preparing for pandemic - cidrap€¦ · symptoms include fever, headaches, cough, aches, and sore...

pandemic flu

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arlington, virginia

public Health

www.arlingtonva.us

2 0 0 7

June2007

DearArlingtonCountyResident,

Becauseapandemicfluispossibleanyyear,ArlingtonCountywantsyoutolearnmoreaboutthispotentialthreat.Thisguideprovidesinformationaboutpandemicflu,birdflu,andseasonalfluandhowtoprotectyourselfnow.

Pleaserememberthesepoints:

• There is NO pandemic at present

• Practicing good cough etiquette and hand washing EVERY DAY prevents exposure to all flu viruses, even the common cold.

• Personal preparation NOW can decrease your risk during a pandemic, as well as other emergencies.

Thingswillchangeduringapandemic.Bepreparedforachangeindailyroutineandmakebackupplansnow.Itwillbeimportanttokeepup-to-date.Duringapandemic,PublicHealthwillgiveadditionaladviceonhowtoavoidbecomingsickandwhattodoifyouaresick.Inanemergency,ArlingtonCountywillprovidepublichealthinformationthroughthemedia,onourwebsitewww.arlingtonva.us,andemergencyradiostation1700AMArlington.

WeurgeyoutokeepthisbrochurewithyourotheremergencypreparednessmaterialsincludingtheEmergencyGuidefromtheArlingtonCountyOfficeofEmergencyManagement.

Thankyouforyouattentiontothisimportantconcern.

Sincerely,

ReubenVarghese,MD,MPHPublicHealthDirector

PANDEmic flu guiDE • Arlington, VirginiA �

ThisbrochurehasbeenpreparedforyoubythestafffromtheArlingtonCountyPublicDepartmentofHumanServices,PublicHealthDivision.ArlingtonCountyalsowantstothanktheArlingtonMedicalSocietyandthefollowingphysicianswhoreviewedtheinformationinthisbrochure:

YorkeAllen,MD,VirginiaHospitalCenterCatherineCasey,MD,privatepracticeN.ThomasConnally,MD,(ret.),ArlingtonFreeClinicWilliamFurlong,MD,privatepracticeDanHanfling,MD,InovaHealthSystemChristopherMcManus,MD,privatepracticeJohnMueller,MD,VirginiaHospitalCenterJohnJ.Sverha,MD,VirginiaHospitalCenterSuzanne,Wittig,MD,privatepractice

for more information about pandemic influenza, visit these sites:

www.pandemicflu.gov

www.vdh.virginia.gov/pandemicflu

www.arlingtonva.us

for travel to areas with bird flu: www.pandemicflu.gov

� PANDEmic flu guiDE • Arlington, VirginiA

Definitions

Influenza or flu is a viral infection of the lungs which may spread from person to person.

Seasonal flu is a common form of flu that spreads each winter. Flu vaccine along with hand washing, is the best protection from infection.

Bird or avian flu is a type of flu that affects poultry (e.g., chickens) and wild birds. Humans get this flu through very close contact with infected birds. Typically, bird flu cannot be spread from person to person.

Pandemic flu is an outbreak of a new or changed form of influenza virus that causes serious illness and may cause death among people.

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� PANDEmic flu guiDE • Arlington, VirginiA PANDEmic flu guiDE • Arlington, VirginiA �

Seasonal and Pandemic Flu are Different

Seasonalinfluenza(“flu”)iscausedbyavirusthataffectsthenose,throat,andlungs.Itusuallylastsbetween3-7days.

Symptomsincludefever,headaches,cough,aches,andsorethroat.Pandemicflusymptomsaresimilarbutmaybemoresevere.

Seasonal flumOccurseachwinter.

mAffectsabout10%ofthepopulation.

mFormostpeople,itisunpleasantbutnotlife-threatening.

mThoseatmostriskaretheveryyoung,andtheveryold.*

mAnnualfluvaccineandhandwashingarethebestwaystoprotectagainstseasonalflu.

mAntiviraldrugsareavailabletotreatthoseatspecialrisk.

*Others at risk include those with HIV/AIDS, cancer, and other chronic conditions such as kidney, lung or heart disease.

pandemic flumMayoccuratanytimeofyear.

mMayaffectupto50%ofthepopulation.

mCanbeamoreseriousinfectionforeveryone.

mPeopleofeveryagemaybeatrisk.

mAvaccinewillprobablynotbeavailableearlyinapandemic.

mAntiviraldrugsmaybeinlimitedsupplyandmaynotwork.

NOTE: Previous pandemics have occurred over long periods. A community may have 2 – 4 periods of flu lasting up to 4 months each.

During the 1918 pandemic, young healthy adults were at greatest risk for complications because of the particular virus strain.

Everyoneisatriskofgettingtheflu,andeveryoneneedstotakestepstopreventgettingtheflu!

m4Seasonal vs. pandem

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Practice good health habits daily to help prevent the fluFlumayspreadpersontopersonwhenaninfectedpersoncoughs,sneezesortouchesthingsothersuse.

mcover your mouth and nosewithatissueoryoursleevewhenyoucoughorsneeze.

mWash your handsoftenwithsoapandwarmwaterfor20seconds.Ifwaterisunavailable,useanalcohol-basedhandgel.

mDon’t touch your eyes, nose, and mouth.Fluspreadswhenapersontouchesitemscoveredwithvirusandthentoucheshiseyes,noseormouth.

mStay home when you’re sickorhaveflusymptoms.

mAvoid close contact with people who are ill.Maintainat leasta3feetdistance.

mDisinfect items people touch(likedoorknobs,toys,keyboards,faucets,remotecontrols,phones,andswitches).Usealabeledhouseholddisinfectantorchlorinebleachmixture*

mAnannual flu vaccinecanreduceyourriskofgettingseasonalfluduringapandemic.

mPractice other good health habits.Getplentyofsleep,bephysicallyactive,manageyourstress,drinkplentyoffluids,andeatproperly.

mAvoid smoking.Smokingmayincreasetheriskofseriousproblemsifyougettheflu.

mIfyoutravel to areas with bird flu,avoidlivebirdmarkets,farms,ordirectcontactwithbirdsortheirsecretions.

* You can make a disinfectant by mixing ¼ cup store brand chlorine bleach with 1 gallon of cool water. Allow 10 minutes of contact on surface before wiping disinfectant off. Make fresh daily.

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Is It a Cold or the Flu?

Symptoms Cold FluFever Rare Usual;high(100ºFto102ºF; occasionallyhigher, especiallyinyoung children);lasts3to4days

Headache Rare Common

GeneralAches, Slight Usual;oftenseverePains

Fatigue, Sometimes Usual;canlastupWeakness to2to3weeks

Extreme Never Usual;atthebeginningExhaustion oftheillness

StuffyNose Common Sometimes

Sneezing Usual Sometimes

SoreThroat Common Sometimes

ChestDiscomfort, Mildtomoderate; Common;canCough hackingcough becomesevere

Treatment Antihistamines Antiviralmedicines- Decongestants see your doctor Nonsteroidal anti-inflammatory medicines

Prevention Washhandsoften Washhandsoften Coveryourcough Coveryourcough Stayhomewhenill Stayhomewhenill Avoidclosecontact Avoidclosecontact withanyonewith withanyonewiththeflu acold Annualvaccination Antiviralmedicine see your doctor

Complications Sinuscongestion Bronchitis,dehydration Middleearinfection pneumonia;canbelife Asthma threatening

is it a cold or flu?


Recognizing the Flu Symptomsoffluforthoseage5andolderinclude: •Fever(upto102-103°F) •Chillsandsorethroat •Fatigueandweakness •Runnyorstuffynose •Achesandpains •Headaches •Drycough •Lossofappetite

influenza is more severe in childrenunder 5 years,especiallythosebetweentheagesof6and12months.

•Afevercanbetheonlysymptominbabies.

•Childrenmayhaveseizures,vomiting,irritability,sensitiveeyes,headache,earinfections,redsoreeyes,andsoremuscles.

•Temperaturesareoftenover103.1°F.

•Children3yearsoldoryoungermayhavenausea,vomiting,diarrhea,andstomachpain.

REMEMBER: The very young do not know how to tell people if they are sick with the flu. Tell-tale signs include hoarse and barking cough, irritability, and lack of appetite.

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Public instructions you may be asked to follow during a pandemic

Social distancingisusedtokeeppeopleatsafedistancesfromeachothertopreventexposuretoflu.Forexample,

sportingevents,moviesandothermeetingsmaybecancelled.PublicHealthofficialswillaskpeopletostayawayfromlargecrowds.Duringtheearlyandlatestagesofapandemic,quarantineandisolationmayberecommended.

Duringquarantine,officialsmayaskaperson exposed to flutostayhomeforaperiodoftimetoseeifheorshebecomessick.

During isolation,officialsmayaskaperson sick with flutostayhomeforaperiodoftimeuntilheorshecannotspreadflutoothers.

Mostwillfollowtheseinstructionsvoluntarily.Why?Becausewhenyouaresickwiththeflu,youwanttostayhomeandrest.Virginia,likeotherstates,hasprocedurestoenforcecomplianceifnecessary.

NOTE: if used, mandatory enforcement will occur at the beginning or end of a pandemic wave. This may help to slow the early spread of the flu or to help end the wave earlier.

public instructions


Masks, Pan flu Vaccine, & Antiviral Drugs during a Pandemic

Masks,panfluvaccine,andantiviraldrugswillbeinshortsupplyearly.MedicalandEMSpersonnelwillgetthemfirstbecause

theyareathighestriskofexposuretotheflu.Wewantthemtostayhealthytotakecareofthesickandrecoverquicklytogetbacktotakingcareofthesick.

more about mask and respiratorsThereisnoclearscientificevidenceaboutthebenefitsofwearingfacemasksandrespiratorstohelpcontrolthespreadofpandemicfluamongthegeneralpublic.*Studiesareunderway,butresultswillnotbeavailableforseveralmonthstoyears.

Facemasksareloosefitting,disposablemasksthatcoverthenoseandmouth,suchassurgicalmasks.Facemaskscanhelptoprotectyournoseandmouthfromdropletsfromotherpeople’scoughsandsneezesandpreventyoufromcoughingorsneezingonothers.

RespiratorssuchastheN95fittightlytothefaceandhelptoprotectyoufrombreathinginverysmallparticleswhichmightcontainviruses.Toworkbest,theN95shouldbespeciallyfittedforeachperson.

* Influenza viruses are transmitted through droplets. Recent evidence suggest that influenza viruses may also be transmitted in smaller particles than droplets.

Considerthefollowing:•Ratherthanrelyingontheuseoffacemasksandrespirators,avoid

closecontactandcrowdedconditionsduringaninfluenzapandemic.•Wearafacemaskifyoumustentercrowdedsettings.•Usearespiratorifyoumustbeinclosecontactwithotherswho

aresickwithinfluenza.

Mask and respirators should be used once and placed in the trash.

For more guidance on masks and respirators, vaccines

and antiviral drugs go to: www pandemicflu.gov

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Self Care Tips for Flu:•Restinbed(especiallyifyouhaveafever).

•Drinklightliquids(water,tea,sodadrinks,juice,clearsoup,rehydrationsolution,*etc.)topreventdehydration.Itisimportanttodrinkfluidsearlyandoftentopreventdehydration.

•Eateasilydigestiblefoodsthatappealtoyou.

•Takeaspirin-freepainrelievers(e.g.,acetaminophenoribuprofen)asdirectedbyyourdoctortoreducefeverandrelieveachesandpains.

•Donotwakeachildtogivemedication.

•Ibuprofenshouldnotbeusedforinfantslessthan4monthsold.

WARNING: Avoid aspirin or aspirin-containing products to prevent Reye’s Syndrome, a rare but serious disease.

*Examplesofrehydrationsolutions:Pedialyteforkids,Gatoradeforadultsandteens.Ifastoreboughtsolutionisunavailable,mixtheingredientsbelowuntilthesugardisappearstomakeyourownrehydrationsolution.

•4cupsofcleanwater•2tablespoonsofsugar•1/2teaspoonofsalt

recovery from flu: Oncetheworsthaspassed,continuetoeatandrestforfasterrecovery.Increaseactivitybasedonhowyoufeel.NOTE: the only real cure for flu is time.

Self care tips

� 0 PANDEmic flu guiDE • Arlington, VirginiA

When to seek medical advice for an adultIfyouhaveflusymptomsandareatriskforcomplications,consultyourdoctorrightaway.*Thoseusuallyconsideredathighriskforcomplicationsinclude:

•People65yearsorolder

•Peoplewithchronicheart,lungdiseaseoranyotherconditionthatrequiresregularmedicalattention(e.g.congestiveheartfailure,asthma,ordiabetes)

•Peoplewhohavediseasesortreatmentthatweakenstheimmunesystem

•Pregnantwomen

•Youngchildren

*NOTE: If antiviral medications are appropriate AND available, your doctor may prescribe these within the first 48 hours to reduce symptoms and duration of illness and to prevent more serious problems.

Ifyouhavebacterialpneumonia,youwillneedantibiotics.Otherwise,antibioticsareNOTneededtotreatfluwhichiscausedbyavirus.

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� 0 PANDEmic flu guiDE • Arlington, VirginiA PANDEmic flu guiDE • Arlington, VirginiA � �

When to call 911 and take an adult to the emergency roomSeek care if you have any one of the following:

•Shortnessofbreathwhilerestingordoinglittle

•Difficultorpainfulbreathing

•Coughingupsputumorphlegm

•Wheezing

•Chestpain

•Feverfor3to4dayswithoutimprovement

•Feelingbetterandthensuddenlyhavingahighfeverorbecomingillagain

•Extremedrowsinessanddifficultyawakening

•Disorientationorconfusion

•Severeearache

•Suddeninabilitytofunctioninanormallyindependentelderlyperson

•Constantvomiting

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� � PANDEmic flu guiDE • Arlington, VirginiA

When to seek medical advice for a childSeekmedicalcareifachildhasflu-likesysmptonsandanyoneofthefollowingconditions:

•Is3monthsoldoryounger.

•Hasaheartorlungdiseaseoranychronicillnessrequiringregularmedicalcare.

•Hasadiseaseortreatmentsthatweakentheimmunesystem.

•Takesaspirinregularlyforamedicalcondition.

•Hasachangeinbreathing(suchasbreathingfast)ordifficultybreathing.

•Isdrowsyandlosesinterestinplaying,watchingTV,eatingordrinking.

•Isveryirritableandcriesalot.

•Urinateslessthanusual(lessoftenthanevery6hourswhileawake)orhasdrydiaperformorethan3hoursifyoungerthan6months,orlongerthan6hoursif6to23monthsold.

*NOTE: If antiviral medications are appropriate AND available, your child’s doctor may prescribe this to reduce symptom duration and prevent more serious problems.

Ifyourchildhasbacterialpneumonia,youwillneedantibiotics.Otherwise,antibioticsareNOTneededtotreatfluwhichiscausedbyavirus.

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� � PANDEmic flu guiDE • Arlington, VirginiA PANDEmic flu guiDE • Arlington, VirginiA � �

When to call 911 and take a child to the emergency roomSeek care right away if your child:

•Hasseveretroublebreathingthatisnotcausedbyastuffynose.

•Hasbluelipsorhands,suddenlybecomespale,orhascoldlegs.

•Isdroopyorunabletomove.

•Issosleepythatheorshedoesnotrespondwhenyoutrytogethimorherup.

•Showssignofpain,suchasheadacheorstiffneck,especiallyifheorshealsohasafever,islistlessandhisorhereyesaresensitivetolight.

•Seemsconfused,sluggishornotactingnormally.

•Hasaseizure.

•Hasanyofthesymptomslistedunder“Whentocall911andtakeanadulttotheemergencyroom.”(pg.11)

When to go to em

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Preparation at home for pandemic is important

Talkabouthowandwherelovedoneswouldbecaredforiftheybecomesickandwhatyouneedtocareforthemathome.

Discussend-of-lifeissueswithyourlovedonessuchastheirwishesforresuscitationoruseofaventilator.Parentsshoulddecidehowdecisionswillbemadeabouttheirchildrenifparentsareunabletomakethosedecisions.Adultsshouldasalwayshavealivingwill.

NOTE: Plan NOW for someone to care for children, those with special needs and pets if you are sick.

Toprepareforpandemicsandotheremergencies,haveatleasttwoweeksworthoffood,non-perishables,andhealthandemergencysupplies.This includes prescription drugs.Alltheseitemsmaybedifficulttogetduringapandemic.

NOTE: Many health plans allow ordering 90 day supplies of medications. Ask your doctor if this is right for you.

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� � PANDEmic flu guiDE • Arlington, VirginiA PANDEmic flu guiDE • Arlington, VirginiA � �

Items to have on hand for an extended stay at home:Ready-to-eatcannedmeats,fish,fruits,vegetables,beans,andsoups

Proteinorfruitbars

Drycerealorgranola

Peanutbutterornuts

Driedfruit

Crackers

Cannedjuices

Bottledwater

Cannedorjarredbabyfoodandformula

Manualcanopener

Garbagebags

Tissues,toiletpaper,disposablediapers

Petfood

Neededmedicationsandsuppliessuchasglucosemonitoringequipment

Soapandwateroralcohol-based(60–95%)handwash

Medicinesforfever,suchasacetaminophenoribuprofen

Thermometer*

Anti-diarrhealmedication

Rehydrationsolutions(seepg.9,SelfCareTips)

Coughsyrup

Portableradio

Flashlight

Batteries

*Have a thermometer for each member of the household to reduce passing germs from person to person.

items to have on hand


in summaryTherearemanythingsyoucandotoprepareforapandemicfluemergency.Inanemergency,publichealthwillprovideyouwithadditionalinformationbutdon’twaitforanemergencytogetready.Actnow!

•Beinformed •Makeaplan •Getinvolved

Foradditionalinformationabouthowtoprepareforfluinyourcommunityorganizationsorworksites,contactPublicHealthat(703)228-5580.

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