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April 27, 2009

Swine Flu Update

Mexico's suspected swine flu death toll had climbed to 149 as of April 27, 2009. Most of those who died did not get medical treatment until they were very seriously ill. Many had to be rushed immediately into intensive care. People who have fly symptoms need to be prudent and seek early medical care.

Center for Disease control: Swine flu and You

What should I do if I get sick?

If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing
Bluish skin color
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
Fever with a rash

In adults, emergency warning signs that need urgent medical attention include:

Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water. or clean with alcohol-based hand cleaner. we recommend that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.


CDC interim Interim Guidance for Swine influenza A (H1N1): Taking Care of a Sick Person in Your Home.

Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye’s syndrome.

* Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.
* Teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.
* Children younger than 2 years of age should not be given over-the-counter cold medications without first speaking with a healthcare provider.
* The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.
* Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS).

More info at the bottom of this article.

The European Union advised against nonessential travel to the U.S. and Mexico, while China, Taiwan and Russia considered quarantines and several Asian countries scrutinized visitors arriving at their airports.

U.S. customs officials began checking people entering U.S. territory. Officers at airports, seaports and border crossings were watching for signs of illness, said Customs and Border Protection spokesman Lloyd Easterling.

In Mexico, the outbreak's center, soldiers handed out 6 million face masks to help stop the spread of the virus that is suspected in up to 103 deaths. Most other countries are reporting only mild cases so far, with most of the sick already recovering.


Health Secretary Jose Angel Cordova says only 20 of the deaths have been confirmed to be from swine flu and the government was awaiting tests results on the rest.

He says 1,995 people have been hospitalized with serious cases of pneumonia since the first case of swine flu was reported on April 13. The government does not yet know how many were swine flu. Of those hospitalized, 1,070 have been released.









“This is very important: The disease is curable and we have the medicine for it,” Mexican President Felipe Calderon said today.

CDC home care Guidelines

Steps to Lessen the Spread of Flu in the Home
When providing care to a household member who is sick with influenza, the most important ways to protect yourself and others who are not sick are to:

keep the sick person away from other people as much as possible (see “placement of the sick person at home”)
remind the sick person to cover their coughs, and clean their hands with soap and water or an alcohol-based hand rub often, especially after coughing and/or sneezing.
have everyone in the household clean their hands often, using soap and water or an alcohol-based hand rub
ask your healthcare provide if household contacts of the sick person, particularly those contacts that may have chronic health conditions, should take antiviral medications such as oseltemivir (Tamiflu®) or zanamivir (Relenza®) to prevent the flu.

Placement of the sick person

Keep the sick person in a room separate from the common areas of the house. (For example, a spare bedroom with its own bathroom, if that’s possible.) Keep the sickroom door closed.

Unless necessary for medical care, persons with the flu should not leave the home when they have a fever or during the time that they are most likely to spread their infection to others (7 days after onset of symptoms in adults, and 10 days after onset of symptoms in children).
If persons with the flu need to leave the home (for example, for medical care), they should cover their nose and mouth when coughing or sneezing and wear a loose-fitting (surgical) mask if available.
Have the sick person wear a surgical mask if they need to be in a common area of the house near other persons.
If possible, sick persons should use a separate bathroom. This bathroom should be cleaned daily with household disinfectant (see below).

Protect other persons in the home

The sick person should not have visitors other than caregivers. A phone call is safer than a visit.
If possible, have only one adult in the home take care of the sick person.
Avoid having pregnant women care for the sick person. (Pregnant women are at increased risk of influenza-related complications and immunity can be suppressed during pregnancy).
All persons in the household should clean their hands with soap and water or an alcohol-based hand rub frequently, including after every contact with the sick person or the person’s room or bathroom.
Use paper towels for drying hands after hand washing or dedicate cloth towels to each person in the household. For example, have different colored towels for each person.
If possible, consideration should be given to maintaining good ventilation in shared household areas (e.g., keeping windows open in restrooms, kitchen, bathroom, etc.).
Antivirals can be used to prevent the flu, so check with your healthcare provider to see if some persons in the home should use antiviral medications.

If you are the caregiver

Avoid being face-to-face with the sick person.
When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.
Clean your hands with soap and water or use an alcohol-based hand rub after you touch the sick person or handle used tissues, or laundry.
Caregivers might catch flu from the person they are caring for and then the caregiver might be able to spread the flu to others before the caregiver shows symptoms. Therefore, the caregiver should wear a mask when they leave their home to keep from spreading flu to others in case they are in the early stages of infection.
Talk to your health care provider about taking antiviral medication to prevent the caregiver from getting the flu.
Monitor yourself and household members for flu symptoms and contact a telephone hotline or health care provider if symptoms occur.

Using Facemasks or Respirators

Avoid close contact (less than about 6 feet away) with the sick person as much as possible.
If you must have close contact with the sick person (for example, hold a sick infant), spend the least amount of time possible in close contact and try to wear a facemask (for example, surgical mask) or N95 disposable respirator.
An N95 respirator that fits snugly on your face can filter out small particles that can be inhaled around the edges of a facemask, but compared with a facemask it is harder to breathe through an N95 mask for long periods of time. More information on facemasks and respirators can be found at www.cdc.gov/swineflu
Facemasks and respirators may be purchased at a pharmacy, building supply or hardware store.
Wear an N95 respirator if you help a sick person with respiratory treatments using a nebulizer or inhaler, as directed by their doctor. Respiratory treatments should be performed in a separate room away from common areas of the house when at all possible.
Used facemasks and N95 respirators should be taken off and placed immediately in the regular trash so they don’t touch anything else.
Avoid re-using disposable facemasks and N95 respirators if possible. If a reusable fabric facemask is used, it should be laundered with normal laundry detergent and tumble-dried in a hot dryer.
After you take off a facemask or N95 respirator, clean your hands with soap and water or an alcohol-based hand sanitizer.

Household Cleaning, Laundry, and Waste Disposal

Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.
Keep surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.
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.
Wash linens (such as bed sheets and towels) by using household laundry soap and tumble dry on a hot setting. Avoid “hugging” laundry prior to washing it to prevent contaminating yourself. Clean your hands with soap and water or alcohol-based hand rub right after handling dirty laundry.
Eating utensils should be washed either in a dishwasher or by hand with water and soap.

For More Information
The Centers for Disease Control and Prevention (CDC) Hotline (1-800-CDC-INFO) is available in English and Spanish, 24 hours a day, 7 days a week.

The virus, however, appears to be vulnerable to existing antiviral drugs such as Tamiflu. Napolitano said the US government would release a quarter of the 50 million courses of antiviral drugs in the national stockpile. The Defense Department has another 7 million courses ready, she says.

Officials don't know yet how the epidemic originated, but they downplayed the potential that it represents a bioterrorist attack. "We're looking at all potential explanations here – but no evidence whatsoever on the bioterrorism," said John Brennan, a White House official.

The epidemic is almost certain to spread further, but officials attempted to assuage concerns the current swine flu epidemic could play out like the 1918 influenza pandemic, which killed millions.

"The laboratory capability that we have now is not what it was five years ago, let alone in 1918. We understand a lot about how flu should be managed and treated," Besser said.


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