H1N1 (Swine Influenza) Update as of March 5, 2010
Since the World Health Organization declared an H1N1 pandemic in June 2009, the H1N1 virus has spread world wide. At this time the H1N1 virus continues to circulate at low levels causing overall influenza activity to decline or remain low in most places. The United States' Centers for Disease Control (CDC) reports on March 5, 2010, that only four states are reporting regional influenza activity while all other states are reporting no activity, including NH. The majority of the influenza viruses identified so far continues to be 2009 H1N1 influenza A viruses. On going monitoring has shown that the virus remains virtually identical to initial outbreaks acting very much like seasonal influenza and has not changed over the course of this pandemic and is no more virulent now than it was in early spring. Most people who have become ill have recovered without requiring medical treatment.As of December 17th NH DHHS announced that all Granite Staters 6 months and older are eligible to receive H1N1 vaccine. Recent shipments of the vaccine into the state have allowed DHHS to expand vaccination efforts to the general public.
In addition to the general public, the following high risk groups are still encouraged to be vaccinated against H1N1:
- Pregnant women
- People living with or caring for infants younger than 6 months old (including partners of pregnant women)
- Anyone between the ages of 6 months and 24 years of age
- People 25 – 64 years of age with underlying medical conditions
- Healthcare workers and first responder with direct patient contact
The vaccine is free and available through health care providers and the public and school based clinics that are being organized through the state’s All Health Hazard Regions (AHHR). Children younger than 6 months of age are not eligible to receive the vaccine because the influenza vaccine is not approved for use in this age. Children under the age of 10 years require two doses of the vaccine separated by 4 weeks.
Influenza pandemics are highly unpredictable and no one can say for sure when they will start or when they will end. Infections are expected to occur for weeks to come, possibly resulting in another wave of widespread illness. Now is a good time to receive your influenza immunization if you have not already done so. CDC and NH DHHS continue to recommend influenza immunization because it is not known when this will end. It is not too late to receive influenza immunization. A listing of free immunization clinics can be found on NH DHHS web site or by calling 211.
The leadership staff from Exeter Hospital and Core Physicians continues to stay in communication with The New Hampshire Hospital Association, NH DHHS and our regional emergency preparedness staff (AHHR) to make sure that we are well coordinated with the other hospitals and health care providers and that we are taking the necessary steps to prepare as the pandemic continues. In addition the hospital has partnered with our region AHHR to provide community and school based clinics.
As a result of intense planning over the past few years, New Hampshire’s hospitals are better prepared than ever to respond to the H1N1 pandemic. Preparedness is always a work in progress, but hospitals throughout the state have been planning and preparing for a pandemic for several years.
Signage has been placed at entry points of the hospital instructing visitors to self assess themselves for respiratory signs and symptoms and not enter the hospital if they have signs of influenza like illness. If they must enter the building, masks are available for them to put on. In order to ensure the safety and wellbeing of our patients, staff and visitors, we have implemented a significant number of intensive measures in addition to our normal infection control practices including:
- Signage posted at entry points of the hospital encouraging visitors to self assess for signs of influenza like illness. Discouraging those with signs of influenza illness from visiting and providing masks for those who must enter the facility.
- Visitors to the Family Center, Intensive care unit (ICU) and Progressive Care unit (PCU) are screened by staff at the entrance to those areas. Those with signs and symptoms of influenza like illness are not allowed to visit.
- Enhanced triage assessments in our Emergency Department and physician practices to enable the segregation of potentially infected patients.
An expanded screening process for employees who begin to display symptoms, become sick or who may have been exposed during time away from the hospital. Employees who become ill at home are required to check in with our Staff Health Office before returning to work. - Staff Education
- Per CDC and NH DHHS guidelines and recommendations we have educated our staff on the necessary precautions to take to protect themselves as well care for patients with suspected, probable or confirmed H1N1.
- Continue to partner with local as well as state Public Health Officials (NH DHHS and region AHHR) and federal Public Health Officials (CDC) to stay on top of latest developments and recommendations and plan future immunization clinics.
- H1N1 immunization to all of our staff especially those with direct patient care as well as all pregnant staff. Signs and symptoms of H1N1 influenza are very much like seasonal influenza:
- Offer H1N1 vaccine to our patients who have not already received it.
- Fever 100 F or greater
- Chills
- Cough
- Sore throat
- Muscle/joint aches
- Fatigue
- Vomiting/diarrhea (mostly in children)
According to NH DHHS, H1N1 is spread from person to person and there is no risk of contracting this flu virus by eating pork. There are, however, some basic precautions that everyone should be taking to prevent becoming ill or spreading illnesses, not just H1N1 (swine flu).
- Take everyday actions to stay healthy.
- 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 hands cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
- The CDC adds that to avoid contracting the flu people should 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 to touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.
According to the CDC and NH DHHS, if you are experiencing flu-like symptoms and feel you need to be evaluated, call your physician first. It is important for people at higher risk for complications from influenza to contact their doctor if they have fever of 100.4 or greater, and a cough or sore throat. People at higher risk of complications from influenza include children younger than 5, people 65 or older, pregnant women, and those with chronic diseases illness such as asthma. To reduce the risk of spreading influenza to others, we urge you to avoid going to the hospital emergency room unless you are experiencing severe signs of illness. Please ask your doctor for advice before you come to the hospital. He or she will determine if influenza testing or treatment is necessary. Patients who do not have a primary care provider can call the NH DHHS swine flu hotline: 1-888-330-6764. The hotline is open every day, from 8 a.m. to 8 p.m.
If you are sick, stay home from work, school or public events. Cover your nose and mouth with a tissue or your arm when coughing or sneezing. If you use a tissue, throw it away. Hand washing is the first and best way to prevent the spread of any infection. Clean your hands every time you cough or sneeze. Please consider not visiting patients you know in the hospital if you have any flu-like symptoms.
Seek emergency medical care:
If your child experiences any of the following:
- Fast breathing or trouble breathing
- Bluish skin color
- Not drinking enough fluids
- Not waking up or not interacting
- Severe or persistent vomiting
- 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
- Important Note: According to the CDC parents should avoid using aspirin on children under 18 as a fever/pain reducer for children with confirmed or suspected cases of swine influenza A (H1N1) due to the risk of Reye syndrome. For relief of fever, CDC recommends the use of acetaminophen (such as Tylenol) or other non-steroidal anti-inflammatory drugs (such as Ibuprofen – Motrin/Advil).
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness
- Confusion
- Severe or persistent vomiting
- Stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your temperature should be normal without the use of fever reducing medicine).
- Keep away from others as much as possible. This is to keep from making others sick.
- Drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated.
- Dishes should be done in dishwasher or with hot soapy water.
- Through away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues.
- Have everyone in the household wash hands often with soap and water, especially after coughing or sneezing. Alcohol based hand cleansers are also effective.
- Avoid touching your eyes, nose, and mouth. Germs spread this way.
The New Hampshire Department of Health and Human Services announced the activation of New Hampshire’s H1N1 Flu Public Inquiry Line. DHHS is urging residents with questions about the H1N1 influenza virus, the H1N1 vaccine, and any other questions related to H1N1 to contact 2-1-1 NH by dialing 2-1-1. The public inquiry line will be open for H1N1 related questions from 8 am – 5 pm Monday through Friday.
For more information on swine influenza, visit the NH DHHS or the CDC websites.
Frequently Asked Questions
H1N1 Vaccine Fact Sheet (10/8/09)
Additional information is available from:
The Centers for Disease Control and Prevention
The NH Department of Health and Human Services
