H1N1 (Background and reports)

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"I am reluctant to judge things without being informed."
Giorgio Moroder

FYI. Pinoys!
Got the info from Centers for Disease Control and Prevention, Bkkpst, The Ntion, Phil. Daily Inquirer and Philippine Department of Health. Pinagtagpi-tagpi lang for easier reading. Please feel free to add more details. Would be very helpful to get ourselves updated.


Background:


Novel influenza A (H1N1) is a new flu virus of swine origin that first caused illness in Mexico and the United States in March and April, 2009. It’s thought that novel influenza A (H1N1) flu spreads in the same way that regular seasonal influenza viruses spread, mainly through the coughs and sneezes of people who are sick with the virus, but it may also be spread by touching infected objects and then touching your nose or mouth.

Novel H1N1 infection has been reported to cause a wide range of flu-like symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. In addition, many people also have reported nausea, vomiting and/or diarrhea.


April 15, 2009 - The first novel H1N1 patient in the United States was confirmed by laboratory testing at CDC April 15, 2009.

April 17, 2009 - The second patient was confirmed . It was quickly determined that the virus was spreading from person-to-person.

April 22  -  CDC activated its Emergency Operations Center to better coordinate the public health response.

April 26, 2009 - the United States Government declared a public health emergency and has been actively and aggressively implementing the nation’s pandemic response plan

May 10, 2009 -  Thailand reported it’s first swine flu case detected  out of 25 suspects from April 28-May 9.

June 11, 2009 – WHO  signaled that a global pandemic of novel influenza A (H1N1) was underway by raising the worldwide pandemic alert level to Phase 6 . This action was a reflection of the spread of the new H1N1 virus, not the severity of illness caused by the virus.

June 19, 2009 -  all 50 states in the United States, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands have reported novel H1N1 infection. While nationwide U.S. influenza surveillance systems indicate that overall influenza activity is decreasing in the country at this time, novel H1N1 outbreaks are ongoing in parts of the U.S., in some cases with intense activity.

June 19 -  A 49-year-old woman who has a chronic heart disease became the first fatality from swine flu in the Philippines. She died two days after she was ill.

June 24 - the World Health Organization reported 55,867 cases with 238 deaths from 102 reporting countries.

June 25 - Philippine health authorities  confirmed on June 22 that the first cluster of swine flu cases in the country, where the total number of infections has risen to nearly 200. Health Undersecretary Mario Villaverde said the source of the outbreak in Helera village in Jaen town, Nueva Ecija province, 90 kilometres north of Manila, has not yet been identified.

June 26, 2009- The Philippines reported 134 more mild cases of A (H1N1). These additional cases bring the total count of confirmed cases of the novel virus to 861.

The total sum, on the other hand, of fully recovered patients still stands at 634 or 74% of the total number of confirmed cases reported since May 21.
The additional 134 cases involved 60 males and 74 females. The age range of these cases is 2-58 years old, with 16 as median age. One hundred eighteen (118) of the new cases are Filipinos, the remaining 16 are foreigners. Twenty (20) of these cases have a history of travel to a country affected by A (H1N1).

June 28, 2009 – Thailand confirmed first TWO deaths. 40-year-old-woman at a Bangkok hospital on June 20 and 42-year-old-man in Siracha, Chonburi on June 26.

July 13, 2009 - Two more swine flu patients in the Philippines have died, bringing the death toll from the flu to three, Philippine health officials said Monday.

July 22, 2009 – Bkkpost reported Flu death toll to 44 in Thailand.  Total number of  flu cases, 6,776.  6, 697 out of 6,776 had recovered.

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H1N1 FAQs

Q: Why are health officials concerned about the outbreak of N1H1 (swine flu)?

A: When flu viruses mix genes with one another, they can take on new forms. New flu viruses are harder for the human immune system to defend against. With little or no opposition from the immune resistance, the virus can grow quickly and invade many tissues and organs. They may also set off a harmful immune overreaction in the body, called a “cytokine storm,” that may be lethal in itself. The swine flu virus from Mexico may have the ability to spread quickly and kill people, possibly causing a worldwide pandemic, according to the WHO. Researchers are conducting studies to determine how easily the virus spreads in people and how dangerous it is.

Q: What’s a flu pandemic?

A: A flu pandemic occurs when a new influenza virus spreads quickly and few people have immunity. While influenza viruses were only discovered about a century ago, researchers believe flu pandemics hit about two or three times each century. Some pandemics kill a few million people globally. The most severe flu pandemic on record was the 1918 Spanish Flu. Researchers estimate it killed about 50 million people around the world.

Q: How do people catch H1N1?

A: Studies are ongoing about how this particular swine flu is transmitted. Flu is generally transmitted through the respiratory tract. Droplets of infected body fluids may carry flu when people cough or sneeze. Studies indicate that masks called N95 respirators, when properly used, filter germs from the breath and hamper the spread of flu. Neither contact with pigs nor eating pork has been linked to the spread of the flu, Fukuda said.


Q: What are the symptoms of H1N1?

A: About one to four days usually elapse between the time a person is infected and the onset of symptoms. Influenza normally causes symptoms such as coughing, sneezing, headaches and body aches, fever, chills, and sometimes vomiting and diarrhea. Swine flu causes the same symptoms, and may be difficult to distinguish from other strains of flu and respiratory illnesses. Severe cases of flu that lead to death are normally seen in very young and very old people whose immune systems are too weak to fight off the virus. Adults with severe illness may also have difficulty breathing, dizziness, confusion, or severe vomiting and diarrhea.

Q: How can I tell if my child is sick?

A: Children who are breathing abnormally fast or slowly may have respiratory illness. Bluish skin indicates a need for quick attention. Children who are abnormally sluggish and sleepy, irritable, or have fever or rash may also need attention.



Q:  What are the Emergency Warning Signs

A:  If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing
Bluish or gray skin color
Not drinking enough fluids
Severe or persistent vomiting
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Flu-like symptoms improve but then return with fever and worse cough


regards,

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H1N1 Prevention and Protection for Self, Family and Community


There is no vaccine available right now to protect against novel H1N1 virus. But, there are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Follow some common sense protections emphasized for any flu, including seasonal flu:


1. Personal hygiene measures. Keep your hands washed and sanitized.

A.  Carry hand sanitizer with you and use it liberally each time you touch something that someone else may have touched. Show your children how to use sanitizer, too. Items at work, at school, church, the supermarket, the library, soccer practice -- anywhere others who may have been exposed.

B.  Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

C.  Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
   
D. Avoid touching your eyes, nose and mouth. Germs spread this way.

E.  In areas where any virus is running rampant, facemasks  protect  from breathing any droplets of virus that might be left in the air from someone who sneezed or coughed. Health officials are not sure whether those masks are helpful or not, but they certainly can't hurt.



2. Avoid being near others who are coughing or sneezing who might be sick to get away breathing droplets they have sneezed or coughed, or touching something they have touched.


3.  When you greet others, consider not shaking their hands or hugging or kissing them during this time. Those are generally courtesies. You might even explain that you are doing them a favor! They'll respect you for it.


4.  Stay informed. If you have travel plans, do some due diligence and consider changing plans if you will be traveling to an area where cases of swine flu, even possible cases of swine flu, have been identified. The CDC issues travel advisories. (visit the website)


5.  Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.


6.  Plan ahead for the possibility that you or your children (meaning, you, too) might need to stay home from work or school. If it seems like people at work or school have an upper respiratory illness, even if they have not identified it as swine flu, you may want to consider staying home, too.


7.  If you are sick with a flu-like illness, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is  longer, except to seek medical care or for other necessities.

Keep away from other household members as much as possible. This is to keep you from  infecting others and spreading the virus further.


8. If you are sick and sharing a common space with other household members in your home, wear a facemask, if available and tolerable, to help prevent  spreading the virus to others..


9. Consider developing a family emergency plan as a precaution. This should include storing a supply of extra food, medicines, and other essential supplies.



source: wwww.about.com

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Contamination & Cleaning (In response to H1N1 Pandemic)


1. HOW LONG CAN INFLUENZA VIRUS REMAIN VIABLE (such as books and doorknobs)?

Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for up to 2-8 hours after being deposited on the surface.

2. WHAT KILLS INFLUENZA VIRUS?

Influenza virus is destroyed by heat (167-212°F [75-100°C]).

In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time.

For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry.

3. WHAT SURFACES ARE MOST LIKELY TO BE SOURCES OF CONTAMINATION?

Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Droplets from a cough or sneeze of an infected person move through the air.

Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.

4. HOW SHOULD WASTE DISPOSAL BE HANDLED TO PREVENT THE SPREAD OF INFLUENZA VIRUS?

To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash.

Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste.

5. WHAT HOUSEHOLD CLEANING SHOULD BE DONE TO PREVENT SPREAD OF INFLUENZA VIRUS?

To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

6. HOW SHOULD LINENS, EATING UTENSILS AND DISHES OF PERSONS INFECTED WITH INFLUENZA VIRUS BE HANDLED?

Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.

Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting.

Individuals should avoid “hugging” laundry prior to washing it to prevent contaminating themselves.

Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry.

Eating utensils should be washed either in a dishwasher or by hand with water and soap.


source: CDC (Centers for Disease Control and Prevention)

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From our very own Philippine Department of Health. With the slogan "To-DOH- Alerto laban sa Flu". There's a Swine Flu Broadsheet in the website with The President, Gloria Macapagal Arroyo "Alagaan ang Kalusugan, Labanan ang Kahirapan". I'm so proud of our DOH they are indeed doing their job very well. Bravo DOH!!! Saludo kami sa iyo! Health Secretary Francisco T. Duque!!!  

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Prevention of Illness in Well Employees

Spread of this novel influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their eyes, mouth, or nose.

What can employers do to protect employees?

•Encourage sick workers to stay home and away from the workplace, and provide flexible leave policies.
•Encourage infection control practices in the workplace by displaying posters that address and remind workers about proper hand washing, respiratory hygiene, and cough etiquette. These posters can be found on the Germ Stopper: Posters and Other Materials page.
•Provide written guidance (email, etc.) on novel influenza A (H1N1) flu appropriate for the language and literacy levels of everyone in the workplace. Employers should work closely with local and state public health officials to ensure they are providing the most appropriate and up-to-date information (e.g., the CDC H1N1 Flu website).
•Provide sufficient facilities for hand washing and alcohol-based (at least 60%) hand sanitizers* (or wipes) in common workplace areas such as lobbies, corridors, and restrooms.
•Provide tissues, disinfectants, and disposable towels for employees to clean their work surfaces, as well as appropriate disposal receptacles for use by employees.
•One study showed that influenza virus can survive on environmental surfaces and can infect a person for up to 2-8 hours after being deposited on the surface. To reduce the chance of spread of the novel influenza A (H1N1) virus, disinfect commonly-touched hard surfaces in the workplace, such as work stations, counter tops, door knobs, and bathroom surfaces by wiping them down with a household disinfectant according to directions on the product label.

What can employees do to reduce the spread of novel influenza A (H1N1) flu in the workplace?

•Stay home if you are sick. If you have symptoms of influenza-like illness, stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities (your fever should be gone without the use of a fever-reducing medicine). Keep away from others as much as possible. This is to keep from making others sick.
•Employees who are well but who have an ill family member at home with novel H1N1 flu can go to work as usual. These employees should monitor their health every day, notify their supervisor and stay home if they become ill. Employees who have an underlying medical condition or who are pregnant should call their health care provider for advice, because they might need to receive influenza antiviral drugs to prevent illness.
•Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
•Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand sanitizers* can be used if soap and water are not available.
•Avoid touching your eyes, nose, or mouth. Germs spread this way.
•Avoid close contact with sick people. If an employee suspects that they have been exposed to a sick person with novel H1N1 influenza they may continue to go to work as usual. These employees should monitor their health every day and should notify their supervisor and stay home if they become ill.

Management of Employee Exposure in the Workplace after a Confirmed Case of Novel Influenza A (H1N1) Flu

What to do when an employee comes to work with influenza-like illness symptoms in a community where novel influenza A (H1N1) virus is circulating

•Notify appropriate health center or first aid personnel.
•Place the employee in a room by him- or herself.
•If the employee needs to go into a common area, he or she should cover coughs/sneezes with a tissue or wear a facemask if available and tolerable.
•Notify the employee’s supervisor or employer.
•Send the employee home as soon as possible.
•Call for emergency medical services if the ill person develops any of the emergency warning signs. See What to Do If You Get Flu-Like Symptoms to review emergency warning signs and for more information on what employees should do if they become sick.
•Ensure the ill employee stays home for at least 24 hours after your fever is gone except to get medical care or for other necessities (their fever should be gone without the use of a fever-reducing medicine).
•For recommendations on facemask and respirator use for the person assisting the ill employee see Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission.

What to do for co-workers of an employee who is a suspected or confirmed case of novel influenza A (H1N1) flu

•Inform the employees of their exposure in the workplace with confirmed, probable, or suspected novel H1N1 flu during the ill person’s infectious period.  Such disclosure of information should be conducted in accordance with the privacy and confidentiality requirements of the Americans with Disabilities Act (ADA), which stipulates that employers are required to keep all employees’ medical information private and confidential.  Please refer to more information on privacy issues.
•Have the exposed employees monitor themselves for symptoms.
•Advise employees to check with their health care provider about any special care they might need if they are pregnant or have a chronic health condition such as diabetes, heart disease, asthma, or emphysema.

What to do for an employee with confirmed novel influenza A (H1N1) flu while he or she is on travel status

•Notify his or her supervisor or employer if an employee becomes ill on travel or temporary assignment.
•If outside the U.S., contact medical provider or overseas medical assistance companies to assist in finding an appropriate medical provider in that country, if needed. A U.S. consular officer can help locate medical services. Take note that U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or to give medications, vaccines, or medical care to private U.S. citizens overseas.
•See Novel H1N1 Flu and Travel for more information for travelers.

Considerations for Pregnant Employees with Suspected Novel Influenza A (H1N1) Flu

Pregnant women are known to be at higher risk for seasonal influenza complications. They might also be at higher risk for novel H1N1 influenza complications. Pregnant women with flu-like symptoms should contact their health care provider. For more information, please visit What Pregnant Women Should Know About H1N1 Virus

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H1N1 death toll surpasses 2,100
Writer: AFP
Published: 28/08/2009 at 10:37 PM

The World Health Organisation said Friday that 2,185 people have died from swine flu, with some tropical countries reporting "moderate strains'' on their healthcare systems amid surges in infections.
"Many countries in tropical regions _ represented by central America and tropial regions of Asia, continue to see increasing or sustained high levels of influenza activity with some countries reporting moderate strains ont he healthcare system,'' it said in a statement.
Most countries in the southern hemisphere have passed their peak, and in the northern hemisphere, flu activity was law, added the UN health agency.
The latest death toll posted on the WHO's website was an increase from the 1,799 deaths posted over a week ago.

Most deaths were recorded in the Americas region, where 1,876 people have died from their influenza A(H1N1) infection.
In Asia-Pacific, 203 deaths were recorded. This was followed by Europe, with at least 85 deaths.
Middle East recorded 10 deaths, while Africa posted 11.

Cameroon, Madagascar and Mozambique also recorded their first infections since the last update.
In all 209,438 laboratory confirmed swine flu infections have been reported to the global health watchdog.
However, the WHO says that figure vastly understates the full number of infections since individual cases no longer have to be tested or reported in each country.

http://www.bangkokpost.com/breakingnews/152940/h1n1-death-toll-surpasses-2100

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H1N1 now most prevalent flu strain
Writer: AFP
Published: 28/08/2009 at 11:43 PM



The World Health Organisation said Friday that the swine flu virus has overtaken other viruses to become the most prevalent flu strain.
"Evidence from multiple outbreak sites demonstrates that the A(H1N1) pandemic virus has rapidly established itself and is now the dominant influenza strain in most parts of the world,'' said the WHO in a statement.
"The pandemic will persist in the coming months as the virus continues to move through susceptible populations,'' it added.
Some 2,185 people have died from the virus, and some tropical countries are are already reporting "moderate strains'' on their healthcare systems amid surges in infections.

"Many countries in tropical regions _ represented by central America and tropial regions of Asia, continue to see increasing or sustained high levels of influenza activity with some countries reporting moderate strains on the healthcare system,'' said the UN health agency.
Swine flu also showed several significant differences from seasonal flu, it added.

While 90 percent of severe and fatal cases occur in people aged above 65 in seasonal flu, most of those who die from swine flu are under the age of 50.
A "very severe form of disease'' affecting the lungs and causing severe respiratory failure among young and healthy people was reported, WHO said, adding that highly specialised care was required.
Large numbers of such patients could therefore "overwhelm'' intensive care units and disrupt the provision of care for other diseases, it warned.
In the southern hemisphere where the flu-prone winter season is tampering, the WHO said several countries had reported that nearly 15 percent of hospitalised cases required intensive care.
"Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases,'' it said.


http://www.bangkokpost.com/breakingnews/152941/h1n1-now-most-prevalent-flu-strain