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Premium member Presentation Transcript Health Care Workers Safety Influenza Dr.T.V.Rao MD: Health Care Workers Safety Influenza Dr.T.V.Rao MD Dr.T.V.Rao MD 1Circulating Influenza Strains and Pandemics in The 20th Century: Circulating Influenza Strains and Pandemics in The 20 th Century 1920 1940 1960 1980 2000 H1N1 H2N2 H3N2 1918: “Spanish Flu” 1957: “Asian Flu” 1968: “Hong Kong Flu” 20-40 million deaths 1-4 million deaths 1-4 million deaths Dr.T.V.Rao MD 2What is Swine Flu?: What is Swine Flu? Swine flu (also called swine influenza ) is 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. The 2009 swine flu outbreak (began in April) in humans is due to a new strain of influenza A virus subtype H1N1 that derives in part from human influenza, avian influenza, and two separate strains of swine influenza. Dr.T.V.Rao MD 3CHALLENGES WE FACE: CHALLENGES WE FACE Recognition of disease Not to forget chikungunya & dengue, other viral infections Difficulty in Confirmation of disease Self protection Protection of people around us Notification To know more ; Are we facing the pandemic? Dr.T.V.Rao MD 4How does swine flu spread? : How does swine flu spread? Dr.T.V.Rao MD 5PowerPoint Presentation: Viral Re-assortment Reassortment in pigs Reassortment in humans Pandemic Influenza Virus Dr.T.V.Rao MD 6PIG THE CREATOR: PIG THE CREATOR Dr.T.V.Rao MD 7EPIDEMIOLOGY: EPIDEMIOLOGY Incubation period- 1-7 days Transmission PRIMARY CASE –direct contact with pigs SECONDARY CASES sneezing, coughing respiratory droplets body fluids(diarroeal stool) contact surfaces Dr.T.V.Rao MD 8Transmission : Transmission Dr.T.V.Rao MD 9Spread of Influenza Virus: Spread of Influenza Virus This virus is not transmitted from eating pork or pork products Contagiousness: 1 day onset of symptoms 7 days Children are contagious for longer periods. . Majority of patients were previously healthy. Clinical course mild in PCR negative influenza. Dr.T.V.Rao MD 10EARTH LIVING SPACE FOR ALL Including Influenza Virus: EARTH LIVING SPACE FOR ALL Including Influenza Virus Epidemic: An increase in disease above what is normally expected Pandemic: A worldwide epidemic A pandemic begins when: there is person-to-person sustained transmission on multiple continents Dr.T.V.Rao MD 11Proper Handling of Pig meat a Priority: Proper Handling of Pig meat a Priority Influenza viruses do not affect the safety of pork, according to the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO). As with any raw meat, pork should always be properly handled and cooked to eliminate a range of food safety concerns. Dr.T.V.Rao MD 12Signs and Symptoms: Signs and Symptoms Human Influenza Type of infection Upper and lower respiratory Fever Yes Headache Yes Cough Yes Respiratory symptoms Varies; sore throat to difficulty breathing Gastrointestinal symptoms Uncommon, except children, elderly Recovery 2-7 days Dr.T.V.Rao MD 13Swine flu – A Acute respiratory infection: Swine flu – A Acute respiratory infectio n Swine flu is an infection caused by a virus. It's named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. The virus is contagious and can spread from human to human. 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. Dr.T.V.Rao MD 14Swine flu spreads through Respiratory route: Swine flu spreads through Respiratory route The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. Dr.T.V.Rao MD 15Swine flu can begin with: Swine flu can begin with F ever with S udden symptoms of A ches C hills T iredness Dr.T.V.Rao MD 16May Preset with more severe Symptoms: May Preset with more severe Symptoms Fever (usually high) Headache Muscle aches Chills Extreme tiredness Dry cough Runny nose may also occur but is more common in children than adults Stomach symptoms, such as nausea, vomiting, and diarrhea, may also occur but are more common in children than adults Donot self Diagnose Visit a Health Centre Dr.T.V.Rao MD 17Collection of Specimens : Collection of Specimens Nasopharyngeal swab, nasal swab, throat swab, combined oropharyngeal/ nasopharyngeal swab, or nasal aspirate Swabs with a synthetic tip (eg, polyester or Dacron) and an aluminum or plastic shaft should be used. Swabs with cotton tips and wooden shafts are not recommended. The collection vial in which the swab is placed should contain 1 to 3 mL of viral transport media. Dr.T.V.Rao MD 18PowerPoint Presentation: Dr.T.V.Rao MD 19Collection and Transportation: Collection and Transportation Respiratory specimen should be collected within 4 to 5 days of illness or at the earliest Specimens should be placed in viral transport media and placed on ice (4ºC) or refrigerated immediately for transportation to the laboratory Dr.T.V.Rao MD 20Whom to test: Whom to test Testing for pandemic H1N1 influenza A should be considered in individuals with an acute febrile respiratory illness ( temperature of 100ºF or higher and recent onset of at least one of the following: rhinorrhea, nasal congestion, sore throat, or cough) or sepsis-like syndrome Dr.T.V.Rao MD 21Priority and Recommendations in Testing: Priority and Recommendations in Testing Priority for testing should be given to : Those who require hospitalization and Those who are at high risk for severe complications No testing if illness is mild or the person resides in an area with confirmed cases Recommended test for suspected cases is real-time reverse transcriptase (RT)-PCR for influenza A, B, H1, and H3 Dr.T.V.Rao MD 22Diagnosis: Diagnosis To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer . Identification as a swine flu influenza A virus Dr.T.V.Rao MD 23Rapid Diagnosis: Rapid Diagnosis RT PCR can make rapid Diagnosis Dr.T.V.Rao MD 24PowerPoint Presentation: Frequent hand washing Covering coughs and sneezes Avoidance of crowded settings when possible advising ill persons to stay home (except to seek medical care) and minimize contact with others in household voluntary home quarantine of members of households with confirmed or probable swine influenza cases General precautions: Dr.T.V.Rao MD 25Hand Washing: Hand Washing Method Wet hands with clean (not hot) water Apply soap Rub hands together for at least 20 seconds Rinse with clean water Dry with disposable towel or air dry Use towel to turn off faucet Dr.T.V.Rao MD 26 Alcohol-based Hand Rubs: Alcohol-based Hand Rubs Effective if hands not visibly soiled More costly than soap & water Method Apply appropriate (3ml) amount to palms Rub hands together, covering all surfaces until dry Dr.T.V.Rao MD 27PowerPoint Presentation: Isolation Precautions Dr.T.V.Rao MD 28PowerPoint Presentation: Dr.T.V.Rao MD 29Care for common materials used by Swine flu patients: Care for common materials used by Swine flu patients 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. Dr.T.V.Rao MD 30PowerPoint Presentation: Dr.T.V.Rao MD 31Antivirals- Oseltamivir: Antivirals- Oseltamivir Treatment is 75 mg twice a day for 5 days. Prophylaxis is 75 mg once a day for 7 days after last exposure. Prophylaxis: High risk exposure (household contacts) Moderate risk (unprotected very close exposure to sick animals; HCW with unprotected exposure to patients) Low risk exposure: no need for prophylaxis unless activation of exceptional measures. Dr.T.V.Rao MD 32PowerPoint Presentation: * household close contacts (of confirmed, probable, or suspected case) at high-risk for complications of influenza + chronic medical conditions + aged ≥ 65 years + aged ≤ 5 years + pregnant women * school children or children in daycare at high-risk for complications of influenza (certain chronic medical conditions) who had close contact (face-to-face) with confirmed, probable, or suspected case I ndications for antiviral chemoprophylaxis Dr.T.V.Rao MD 33PowerPoint Presentation: * Any healthcare worker at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) working in area with confirmed swine influenza A (H1N1) cases, or who is caring for patients with any acute febrile respiratory illness * Non-high risk travelers to Mexico, first responders, or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection I ndications for antiviral chemoprophylaxis Dr.T.V.Rao MD 34PowerPoint Presentation: Pre-exposure – T reat during exposure period and for 10 days after last known exposure to ill confirmed case of swine influenza A (H1N1) virus infection Post-exposure – T reat for 10 days after last known exposure to ill confirmed case of swine influenza A (H1N1) virus infection Chemoprophylaxis treatment Dr.T.V.Rao MD 35Use of Mask by Patients and Health care Workers: Use of Mask by Patients and Health care Workers The use of surgical or procedure masks by infectious patients may help contain their respiratory secretions and limit exposure to others. Likewise, when a patient is not wearing a mask, as when in an isolation room, having health-care personnel mask for close contact with the patient may prevent nose and mouth contact with respiratory droplets Dr.T.V.Rao MD 36Can the Mask Prevent the Spread of Flu ???: Can the Mask Prevent the Spread of Flu ??? However, no studies have definitively shown that mask use by either infectious patients or health-care personnel prevents influenza transmission Dr.T.V.Rao MD 37Prevention is best option: Prevention is best option Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. D Dr.T.V.Rao MD 38Using N95 mask reduces the Risk: Using N95 mask reduces the Risk You can cut your risk of contracting the flu or other respiratory viruses by as much as 80 percent by wearing a mask over your nose and mouth, according to a new study. Emerging Infectious Diseases , the journal of the Centres for Disease Control and Prevention (CDC) . Dr.T.V.Rao MD 39Mask can increase Personal Protection: Mask can increase Personal Protection Dr.T.V.Rao MD 40Why do we need vaccine: Why do we need vaccine COST EFFECTIVE TARGET AT RISK PEOPLE VACCINE WINTER SEASON TO COME(LOW HUMIDITY,TEMP) RAPID GLOBAL SPREAD SEASONAL VACCINE PROTECTION? Dr.T.V.Rao MD 41"flu shot”: " flu shot” The "flu shot " — an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions. Dr.T.V.Rao MD 42Nasal Vaccination: Nasal Vaccination The nasal-spray flu vaccine —a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for "live attenuated influenza vaccine" or FluMist®). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant. Dr.T.V.Rao MD 43How to Keep Away from Swine Flu? A,B,C,D of Prevention: How to Keep Away from Swine Flu? A,B,C,D of Prevention Wash your hands with soap or hand cleaners. Avoid touching your eyes, nose or mouth. Drink plenty of fluids and eat nutritious food. Cover your nose and mouth with a tissue. Try to stay in good general health. Get plenty of sleep to be physically active. Manage your stress. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick. Get treatment and/or prevention of the infection with antiviral drugs. Dr.T.V.Rao MD 44Dealing with the Deceased: Transport of deceased persons in a transport bag. Hand hygiene should be performed after completing transport. For deceased persons with confirmed, probable, or suspect novel influenza A (H1N1): limit contact with the body in health care settings to close family members Direct contact with the body is discouraged Necessary contact may occur as long as hands are washed immediately with soap and water. Dealing with the Deceased Dr.T.V.Rao MD 45Stop Spreading Virus Promote Prevention: Stop Spreading Virus Promote Prevention Dr.T.V.Rao MD 46Your Hand Washing Practices are best contribution to Hospital Safety: Your Hand Washing Practices are best contribution to Hospital Safety Dr.T.V.Rao MD 47PowerPoint Presentation: The Programme Created by Dr.T.V.Rao MD as Public Health Message on Prevention and Control of Swine Flu among the Health Care Workers Email email@example.com Dr.T.V.Rao MD 48 You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.