1. Pandemic Influenza (H1N1) Carol Franklin, MSN Ed, RN Public Health Doctoral Student Walden University

2. Objectives To define the terms pandemic and influenza. To reflect on historic pandemics worldwide. To identify the signs and symptoms of influenza. To discuss available treatments. To identify who is at risk for contracting influenza.

3. What does pandemic mean ? Pandemic is a worldwide outbreak of a new disease in which humans have no immunity meaning that it occurs everywhere in the world. In 1918 there was a global pandemic of Spanish flu that killed approximately 50 million people worldwide. Arizona Department of Health Services. (2009). Pandemic Flu Information. Retrieved on October 4, 2009 from http://www.azdhs.gov/pandemicflu/index.htm

4. What is Influenza? A viral infection that affects the nose, throat, bronchi and sometimes lungs. It is transmitted from person to person via droplets when others cough or sneeze World Health Organization. (2009). Influenza. Retrieved on October 10, 2009 from http://www.who.int/topics/influenza/en/

5. Signs and Symptoms 1.Fever 2.Loss of appetite 3.Rhinitis, sore throat 4.Congestion, cough 5.Nausea, vomiting 6.Diarrhea 1.Fever 2.Loss of appetite 3.Rhinitis, sore throat 4.Congestion, cough 5.Nausea, vomiting 6.Diarrhea World Health Organization. (2009). Influenza. Retrieved on October 10, 2009 from http://www.who.int/topics/influenza/en/ Image URL: swineflu.myinvitation.co.in/files/2009/08/Swi

6. Did you know? That in 1918 there was the “Spanish Flu” pandemic that caused 20- 40 million deaths. In 1957 there was the “Asian Flu” that caused 1-4 million deaths. In 1968 there was the “Hong Kong Flu” that caused 1-4 million deaths. The Kansas Department of Health and Environment. (2009). Pandemic Influenza Update. Retrieved on October 12, 2009 from http://www.kdheks.gov

7. Seasonal vs Pandemic Flu Seasonal Flu  Occurs annually during the winter.  Affects up to 10% of the population.  Unpleasant but not life-threatening in most cases.  Very young, very old, and people with certain chronic illnesses most at risk.  Vaccines are available to protect us from seasonal flu.  Antiviral drugs available to treat those at special risk. Connecticut Department of Public Health. (2009). Be Aware Be Prepared for Pandemic Influenza. Retrieved on October 10, 2009 from http://www.ct.gov/dph/lib/dph/communications/cerc/ct_dph_panflu_ihd.

8. Seasonal vs. Pandemic Flu Pandemic Flu  Occurred three times in the last 90 years.  Can occur at any time of the year.  Symptoms similar to those of seasonal flu but more severe.  People of every age may be at risk of serious illness. Connecticut Department of Public Health. (2009). Be Aware Be Prepared for Pandemic Influenza. Retrieved on October 10, 2009 from http://www.ct.gov/dph/lib/dph/communications/cerc/ct_dph_panflu_ihd.

9. Affected Areas Centers for Disease Control and Prevention. (2009). Flu Activity and Surveillance. Retrieved on November 3, 2009 from http://www.cdc.gov/h1n1flu/.

10. How are we affected globally? RegionCumulative total (10/18/09) Cases Deaths Africa 13,297 75 Americas 160,129 3,539 Eastern Mediterranean 14,739 96 Europe 63,000 + At least 261 South East Asia 41,513 573 Western Pacific 122,267 455 Total > 414,945 At least 4999

11. The Global Impact The World Health Organization declared a worldwide pandemic of H1N1 flu by increasing the alert level to phase 6. 70 countries have reported cases of H1N1. The United States has the highest number of reported cases. The United States Department of Health and Human Services. (2009). Retrieved on October 8, 2009 from http://www.pandemicflu.gov/individualfamily/about/current/index.html#learn

12. Morbidity and Mortality Rates Centers for Disease Control and Prevention. (2009). Fluview. Retrieved on October 28, 2009 from http://www.cdc.gov/flu/weekly/

13. Am I at risk? Pandemic Influenza Children less Than 5 yrs of age People over The age Of 65 yrs Pregnant Women People with Chronic disorders United States Department of Health and Human Services. (2009). 2009: H1N1Flu: Who’s at risk for complications? Retrieved on October 10, 2009 from http://www.flu.gov/pdfs/whosathighrisk.pdf

14. How can I control influenza? Wash my hands. Cover my nose and mouth when I sneeze and wear a mask if I have any respiratory symptoms

15. Are there preventive methods? Yes….. Wash your hands often with soap and water. If soap is not available use alcohol based hand cleaner. Cover your nose and mouth with a tissue. Discard the tissue in the trash can. If you do not have tissues, cough or sneeze into the inner elbow. Avoid close contact with sick people. Avoid touching your eyes, nose and mouth. Germs spread this way. Centers for Disease Control and Prevention. (2009). 2009 H1N1 Flu: What do I need to know and do? Retrieved on October 8, 2009 from http://www.epi.state.nc.us/epi/gcdc/pdf/H1N1Flu_FactSheet.pdf

16. What other ways can we control the spread of the flu? ImmunizationsImmunizations Anti-viralsAnti-virals MasksMasks Stay home if you are sickStay home if you are sick

17. Know, Do, and Go 3 Things to Know 3 Things to Do 3 Places to Go Pandemic flu is world- wide, more people will get sick. Wash your hands consistently, cover your mouth and nose when you sneeze and not in your hands. Contact your local health department for questions or concerns regarding the flu. There may be a limited supply of food and other necessities Encourage parents to stock up on canned foods and bottled water, batteries, tissue and flash lights. Visit these websites: www.flu.gov www.ncpublichealth.com There may be less healthcare workers to care for you because they too may be sick Have a thermometer on hand, fever reducing medications and first aid kit. Call the toll free hotline: 1-800-CDC-INFO (1-800- 232-4636).

18. CDC’s Recommendations  Schools and other facilities with confirmed cases do not have to close.  Students and/or staff members should stay at home for 7 days if they are infected with the virus.  Good hygiene including hand washing, and sanitizing should be implemented. Centers for Disease Control and Prevention. (2009). 2009 H1N1 Flu: What do I need to know and do? Retrieved on October 8, 2009 from http://www.epi.state.nc.us/epi/gcdc/pdf/H1N1Flu_FactSheet.pdf

19. Let’s Review  Influenza pandemics are naturally recurring events. They come in different intervals.  We are currently experiencing an influenza pandemic.  All countries will be affected and illness will be widespread. Mortality rates will continue to increase if we do not protect ourselves.  Healthcare workers and systems will be overwhelmed.  Risk minimized through preventive steps such as good hand hygiene, immunization and disinfecting.  New influenza vaccine available.  Everyone needs to be prepared.

20. Questions?  This concludes the presentation.

21. References  Arizona Department of Health Services. (2009). Pandemic Flu Information. Retrieved on October 4, 2009 from http://www.azdhs.gov/pandemicflu/index.htm http://www.azdhs.gov/pandemicflu/index.htm  Centers for Disease Control and Prevention. (2009). Flu Activity and Surveillance. Retrieved on November 3, 2009 from http://www.cdc.gov/h1n1flu http://www.cdc.gov/h1n1flu  Centers for Disease Control and Prevention. (2009). Fluview. Retrieved on October 28, 2009 from http://www.cdc.gov.gov/flu/weekly/  Connecticut Department of Public Health. (2009). Be Aware Be Prepared for Pandemic Influenza. Retrieved on October 10, 2009 from http://www.ct.gov/dph/lib/dph/communications/cerc/ct_dph_panflu_ihd  North Carolina Department of Health and Human Services. (2009). 2009 H1N1 Flu: What do I need to know and do? Retrieved on October 8, 2009 from http://www.epi.state.nc.us/epi/gcdc/pdf/H1N1Flu_FactSheet.pdf  The Kansas Department of Health and Environment. (2009). Pandemic Influenza Update. Retrieved on October 12, 2009 from http://www.kdheks.gov  The United States Department of Health and Human Services. (2009). The Current Flu Situation. Retrieved on October 8, 2009 from http://www.pandemicflu.gov/individualfamily/about/current/index.html#learn  The United States Department of Health and Human Services. (2009). 2009: H1N1Flu: Who’s at risk for complications? Retrieved on October 10, 2009 from http://www.flu.gov/pdfs/whosathighrisk.pdf  World Health Organization. (2009). Influenza. Retrieved on October 10, 2009 from http://www.who.int/topics/influenza/en/

22. Additional Resources  Federal government's pandemic influenza website: www.pandemicflu.gov  Centers for Disease Control and Prevention: www.cdc.gov  Department of Homeland Security: www.dhs.gov  World Health Organization: www.who.int  Association of Sate and Territorial Health Officials: www.astho.org http://www.PandemicFlu.gov http://www.PandemicFlu.gov  CDC’s Swine Flu Info Center: http://www.cdc.gov/swineflu/?s_cid =swineFlu_outbreak_001 =swineFlu_outbreak_001  WHO’s Swine Flu Info Center http://www.who.int/csr/disease/swineflu/en/