Where does influenza A virus come from

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Where does influenza A virus come
from?

• Human influenza A viruses start as avian (bird)
  influenza viruses

Migratory water birds
Humans and other animals
Domestic birds
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Pandemic influenza in the 20th Century
1918 Spanish Flu
1957 Asian Flu
1968 Hong Kong Flu
20-40 million deaths
1 million deaths
1 million deaths
H2N2
H3N2
H1N1
1920 1940 1960 1980 2000
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H1N1 (Swine Flu)April 2009

• Worldwide pandemic
• gt200,000 cases 2,185 deaths
• Widespread in U.S.
• gt40,000 in August
• 9,079 hospitalized 593 deaths
• MN 263 hospitalized 3 deaths
• SE MN 18
• Metro 212

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Novel H1N1 Confirmed and Probable Case Rate in
the U.S. By Age Group
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Novel H1N1 U.S. Hospitalization Rate per 100,000
Population, By Age Group
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Influenza

• Respiratory Infection
• Spread through contact with an infected person
  during coughing and sneezing
• 1 to 5 days from exposure to onset of symptoms
• Infectious up to 24 hours before symptoms appear
• Occurs October through April in North America

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Influenza Symptoms

• Rapid onset of
• fever
• chills
• body aches
• sore throat
• non-productive cough
• runny nose
• headache

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Influenza Virus Strains

• Type A
• moderate to severe illness
• animals and humans
• all age groups
• Type B
• milder epidemics
• humans only
• primarily affects children
• Type C
• no epidemics
• rarely reported in humans

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What can be done to slow
the spread of the Influenza?

• Vaccine
• Seasonal flu vaccine
• H1N1 vaccine
• Antivirals
• Recommended for persons at high risk of
  complications from influenza
• Disease containment measures
• Handwashing
• Stay home when sick
• Social distancing
• Keep hands away from eyes, nose, mouth

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SeasonalInfluenza Vaccine

• Up to 90 effective in preventing clinical
  illness in young, healthy adults
• 30-40 effective in preventing illness among
  frail elderly
• 50-60 effective in reducing hospitalization
• Up to 75 effective in preventing death

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Seasonal Influenza vaccination recommendations

• Persons at high risk of hospitalization or death
  due to influenza complications
• Pregnant women- any stage
• Persons 2-18 on long term aspirin therapy
• Persons who live in a long term care facility
• Persons 2-64 years with a chronic medical
  condition
• Heart disease
• Lung disease including asthma
• Kidney disease
• Metabolic disease
• Immunosuppression
• Blood disorders

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Others recommended to get a flu shot

• All children age 2-18
• Persons who will be in contact with those at risk
  for complications
• HCWs and facility staff
• Household contacts of all persons in the fore
  mentioned risk groups
• Household contacts of infants lt 6 mos. old
• Out-of-home caregivers of infants lt 6 months old
• Anyone who doesnt want to get the flu

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H1N1 VaccinationRecommendations

• Pregnant women
• Household contacts caregivers of infants lt 6
  mos. old
• Healthcare and emergency medical services workers
• All people age 6 mos.-24 yrs.
• Persons age 25-64 at higher risk of complications
  from the flu

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Should we be scared?
What would we do?
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Think Ahead. Develop Plans.

• COOP
• Continuity of Operations Plan
• Develop a Plan that includes pandemic
  preparedness--Think All-Hazards
• Ensure that your leave policies are flexible and
  non-punitive.

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Protecting Employees

• Do education campaign re influenza
• Improve hand hygiene
• Have hand gel around office
• Encourage hand washing
• Cover coughs and sneezes
• Routine cleaning of commonly touched surfaces
• Provide plastic guards if face to face with
  public

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Encourage Stay home when sick

• Dont come to work when you are sick.
• Stay home at least 24 hours after fever has gone
  (without taking medication).
• Allow sick workers to stay home without fear of
  losing their jobswhether they are sick or caring
  for sick family members.
• Know your normal seasonal absenteeism rates. Know
  how to monitor for any unusual increases.

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New practices to implementSocial Distancing

• Six feet distance between people
• Space workers farther apart
• Avoid crowded work settings
• Cancel face-to-face meetings
• Cancel non-essential travel

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Social Distancing

• Flexible work shifts / Staggered shifts
• Flexible worksites / Telecommuting
• Abbreviated hours of operation
• Assess and test computer system ahead of time to
  assure it can handle remote users.

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Share your plan.Items to consider

• Let your employees understand policies.
• Develop flexible leave policies so workers can
  stay home to care for sick family members.
• Ensure that sick workers receive care
• Donated leave programs
• Leave policies that provide partial or reduced
  pay
• Adequate leave and incentives to stay home if ill

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COOP

• Identify essential business functions. Which
  services must be maintained to keep your company
  functioning?
• How will your business operate if there is
  increased absenteeism or supply chains
  interrupted? Have back-up suppliers
• Check out alternative work pools if need
• Cross-train staff
• Be prepared to change your business practices if
  needed

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More for employees

• Encourage seasonal flu shots and H1N1
  vaccinations-educate and communicate!
• Inform employees that some are at higher risk
  than others and to check with health care
  provider
• Consider reassigning high risk workers so have
  minimal contact with others
• Check the CDC website for travel info

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Additional H1N1 and pandemic influenza information

• MDH
• http//www.mdhflu.com
• CDC
• http//www.cdc.gov/H1N1
• Goodhue County Public Health Service
• http//www.co.goodhue.mn.us
• 651.385.6100