Influenza PreventionInfluenza Prevention

We anticipate that there will be We anticipate that there will be two types of influenzatwo types of influenza illness and two different types of influenza vaccine this illness and two different types of influenza vaccine this yearyear

• Seasonal influenzaSeasonal influenza – the usual flu that causes illness in – the usual flu that causes illness in fall and winter every year fall and winter every year

• H1N1 InfluenzaH1N1 Influenza – a novel flu virus that began causing – a novel flu virus that began causing illness for the first time in April 2009illness for the first time in April 2009

Do you plan to or have you already received Do you plan to or have you already received seasonal seasonal flu vaccine flu vaccine this year ? this year ?

NOYESYES

• The following presentation will take The following presentation will take approximately 5 minutes to viewapproximately 5 minutes to view

• You will be asked to answer a You will be asked to answer a question at the end of the question at the end of the presentationpresentation

Seasonal Influenza Basics and Mode Seasonal Influenza Basics and Mode of Spreadof Spread

• Influenza is a viral infection

• Symptoms include: abrupt onset of fever, body aches, tiredness, cough and sore throat.

• Influenza is Influenza is easily spreadeasily spread from person to person by from person to person by coughing or sneezing coughing or sneezing

• People with influenza can spread it to others starting People with influenza can spread it to others starting 1 day before1 day before and up to 5-7 days after and up to 5-7 days after they feel sickthey feel sick

You can spread influenza to others even if you don’t You can spread influenza to others even if you don’t feel sick yourselffeel sick yourself

Burden of InfluenzaBurden of Influenza

In an average year in the US, seasonal In an average year in the US, seasonal influenza results ininfluenza results in

• 30 million people getting sick30 million people getting sick

• 11 million out patient visits11 million out patient visits

• 200,000 hospital admissions200,000 hospital admissions

• 36,000 deaths36,000 deaths

Importance of Seasonal Flu Vaccine Importance of Seasonal Flu Vaccine for Healthcare workersfor Healthcare workers

• Because you work in health care, you are twice as likely to get influenza compared to the general population

• If you get influenza you can spread it to your patients, family and co-workers

The single best way to prevent influenza is to The single best way to prevent influenza is to get the flu vaccine each yearget the flu vaccine each year

Effectiveness of VaccineEffectiveness of Vaccine

• How well the flu vaccine works each year depends on a) the match between the vaccine strains and circulating strains and b) the age and health status of the person getting the vaccine

• The vaccine works best in young, healthy adults where it is 70-90% effective in preventing influenza. In those who get influenza despite vaccine, the illness is usually less severe.

• The vaccine is less effective in older people and those with health problems. Thus it is doubly important that people around them (family members and healthcare workers) get the flu vaccine

Age Status Vaccine effectiveness*

6mo-

64 yrs

Healthy 70-90% against infection

>65 yrs Community dwelling

30-70% against hospitalization

>65 yrs Nursing home or long term care

30-40% against infection

50-60% against hospitalization

80% against death

**When vaccine well matched to circulating When vaccine well matched to circulating Influenza virus strains Influenza virus strains

Flu vaccine side-effectsFlu vaccine side-effects

Two types of seasonal flu vaccine will be available at Mayo Two types of seasonal flu vaccine will be available at Mayo

Flu shot:Flu shot: • An inactivated vaccine given as an An inactivated vaccine given as an injectioninjection • Side-effects include: Soreness at the vaccine site and Side-effects include: Soreness at the vaccine site and

muscle painmuscle pain

FluMist:FluMist: • A live vaccine given as a A live vaccine given as a nasal spray. You cannot receive . You cannot receive

FluMist if you are 50 years or older, have chronic health FluMist if you are 50 years or older, have chronic health problems or if you are pregnantproblems or if you are pregnant

• Side-effects include: Cough, runny nose, headacheSide-effects include: Cough, runny nose, headache

Side-effects with both types of vaccine are mild Side-effects with both types of vaccine are mild and generally last less than 48 hoursand generally last less than 48 hours

TOP REASONS why you should get the flu vaccine

You are at higher risk of influenza because you work in healthcare

If you get influenza you can spread it to patients and others even though you may not feel sick

The flu vaccine is safe and effective and free

By getting the flu vaccine you protect your patients, family, co-workers and community

Protect our patients, protect yourself !

After viewing this presentation,After viewing this presentation, if you stillif you still DO NOT DO NOT plan plan to get the to get the SEASONAL FLUSEASONAL FLU vaccine, please let us know vaccine, please let us know

why. Pick the choice that best explains your reasonwhy. Pick the choice that best explains your reason

I don’t think I need the vaccineI don’t think I need the vaccine

The flu vaccine makes me sickThe flu vaccine makes me sick

The flu vaccine doesn’t really work The flu vaccine doesn’t really work

The vaccine side effects are worse than the flu The vaccine side effects are worse than the flu

I don’t think employee flu vaccination protects patientsI don’t think employee flu vaccination protects patients

I am allergic to the vaccine. Consider Allergy Clinic consultI am allergic to the vaccine. Consider Allergy Clinic consult

All answers are CONFIDENTIALAll answers are CONFIDENTIALIndividual responses will not be shared, only aggregate data will Individual responses will not be shared, only aggregate data will be analyzed to find ways to improve the employee flu be analyzed to find ways to improve the employee flu vaccination program vaccination program

Other Influenza Prevention MeasuresOther Influenza Prevention Measures

Cover your mouth and nose while coughing or sneezing and encourage others to do the same.

Make sure the Respiratory Etiquette Signs are displayed in outpatient areas

Use a droplet mask when you evaluate patients with a fever/ new cough

Perform hand hygiene using soap and water or alcohol hand rub

Place hospital patients with fever and new cough in Droplet Plus isolation, comply with the instructions on the Isolation door cards

If you think you have Influenza….

Do not come in to work if you have fever and new cough.

If you are diagnosed with seasonal influenza, you must stay home until fever resolves

Talk to your primary provider, about antivirals. Antivirals may be useful if started soon after you develop symptoms. This is especially important you have heart or lung problems or are immunosuppressed

Remember the flu vaccine is not 100% effective. So you can still get the flu even if you have had the flu vaccine.

H1N1 Influenza H1N1 Influenza

• H1N1 flu virus is a novel flu virus that began causing H1N1 flu virus is a novel flu virus that began causing flu-like illness in April of 2009flu-like illness in April of 2009

• Over 7000 cases and 500 deaths due to H1N1 have been Over 7000 cases and 500 deaths due to H1N1 have been reported in the US as of August 2009reported in the US as of August 2009

• Increased numbers of H1N1 infection are predicted this Increased numbers of H1N1 infection are predicted this fallfall

• H1N1 illness is similar to seasonal flu – main symptoms H1N1 illness is similar to seasonal flu – main symptoms are fever, muscle aches, cough, sore throatare fever, muscle aches, cough, sore throat

• Unlike seasonal influenza, the majority of cases of Unlike seasonal influenza, the majority of cases of H1N1 have occurred in H1N1 have occurred in younger peopleyounger people, especially , especially those between the age of 5 and 24 years those between the age of 5 and 24 years

H1N1 VaccineH1N1 Vaccine

• The The seasonal flu vaccine will not protect against H1N1

• An H1N1 vaccine will be available later this year

• Groups with highest priority for H1N1 vaccination include: Groups with highest priority for H1N1 vaccination include:

• Pregnant women Pregnant women • People who care for children younger than 6 months People who care for children younger than 6 months • Health care workers who have direct patient contact Health care workers who have direct patient contact • Children 6 months - 4 yearsChildren 6 months - 4 years• Children 5 -18 years with chronic medical conditionsChildren 5 -18 years with chronic medical conditions

• It is likely that 2 doses of H1N1 vaccine separated by 3 It is likely that 2 doses of H1N1 vaccine separated by 3 weeks will be neededweeks will be needed. .

Other measures to prevent H1N1 Other measures to prevent H1N1

• H1N1 is spread in the same ways as seasonal H1N1 is spread in the same ways as seasonal influenzainfluenza

• Hand hygieneHand hygiene, , respiratory etiquetterespiratory etiquette and and appropriate appropriate isolationisolation prevent spread of both seasonal and H1N1 prevent spread of both seasonal and H1N1 influenzainfluenza

• Stay homeStay home if you have fever and new cough. if you have fever and new cough.

• If you are diagnosed with H1N1 infection you must If you are diagnosed with H1N1 infection you must stay home for stay home for 7 days from onset of symptoms7 days from onset of symptoms or until or until fever resolves – whichever is longerfever resolves – whichever is longer

• H1N1 information changes rapidly. H1N1 information changes rapidly.

• AOEC thanks William Buchta, MD of AOEC thanks William Buchta, MD of the Mayo Clinic System for donating the Mayo Clinic System for donating this set of slides. August 2009this set of slides. August 2009