Swine Influenza

4/30/09

Background

• Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza virus– Regularly causes outbreaks of influenza in pigs

• Like all influenza viruses, swine flu viruses change constantly– Pigs can be infected by avian influenza and human

influenza viruses as well as swine influenza viruses. When influenza viruses from different species (birds, pigs, humans) infect pigs, the viruses can reassort (i.e. swap genes)

• Sporadic human infections with swine flu have occurred

Swine Flu – Symptoms

• The symptoms of swine flu in people are expected to be similar to the symptoms of regular human season influenza and include fever, cough, rhinorrhea, sore throat, malaise, fatigue, lack of appetite. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea.

Swine Flu – Transmission

• Thought to occur in the same way as seasonal flu occurs in people– Person-to-person transmission through

coughing or sneezing of people infected with the influenza virus

– People may become infected by touching something with flu viruses on it and then touching their eyes, mouth or nose.

Current Swine Flu Epidemic

• International – WHO Stage 5 (Pandemic Imminent)

• Nationally (CDC 5/01 6AM)• 109 cases in 11 states (AZ, CA, IN, KS, MA, MI,

NV, NY, OH, SC,TX)• 1 fatality

• Locally– 6 probable cases

Swine Flu Prevention at JHH

• Incident Command Center in the Smith Room (410-955-3333)

• Departmental Command Centers • A daily briefing occurs in the Hurd Hall at 12N• For updated information [Hospital Epidemiology

and Infection Control (HEIC) website]– http://www.hopkinsmedicine.org/heic

• WASH HANDS, RESPIRATORY ETIQUETTE, STAY HOME IF YOU HAVE FEBRILE URI

http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

Swine Flu Prevention at JHH

http://www.hopkinsmedicine.org/heic

• Swine Flu Q&A• Swine Flu Respiratory Screening Card• Swine Flu Procedures for Screening Patients• Swine Flu Employee Screening (algorithm)

– Updated daily - source of all current information from the CDC and the status of our prevention and screening activities.

http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

Swine Flu Prevention at JHH

• Staging

• Screening– Patients– Employees

• Fit testing

http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

JHH EPRI Response Plan Format

Type of Transmission

Location of CasesAre there cases at

JHH?Stages

Person-to-person transmission

Anywhere in the world No 1

Person-to-person transmission

Anywhere in North America No 2

Person-to-person transmission

In region: MD,PA,VA,DC,DE,NJ,WV

or close to bordersPossibility exists 3

Any At JHHYes, but no nosocomial

transmission 4

Person-to-Person transmission

At JHHYes, nosocomial

transmission from known sources only

5

Person-to-Person transmission

At JHHYes, nosocomial transmission from unclear sources

6

Current Screening at JHH

• This may change daily– Patients (Respiratory Report Card on HEIC

website)

http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

Screening at JHH

• This may change daily– Patients (Respiratory Report Card on HEIC

website)• Screening at reception • Phone screening & triage

– Employees (Respiratory Report Card)• Screening of all staff with symptoms• Screening of staff returning from areas with

infection• OHS maintain list of staff under surveillance

http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

Screening at JHH

• If a patients or employee meets the case definition– Place mask on patient/employee – Isolate on droplet – Healthcare workers must wear N-95 with eye protection

or PAPR– Call HEIC (pager 3-3426)– Refer or perform NP aspirate

• Obtain in negative pressure setting (airborne precaution room or portable HEPA in room, N95 or PAPR for HCW)

http://www.hopkinsmedicine.org/heic/SwineFlu/index.html

Fit Testing JHH

• All employees need to be fit tested for an N-95 respirator

• A priority list has been determined by the Incident Command Team

• Please call Gai Cole (410-935-0668)

http://www.hopkinsmedicine.org/heic/SwineFlu/index.html