Swine Flu information and recommendations

Dear ADRA Colleagues:
As you may know, this weekend the World Health Organization (WHO) and the United States Government declared public health emergencies due to confirmed human cases of a new influenza virus, swine influenza [H1N1]. Countries around the world are reporting on "possible", "suspected" or "probable" cases. The key signs are difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion and severe or persistent vomiting. Potential symptoms are headache, fever, cough, muscle pain, lethargy, lack of appetite, runny nose, sore throat, vomiting, and diarrhea. If you should exhibit any of these signs and/or symptoms, please seek medical care and attention as soon as possible.

As we are interested and concerned for your health and safety, the Health Sector has appointed Bridget Aidam, Senior Technical Health Advisor, as a point of contact to review updates on the current outbreak and communicate them quickly to you. If you should have any questions or concerns, please contact Bridget directly at bridget.aidam@adra.org.
Due to epidemiological data demonstrating human-to-human transmission, this afternoon, WHO¡¦s Director-General raised the level of influenza pandemic alert from the current phase 3 to phase 4. The change to a higher phase of pandemic alert indicates that the likelihood of a pandemic has increased. However, please note that it does not indicate that a pandemic is inevitable. As further information becomes available, WHO may decide to either revert to phase 3 or raise the level of alert to another phase. There are currently six Pandemic Influenza Phases as outlined by WHO. For definitions of each WHO Pandemic Phase, visit http://www.who.int/csr/disease/avian_influenza/phase/en/index.html.
As there are presently quite a few epidemiological terms being discussed in media, it may be helpful to define and differentiate a few key terms, in the context of disease:

Outbreak: A sudden breaking out or occurrence of a disease.
Epidemic: A disease spreading rapidly and extensively, affecting many people in an area or population at the same time. [An outbreak of a contagious disease that spreads rapidly and widely].
Pandemic: A disease prevalent throughout an entire country or world. [An epidemic over a large area]
Given the widespread presence of the virus, the Director-General considered that containment of the outbreak is not feasible and that current focus should be on mitigation measures. The Director-General recommended not to close borders and not to restrict international travel. It was considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention.

„X Please review your emergency and preparedness plans and communicate updates to Bridget at ADRA International
„X Consider appointing a point person in each of your offices for rapid communication, and encourage point persons to review key documents for swine flu (links are below).
„X Consider establishing a communications tree of senior staff for rapid communication
„X Visit www.coregroup.org/h2p for examples of NGO preparedness plans, staff safety guidance, and communications for staff
„X Stay tuned for further information as the situation unfolds; if you would like to refer to additional information sources, please focus on official updates from WHO and CDC to avoid misinformation from general media reporting.

Q & A on Current Swine Flu Outbreaks

Q. What is the virus? How does it relate to human influenza or bird flu?

A: The H1N1 strain is NOT related to H5N1 avian influenza. This unusual strain of H1N1 virus is primarily a swine influenza, including genes from North American swine and avian influenza, human flu, and a European/Asian strain of swine flu. This strain is of interest to health authorities because it is different from human influenza A viruses; therefore, there is a concern that:

1. A large proportion of the population might be susceptible to infection
2. The seasonal flu vaccine H1N1 strain may not provide protection

Q: Could this virus lead to a pandemic?

A: For a virus to be a potential cause of a pandemic it needs to meet three characteristics:

1. A new strain of influenza virus emerges
2. That strain is easily spread from person to person
3. The virus causes serious illness in humans

Currently, it seems that the first two conditions are met. What we don't know is the virulence of the virus. Flu viruses are extremely unpredictable. Therefore, expect to see new information being reported each day. Also, now that the world is on alert, we will be picking up more and more cases through intensive surveillance efforts.
Q. What should individuals do?

A. Individuals should follow hand hygiene and respiratory etiquette:

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

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

Q. Can I get swine influenza from eating or preparing pork?

A. 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.

Recommended links for up-to-date information:

1. Wide selection of newspaper stories, updated every few minutes:

2. Official pandemic flu sites, but can be very slow to report breaking news as it takes time to confirm

3. Effect Measure by "Revere": Best timely independent expert analysis of flu news
As mentioned, Bridget will continue to send you updates and recommendations as the situation unfolds. Until then, keep safe and remember to follow recommended hand hygiene and respiratory etiquette!

Martine Y. Polycarpe

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