HURON COUNTY GENERAL HEALTH DISTRICT
180 Milan Avenue
Norwalk, OH 44857
419-668-1652
419-668-5423 FAX
1-888-694-2443 Toll-Free
Environmental Health
419-660-0129 FAX
E-mail: information@huroncohealth.com

Timothy Hollinger, MPH
Health Commissioner

SUBJECT:   School Advisory Regarding Swine Flu in United States

DATE: April 29, 2009

Click For a Printable version:

Letter to Parents from Tim Hollinger
CDC Swine Flu Q & A
CDC Swine Flu Q & A in Spanish

URGENCY LEVEL:  [X] Health Alert     [  ] Health Advisory     [  ] Health Update

FOR MORE INFORMATION CONTACT: 
Christina Cherry BSN, RN
Huron County General Health District
180 Milan Avenue, Suite 8
Norwalk, Ohio 44857
Phone: 419-668-1652, ext: 230
don@huroncohealth.com

SENT TO:  Huron County School Administrators and Associated Child Care Facilities

DETAILS:   Swine flu is a respiratory disease of pigs caused by a type A influenza virus that regularly causes outbreaks of influenza among pigs.  Swine flu viruses do not normally infect humans; however, human infections with swine flu do occur.  Public health officials have determined that this strain of swine flu virus spreads from human to human and can cause illness.

To date, the CDC has confirmed 91 cases of swine flu in the U.S.  At this time, cases of swine influenza have been confirmed in Arizona, California, Indiana, Kansas, Massachusetts, Michigan, New York City, Ohio and Texas.  Based on the rapid spread of the virus thus far, public health officials believe that more cases will be identified over the next several weeks. 

Swine flu is similar to the influenza virus and people should not become overly alarmed.  However, the main difference from influenza (which would most severely affect the very young, very old and people with compromised immune systems) is that swine flu has also been found to infect the young and healthy.

The following are recommendations from the CDC when human infection with swine flu virus is confirmed in a community.

School Dismissal and Childcare Facility Closure:

  • Dismissal of students should be strongly considered in schools with a confirmed case
  •  Dismissal of students should be strongly considered in schools with a suspected case epidemiologically linked to a confirmed case. (Example: A male student comes to school presenting flu-like symptoms and has been in close contact with his grandma, who has a confirmed case of swine flu.)
  • Decisions regarding broader school dismissal within these communities should be left to local authorities, taking into account the extent of influenza-like-illness (ILI) in the community.
  • If the school dismisses students or a childcare facility closes, they should also cancel all school or childcare related gatherings and encourage parents and students to avoid congregating outside of the school.
  • Schools and childcare facilities should dismiss students for a time period to be evaluated on an ongoing basis depending upon epidemiological findings.  
  • Schools and childcare facilities should consult with their local or state health departments for guidance on reopening.  If no additional confirmed or suspected cases are identified among students (or school-based personnel) for a period of 7 days, schools may consider reopening.
  • Schools and childcare facilities in unaffected areas should begin to prepare for the possibility of school dismissal or childcare facility closure.  This includes asking teachers, parents and officials in charge of critical school-associated programs (such as meal services) to make contingency plans.

*Childcare facility: centers and facilities that provide care to any number of children in a nonresidential setting, large family childcare homes that provide care for seven or more children in the home of the provider and small family childcare homes that provide care to six or fewer children in the home of the provider. 
Other Social Distancing Interventions: 

  • Large gatherings linked to settings or institutions with laboratory-confirmed cases should be cancelled, for example a school event linked to a school with cases; other large gatherings in the community may not need to be cancelled at this time.
  • Additional social distancing measures are currently not recommended.
  • Persons with underlying medical conditions who are at high risk for complications of influenza may wish to consider avoiding large gatherings.

Special Considerations for Children 
Aspirin or aspirin-containing products (e.g. bismuth subsalicylate – Pepto Bismol) should not be administered to any confirmed or suspected ill case of swine influenza A (H1N1) virus infection aged 18 years old and younger due to the risk of Reye syndrome. For relief of fever, other anti-pyretic medications are recommended such as acetaminophen or non steroidal anti-inflammatory drugs.

Symptoms of Swine Flu
Similar to the symptoms of seasonal flu in humans and may include:

  • Fever (greater than 100F)
  • Sore throat
  • Cough
  • Stuffy nose
  • Chills
  • Headache and body aches
  • Fatigue
  • Some people have reported diarrhea and vomiting associated with swine flu 

To Prevent the Spread of Swine Flu

  • Avoid contact with ill persons.
  • When you cough or sneeze, cover your nose and mouth with a tissue or your sleeve (if you do not have a tissue).  Throw used tissues in a trash can.
  • After you cough or sneeze, wash your hands with soap and water, or use an alcohol-based hand gel.
  • If a person thinks they are ill with the flu, avoid close contact with others as much as possible.  Stay home.  Seek medical care if severely ill (such as having trouble breathing).  There are antiviral medications for prevention and treatment of swine flu that a doctor can prescribe. 
  • Do not go to work, school or travel while ill.

For more information concerning swine flu infection, please see the CDC website:
http://www.cdc.gov/swineflu/

 

Swine Flu
QUESTIONS & ANSWERS
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Swine Influenza and You

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What is swine flu?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular 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.
Are there human infections with swine flu in the U.S.?
In late March and early April 2009, cases of human infection with swine influenza A (HIN1) viruses were first reported in Southern California and near San Antonio, Texas.  Other U.S. states have reported cases of swine flu infection in humans and cases have been reported internationally as well.  An updated case count of confirmed swine flu infections in the United States is kept at http://www.cdc.gov/swineflu/investigation.htm CDC and local and state health agencies are working together to investigate this situation.
Is this swine flu virus contagious?
CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human.  However, at this time, it is not known how easily the virus spreads between people.
What are the signs and symptoms of swine flu in people?
The 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.  Some people have reported diarrhea and vomiting associated with swine flu.  In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people.  Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.
How does swine flu spread?
Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads.  Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza.  Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick.  That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.
What should I do to keep from getting the flu?
First and most important: wash your hands.  Try to stay in good general health.  Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.  Try not touching surfaces that may be contaminated with the flu virus.  Avoid close contact with people who are sick.
Are there medicines to treat swine flu?
Yes.  CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these swine influenza viruses.  Antiviral drugs are prescription medicines (pills, liquid, or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body.  If you get sick, antiviral drugs can make your illness milder and make you feel better faster.  They may also prevent serious flu complications.  For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).
How long can an infected person spread swine flu to others?
People with swine influenza virus infection should he considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset.  Children, especially younger children, might potentially be contagious for longer periods.
What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.  Droplets from a cough or sneeze of an infected person move through the air.  Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk and then touches their own eyes, mouth, or nose before washing their hands.
How long can viruses live outside the body?
We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks.  Frequent hand washing will help you reduce the chance of getting contamination from these common surfaces.
What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against swine flu.  There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.  Take these everyday steps to protect your health:

  • Cover your nose and mouth with a tissue when you cough or sneeze.  Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze.  Alcohol-based hand cleaners are also effective.
  • Avoid touching your eyes, nose, or mouth.  Germs spread this way.
  • Try to avoid close contact with sick people.
  • If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

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 he 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.
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

How serious is swine flu infection?
Like seasonal flu, swine flu in humans can vary in severity from mild to severe.  Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring.  However, swine flu infection can be serious.  In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later.  A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.
Can I get swine influenza from eating or preparing pork?
No.  Swine influenza viruses are not spread by food.  You cannot get swine influenza from eating pork or pork products.  Eating properly handled and cooked pork products is safe.

 

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La influenza porcina y usted (gripe porcina)

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¿Quê es Ia influenza porcina?

La influenza porcina (gripe porcina) es un tipo de influenza que afecta por lo general a los cerdos.  En ocasiones, las personas se enferman de influenza porcina.  Antes de este reciente brote de influenza porcina, la mayoría de las personas que se enfermaban con este virus generalmente habían tenido contacto cercano con los cerdos. Hay ocasiones en las que una persona con influenza porcina puede transmitirla a alguien más.
¿Hay personas en los EE. UU. que tienen la influenza porcina?
A finales de marzo y principios de abril del 2009, se inform6 de casos de influenza porcina en personas en los EE. UU. y a nivel internacional.  El subtipo específico de la influenza porcina es la influenza tipo A (H1N1). Los CDC y las agencias de salud estatales y locales están trabajando conjuntamente en la investigación de esta situatión.
¿Este virus de la influenza porcina se contagia facilmente?
En la actualidad, el virus de la influenza porcina se está transmitiendo de persona a persona.  En este momento, no se sabe con qué facilidad se transmite este virus de una persona a otra.
¿Cuáles son los signos y síntomas de la influenza porcina en las personas?
Los síntomas de la influenza porcina son parecidos a los síntomas de la influenza o gripe estacional.  Entre ellos se incluyen fiebre, tos, dolor de cabeza, dolor del cuerpo, dolor de cabeza, escalofríos y cansancio.  Algunas personas también pueden tener diarrea y vómito.  En años anteriores, algunas personas con la influenza porcina sufrían enfermedades graves (neumonía e insuficiencia respiratoria) o morían.  Tal como ocurre con la influencia estacional, la influenza porcina tambien puede empeorar afecciones médicas existentes.
¿Qué tan grave es la influenza porcina?
Al igual que ocurre con la influenza estacional, la influenza porcina en los seres humanos puede varier de leve a grave.  Desde el 2005 haste febrero del 2009, 12 personas en los EE. UU. contrajeron la influenza porcina.  No se reportaron muertes, pero dos personas se enfermaron gravemente. Sin embargo, la influenza porcina puede ser muy grave.  En 1988, una mujer embarazada fue hospitalizada en Wisconsin y murió posteriormente debido complicaciones de la influenza porcina.  Algunos trabajadores del área de atención médica que cuidaron a esta paciente también resultaron infectados por el virus.  Un brote de influenza porcine ocurrido en Nueva Jersey en 1976 enfermó a más de 200 personas y causó la muerte a una persona.
¿Cómo se contrae la influenza porcina?
Usted puede contraer la influenza porcina de dos maneras:

  • Por el contacto con cerdos infectados o con superficies contaminadas con los virus de la influenza porcina.
  • A través del contacto con una persona que tenga influenza porcine.  Es probable que la transmisión de la influenza porcina entre las personas ocurra de la misma forma en que se transmite la influenza estacional.
  • Se cree que los nuevos virus de la influenza porcina y los de la influenza estacional se transmiten de persona a persona cuando alguien infectado tose o estornuda.

¿Hay medicamentos para tratar Ia influenza porcina?
Los CDC recomiendan dos medicamentos antivirales que se expiden con receta médica para tratar o prevenir la influenza porcina.  Estos medicamentos son oseltamivir (nombre comercial Tamiflu®) o zanamivir (nombre comercial Relenza®).  Ambos medicamentos recetados combaten la influenza porcina al evitar que los virus de esta enfermedad se reproduzcan en el cuerpo.  Si usted se enferma, estos medicamentos pueden hacer que su enfermedad sea más leve y que usted se sienta mejor en forma más rápida.  Tambien pueden ayudar a prevenir que ocurran graves problemas de salud.  En relación con el tratamiento, los medicamentos son más eficaces si se inician dentro de los 2 dias siguientes a la aparición de la enfermedad.
¿Por cuánto tiempo puede una persona infectada propagar la influenza porcina a otras?
Las personas infectadas por el virus de la influenza porcina pueden transmitir la enfermedad mientras tengan los síntomas (fiebre, tos, dolor de garganta, dolores en el cuerpo, dolor de cabeza, escalofrios y cansancio, y en algunos casos diarrea y vómito) y posiblemente haste siete días después del inicio de la enfermedad.  Los niños, especialmente los más pequeños, podrían ser contagiosos durante periodos más largos.
¿Qué puedo hacer para evitar enfermarme?
En este momenta no hay una vacuna contra la influenza porcina.  Pero hay medidas clue usted puede tomar para ayudar a prevenir la propagación de gérmenes que causan enfermedades respiratorias como la influenza porcina y la influenza estacional.  Siga estas medidas a diario para proteger su salud:

  • Cúbrase la boca y la nariz con un parñuelo desechable al toser o estornudar.  Bote el pañuelo desechable a la basura después de usarlo.
  • Lávese las manos a menudo con agua y jabón, especialmente después de toser a estornudar.  Los desinfectantes para manos a base de alcohol también son eficaces.
  • Trate de no tocarse los ojos, la nariz ni la boca.  Esta es la manera en que se propagan los gérmenes.
  • Trate de evitar el contacto cercano con personas enfermas.
  • Si usted se enferma, los CDC recomiendan que se quede en casa y que no vaya al trabajo o a la escuela.  No se acerque mucho a otras personas para evitar contagiarlas.

¿Qué debo hacer si me enfermo?
Comuníquese con su proveedor de atención médica si usted vive en un área donde se hayan identificado casos de infecciones por influenza porcina en personas y se enferma con síntomas parecidos a los de la influenza (entre ellos, fiebre, dolor del cuerpo, secreciones de la nariz, dolor de garganta, náusea o vómito o diarrea).  El proveedor de atención medica decicirá si hace falta realizar pruebas para detectar la influenza o si necesita que le hagan tratamiento.
Si esta enfermo, se debe quedar en casa y evitar el contacto con otras personas tanto como sea posible para evitar propagar su enfermedad a otros.
Si se enferma y presenta alguno de los siguientes signos de advertencia, busque atención médica de inmediata.
En los niños, los principales signos de emergencia que requieren atención médica inmediata son:

  • Respiración agitada o dificultad para respirar.
  • Color azulado on la piel.
  • Que el niño no esté tomando suficientes líquidos.
  • El niño no quiere despertarse ni interactuar con los otros.
  • Que el niño esté tan molesto que no quiera que lo carguen.
  • Los síntomas similares a los de la influenza o gripe mejoran pero luego regresan con fiebre y una tos peor.
  • Fiebre con sarpullido.

En los adultos, los principales signos de advertencia que requieren atención médica de emergencia son:

  • Dificultad para respirar o se queda sin aliento.
  • Dolor o presión en el pecho o el abdomen.
  • Mareo repentino.
  • Confusión.
  • Vómitos fuertes o constantes.

¿Me puede dar influenza porcina por comer o cocinar carne de cerdo?
No.  La influenza porcina no se encuentra en los alimentos.  Usted no puede contraer la influenza porcina por comer carn de cerdo o sus productos derivados.  No hay riesgos si se come carne de cerdo y sus derivados que han sido manipulados y cocinados de manera adecuada.