H1N1 in FloridaH1N1 in FloridaResearch Project: Research Project: Application of Application of EpidemiologyEpidemiology

Executive Summary of Executive Summary of H1N1 surveillance in H1N1 surveillance in FloridaFlorida H1N1 flu is a viral infection H1N1 flu is a viral infection

associated with the inflammation associated with the inflammation of the respiratory systemof the respiratory system

In Florida the H1N1 virus is less In Florida the H1N1 virus is less severe in elderly than the youngsevere in elderly than the young

H1N1 is severe on people suffering H1N1 is severe on people suffering from asthma and other respiratory from asthma and other respiratory diseasesdiseases

H1N1 Controlled through H1N1 Controlled through Vaccination, Isolation and high Vaccination, Isolation and high hygienehygiene

Historical Historical Development of H1N1Development of H1N1 The H1N1 virus was initially The H1N1 virus was initially

referred to as swine flu after its referred to as swine flu after its genes were found to resemble the genes were found to resemble the ones for the virus that is usually ones for the virus that is usually found in swine found in swine

Being a subtype of type A virus, Being a subtype of type A virus, the H1N1 virus is related to swine the H1N1 virus is related to swine influenza and ‘Spanish influenza’ influenza and ‘Spanish influenza’

H1N1 virus differs from the famous H1N1 virus differs from the famous ‘Spanish flu’ for its being less ‘Spanish flu’ for its being less dangerous dangerous

The source of H1N1 FluThe source of H1N1 Flu H1N1 virus was first diagnosed in H1N1 virus was first diagnosed in

Mexico in the year 2009, near a USA pig Mexico in the year 2009, near a USA pig factory factory

The first diagnosed victim for H1N1 The first diagnosed victim for H1N1 virus was a five year boy called Edgar virus was a five year boy called Edgar

The H1N1 virus spread very fast to the The H1N1 virus spread very fast to the entire Northern American region entire Northern American region including Florida within a period of less including Florida within a period of less than a monththan a month

No precise source of H1N1 has been No precise source of H1N1 has been established up now but researchers established up now but researchers postulate its eruption from swine flu postulate its eruption from swine flu virusvirus

Human Behaviors Human Behaviors Implicated in H1N1 Implicated in H1N1 EtiologyEtiology The etiology of H1N1 virus in human The etiology of H1N1 virus in human

beings is associated with previously beings is associated with previously diagnosed respiratory disease diagnosed respiratory disease

The availability of previous infections The availability of previous infections like Diabetes, heart diseases and like Diabetes, heart diseases and asthma in the H1N1 victim constitute asthma in the H1N1 victim constitute to the severity of the H1N1 fluto the severity of the H1N1 flu

The age of have been revealed to be The age of have been revealed to be one of the main factors determining one of the main factors determining the contraction of the H1N1 virus the contraction of the H1N1 virus

The Mode of The Mode of Transmission of H1N1 Transmission of H1N1 VirusVirus H1N1 Transmitted mainly through H1N1 Transmitted mainly through

direct contact to an infected persondirect contact to an infected person More so, H1N1 is highly contagious More so, H1N1 is highly contagious

through the medium of airthrough the medium of air Contacting contaminated objects is Contacting contaminated objects is

also a medium through which H1N1 also a medium through which H1N1 is transmitted is transmitted

The period of Exposure The period of Exposure of the H1N1 fluof the H1N1 flu The Incubation period of H1N1 is 5 to 7 The Incubation period of H1N1 is 5 to 7

days after infectiondays after infection In most cases witnessed in Florida, the In most cases witnessed in Florida, the

victims of the H1N1 virus could usually victims of the H1N1 virus could usually take 3 to 7 days before fully showing the take 3 to 7 days before fully showing the signs of being ill signs of being ill

Generally, re-infection of H1N1 flu has Generally, re-infection of H1N1 flu has been a common happening in many cases been a common happening in many cases where the virus is not treated where the virus is not treated immediately immediately

Characteristics Characteristics Underlying the Infection Underlying the Infection of H1N1 fluof H1N1 flu The spread of the H1N1 was accelerated The spread of the H1N1 was accelerated

by the frequent interaction of citizens by the frequent interaction of citizens from these North American countries from these North American countries

Considering the initial case of the Considering the initial case of the disease, a five year old boy, his disease, a five year old boy, his interaction with his schoolmates before interaction with his schoolmates before showing signs of being ill enhanced the showing signs of being ill enhanced the spread of the flu to a great extent spread of the flu to a great extent

More so, the long incubation period of More so, the long incubation period of the disease enhanced its fast spreadthe disease enhanced its fast spread

Factors Accelerating Factors Accelerating the Transmission of the Transmission of H1N1 flu H1N1 flu H1N1 virus is most transmitted under H1N1 virus is most transmitted under

temperate climatic conditions, temperate climatic conditions, especially in summer-time especially in summer-time

Situations where individuals are closed Situations where individuals are closed in communities encourage the spread in communities encourage the spread of the virus greatlyof the virus greatly

H1N1 virus’ large outbreaks are more H1N1 virus’ large outbreaks are more stimulated by warm air, which is stimulated by warm air, which is scientifically believed to be more scientifically believed to be more mobile than cold air mobile than cold air

Causality effects Causality effects underlying the spread of underlying the spread of H1N1H1N1 There is sufficient evidence to There is sufficient evidence to

explain the outbreak of H1N1 in explain the outbreak of H1N1 in terms of its cause-effect relationships terms of its cause-effect relationships

In Florida today, 95% of flu cases In Florida today, 95% of flu cases reported in hospitals have been reported in hospitals have been found to be caused by the H1N1 found to be caused by the H1N1 virus virus

Generally, H1N1 flu causality is much Generally, H1N1 flu causality is much embedded on the respiratory system embedded on the respiratory system conditions of an individual conditions of an individual

Characteristics of Characteristics of H1N1 flu SurveillanceH1N1 flu Surveillance The early surveillance of H1N1 virus varies The early surveillance of H1N1 virus varies

in magnitude from one individual to in magnitude from one individual to another on the basis of age and pre-another on the basis of age and pre-liquisite allegation of respiratory infections liquisite allegation of respiratory infections

Seasonal outbreaks of the virus are Seasonal outbreaks of the virus are associated with changes in climatic associated with changes in climatic conditions resulting into the spread of the conditions resulting into the spread of the virus virus

Typical influenza is much associated with Typical influenza is much associated with the rate of Hospitalization; where the rate of Hospitalization; where individuals who are frequently hospitalized individuals who are frequently hospitalized are more prone to the H1N1 virus infection are more prone to the H1N1 virus infection

Investigative Health Investigative Health Protocol on H1N1 by Protocol on H1N1 by CDC CDC The CDC has been ceaselessly involved in The CDC has been ceaselessly involved in

carrying out researches on the H1N1 virus carrying out researches on the H1N1 virus to establish its ultimate effects on the to establish its ultimate effects on the basis of its already known viruses of type basis of its already known viruses of type A A

Certainly, it has been revealed that, Certainly, it has been revealed that, various antiviral treatments have been various antiviral treatments have been established in the pursuit of preventing established in the pursuit of preventing and treating the H1N1 flu and treating the H1N1 flu

The main sources of treatments for the flu The main sources of treatments for the flu have been suggested to be in hospitals have been suggested to be in hospitals and recommended health centers and recommended health centers

Statistical Comparison Statistical Comparison between H1N1 outbreak between H1N1 outbreak in Mexico and Florida in Mexico and Florida

Age in Age in years years

Florida Florida Mexico Mexico

TotalTotal HospitalizeHospitalizedd

TotalTotal HospitalizeHospitalizedd

<2<2 7979 1717 115115 2626

3-663-66 457457 5151 897897 8787

>67>67 99 00 10231023 9797

TotalTotal 555555 6666 21452145 200200

Epidemic curve of the Epidemic curve of the H1N1 cases found in H1N1 cases found in FloridaFlorida

Prevention and Control Prevention and Control Measures for H1N1 fluMeasures for H1N1 flu Primarily H1N1 controlled through Primarily H1N1 controlled through

vaccination with the recommended vaccination with the recommended H1N1 vaccines H1N1 vaccines

Secondary control measures include Secondary control measures include isolating infected people and using isolating infected people and using sterilized gloves while handling H1N1 sterilized gloves while handling H1N1 patientspatients

In addition Hygienic conditions and In addition Hygienic conditions and treatment of water should be consideredtreatment of water should be considered

Legislative measures to Legislative measures to control H1N1 flu in control H1N1 flu in FloridaFlorida Compulsory vaccination for all Compulsory vaccination for all

children below fifteen years was children below fifteen years was one of the measure was found to one of the measure was found to be an effective measure against be an effective measure against H1N1 fluH1N1 flu

More so, all health attendants More so, all health attendants were required to separate victims were required to separate victims of H1N1 from the other victims of H1N1 from the other victims

Implications of H1N1 Implications of H1N1 Outbreak AnalysisOutbreak Analysis Two Levels of Analysis:Two Levels of Analysis: Organizational RestructuringOrganizational Restructuring

health care organizations are advised to take health care organizations are advised to take into considerations various factors in their into considerations various factors in their dealing with the disease based on proper fund dealing with the disease based on proper fund allocationallocation

Introduction of new Scientific Research Introduction of new Scientific Research CentersCenters

Resource utilizations should also be Resource utilizations should also be reviewed in the pursuit of enhancing the reviewed in the pursuit of enhancing the prevention and control of the deadly virus prevention and control of the deadly virus

Epidemiological Designs Epidemiological Designs used in the Surveillance used in the Surveillance of H1N1of H1N1 The main research designs used in The main research designs used in

this surveillance are quantitative this surveillance are quantitative and qualitative research designs and qualitative research designs

Qualitative research methods were Qualitative research methods were first used in the initial stages of the first used in the initial stages of the study, and then later-on study, and then later-on quantitative methods followed. By quantitative methods followed. By so doing, a highly credible so doing, a highly credible information was acquired.information was acquired.

Future Directions for Future Directions for Research on H1N1 fluResearch on H1N1 flu it would be more advisable to use more it would be more advisable to use more

detailed study methods like descriptive detailed study methods like descriptive researches and naturalistic observation. researches and naturalistic observation.

Through the use of deceptive researches Through the use of deceptive researches and naturalistic observation more data and naturalistic observation more data would be made available and as a result, would be made available and as a result, more reliable and precise more reliable and precise recommendations would be enhanced. recommendations would be enhanced.

Reference listReference list

Center for Disease Control CDC (2009). Center for Disease Control CDC (2009). Outbreak of Outbreak of Swine- Swine-

Origin Influenza A (H1N1) Virus Infection in Origin Influenza A (H1N1) Virus Infection in Florida.Florida.

Retrieved on Nov 4, 2010 from Retrieved on Nov 4, 2010 from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817a5.htma5.htm

Espanol, K. (2010). Espanol, K. (2010). H1N1 flu Outbreak in Florida.H1N1 flu Outbreak in Florida. Retrieved onRetrieved on

Nov 4, 2010 from Nov 4, 2010 from ttp://www.doh.state.fl.us/demo/php/H1N1_Swine_Flu_frttp://www.doh.state.fl.us/demo/php/H1N1_Swine_Flu_frequentequently_asked_questions.htmlly_asked_questions.html

Nadia, N. (2009). Nadia, N. (2009). April 2009: an Outbreak of Swine-April 2009: an Outbreak of Swine-Origin Origin

Influenza A(H1N1) Virus with Evidence for Influenza A(H1N1) Virus with Evidence for Human to Human to

human Transmission.human Transmission. Retrieved on Nov 4, 2010 Retrieved on Nov 4, 2010 from from http://download.thelancet.com/flatcontentassets/H1N1-fhttp://download.thelancet.com/flatcontentassets/H1N1-flu/epidemiology/epidemiology-70.pdflu/epidemiology/epidemiology-70.pdf