A Pandemic Is Declared
On June 11, 2009, the World Health Organization (WHO) raised the worldwide pandemic alert level to Phase 6
in response to the ongoing global spread of the novel influenza A
(H1N1) virus. A Phase 6 designation indicates that a global pandemic is
underway.
More than 70 countries are now reporting
cases of human infection with novel H1N1 flu. This number has been
increasing over the past few weeks, but many of the cases reportedly
had links to travel or were localized outbreaks without community
spread. The WHO designation of a pandemic alert Phase 6 reflects the
fact that there are now ongoing community level outbreaks in multiple
parts of world.
WHO’s decision to raise the
pandemic alert level to Phase 6 is a reflection of the spread of the
virus, not the severity of illness caused by the virus. It’s uncertain
at this time how serious or severe this novel H1N1 pandemic will be in
terms of how many people infected will develop serious complications or
die from novel H1N1 infection. Experience with this virus so far is
limited and influenza is unpredictable. However, because novel H1N1 is
a new virus, many people may have little or no immunity against it, and
illness may be more severe and widespread as a result. In addition,
currently there is no vaccine to protect against novel H1N1 virus.
In the United States, most people who have become ill with the
newly declared pandemic virus have recovered without requiring medical
treatment, however, CDC anticipates that there will be more cases, more
hospitalizations and more deaths associated with this pandemic in the
coming days and weeks. In addition, this virus could cause significant
illness with associated hospitalizations and deaths in the fall and
winter during the U.S. influenza season.
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.
The first novel H1N1 patient in the United States was confirmed by
laboratory testing at CDC on April 15, 2009. The second patient was
confirmed on April 17, 2009. It was quickly determined that the virus
was spreading from person-to-person. On April 22, CDC activated its
Emergency Operations Center to better coordinate the public health
response. On 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.
Since the
outbreak was first detected, an increasing number of U.S. states have
reported cases of novel H1N1 influenza with associated hospitalizations
and deaths. By June 3, 2009, all 50 states in the United States and the
District of Columbia and Puerto Rico were reporting cases of 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.
CDC is continuing to watch the situation carefully, to support the
public health response and to gather information about this virus and
its characteristics. The Southern Hemisphere is just beginning its
influenza season and the experience there may provide valuable clues
about what may occur in the Northern Hemisphere this fall and winter.
CDC Response
CDC continues to take
aggressive action to respond to the outbreak. CDC’s response goals are
to reduce the spread and severity of illness, and to provide
information to help health care providers, public health officials and
the public address the challenges posed by this new public health
threat.
CDC is issuing updated interim guidance in response to the rapidly evolving situation.
Clinician Guidance
CDC has issued interim guidance for clinicians on identifying and caring for patients with novel H1N1, in addition to providing interim guidance on the use of antiviral drugs.
Influenza antiviral drugs are prescription medicines (pills, liquid or
an inhaled powder) with activity against influenza viruses, including
novel influenza H1N1 viruses. The priority use for influenza antiviral
drugs during this outbreak is to treat people hospitalized with
influenza illness, and to treat people at increased risk of severe
illness, including pregnant women, young children, and people with
chronic health conditions like asthma, diabetes and other metabolic
diseases, heart or lung disease, kidney disease, weakened immune
systems, and persons with neurologic or neuromuscular disease.
Public Guidance
CDC has provided guidance for the public on what to do if they become sick with flu-like symptoms, including infection with novel H1N1. CDC also has issued instructions on taking care of a sick person at home and the use of facemasks and respirators to reduce novel influenza A (H1n1) transmission.
Everyone should take everyday preventive actions to stop the spread of
germs, including frequent hand washing and people who are sick should
stay home and avoid contact with others in order to limit further
spread of the disease.
Testing
CDC has developed
a PCR diagnostic test kit to detect this novel H1N1 virus and has now
distributed test kits to all states in the U.S. and the District of
Columbia and Puerto Rico. The test kits are being shipped
internationally as well. This will allow states and other countries to
test for this new virus.
Vaccine
Vaccines are a
very important part of a response to pandemic influenza and the U.S.
Government is aggressively taking early steps in the process to
manufacture a novel H1N1 vaccine, working closely with manufacturers.
CDC has isolated the new H1N1 virus, made a candidate vaccine virus
that can be used to create vaccine, and has provided this virus to
industry so they can begin scaling up for production of a vaccine, if
necessary. Making vaccine is a long multi-step process requiring
several months to complete.
Stockpile Deployment
CDC has deployed 25 percent of the supplies in the Strategic National
Stockpile (SNS) to all states in the continental United States and U.S.
territories. This included antiviral drugs, personal protective
equipment, and respiratory protection devices. The influenza A (H1N1)
virus is susceptible to the prescription antiviral drugs oseltamivir
and zanamivir. These supplies and medicines will help states and U.S.
territories respond to novel H1N1 virus.
Surveillance
Novel influenza A (H1N1) activity is now being detected through CDC’s routine influenza surveillance systems
and reported weekly in FluView. CDC tracks U.S. influenza activity
through multiple systems across five categories. While our influenza
surveillance systems indicate that overall influenza activity is
decreasing in the United States, novel H1N1 outbreaks are ongoing in
different parts of the U.S., in some cases with intense influenza-like
activity. Most of the influenza viruses being detected now are novel
H1N1 viruses.
Shared Responsibility
Individuals have an important role in protecting themselves and their families.
- Stay informed. Health officials will provide additional information as it becomes available.
- Everyone should take these everyday steps to protect your health and lessen the spread of this new virus:
- 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 cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread this way.
- Try to avoid close contact with sick people.
- 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. This is to keep from infecting others and
spreading the virus further.
- Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
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On
Saturday, April 25th, Gov. Rick Perry bolstered the state’s
precautionary measures to address the swine flu threat as a result of
confirmed cases in certain parts of the state by issuing a disaster
declaration for the entire state of Texas. The disaster declaration
allows the state to implement emergency protective measures and seek
reimbursement under the federal Stafford Act for protective measures
associated with the state’s response to this public health threat.
The
governor was joined by Department of State Health Services Commissioner
Dr. David Lakey and Texas Education Commissioner Robert Scott at a
press conference to discuss the state’s response to this threat. The
state of Texas continues to closely coordinate with local and federal
health officials and emergency management partners by monitoring and
responding to this changing threat.
Gov. Perry also announced that
the Centers for Disease Control and Prevention (CDC) has approved his
increased request for 25 percent (850,000 courses) of the Texas
allotment of antiviral medication from the CDCs Strategic National
Stockpile to be prepositioned in the state. This request augments more
than 840,000 courses of antiviral medication on hand in Texas following
a purchase authorized by Gov. Perry and the 80th Legislature in 2007.
CDC's
Strategic National Stockpile (SNS) has large quantities of medicine and
medical supplies to protect the American public if there is a public
health emergency (terrorist attack, flu outbreak, earthquake). For more
information on the SNS, visit www.bt.cdc.gov/stockpile.
The Texas
Department of State Health Services recommends the following people see
their physician for evaluation and testing for the folowing reasons.
1. Fever greater than 100 degrees F with influenza-like illness (cough, nasal congestion, sorethroat, headache, body aches)
2. History of recent travel to Mexico in the last 7 to 10 days, or contact with a person who has been diagnosed with Influenza.
“We
have testing available in the clinics here in Spearman,” stated Dr.
Mark Garnett. “In addition, we also have medicine on hand to treat any
persons with the swine flu or people who have been exposed to the swine
flu.
“We also recommend good hygenic practices such as washing your
hands frequently, not sharing cups or utensils, covering your mouth
when you cough or sneeze, and avoiding crowds if you are feeling ill,”
continued Dr. Garnett
For additional information on the swine flu, please visit:
http://www.dshs.state.tx.us/news/releases/swine_flu.shtm
http://www.cdc.gov/swineflu/
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Swine Influenza and You
What is swine flu? Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people.
Are there human infections with swine flu in the U.S.?
In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were first reported in Southern California and near San Antonio, Texas. Other U.S. states have reported cases of swine flu infection in humans and cases have been reported internationally as well. An updated case count of confirmed swine flu infections in the United States is kept at http://www.cdc.gov/swineflu/investigation.htm CDC and local and state health agencies are working together to investigate this situation.
Is this swine flu virus contagious? CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.
What are the signs and symptoms of swine flu in people? The symptoms of swine flu in people are similar to the symptoms of regular human flu and include 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.
How does swine flu spread? Spread of this swine 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 of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
How can someone with the flu infect someone else? Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.
What should I do to keep from getting the flu? First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.
Are there medicines to treat swine flu? Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).
How long can an infected person spread swine flu to others? People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.
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 and then touches their own eyes, mouth or nose before washing their hands.
How long can viruses live outside the body? We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent handwashing will help you reduce the chance of getting contamination from these common surfaces.
What can I do to protect myself from getting sick? There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:
* 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 cleaners are also effective.
* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
What is the best way to keep from spreading the virus through coughing or sneezing? If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.
What is the best way to keep from spreading the virus through coughing or sneezing? If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.
What is the best technique for washing my hands to avoid getting the flu? Washing your hands often will help protect you from germs. Wash with soap and water. or clean with alcohol-based hand cleaner. we recommend that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.
What should I do if I get sick? If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.
If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.
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 skin color
* Not drinking enough fluids
* 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
* Fever with a rash
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
How serious is swine flu infection? Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.
Can I get swine influenza from eating or preparing pork? No. Swine influenza viruses are not spread by food. You cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.
The Texas Department of State Health Services recommends the following people see their physician for evaluation and testing for the folowing reasons.
1. Fever greater than 100 degrees F with influenza-like illness (cough, nasal congestion, sorethroat, headache, body aches)
2. History of recent travel to Mexico in the last 7 to 10 days, or contact with a person who has been diagnosed with Influenza.
“We have testing available in the clinics here in Spearman,” stated Dr. Mark Garnett. “In addition, we also have medicine on hand to treat any persons with the swine flu or people who have been exposed to the swine flu.
“We also recommend good hygenic practices such as washing your hands frequently, not sharing cups or utensils, covering your mouth when you cough or sneeze, and avoiding crowds if you are feeling ill,” continued Dr. Garnett
For additional information on the swine flu, please visit:
http://www.dshs.state.tx.us/news/releases/swine_flu.shtm
http://www.cdc.gov/swineflu/
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