H1N1 Influenza A
(Swine Flu)
What is H1N1 Influenza A Virus (Swine Flu)?




H1N1 (referred to as “swine flu” early on) is a
new influenza virus causing illness in people.
This new virus was first detected in people in
April 2009 in the United States.
H1N1 Influenza A (swine flu) is transmitted by
respiratory secretions
This virus was originally referred to as “swine
flu” because laboratory testing showed that
many of the genes in this new virus were very
similar to influenza viruses that normally occur
in pigs in North America.
Can Humans Catch
H1N1 Influenza A (swine flu)?

It is determined that this new H1N1
Influenza A 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 & Symptoms of H1N1
Influenza A in Humans?



The symptoms of this new influenza A H1N1 virus in
people are similar to the symptoms of regular human flu
and include fever (greater than 100.0º F or 37.8 º C),
cough, sore throat, body aches, headache, chills and
fatigue.
A significant number of people who have been infected
with this virus also have reported diarrhea and
vomiting.
Also, like seasonal flu, severe illnesses and death has
occurred as a result of illness associated with this virus.
How Does H1N1 Influenza A Spread?



Human-to-human
transmission
of
H1N1
Influenza A predominantly occurs through direct
droplet transmission (Usually within 6-10 feet).
This is thought to occur in the same way as
seasonal flu, which is mainly person-to-person
transmission through coughing or sneezing of
infected people.
People may become infected by touching
something with flu viruses on it and then touching
their mouth or nose (moist mucous membranes).
How Long Can an Infected Person
Spread this Virus to Others?
 With
seasonal flu, studies have shown
that people may be contagious from one
day before they develop symptoms to up
to 7 days after they get sick.
 Children, especially younger children,
might potentially be contagious for
longer periods.
How Can Someone with the H1N1 Influenza
A Infect Someone Else?
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.

What is the Infectious Period?


Persons who continue to be ill longer than 7 days
after illness onset should be considered potentially
contagious until symptoms have resolved.
Non-hospitalized ill persons who are a confirmed
or suspected case of swine-origin influenza A
(H1N1) virus infection are recommended to stay at
home (voluntary isolation) for at least the first 7
days after checking with their health care provider
about any special care they might need if they are
pregnant or have a health condition such as
diabetes, heart disease, asthma, or emphysema.
What Can I do to Keep From
Getting the Flu (Influenza)?





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 touch surfaces that may be contaminated
with the flu virus.
Avoid close contact with people who are sick.
Interim Recommendations for Assessment
of “Influenza-Like Illness” (ILI)
Step 1: EMS personnel should stay more than 6
feet away from patients and bystanders with
symptoms and exercise appropriate routine
respiratory droplet precautions while assessing
all patients for suspected cases.
 Step 2: Assess all patients for symptoms of
acute febrile respiratory illness (fever plus one or
more
of
the
following:
nasal
congestion/rhinorrhea, sore throat, or cough).

Personal Protective Equipment
(PPE)



EMS Personnel should ensure that they have the
necessary personal protective equipment
N95 mask, surgical masks, gloves, eye protection,
gown, and other standard equipment for droplet
precautions
Fit-tested disposable N95 respirator and eye
protection (e.g., goggles; eye shield), disposable
non-sterile gloves, and gown, when coming into
close contact with the patient.
Infection Control
Interim Recommendations:


When removing PPE make every attempt to avoid
contact with contaminated areas and wash hands
before touching a clean area.
All patients with acute febrile respiratory illness should
wear a surgical mask or approved respiratory barrier, if
tolerated by the patient.
+
=
Sequence for Removing PPE

Gloves

Face shield or goggles

Gown

Mask or respirator
How to Remove Gloves

Grasp outside edge near wrist

Peel away from hand, turning glove inside-out

Hold in opposite gloved hand
How to Remove Gloves
(continued)

Slide ungloved finger under the wrist of the remaining
glove

Peel off from inside, creating a bag for both gloves

Discard in approved biomedical waste container
Removing Goggles or Face Shield

Grasp ear or head pieces with ungloved hands

Lift away from face

Discard in approved biomedical waste container
Removing Isolation Gown

Unfasten ties

Peel gown away from
neck & shoulder

Turn contaminated
outside toward the inside

Fold or roll into a bundle

Discard in approved
biomedical waste
container
Removing a Mask

Untie the bottom, then top, tie

Remove from face

Discard in approved biomedical waste container
Removing a Particulate Respirator
Lift the bottom elastic
over your head first
 Then lift off the top
elastic
 Discard in approved
biomedical
waste
container

Hand Hygiene

Perform hand hygiene immediately after removing
PPE.

Wash hands with soap and water or use an alcoholbased hand rub

Ensure that hand hygiene facilities are available at
the point needed (sink or alcohol-based hand rub)
Interfacility Transport



EMS personnel involved in the interfacility transfer of
patients with suspected or confirmed H1N1 Influenza
(swine flu) should use standard, droplet and contact
precautions for all patient care activities.
This should include wearing a fit-tested disposable N95
respirator, wearing disposable non-sterile gloves, eye
protection (e.g., goggles, eyeshield), and gown, to prevent
conjunctival exposure.
If the transported patient can tolerate a facemask (e.g., a
surgical mask), its use can help to minimize the spread of
infectious droplets in the patient care compartment.
Interfacility Transport
(continued)



Encourage good patient compartment vehicle airflow/
ventilation to reduce the concentration of aerosol
accumulation when possible.
If the transported patient can tolerate a facemask (e.g., a
surgical mask), its use can help to minimize the spread
of infectious droplets in the patient care compartment.
Encourage good patient compartment vehicle airflow/
ventilation to reduce the concentration of aerosol
accumulation when possible.



Routine cleaning with soap or detergent and
water to remove soil and organic matter,
followed by the proper use of disinfectants, are
the
basic
components
of
effective
environmental management of influenza.
Reducing the number of influenza virus particles
on a surface through these steps can reduce the
chances of hand transfer of virus.
Influenza viruses are susceptible to inactivation
by a number of chemical disinfectants readily
available from consumer and commercial
sources.
Antiviral Treatment for H1N1 Influenza A
(Swine Flu) Infections in Humans



Antivirals may be used as either a treatment to a confirmed or
suspected case of H1N1 Influenza A (swine flu) or as
prophylactic treatment to exposed individuals under specified
conditions
At this time, prehospital treatment of patients with antiviral
agents is not being utilized
CDC recommends the use of Tamiflu (oseltamivir phosphate) or
Relenza (zanamivir) as part of the treatment and/or reduction
of severity of infection with swine influenza viruses.
Vaccinations


There is no vaccine to protect humans from
H1N1 Influenza A (swine flu) at this time.
The seasonal influenza vaccine will likely help
provide partial protection against swine H3N2,
but not swine H1N1 viruses.
Recommendations for:
Vehicle Decontamination

Upon completion of patient care (single call), clean all
equipment that came in contact with or was within 6 feet
of the suspected ILI patient with an approved disinfectant.

The equipment may include stretchers, railings,
medical equipment control panels, adjacent
flooring, walls, ceilings and work surfaces, door
handles, radios, keyboards, and/or cell phones.

Cleanse all surfaces within 6 feet of the patient or surfaces
touched by the patient or caregivers with an approved
disinfectant.
Recommendations for:
Vehicle Decontamination (Continued)




Large spills of bodily fluids (e.g., vomit) should first be
managed by removing visible organic matter with
absorbent material.
Place contaminated reusable patient care devices and
equipment in biohazard bags.
Clean and disinfect non-patient-care areas of the vehicle
according to the vehicle manufacturer’s recommendations.
Cleaning should be done with detergent and water and
then disinfected using an EPA-registered hospital
disinfectant in accordance with the manufacturer's
instructions.
Thank you