H1N1 Flu UpdateH1N1 Flu Update(Swine Flu)(Swine Flu)

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

SpreadSpread

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

Pandemic H1N1 Influenza Virus in Pandemic H1N1 Influenza Virus in PAPA

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%)

Influenza Viruses in PA (through Influenza Viruses in PA (through Aug. 3)Aug. 3) Yellow represents H1NI, Other colors Yellow represents H1NI, Other colors represent seasonal flu. represent seasonal flu.

Surge of H1N1 noted in weeks 20 - 27(May - June)Surge of H1N1 noted in weeks 20 - 27(May - June)

School Guidance – General School Guidance – General RecommendationsRecommendations

School is not the place to be when you’re 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

School Guidance - MonitoringSchool 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

School Guidance - MonitoringSchool 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

School Guidance – Control School Guidance – Control MeasuresMeasures 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 Have plans for home learning

School Guidance - MiscellaneousSchool 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

Target Population

Primary Venue Goal

Pregnant women; household contacts of children under 6 months

Providers and community clinics

Reduce complications of Novel H1N1

Persons 6 months to 24 years

Schools and child care centers; providers and community clinics

Reduce the spread of Novel H1N1

Adults under 65 with medical conditions

Worksites, community clinics, providers, pharmacists

Reduce hospitalizations and death

Healthcare workers and EMS personnel

Worksites, providers Reduce risk of illness to sustain health system functioning

Vaccine Availability: October/November Vaccine Availability: October/November ..

Vaccination program will be Vaccination program will be voluntaryvoluntary..Encourage both seasonal and pandemic vaccine.Encourage both seasonal and pandemic vaccine.Pandemic vaccine – two dosePandemic vaccine – two doseSeasonal – one doseSeasonal – one dose

NEXT STEPS/More InformationNEXT 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