Report on Pandemic Influenza

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    CHAPTER ONE

    INTRODUCTION

    1.1 Background of the study

    It is hard to avoid hearing about influenza virus these days. The new influenza virus (H1N1) was

    first detected in people in the Mexico in April 2009. This virus is spread from person-to-person,

    transmitted by inhalation of infectious droplets and droplet nuclei, by direct contact, and

    perhaps, by indirect contact, probably in much the same way that regular seasonal influenza

    virus spread. As like all influenza viruses, swine flu viruses change constantly. Seasonal flu,

    severe illnesses and death has occurred as a result of illness associated with this virus. The

    new spread of this virus has lead to 66 deaths in Malaysia (updated on 18 August 2009) and

    many people being contact with the influenza either directly or indirectly. There is no vaccine

    available right now to protect against novel H1N1 virus. There are everyday actions that canhelp prevent the spread of germs that cause respiratory illnesses like influenza. Thus, it is

    important to discover the level of awareness especially among UMP students. As observed, we

    can identify that different students in UMP might have different perceptions or attitude towards

    prevention and protection strategy of influenza. For example, keep ourselves away from the

    crowded areas; wear suitable personal protective equipment such as masks or glove when

    necessary. Thus, a case study such as this may help create deeper awareness on the effects of

    pandemic influenza.

    1.2 Problem statement

    The spread of influenza is increasing rapidly and vaccines are not found easily, a measure to

    protect mankind from getting this flu is important. Not many are aware on how to react if they

    are faced with such a situation, thus awareness is a must.

    1.3 Research objectives

    1.3.1 To investigate the level of awareness on pandemic influenza.

    1.3.2 To find out influenza self-prevention strategy among students.

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    1.4 Research Question

    1.4.1 Do UMP students know what pandemic influenza is?

    1.4.2 Are they aware pandemic influenza?

    1.4.3 Do UMP students practice positive attitude towards pandemic influenza?

    1.4.4 Do UMP students work towards practicing self-prevention from the spread of influenza?

    1.5 Definition of the terms

    1.5.1Awareness

    Awareness is the state of elementary or undifferentiated consciousness among the students. It

    is an alert cognitive state in which the students are aware of themselves and their situation.

    1.5.2Pandemic

    Pandemicis a geographical widespread outbreak of an infectious disease in which many people

    are infected at the same time; occurring throughout a region or even throughout the world.

    1.5.3Influenza

    Influenza is an acute febrile which is characterized by fever and highly contagious viral disease.

    It is easily diffused or spread as from one person to another by infection.

    1.6 Review of methodology

    As to conduct this research, we decided to use one type of instruments which is survey

    questionnaires. The target audience involve in this research are 80 UMP students from varies

    faculties. For the survey questionnaires participants, we decided to choose them according to

    our distribution ratio which is non-random technique.

    1.7 Organization of chapters

    This study comprises of five chapters which are introduction, review of literature, methodology,

    findings, conclusion and recommendation. Under chapter one of introduction, the chapter is

    sub-divided into background of the study which explains a history on pandemic influenza,

    problem statement, research objectives, research questions and definition of the terms.

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    As for the second chapter of review of literature, it is all about the synthesis of articles related to

    the study of the level of awareness for pandemic influenza.

    The third chapter of methodology is sub-divided into three which are description of participants

    who are involved in the survey questionnaires, data collection instruments which are survey

    questionnaire and individual interview and data analysis.

    The fourth chapter is on the findings and discussion of the survey and interview conducted and

    for the results obtained.

    As for the last chapter which is conclusion and recommendation is an overall on the study and

    to provide measures for improvement.

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    CHAPTER TWO

    REVIEW OF LITERATURE

    The review of literature of this pandemic influenza research consists of three sub-elements. The

    sub-elements are pattern of pandemic influenza, symptoms and effect of pandemic influenza,

    prevention and control measures of pandemic influenza and Malaysian government policy and

    reaction towards influenza. Basically we synthesized related articles from various case studies

    of pandemic influenza as a support evidence of every fact that we discussed.

    2.1 Pattern of pandemic influenza

    From history, there are several types of pandemic influenza that been attacked human starting

    from year 1918 (H1N1, Spanish Flu), 1957 (H2N2, Asian Flu) and 1968 (H3N2, Hong Kong Flu).

    (Yu, Tsung, Ding, Pei, Luan, Chun, Chin, Fu, Li, 2006) The latest pandemic influenza before

    Influenza A, H1N1 is H5N1 which called as bird flu that attacked in year 2006. The same

    patterns of all these pandemic influenza are the characteristic, symptoms and effects of this

    virus. But the levels of seriousness of the pandemic influenza are different. From the research, it

    can be realized that the level of severity of this virus is increasing from the first pandemic

    influenza till the latest one (bird flu in 2006). A researcher predicted that the new pandemic

    influenza that will be more severe than the bird flu because the virus can be transmitted

    between human to human compared to the previous which is bird flu (transmitted between

    poultry to human only) (Robin B. M., 2007) This statement has been proven by the existing

    pandemic influenza in 2009 which is swine flu, H1N1. From the bird flu cases, the wide spread

    of the virus are because of seasonality element. This is due to the virus which is transmitted via

    bird. The bird usually transfer from one place to another place when the change of season.

    Thats make the avian influenza spread. (Andrew, W. P., Kathryn G., 2007) As the conclusion,

    from the past cases of pandemic influenza, we can predict what the characteristic of the future

    pandemic influenza is. If we can predict it earlier, the vaccine of the pandemic influenza can be

    produced faster than before and that makes the number of fatality or infected persons can be

    decrease.

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    2.2 Symptoms and effect of pandemic influenza

    The pandemic influenza factsheet is the research on comparing symptoms and complications

    with symptoms of the common cold. The symptoms of pandemic influenza are similar as

    seasonal influenza. A guide from a medical officer of health claim that the symptoms appear

    suddenly and can include, muscle aches and pains, tiredness, loss of appetite, cough, sore

    throat and stuffy or runny nose. Depending on the new subtype that emerges, symptoms may

    be more severe and complications more widespread because nobody will have any immunity or

    protection against that particular virus. In his study of pandemic influenza and health care

    demand, (Hageenaars, 2004) found that the effect of differences in timing of vaccination

    campaigns, and the impact of strategies in which anti viral are prescribed to certain groups up

    until the moment that a newly developed vaccine becomes available. Other than that, he

    revealed that there are some nonlinear effects such as the reduction of the transmission

    intensity that occurs when therapeutic antiviral use leads to a reduced duration of infectiousness

    and when the number of susceptible individuals is reduced through vaccination. On the other

    hand, the effect arises because immune individuals are not only unable to acquire the infection

    but also unable to pass it on to others. As for that, it can be said that the pandemic symptoms

    are serious than seasonal influenza and the effect of the disease can be more serious if the

    early prevention measure are not taken when the symptoms are clearly appear to the victim.

    2.3Prevention and control measures

    Research conducted in the 20th century has revealed the spread of influenza is constantly

    increasing and is predicted to continue increasing in the near future (Cinti, 2005). Pandemic

    preparedness has been visible across the world. Exposure to influenza such as type A (H1N1)

    requires prevention and control measures. Kitler (2002) in his research on prevention and

    control of influenza says that, medically vaccination has been proven to be most effective to

    stimulate the production of antibodies and also to reduce the replication capabilities of the virus.

    In addition to that, extensive experience with vaccines has demonstrated that vaccines provide

    good protection. On the other hand (Cinti, 2005) the control measures such as quarantine is

    said to be most effective for the moment, delaying the spread of epidemic. Wearing mask,

    adequate ventilation can help to equally prevent influenza spread that is airborne. On the other

    hand, Kitler (2002) claims that early warning through pandemic surveillance around the world is

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    most effective in achieving early prevention and protection against such spread of influenza. In

    addition, pandemic readiness based on international, national and regional planning across the

    world in order to develop the worlds capacity to respond to the epidemics (Cox, 2003).

    Therefore, it can be said that prevention of such deadly spread of influenzas is much needed to

    sustain the human population. Its best said that prevention is better than cure.

    2.4 Malaysian government policy and reactions towards influenza

    The Disease Control Division, Ministry of Health Malaysia has taken some measures on

    preventive and control actions on the novel pandemic influenza, H1N1. Some measures such

    as school closure, setting up operation rooms for the monitoring of influenza H1N1 since 26

    April 2009. (MOH, 2009) The Government has also developed the interim guidelines on

    surveillance of influenza A H1N1 in Malaysia. The Society of Occupational and Environmental

    Medicine (SOEM) of the Malaysian Medical Association (MMA) with the collaboration of Ministry

    of Health (MOH) Malaysia had defined the pre-pandemic and pandemic action stage on

    recommendations on influenza for industry in Malaysia (MOH, SOEM, 2006). Those agencies

    have listed down the level of influenza pandemic phase and strategic actions to be taken. This

    included the list of the participating designated hospitals. It is also explained the guidance

    provided under NIPPP for the preparedness and response needed in facing the threat of an

    influenza pandemic and the roles or functions of other ministries, departments and non-

    governmental organizations during influenza pandemic (NIPPP,2009).

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    CHAPTER THREE

    METHODOLOGY

    In this chapter, we will discuss about the specification of method used to conduct our research.

    This methodology chapter consist of three elements which are participants, data collection

    instruments and data analysis. The participants section discusses about the target audience of

    this survey and how we distribute our instruments to the participants. For the second section,

    we explain about the detail of instruments used which are survey questionnaires. The last

    section will explain about how we analyze the collected data.

    3.1 Participants

    As for the first method to conduct this research, we decided to use the survey questionnaire

    method. Generally the participants are UMP students from all faculties including male and

    female. The faculties involved in this survey are Faculty of Technology Management, Faculty of

    Manufacturing Engineering, Faculty of Electrical Engineering, Faculty of Mechanical

    Engineering, Faculty of Chemical Engineering, Faculty of Civil Engineering & Natural Resource,

    Faculty of Computer Science & Software Engineering, and Faculty of Science & Industrial

    Technology. Each faculty will be given an equal number of survey questionnaires which is 10

    per faculty. From each faculty, we divide it into two categories which are male and female and

    the distribution ratio is 50:50. For a clearer view of the participant division, refer to the table

    below.

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    Table 3.1

    No

    .

    FACULTY MALE FEMALE TOTAL

    1 Faculty of Technology Management 5 5 10

    2 Faculty of Manufacturing Engineering 5 5 103 Faculty of Electrical Engineering 5 5 10

    4 Faculty of Mechanical Engineering 5 5 10

    5 Faculty of Chemical & Natural Resources

    Engineering

    5 5 10

    6 Faculty of Civil & Environmental Engineering 5 5 10

    7 Faculty of Computer Science & Software

    Engineering

    5 5 10

    8 Faculty of Industrial Science & Technology 5 5 10

    TOTAL 80

    Breakdown of participants according to gender and faculty

    3.2 Data collection instruments

    There are several methods to collect primary source data. Therefore we chose two methods

    that are survey questionnaires and individual interview.

    Survey questionnaire on the awareness of pandemic influenza among UMP students is our

    main method to collect primary data about the study mentioned above. The survey consists of

    19 questions. The survey questionnaire is sub-divided into two which are open ended and close

    ended questions. The close ended form is equally sub-divided into a few types which are

    dichotomous, rank and multiple choices.

    3.3 Data analysis

    After we conducted the survey, the data are collected and interpreted. There are 80

    respondents for survey questionnaire.

    The analyses of survey questionnaires are done using Microsoft Excel spreadsheet. The

    feedback from 80 respondents has been analyzed in the spreadsheet because it will be easy for

    calculating the frequency for each choice of the answer.

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    Step 1

    Numbering each of the questions.

    Step 2

    Number each question and variable. For example each type of question will have a different

    way of numbering:

    i. For all closed, open-ended, multiple choice (in which respondents can only choose one

    answer), fill in relevant information and scale question, each question will be considered as

    individual variables.

    ii. With rank questions, each choice is a variable.

    Step 3

    Once we have collected the feedback from respondents, we transferred the data into

    Microsoft Excel worksheet. The summary of the data look like the table below:

    Variables

    Respondents

    V1 V2 V3 V4 V5 V6 V7

    R1

    R2

    R4

    R5

    Step 4

    Tabulate the information :

    Table 1 Program Respondents n = 80Gender Frequency Percentage (%)

    Male 40 50

    Female 40 50

    Total 80 100

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    CHAPTER FOUR

    FINDINGS AND DISCUSSION

    This chapter is the analysis of the findings on the level of awareness among UMP students

    towards pandemic influenza and UMP students awareness towards self-prevention from the

    spread of pandemic influenza. This analysis will be presented in table form, pie chart and

    diagram.

    4.1 PARTICIPANTS INFORMATION

    Eighty UMPs students are involved in this research. Table 4.1 illustrates the breakdown of the

    participants according to gender and faculty.

    Table 4.1

    Breakdown of participants according to gender, faculty and year of study

    From the table 4.1, it indicates that 10 students (5 male and 5 female) of each faculty

    participated in this study. According to the year of study, most of the participants were a second

    year students.

    GENDER MALE FEMALE TOTAL

    FACULTY / YEAR OF STUDY 1 2 3 4 1 2 3 4

    TECHNOLOGY MANAGEMENT 5 5 10

    MECHANICAL ENGINEERING 2 2 1 3 2 10

    CHEMICAL ENGINEERING 4 1 5 10

    ELECTRICAL ENGINEERING 5 5 10

    MANUFACTURING ENGINEERING 5 5 10

    COMPUTER SCIENCE 5 5 10

    INDUSTRIAL SCIENCE 5 5 10

    CIVIL ENGINEERING 2 1 1 1 2 3 10

    TOTAL 2 32 4 2 0 33 4 3 80

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    4.2INVESTIGATE THE LEVEL OF AWARENESS TOWARDS PANDEMIC INFLUENZA

    Figure 4.2

    Sources of being infected by pandemic influenza

    The pie chart above shows the sources of being infected by pandemic influenza chosen by

    UMP students. According to the chart, we can conclude that majority of UMP students, 28(35%), believe that the source of being infected by pandemic influenza is by visiting foreign

    countries followed by being in direct contact with the body liquid of a H1N1 patient, 25 (31%),

    being around public places, 21 (26%), and involvement in outdoor activities, 6 (8%). From the

    results, it can be conclude that probably the virus of pandemic influenza is more spread in the

    foreign country, so for those who visiting the foreign country which is already be overcome by

    the virus can easily got the disease from there. Perhaps the students are not aware and did not

    care about how pandemic influenza spread and where the virus come from because the

    accurate source actually is being in direct contact with the body fluid of a H1N1 patients.

    21, 26%

    28, 35%

    25, 31%

    6, 8%

    Being around public places

    Visiting foreign countries

    Being in direct contact with the

    body liquid of a H1N1 patient

    Involvement in outdoor activity

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    Figure 4.3

    The effects of infected by pandemic influenza

    The results shows the majority, 61 (76%), says that the effect is the victim face to the death or

    fatal. 16 (20%) of UMP students said that the effect of the disease is semi-conscious. Least

    number of students thought that the effect of the pandemic influenza can cause stroke and

    coma. Only a few of the students does not really aware of the effect of pandemic influenza.Consequently besides the control measures taken, the goals to minimize the impact of

    pandemic influenza are identifying pandemic influenza and monitoring its spread and impact,

    containing the spread of infection to the extent that this is possible, reducing illness and saving

    lives, ensuring the continuation of essential services, thereby minimizing social and economic

    disruption, and ensuring that the public, health professionals and media have up-to-date,

    comprehensive information at all stages. As for that, it can be summarized that the virus of

    pandemic influenza can cause fatal if there are no prevention or control measures taken with

    the goals to minimize the impact and the students should aware on the effect related to thedisease.

    From the survey also, we are able to identify weather they aware on type of viruses that can be

    classified under pandemic influenza. Almost all students agree that swine flu (66, 83%) and bird

    flu (66, 83%) are both under the pandemic influenza family. We can see that the student knows

    how to classify the viruses, and aware about the types of pandemic influenza. Only some of

    2, 3%

    61, 76%

    16, 20%

    1, 1%

    Coma

    Fatal

    Semi-concious

    Stroke

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    them are not really knows about the types of pandemic influenza because they also classified

    SARS (50, 63%), JE virus (28, 35%) and even AIDS (10, 13%) with the pandemic influenza

    group.

    When talking about the sources of information of pandemic influenza, almost all UMPs student

    agree that they get the information from the news (77, 96%). News can be in several type of

    mass media includes from news paper, radio and television. Almost half of them are also gain

    the information from the advertisement (39, 49%) and the internet (52, 65%). The least number

    of students got the information about the pandemic influenza through magazines (15, 19%).

    From this data, we can conclude that student rely on the news to get the real facts or

    information about the current issues.

    Figure 4.4

    Symptoms of pandemic influenza

    From the diagram above, it is stated that almost 90% of UMPs student know about the fact

    about the symptoms of pandemic influenza which is cough (71, 89%), flu (67, 84%), runny nose

    (41, 51%) and difficulty in breathing (65, 81%). It is prove that the information that they get from

    new, advertisement, internet and etc, contains the true information or the fact of pandemic

    influenza. Only minor of them have a little bit confusing fact about the symptoms of pandemic

    influenza because they also certified that eye-swelling (8, 10%) and rashes (6, 8%) as the

    symptoms of the virus.

    71,89%67,84%

    41,51%

    65,81%

    8,10% 6,8%

    0

    10

    20

    30

    40

    50

    60

    70

    80

    Cough Flu Runny nose Difficulty in

    breathing

    Eye-swelling Rashes

    YES

    NO

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    4.3 IDENTIFY STUDENTS AWARENESS TOWARDS SELF-PREVENTION FROM THE

    SPREAD OF PANDEMIC INFLUENZA

    Figure 4.5

    Level of awareness towards preventive measures

    The column graph above shows the level of awareness among UMP students towards self-

    prevention from the spread of pandemic influenza. From this, the highest number of student

    shows that they agree to the fact that quarantine is the most effective way to prevent the

    widespread of pandemic influenza (79, 99%). Apart from that, other measures include good

    hygienic practice (75, 94%), serious measure need to be taken by government (70, 88%) and

    the lowest is wearing mask (27, 34%).

    It can be concluded that quarantine is the most effective way towards self-prevention from the

    spread of pandemic influenza, and this is due to the reason that pandemic influenza is an

    airborne disease and is certain to spread in air. Therefore quarantine is a wise measure to take.

    79,99%

    70,88%

    17,21%

    76,95%

    27,34%

    0

    10

    20

    30

    40

    50

    60

    70

    80

    90

    Quarantine Government

    measures

    Wear mask Hygienic

    practice

    Stay indoor

    AGREE

    DISAGREE

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    Based on the overall findings, we can conclude that majority of the UMP students believe that

    human are easily infected by pandemic influenza if they visiting any foreign country or have the

    direct contact with body liquid of H1N1 patients. They knew that self protection techniques such

    as quarantine from the crowded areas may prevent themselves to be exposed to H1N1 virus

    infection.

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    CHAPTER FIVE

    CONCLUSION AND RECOMMENDATIONS

    In this chapter, we will conclude all the findings that we have found in this research. All findings

    are based on our two research questions and the conclusion will shows whether achieve our

    objectives or not.

    5.1 CONCLUSION

    As we all aware, pandemic influenza is actually a global disease outbreak which spread by the

    airborne. Due to the survey, the results shows that majority students believe that the source of

    being infected by pandemic influenza are visiting foreign countries and being direct contact with

    the body liquid of H1N1 patients. The UMP students realize that this disease can bring to fatal

    cases if there are no precautions measures are taken to avoid from getting the virus.

    Consequently besides the control measures taken, the goals to minimize the impact of

    pandemic influenza are identifying pandemic influenza and monitoring its spread and impact,

    containing the spread of infection to the extent that this is possible, reducing illness and saving

    lives, ensuring the continuation of essential services, thereby minimizing social and economic

    disruption, and ensuring that the public, health professionals and media have up-to-date,

    comprehensive information at all stages. As for that, it can be thought that the virus of pandemic

    influenza can cause fatal if there are no prevention or control measures taken with the goals to

    minimize the impact and the students should aware on the effect related to the disease.

    Besides, they are agreed that swine flu and bird flu can be classified under pandemic influenza

    group. This shows that they are aware about the characteristic of viruses that had been

    attacked human and they can classified the viruses according to its type. Majority of them get all

    this information from the news which provides the true facts about the current virus issues. We

    can see that the students know about the source of information that can provide them valuable

    information so that they can take any possible precaution measures to protect themselves.

    Some of the valuable information that they get are the symptoms of the virus which is cough, flu,

    runny nose and difficulty in breathing. As for that, we can say that news from mass media such

    as newspaper, television and radio provides facts which can contribute to the safety of the

    community.

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    After conducting this survey, it is found that students in UMP have the general idea on how to

    keep themselves protected from the spread of pandemic influenza. From this it can be said that

    they realize the only obvious effective way to protect them from the spread of pandemic

    influenza such as H1N1 is though quarantine. Therefore, it is safe to say that UMP students are

    aware on how to keep them protected.

    As for the overall conclusions, we have found that UMP students are aware on pandemic

    influenza in term of sources of infection, types of pandemic influenza, symptoms and effects of

    the pandemic influenza itself. They are also well aware that quarantine is the most effective way

    to self-prevention at the moment.

    5.2 RECOMMENDATIONS

    We recommend that university should organize some campaign to increase the level of

    awareness among UMP students. The campaign such as seminar, talks or weekly awareness

    road show can communicate effectively to all level of universitys members which may include

    staffs and students as well. Students who know the basis knowledge about pandemic influenza

    can gain more information about the preventive and reactive measures during the road show.

    University must take initiative to advertise these issues to all level of university through internal

    media such as UMP radio, announcement in university web portal or flyer etc. Sometime,

    student may just ignore the impact of pandemic influenza due to human physical weakness.

    Human always create errors, for example, easily forget if there is no remind. A simple daily

    announcement in student portal may give awareness to every student about the pandemic

    influenza.

    Student clinic and affairs department shall provide Personal Protection Equipment (PPE) to

    students for free. Those PPE equipments are masks and hand gloves. PPE is very important to

    eliminate the possible chances of getting infected by pandemic influenza. This will give the

    signal to all students so that everyone will know about the pandemic influenza either direct orindirectly.

    Sanitizer such as hand washer shall provide in public places such as washroom or toilet and

    cafe. Virus can live on hard surfaces for up to two days, and on hands for up to five minutes, so

    washing hand often with suitable sanitizer can keep ourselves and others healthy at most of the

    times. This can help increase the hygiene practices among university students.

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    In addition, every lecturer can plays the vital role in helping to create the healthy scenarios in

    every lecture room before start teaching on the days. For instance, lecturer should start the

    class by communicate to make sure the students health. Lecturer should immediately give

    excuses for quarantine for those who felt uncomfortable in class or having any health problem.

    They should immediately send for medical body check up and being quarantine if necessary.

    Another preventive measure is a personal stress management system. Stress suppresses the

    immune system and makes one vulnerable to infections. A stress management system is

    beyond the scope of this page but is vitally important to maintaining good health and avoiding

    the bugs. University should develop a counseling team to give advice to students who need help

    in stress management especially during the exam weeks.

    Students Clinic should provide nutritional supplements to students who needed it by selling it at

    reasonable price or giving it for free. The use of nutritional supplements to support immune

    function may reduce the incidence, duration, and severity of infections in general. Having the

    immune system working at peak efficiency before getting sick is far more effective than waiting

    until getting sick. Basic immune system function can be boosted dramatically by supplementing

    Vitamins A, C, and Zinc. This combination is particularly beneficial in supporting immune

    function, is relatively inexpensive, and works better than many herbs and other products.

    There are also some recommendations or preventive measures for every individual:

    1. Avoid close contact with people who are sick. When you are sick, keep your distance from

    others to protect them from getting sick too.

    2. Stay home when you are sick. If possible, stay at home from work, school, and errands

    when you are sick. You will help prevent others from catching your illness.

    3. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those

    around you from getting sick.

    4. Washing your hands often with suitable sanitizer will help protect you from germs.

    5. Avoid touching your eyes, nose or mouth with hands. Germs are often spread when a

    person touches something that is contaminated with germs and then touches his or her

    eyes, nose, or mouth.

    6. Practice other good health habits. Get plenty of sleep, be physically active, manage your

    stress, drink plenty of fluids, and eat nutritious food.

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    -PAGE 19-

    REFERENCES

    Andrew, W. P., Kathryn G. (2007) Dynamic patterns of avian and human influenza in east

    and southeast Asia. Retrieved on 28 JULY 2009 from http://infection.thelancet.com

    Calgary Health Region, (December, 2005),Explaining Pandemic Influenza: A Guide fromthe Medical Officer of Health provides health professionals and members of the publicwith a better understanding of pandemic influenza, its likely impact on Canada and theCalgary Health Regions plan to respond, Retrieved on July 15, 2009 fromhttp://www.calgaryhealthregion.ca

    Cinti.S.,MD(2005).Pandemic influenza:Are We ready?.Retrieved on 15 JULY 2009

    from http://download.thelancet.com/flatcontentassets/H1N1-

    flu/preparedness/preparedness-7.pdf

    Hagenaars T.J, Wallinga J, & Genugten M.L.L (2004, June 30).Pandemic influenza andhealth care demand: dynamic modelling, National Institute for Public Health and theEnvironment, PO Box 1, Bilthoven 3720 BA, The Netherlands, Retrieved on July 20,2009, journal from http://www.sciencedirect.com/science

    Kitler.M.E.,Gavinio.P.,Lavanchy.D. (2002).Influenza and the work of the World health

    Organization.CH1211 Geneva 27, Switzerland. Retrieved on 14 JULY 2009 from

    http://www.sciencedirect.com.ezproxy.ump.edu.my/science?_ob=MImg&_imagekey=B6

    TD4-45BHFJK-6-

    1&_cdi=5188&_user=4406426&_orig=search&_coverDate=05%2F15%2F2002&_sk=99

    9799999.8997&view=c&wchp=dGLbVzz-

    zSkzV&md5=029e783932d782333fc30a86e40646b2&ie=/sdarticle.pdf

    Ministry of Health Malaysia (May, 2009) National Influenza Pandemic Preparedness Plan(NIPPP), Retrieved on August 3, 2009) fromhttp://h1n1.moh.gov.my/NIPPP/NIPPP%20STRATEGIES.pdf

    Ministry of Health Malaysia (May 13, 2009), Preventive and Control Actions - Flu A H1N1,Retrieved on August 1, 2009) fromhttp://h1n1.moh.gov.my/TechnicalPresentation/Flu%20A%20H1N1%20-%20Preventive%20&%20Control%20Actions%20(13Mei09).pdf

    Ministry of Health Malaysia; The Society of Occupational and Environmental Medicine(SOEM) of the Malaysian Medical Association (MMA) (March, 2006),RecommendationsOn Influenza Pandemic Preparedness For Industry In Malaysia, Retrieved on July 21,2009 fromhttp://h1n1.moh.gov.my/industri/Preparedness_for_Pandemic_Flu_in_Industry.pdf

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    -PAGE 20-

    Nancy J. C., Susan E. T., Theresa T., (2003).Influenza pandemic

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    Road, NE, Atlanta, GA 30333, USA, Division of Immunization and Respiratory Diseases,

    Perth District Health Unit, Ottawa, Ont., Canada Health Canada, Stratford, Ont., Canada.

    Retrieved on 15 JULY 2009 from http://www.pandemicflu.gov/plan/pdf/guide.pdf

    Robin B. M. (2007)Avian Influenza: The Next Pandemic? Retrieved on 28 JULY 2009

    from http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B75BF-4PC77R8-7-

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    South Australia Government,(September, 2005) Department of trade economydevelopment, Source by Queensland Government Action Plan for Pandemic Influenza,Pandemic Influenza factsheet, Retrieved on July 27, 2009 fromhttp://www.southaustralia.biz

    Yu C. H., Tsung Z. W., Ding P. L., Pei L. S., Luan Y. C., Chun Y. L., Chin Y. L., Fu Y. H.,

    Li M. H. (2006) Influenza Pandemics: Past, Present and Future.Retrieved on 19 JULY

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    -PAGE 21-

    APPENDICES

    i. SAMPLE OF SURVEY QUESTIONAIRES

    Dear respondents

    This survey is to study on the awareness of pandemic influenza among UMP students.

    We hope that you will answer the questions truthfully. Thank you.

    Instructions : Please answer all the questions below.

    Section A :

    1. Gender : Male Female

    2. Age :

    3. Year of studies: 1 2 3 4

    4. Faculty :

    Section B

    This section is to investigate the level of awareness towards pandemic influenza.

    Please put a tick on ONLY one answer.

    5. Pandemic influenza is,

    A.

    B. A pandemic influenza is a global disease outbreak

    C.

    D.

    6. From several cases of pandemic influenza that occurred in Malaysia, what are the sources of being

    infected by this influenza?

    A. Being around public places

    B.Visiting foreign countries

    C. Being in direct contact with the body liquid of a H1N1 patient

    D.Involvement in outdoor activity

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    7. Is this disease fatal?

    Yes No

    Please put a tick on MORE than one answer.

    8. In your opinion, what are the types of influenza stated below that can be classified as pandemic

    influenza?

    Swine flu

    Bird flu

    SARS

    J.E. virus

    AIDS

    9. From what sources, do you receive latest information on a pandemic influenza such as H1N1?

    News

    Advertisement

    Internet

    Magazines

    Others, please specify

    10. From what you have heard, what are the symptoms of the pandemic influenza?

    Coughflu

    muscle pain

    difficulty in breathing

    diarrhea

    rashes

    11. What are the effects of being infected by pandemic influenza?

    A.

    B.

    C.

    D.

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    -PAGE 23-

    Section C

    This section is to identify students awareness towards self-prevention from the spread of pandemicinfluenza.

    Please put a tick on ONLY one answer.

    12. Have you been in direct contact with a person that have pandemic influenza/

    Yes No

    13. Do you think it is important to take measures to control the spread of pandemic influenza seriously?

    Yes No

    Please put a tick according to preferences.

    No. Questions Strongly

    Agree

    Agree Disagree Strongly

    Disagree

    14 Quarantine is the most effective way to prevent

    the widespread of pandemic influenza.

    15 Serious measure need to be taken by the

    government in order to prevent the spread of

    pandemic influenza.

    16 Only H1N1influenza requires patients to mustwear mask.

    17 The hygienic practice must be implemented by allof the UMP students to make sure that they are

    not infected by the pandemic influenza.

    18 If you are a H1N1 patient, it is not necessary to

    stay indoors/ at home all the time.

    19. The university has declared a state of emergency to all students due to the increase spread of confirm

    H1N1 influenza cases, you are trying to avoid from getting the flu. What will you do?

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    -PAGE 24-

    ii. VARIABLE TABLE

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    iii. DATA ANALYSIS

    SECTION A: DEMOGRAPHIC INFORMATION

    SECTION B: IDENTIFICATION ON THE LEVEL OF AWARENESS TOWARDS PANDEMIC

    INFLUENZA

    Definition of Pandemic Influenza

    From the figure 4.1 above, we can see that the most of the UMPs students (41, 51%) think that

    the pandemic influenza is Influenza A, whereas the pandemic influenza is actually a global

    disease outbreak (23, 29%). Others said that pandemic influenza is a viral influenza (13, 16%)

    41, 51%

    23, 29%

    13, 16%

    3, 4%

    Figure 5.1

    Influenza A

    A global disease outbreak

    Viral influenza

    Chronic influenza

    GENDER MALE FEMALE TOTAL

    FACULTY / YEAR OF STUDY 1 2 3 4 1 2 3 4

    TECHNOLOGY MANAGEMENT 5 5 10

    MECHANICAL ENGINEERING 2 2 1 3 2 10

    CHEMICAL ENGINEERING 4 1 5 10

    ELECTRICAL ENGINEERING 5 5 10

    MANUFACTURING ENGINEERING 5 5 10

    COMPUTER SCIENCE 5 5 10

    INDUSTRIAL SCIENCE 5 5 10

    CIVIL ENGINEERING 2 1 1 1 2 3 10

    TOTAL 2 32 4 2 0 33 4 3 80

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    -PAGE 26-

    and a chronic influenza (3, 4%). From the percentage above, it is clearly stated that majority of

    the student are not aware about the meaning of pandemic influenza and dont have the sense of

    curiosity to find out about it.

    FIGURE 5.2

    Sources of being infected by pandemic influenza

    The pie chart above shows the sources of being infected by pandemic influenza chosen by

    UMP students. According to the chart, we can conclude that majority of UMP students, 28

    (35%), believe that the source of being infected by pandemic influenza is by visiting foreign

    countries followed by being in direct contact with the body liquid of a H1N1 patient, 25 (31%),

    being around public places, 21 (26%), and involvement in outdoor activities, 6 (8%). From the

    results, it can be conclude that probably the virus of pandemic influenza is more spread in the

    foreign country, so for those who visiting the foreign country which is already be overcome by

    the virus can easily got the disease from there. Perhaps the students are not aware and did not

    care about how pandemic influenza spread and where the virus come from because the

    accurate source actually is being in direct contact with the body fluid of a H1N1 patients.

    21, 26%

    28, 35%

    25, 31%

    6, 8% Being around public

    places

    Visiting foreign

    countries

    Being in direct contact

    with the body liquid of

    a H1N1 patient

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    -PAGE 27-

    FIGURE 5.3

    The effects of infected by pandemic influenza

    The results shows the majority, 61 (76%), says that the effect is the victim face to the

    death or fatal. 16 (20%) of UMP students said that the effect of the disease is semi-conscious.

    Least number of students thought that the effect of the pandemic influenza can cause stroke

    and coma. Only a few of the students does not really aware of the effect of pandemic influenza.

    Consequently besides the control measures taken, the goals to minimize the impact of

    pandemic influenza are identifying pandemic influenza and monitoring its spread and impact,

    containing the spread of infection to the extent that this is possible, reducing illness and saving

    lives, ensuring the continuation of essential services, thereby minimizing social and economic

    disruption, and ensuring that the public, health professionals and media have up-to-date,

    comprehensive information at all stages. As for that, it can be summarized that the virus of

    pandemic influenza can cause fatal if there are no prevention or control measures taken with

    the goals to minimize the impact and the students should aware on the effect related to the

    disease.

    2, 3%

    61, 76%

    16, 20%

    1, 1%

    Coma

    Fatal

    Semi-concious

    Stroke

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    -PAGE 28-

    FIGURE 5.4

    The fatalities due to pandemic influenza

    The figure prove that large number of UMP students aware that pandemic influenza can

    cause fatal if there are no prevention or control measures taken because the virus can spread

    quickly, affects the health and give big impact to the surrounding people and also almost

    around the world. There is only 13 (16%) of the students think that the virus did not cause fatal

    cases. Majority 67 (84%), think that pandemic influenza can cause fatal because they frequently

    expose to the news and advertisement about this disease. This serious pandemic is also likely

    to cause many deaths, disrupt the daily life of many people and cause intense pressure on

    healthcare and other services. It is clear that pandemic influenza is dangerous. Furthermore, thesymptoms may be more severe because nobody will have any immunity or protection against

    that particular virus.

    67, 84%

    13, 16%

    YES

    NO

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    -PAGE 29-

    Types of virus that can be classified as pandemic influenza

    From the above graph, we are able to identify weather they aware on type of viruses that can be

    classified under pandemic influenza. Almost all students agree that swine flu (66, 83%) and bird

    flu (66, 83%) are both under the pandemic influenza family. We can see that the student knows

    how to classify the viruses, and aware about the types of pandemic influenza. Just some of

    them are not really knows about the types of pandemic influenza because they also classified

    SARS (50, 63%), JE virus (28, 35%) and even AIDS (10, 13%) with the pandemic influenza

    group.

    Sources of information about the pandemic influenza

    66,83% 66,83%

    50,63%

    28,35%

    10,13%

    0

    10

    20

    30

    40

    50

    60

    70

    80

    Swine flu Bird flu SARS J.E. virus AIDS

    FIGURE 5.5

    YES

    NO

    77,96%

    39,49%

    52,65%

    15,19%

    2,3%0

    10

    20

    30

    40

    50

    60

    70

    80

    90

    News Advertisement Internet Magazines Others

    FIGURE 5.6

    YES

    NO

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    -PAGE 30-

    When talking about the sources of information of pandemic influenza, almost all UMPs student

    agree that they get the information from the news (77, 96%). News can be in several type of

    mass media includes from news paper, radio and television. Almost half of them are also gain

    the information from the advertisement (39, 49%) and the internet (52, 65%). The least number

    of students got the information about the pandemic influenza through magazines (15, 19%).

    From this data, we can conclude that student rely on the news to get the real facts or

    information about the current issues.

    Symptoms of pandemic influenza

    From the diagram above, it is stated that almost 90% of UMPs student know about the factabout the symptoms of pandemic influenza which is cough (71, 89%), flu (67, 84%), runny nose

    (41, 51%) and difficulty in breathing (65, 81%). It is prove that the information that they get from

    new, advertisement, internet and etc, contains the true information or the fact of pandemic

    influenza. Only minor of them have a little bit confusing fact about the symptoms of pandemic

    influenza because they also certified that eye-swelling (8, 10%) and rashes (6, 8%) as the

    symptoms of the virus.

    71,89%67,84%

    41,51%

    65,81%

    8,10% 6,8%

    0

    10

    20

    30

    40

    50

    60

    70

    80

    Cough Flu Runny nose Difficulty in

    breathing

    Eye-swelling Rashes

    FIGURE 5.7

    YES

    NO

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    -PAGE 31-

    Level of awareness towards preventive measures

    The column bar graph above shows the level of awareness among UMP students towards self-

    prevention from the spread of pandemic influenza. From this, highest numbers of students show

    that they strongly agree on the fact that quarantine is the most effective way to prevent the

    widespread of pandemic influenza and none disagrees to the fact stated earlier. This is due to

    the reason that pandemic influenza is an airborne disease and is certain to spread in air

    therefore it is clear that the best way students can think of and agree with is quarantine.

    Next students the highest number shows that students agree that serious measures need to be

    taken by the government in order to prevent the spread of pandemic influenza and less than 10

    students disagree to the statement mentioned. This may be because, government not only

    plays a role in preventing such a spread of influenza, and instead its a nations role to play as

    well. Therefore the self-prevention awareness is clear.

    As for the statement that only H1N1 patients are required to wear mask, most students disagree

    to the statement. This is due to the reason that pandemic influenza is airborne, a non H1N1

    patient in the midst of an H1N1 zone are highly likely to be diagnosed with such an influenza

    and awareness are seen among students because the university is distributing mask for every

    individual to wear.

    79,99%

    70,88%

    17,21%

    76,95%

    27,34%

    0

    10

    20

    30

    40

    50

    6070

    80

    90

    Quarantine Government

    measures

    Wear mask Hygienic

    practice

    Stay indoor

    FIGURE 5.8

    AGREE

    DISAGREE

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    It is clear that majority strongly agrees that hygienic practice must be implemented by all of the

    UMP students to make sure that they are not infected by the pandemic influenza. It is a known

    fact that to stay clean always keeps every individual one step away from diseases.

    Lastly, it seems that students on the whole, strongly disagrees that H1N1 patients is not

    required to stay indoors all the time. From this, their level of understanding that quarantine is the

    meaning of the sentence makes it clear that UMP students are well aware.

    FIGURE 5.9

    Student actions towards pandemic influenza

    The pie chart above shows the different types of preventive actions taken by students during the

    outbreak of pandemic influenza. Clearly, quarantine has the highest percentage of actions being

    taken while taking vaccine and sleeping are the lowest. According to the chart, quarantine make

    up a major portion of the actions being taken which is 27 (33%), and this is followed by wearing

    masks which is 23 (29%). The remaining of actions are no comments, hygiene practice, taking

    supplement, medical diagnosis, sleeping, taking vaccine and avoid visiting foreign country which

    make up 11 (14%), 10 (13%), 4 (5%), 2 (3%), 1 (1%), 1 (1%) and 1 (1%) respectively. It can be

    concluded that probably quarantine is the most basis knowledge that students know through the

    advertisement and annoucement in media when there is a outbreak of pandemic influenza.

    Figure 4.9

    11; 14%

    27; 33%23; 29%

    4; 5%

    2; 3%

    1; 1%

    10; 13%

    1; 1%

    1; 1%

    No comment

    Quarantine

    Wearing mask

    Taking supplement

    Medical diagnosis

    Sleeping

    Hygiene practice

    Avoid visiting foreign

    country

    Taking vaccine