The Flu, What it can do and How to protect You!A presentation on the Seasonal and H1N1 Influenzas

By Lisa Hezel, RN WCC

About the SpeakerBeen a nurse for 16 years.Certified in Wound Care with

National Alliance of Wound Care since 2007.

Work at St. John’s Mercy Medical Center in Creve Coeur, MO.

Wife and mother of 2 children.Flu survivor!

Where I workNurse Manager of St. John’s

Hyperbaric and Wound Treatment Center and St. John’s Diabetic Foot Clinic.

I love my job!

What we will cover today:Seasonal Influenza and the Swine

Flu.How it is spreadHow is it treatedWhat you can do to protect

yourself and loved ones.

There are 3 types of Flu:

◦Seasonal (H3N2)

◦Avian (H5N1)

◦Swine (H1N1)

Quick Question….

What does the H & N stand for?◦ It stands for Hemagglutinin and

Neuraminidase. There are 16 types of the H protein, numbered H1 through H16, and 9 types of the N protein, numbered N1 through N9. That makes 144 possible combinations of the virus, a constantly changing challenge for prevention or treatment

Peak months for seasonal influenzaSource:

http://www.cdc.gov/flu/professionals/acip/clinical.htm

How the flu is spreadSneezingCoughingShaking handsSharing drinksClose Contact with sick peopleGoing to work or school when you

are sick—should stay home if you have a fever of 100.8 or more and not return until you are 24 hours with out fever (without using Tylenol).

The most common symptoms of the Seasonal Flu are: SUDDEN onset Chills Fever Sore throat Muscle pains Severe headache Coughing Weakness and general discomfort Runny or stuffy nose

Why you don’t want to get the fluUncomplicated flu usually resolves after 3—7

days for most people, although cough and malaise can persist for up to 2 weeks or more.

The flu can cause primary influenza viral pneumonia or a secondary bacterial pneumonia.

Exacerbate underlying medical conditions, i.e. asthma.

Other possible complications: sinusitis, or otitis media (ear infection); or contribute to co-infections with other viral or bacterial pathogens

Who is most at risk for complications?65 years and olderYoung children, Pregnant women and women up to 2

weeks from end of pregnancyPeople with certain chronic medical

conditions (such as asthma, heart failure, chronic lung disease) and people with a weak immune system (such as diabetes, HIV)

People younger than 19 years of age who are receiving long-term aspirin therapy

How long are you “contagious?”Incubation period: 1—4 daysAdults: shed influenza virus from the day

before symptoms begin through 5—10 days after illness onset.

The amount of virus shed, decreases rapidly by 3—5 days after onset.

Young children: shed virus several days before illness onset, and children can be infectious for 10 or more days after onset of symptoms.

Severely immunocompromised persons can shed virus for weeks or months.

Treating the seasonal fluPrevention is the best method.Anti-viral medications Tamiflu

and Relenza (only helps if taken within the 1st 48 hours)

Rest and fluidsStay Home!

The Swine flu (H1N1)

Swine Influenza (swine flu) is a respiratory disease of pigs caused by Type A influenza viruses that causes regular outbreaks in pigs.

This is now considered a “moderate” pandemic by the CDC (Category 2).

What is a pandemic?A pandemic affects the entire world and

not just a country or continent.

Pandemic flu is usually more severe than seasonal flu with a higher death rate.

What is a pandemic?Pandemic influenza is a virus to

which we have no natural immunity.

It originates in wild birds and then jumps to other species, including pigs and humans.

“Swine flu” has bird, pig andhuman genes, a very unusual occurrence.

Recent Pandemics1918-19 - H1N1, "Spanish flu”

Severe: Humans had no immunity to any ofthe 8 gene sequences

1957-58 “Asian flu” Mild: We had immunity to 5 of 8

gene sequences 1968-69 "Hong Kong flu”

Milder: We had immunity to 6 of 8

gene sequences 1997- ? H5N1, “Bird Flu”

Severe: Humans have no immunity 2009 - ? A/H1N1, “Swine Flu”

Moderate: We have no immunity to any of

the 8 gene sequences, but have modern

medicine to help us this time.

What makes the H1N1Influenza Virus so Strong?

Adaptability: the ability to survive different environments.

This table shows how long 3 different viruses can survive outside of their host.Cold Couple of hours

Flu Up to 8 hours

Small Pox 24 hrs / up to 12 weeks in a scab

What does the Swine Flu Look Like?

What are the symptoms of swine flu?Similar to the symptoms of regular

human flu: fever, cough, sore throat, body aches,

headache, chills and fatigue.

Some people have reported diarrhea and vomiting associated with swine flu.

In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people.

Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

Fatalities from H1N1H1N1 currently has a mortality rate of

around 0.5%, or 5 times the death rate of seasonal influenza, with prompt, first-rate medical care.

Average age of death: 38

Affects children and young adults

1/3 have no pre-existing medical conditions

Who is most at risk for complications?Ages 5-50Pre-existing conditions:

◦Asthma◦Diabetes◦Pregnancy◦Heart disease

Treating the H1N1 is the same as the seasonal fluPrevention is the best method.Anti-viral medications Tamiflu

and Relenza (only help if taken within the 1st 48 hours)

Rest and fluidsStay Home!

When to seek emergency treatment

Adults Children

Difficulty breathing or shortness of breath

Pain or pressure in the chest or abdomen

Sudden dizziness Confusion Severe or persistent

vomiting

• Trouble breathing • Bluish skin color • Not drinking enough• Not waking up or not

interacting • So irritable-- does not

want to be held • Flu-like symptoms

improve but return with fever and worse cough

• Fever with a rash

What to do if you become sick?If you live in areas where swine

influenza cases have been identified and become ill with influenza-like symptoms, contact your health care provider.

Your health care provider will determine whether influenza testing or treatment is needed.

Stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.

Preventing illnessVaccinations for seasonal flu and

H1N1◦Currently the doses of the H1N1 are

being given to populations with the most risk.

◦ Healthcare workers◦ Pregnant women◦ Emergency services◦ “High risk” people—cancer, severe pulmonary

illnesses, etc.

VaccinationsBoth the seasonal and H1N1 vaccines

come in an injectable form and a form you can inhale (Flu-Mist).

Persons with asthma or other pulmonary conditions should not get the flu mist.

Contraindications to the Flu VaccineAllergies to eggsSick with a feverMercury allergy (preservative )History of Guillain-Barre syndromeLess than 14 weeks pregnant.

In years past, pregnancy was also a contraindication to flu vaccine but, today, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control (CDC) recommends flu vaccine for women more than 14 weeks pregnant.

The Seasonal Influenza (H3N2) Vaccine

Each year, many laboratories throughout the world, including in the United States, collect flu viruses.

World Health Organization (WHO) reference laboratories, do detailed testing on these viruses.

WHO also test how well antibodies made to the current vaccine react to the circulating virus and new flu viruses.

This information, along with information about flu activity, is summarized and presented to the U.S. Food and Drug Administration (FDA) and at a WHO meeting.

Three viruses (two subtypes of influenza A viruses and one influenza B virus) to go into flu vaccines for the following fall and winter.

Usually, one or two of the three virus strains in the vaccine are changed each year.

Is the vaccine for H1N1 safe?

Is the vaccine for H1N1 safe?The A/H1N1 flu vaccine is safe

◦According to the CDC in a report released on Wednesday 11/25/09.

22 million Americans have already been inoculated.

3,200 reports of possible side effects.◦Mostly minor:

soreness or swelling from the shot

Why should I get it?As of November 20, 2009 there have

been 4008 deaths from Pandemic Swine Flu in the US.

98,000 Americans have been Hospitalized with the H1N1 Swine Flu.

22 million Americans have gotten ill from it.

Of those, here’s the number for children:◦36,000 have been hospitalized .◦540 have died.

Other ways to protect yourselfCover your nose and mouth when you

cough or sneeze.

Wash your hands often with soap and water, especially after you cough or sneeze.

Alcohol-based hand cleaners are also effective.

Avoid touching your eyes, nose or mouth.

Try to avoid close contact with sick people.

Did you know?

Sneeze Cough

Droplets of whatever is in the nose and mouth come zipping out at about 100 miles an hour.

Coughs come out very fast and can propel germs and moisture up to about 30 feet when you cough.

Proper Etiquette for coughing & sneezingCover your mouth and nose with

a tissue when coughing or sneezing.

Put your used tissue in the waste basket.

Cover your cough or sneeze in your arm.

If you cough or sneeze on your hands, wash them!

Wash your hands!Viruses and bacteria can live 2

hours or longer on surfaces like cafeteria tables, doorknobs, and desks.

Frequent hand washing will reduce the chance of contamination from these common surfaces.

Best hand washing practicesGet your paper towel readyTurn on faucet, wet your hand and

lather well with soap.Rub your hands vigorously for at least

20 seconds. Remember to scrub all surfaces.

Rinse well.Dry your hands with a clean or

disposable towel.If possible, use your towel to turn off the

faucet.

When to wash your hands:

Before After

Preparing food Preparing food, especially raw meat or poultry

Eating Using the toilet/changing a diaper

Treating wounds or giving medicine

Blowing your nose, coughing or sneezing into your hands

Touching a sick or injured person

Touching a sick or injured person

Inserting or removing contact lenses

Treating wounds

Handling garbage or something that could be contaminated, such as a cleaning cloth or soiled shoes

One more Question: Can you get the Swine flu from eating pork?

Can you get the Swine flu from eating pork?No! Eating properly handled and

cooked pork and pork products is safe.

Cooking pork to an internal temperature of 160°F (72°C) kills the swine flu virus as it does other bacteria and viruses.

Enjoy your bacon!

Sourceshttp://www.cdc.gov/flu/weekly/http://www.nydailynews.com/lifes

tyle/health/2009/04/23/2009-04-23_should_we_be_concerned_about_swine_flu_two_new_cases_pop_up_in_california.html

http://www.menshealth.com/cda/article.do?site=MensHealth&channel=health&category=colds.flu&conitem=2111fdf3fed34210VgnVCM10000030281eac____

http://www.vaccineinfo.net/immunization/vaccine/influenza/flu_vaccine_facts.shtml

More sources!http://blogs.abcnews.com/theworl

dnewser/2009/11/98000-americans-have-been-hospitalized-because-of-swine-flu.html

http://www.cdc.gov/Flu/about/qa/fluvaccine.htm

http://news.xinhuanet.com/english/2009-11/26/content_12541662.htm