H1,N1 - Swine Flu Information

In the spring of 2009, the nation saw a flu surge that was clearly off of the regular flu timeline.  This flu virus turned out to be a novel, or new, strain of virus. Although this flu virus seems to be highly contagious, it is so far, a mild flu.  This flu is, however, changing on a daily basis and is being closely tracked by the CDC (Center for Disease Control) and our local King County Health Department.  The Seattle School District Health Services Department takes direct guidance from these two organizations. The following information is from the week of 9/1/09.  The seasonal flu usually affects older adults, but the H1, N1 virus seems to be targeting people in the 6 months-49 year range.  
How does the H1, N1 virus spread?
H1, N1 is spread in ways similar to other flu viruses—by large-particle respiratory droplets that are airborne (particles stay suspended in the air).  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—such as a surface or object—with flu viruses on it and then touching their mouth and nose.  Droplets of this virus seem to live 2-8 hours on surfaces.
Incubation:     The incubation period of the H1, N1 virus is 1-7 days.  This means a person is potentially infectious one day before symptoms to 7 days following onset of illness. 
Symptoms:      Fever, cough, body aches, headache, fatigue, sore throat, runny nose, upset stomach
Take these steps every day 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 cleansers are also effective.
• Avoid touching your eyes, nose or mouth. Germs are spread this way.
• The CDC recommends that people with flu-like illness remain at home at least 24 hours after they are free of fever without use of a fever-reducing medication.

Plan for managing influenza-like illness at school:

• Be prepared. Make your plans NOW for childcare in case of illness. Do not send your child to school sick.
• Children who are presenting with flu-like symptoms during the school day may be isolated from others to reduce the spread of germs.  Parents will be called to pick up their child as soon as possible. Facemasks may be used on students as a barrier while awaiting pick up from parents.  Masks may also be worn by the caregivers in the school office.  

• The decisions to close our school building will depend on the course of the flu (if it becomes a more severe type of flu) OR if we reach large numbers of both student and staff absences. This decision would be made with the guidance from our local health department and the school district.
• If your child is absent, please notify the attendance office. It also would be very helpful in the tracking of this virus to let the attendance/front office/nurse know if your child has flu-like symptoms.

Do not send your child to school if you think they are ill—students need to be well enough to fully participate in the activities of the day. Do not send your child to school so WE can assess their symptoms.  We want to keep sick children at home and well children at school.

We anticipate that we will experience this virus in our community very soon.  We all need to use common sense. Panic and anxiety can be contagious, too.  Be calm and remember that the CDC is finding this to be a fairly mild flu. Be prepared and have a plan for anticipated illnesses. Be responsible and again, stay home if you are ill.  
What should I do if I get sick?
Stay home and away from others.  Staying at home means that you should not leave your home except to seek medical care.  This means avoiding normal activities, including work, school, travel, shopping, social events, and public gatherings.  If you have severe illness or you are at a high risk for flu complications, contact your health care provider or seek medical care.  
If you become ill and experience any of the following warnings signs, seek emergency medical care:
In children, emergency warning signs that need urgent medical attention include:
Fast breathing or trouble breathing Severe vomiting
Bluish or gray skin                                               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
In adults, emergency warning signs that need urgent medical attention include:
Difficulty breathing or shortness of breath Confusion
Pain or pressure in the chest or abdomen          Sudden dizziness
Severe or persistent vomiting
Flu-like symptoms improve but then return with fever or worse cough
Vaccine Information:
Because this is a “novel” or new virus, it takes two shots to reach immunity.  The first shot “primes” the system, and the second shot two weeks later is the one which locks in your protection.
There are five manufacturers working on 45 million doses by mid-October with 20 million doses every week after.  
The health department is recommending the following:

• Get your seasonal flu vaccination shot NOW. There is no problem with immunity if given early—once you are immune, you are immune.  
• Get your H1, N1 vaccine shot as soon as it is available
• Stay home if you are sick

Who should get the vaccine?
First Priority Groups
Pregnant women
People who live with or care for children age  ≤6 months
Health care and emergency services personnel with direct patient contact
Children ages 6 months through 4 years
Children ages 5-18 years who have chronic medical conditions
Target Groups
All pregnant women
People who live with and are for children ≤6 months 
Healthcare and emergency services personnel
All people age 6 months through 24 years
Persons 25-64 years with chronic medical conditions
Use of Facemasks:
Facemasks (surgical masks) may prevent the wearer from coughing on others, and may protect the nose and mouth of the wearer from contact with other people’s coughs.  They do not offer complete protection because they do not fit tightly enough to the face, allowing very small air particles to leak in around the edge of the mask.  
Public health does not recommend the use of masks except for the following people:  Sick people if they must be near others and caregivers of people ill with influenza
When using facemasks
Change masks when they become moist
Do not let masks dangle around the neck
Throw away used masks
After touching or throwing away a used mask, wash hands or use hand sanitizer
Remember that the inexpensive “painter-type” masks are ineffective against these types of viruses. The particles go right through the permeable material.

Julie Kaloper, RN BSN  School Nurse
Salmon Bay School Mon am and all day Tuesdays and Wednesdays 252-1727
Loyal Heights School Mon pm and all day Thursdays 252-1507
jkaloper@seattleschools.org

More Information:
Office of Public Instruction: School Planning efforts and current information on dismissals—http://www.k12.wa.us/HealthServices/H1N1Flu.aspx

Washington State Department of Health:  Health Information about H1, N1 including current information, more on symptoms, and other resources in English and other languages—http://doh.wa.gov/swine flu/

Local Public Health: To find information from your local public health agency — hhtp://www.doh.wa.gov/LHJMap?LHJMap.htm