H1N1 Flu Update Swine Flu

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H1N1 Flu Update(Swine Flu)

• Source of Information
• PA Dept of Health as of August 21, 2009

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Spread

• Same as seasonal influenza coughs and sneezes of
  people who have the virus.
• Most people have little or no immunity.
• Vaccine against this new virus underway.
• Most ill people have recovered without requiring
  medical treatment

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Pandemic H1N1 Influenza Virus in PA

• First laboratory-confirmed case April 29, 2009
• As of August 11, 2009 2,018 probable and
  confirmed cases.
• 51 counties - confirmed cases.
• 59 of probable and confirmed cases between the
  ages of 5 to 19 years old.
• 51 Female and 49 Male.
• 9 confirmed deaths.
• 15 school closures.
• 21 summer camp outbreaks.
• 4 correctional facility outbreaks.
• Number () of confirmed cases
• hospitalized 57 (2.8)
• health care workers 7 (0.4)
• pregnant women 11 (0.5)

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Influenza Viruses in PA (through Aug. 3) Yellow
represents H1NI, Other colors represent seasonal
flu. Surge of H1N1 noted in weeks 20 - 27(May -
June)
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School Guidance General Recommendations

• School is not the place to be when youre sick.
• Support hand washing/hand hygiene.
• Support respiratory etiquette.
• Routine environment cleaning/disinfection.
• High use surfaces.
• Frequently touched objects.
• Staff/Parental cooperation COMMUNICATE CLEARLY
• Letter to be sent to all Division Heads to
  disseminate to parents staff and stakeholders
  ASAP
• Awaiting draft copy from PA Dept of Health

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School Guidance - Monitoring

• Be on the lookout for ill students/staff
• Ill students or staff members
• Send to school nurse for evaluation
• Send home if school nurse unavailable
• Upon return
• Assess eligibility for return/Send back home if
  still ill
• Critical that persons with flu not return early
• Current guidance for return to school/work 24
  hours after resolution of fever without
  fever-reducing medication
• Fever duration generally 2 to 4 days
• Period of exclusion usually 3 to 5 days
• Circumstances where longer duration indicated
• High risk setting (Medically fragile individuals)
• Poor compliance with shorter duration

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School Guidance - Monitoring

• Every school should monitor absenteeism on a
  daily basis and compare to previous trends
• If excess absenteeism
• Determine if due to illness (School
  nurse/administrator)
• Communicate to Division Director
• CCIU will communicate with local and/or state
  health department immediately
• Jointly determine appropriate next steps
• Closure of schools is not recommended as an early
  step and CCIU should determine in partnership
  with Health Dept

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School Guidance Control Measures

• Implement least disruptive measures that will
• Protect health and safety
• Allow continuation of educational activities
• Tailor school response to circumstances (Example
  Outbreak one day prior to a holiday)
• Consider
• Age group affected
• Onset date of ill student
• Likelihood student(s) infectious at school (12 to
  24 hours prior to onset)
• Success of exclusion policy
• Absenteeism
• Special considerations
• Cancellation considered the last option
• Extracurricular activities
• Sports
• Transportation
• Field trips/special events
• Classes
• If necessary, duration of closure 5 to 7 days
• No restrictions on well children/employees

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School Guidance - Miscellaneous

• Personal protective equipment recommended for
  those working with/examining sick persons (Ex.
  School nurse)
• Surgical masks, not N95 respirators
• Refrain from using persons at high risk of
  complications (Ex. Pregnant)
• Use of masks on sick persons when tolerated
• Designation of sick room to separate ill persons
• Maintain lists of individuals with high risk
  conditions
• Maintain up-to-date contact information for
  parents/guardians/health care provider
• Capacity to take temperatures
• Diagnostic testing clinical decision
• Will assist, but not determine public health
  decisions

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Vaccine Availability October/November
. Vaccination program will be voluntary.Encourag
e both seasonal and pandemic vaccine.Pandemic
vaccine two doseSeasonal one dose
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NEXT STEPS/More Information

• CCIU Response plan in development
• CCIU will provide updates as needed
• Related web sites for updates and FAQ
• www.health.state.pa.us
• www.flu.gov
• Stress basic prevention and raise awareness with
  all staff and students (Hard copy and electronic
  related info will be disseminated over the next
  few weeks).
• Handwashing
• Respiratory etiquette
• Environmental controls