1. Swine Influenza Information

2. Update as of 4/28/09 As of 11:00 AM there have been 64 cases reported in the USA. There has not been a confirmed case in Florida yet A great resource is http://www.cdc.gov/swineflu/

3. Case Definition for Swine Influenza A (H1N1) (SIV) A confirmed case of SIV infection is defined as a person w/ an acute respiratory illness (defined on next slide) w/ laboratory confirmed SIV infection at CDC by one or more of the following tests: a.real-time RT- PCR b.Viral culture c.Four-fold increase in SIV specific neutralizing antibodies A probable case of SIV is defined as a person w/ an acute respiratory illness w/ an influenza test that is positive for influenza A, but H1 and H3 negative. A suspected case of SIV is defined as: A person with an acute respiratory illness who was a close contact to a confirmed case of SIV infection while the case was ill OR A person with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected SIV infection OR A person with an acute respiratory illness who has traveled to an area where there are confirmed cases of SIV within 7 days of suspect case's illness onset.

4. Definitions of Respiratory Illness (for previous slide) 1. Patient has acute respiratory illness defined as: Recent onset of at least two of the following: rhinorrhea or nasal congestion sore throat cough fever or feverishness 2. Influenza-like illness: fever >37.8°C (100°F) plus cough or sore throat

5. Recommended PPE Personnel providing care to or collecting clinical specimens from suspected or confirmed cases should wear disposable non-sterile gloves, gowns, masks and eye protection (e.g., goggles) to prevent conjunctival exposure.

6. About that mask Mask – fitted (surgical) mask for patient If patient cannot wear a mask, such as during examination of throat or temp taking the HCP should wear a mask. The N95 mask is recommended by CDC and must be fit tested to determine correct size

7. CDC’s recommendation for the mask Personnel engaged in aerosol generating activities (e.g., collection of clinical specimens, endotracheal intubation, nebulizer treatment, bronchoscopy, and resuscitation involving emergency intubation or cardiac pulmonary resuscitation) for suspected or confirmed swine influenza A (H1N1) cases should wear a fit-tested disposable N95 respirator.* Pending clarification of transmission patterns for this virus, personnel providing direct patient care for suspected or confirmed swine influenza A (H1N1) cases should wear a fit-tested disposable N95 respirator when entering the patient room.

8. Testing If an Influenza screen is positive it will automatically be sent to the health department for typing to determine whether it is the novel swine strain If the test is negative, but you feel that it meets the case definition contact the lab and they will forward it to the state lab for confirmation

9. Patient Flow If you see a patient in your office that you suspect may have Swine Influenza please: Encourage hand hygiene and offer them a mask to wear for any face-to –face interaction If patient is to be seen at SMH please direct the patient to the ECC (avoid the front entrance!) and explain the importance of wearing the mask in public

10. Infection Control Currently CDC is recommending a negative pressure room for suspect or confirmed cases and Standard, Droplet and Contact Precautions Persons should be considered potentially contagious for up to 7 days following illness onset or longer if symptoms persist. Children, especially younger children, might potentially be contagious for longer periods. The duration of infectiousness might vary by SIV strain.

11. Questions? Infection Prevention & Control at Ext.1745