact with infected person (3 - 6ft)  Coughing or sneezing  Kissing or embracing  Sharing eating or drinking utensils  Infectious droplets  Contagious for 7 days  Young children may be contagious longer  Touching contaminated objects  Virus lives several hours  NOT Spread by eating pork

5. Federal Occupational Health U.S. Department of Health and Human Services 5 FeverNo High; >100 o F Generalized achesNo Often severe Fatigue/weaknessSometimes Often severe Congestion/Runny nose Sometimes Sneezing Sometimes Sore throatNo CoughSometimes Often severe Itchy/watery eyes No Symptom Allergy ColdFlu

6. Federal Occupational Health U.S. Department of Health and Human Services 6 H1N1 Assumptions  Continue through Summer  Surge in September  Seasonal influenza to overlap with H1N1 and allergies  High attack rates  Activity may vary by region

7. Federal Occupational Health U.S. Department of Health and Human Services 7 Vaccine Assumptions  Expected in Fall (mid-October)  Limited amounts in beginning  Provide to new target groups (following CDC guidelines): School age children Pregnant women Health care/emergency responders Child care workers Disabled young adults Adults with young children or chronic medical conditions  Two doses (3-4 weeks apart)  Unknown adverse effects  Collaborating with CDC to obtain H1N1 vaccine when available

8. Federal Occupational Health U.S. Department of Health and Human Services 8 What Can Change?  Virus mutation  Severity  Transmissibility  Antiviral resistance  Vaccine effectiveness

9. Federal Occupational Health U.S. Department of Health and Human Services 9 How do I protect myself?  Cough Etiquette Cover your nose/mouth Use then dispose tissue Use sleeve if no tissue  Hand Hygiene Wash with soap and water or Use hand sanitizer Alcohol-based (>60%)

10. Federal Occupational Health U.S. Department of Health and Human Services 10 How do I protect myself?  Stay at home when ill  Avoid close contact with sick people  Avoid touching face with unwashed hands  Limit time in crowds  Get vaccinated  Rest/exercise/diet  Treat medical conditions

11. Federal Occupational Health U.S. Department of Health and Human Services 11 FOH Support for H1N1 Preparedness  Pandemic and H1N1 Training and Education Sessions  Posting Informational Updates/FAQs  Review of Agency Pandemic Plans ­ Identify High Risk Occupations  Providing medical guidance/consultation on H1N1 cases  Respirator Protection Program Preparedness ­ Online medical clearance ­ Respirator fit testing and training  Anti-viral Program Preparedness ­ Medical clearance/Rx ­ Distribution/dispensing  H1N1 vaccine (if available)