Article Archive
EMS Corner
Avoid being KOd by H1N1
Volume 24, No. 6

Pandemics being what they are, often prone to panic type thinking and behavior, it is little surprise that swine flu has been given so much attention. In the early outbreaks of the virus, it was not uncommon to see people in Mexico's major cities wearing protective masks. They even closed many of the ports of call on both coasts causing the cruise industry to cancel many cruises with Mexican destinations. In June of this year the World Health Organization (WHO) declared it officially 'pandemic' with the virus having spread to more than 70 countries. There had also been cases reported in every one of the 50 United States. Then it seemed to back-off. There were fewer cases and deaths reported, the panic seemed to abate, the ports were reopened and hygiene campaigns seemed to take center stage. Now the flu season has arrived and a renewed interest has emerged by the agencies responsible for the tracking, reporting and preventing of this very kind of outbreak.

H1N1 (Figure 1)The CDC (Centers for Disease Control and Prevention) has only issued routine guidelines up until this point but states they expect the cases of swine flu, now categorized as novel influenza A or H1N1, to rise with regular flu during the flu season. Cases in the United States are ongoing with some having increased intensity.

H1N1 is transmitted just like normal flu through droplet infectivity (sneezes and coughs) but is also transmitted via surface (door handles, stair railings) contamination. Apparently studies have shown that the H1N1 (fig. 1) can live on surfaces two-to-eight hours after being deposited. In light of this, it is even more important than ever to make sure shared work spaces are decontaminated frequently. This includes counter surfaces, keyboards, telephones, and other common use shared items.

Flu symptoms are numerous and people should be aware of classic signs before they occur.: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue and, sometimes, diarrhea and vomiting.

It is important to note that not everyone with flu will have a fever and not all of the signs and symptoms may be present. The other issue that has arisen and is truly problematic for all the human resource directors is the recommendation for all employees who present illness of this type be sent home (or remain at home) for a week's (seven day recommendation) convalescence and to remain at home for at least 24 hours past their last incidence of fever and without the use of any fever-reducing medications. The CDC also does not recommend that persons seek medical care unless absolutely necessary. Here is where the problem arises for HR as many of these persons will not have doctors' notes to present for their time off work. It is also not recommended that they be required to have one as this creates an undue and, according to the CDC, an unnecessary burden on the medical community.

Decontamination follows routine procedures and the use of standard germicidal cleaners (or 1:10 sodium hypochlorite solution if allowed) will suffice, but special attention must be paid to the common contact surface areas. It is also encouraged to frequently wash hands in warm water and soap and avoid touching your mouth, nose and eyes. In the absence of soap and water, "waterless" hand sanitizers may be substituted. These are alcohol based, gel in style products that should be used freely, fully wetting the hands and rubbed until dry. They are inexpensive for a large size container. Invest in one and use it.

So, what about total protection via a vaccination program? Well, that is here but there is not? enough of the virus vaccine to completely go around yet. Target groups will be the first to receive

the initial dosages. It takes time, not only to manufacture, but to isolate, develop and of course, clinically test any new vaccine. Are you in a target group? Health care workers and emergency workers are at the top of the list because of the vast exposure to the patient population. The young and elderly come next and pregnant mothers and those who care for dependant children (child care workers) are also slated to receive the vaccine. So have your agency check with the local health district, and see what the current information about the vaccine is, get your people inoculated and get the protection necessary. Visit vaccine sources at This is a full state reference for contact points for the vaccine. Your agency may even become a provider for the vaccine as this may help with its dissemination to the general public. Use good public relations tools. You can never have too many of those.

In the mean time, wash your hands. That has always been the forte for health care workers and now is not the time to back off. Lather soapy water for the time it takes to sing "Happy Birthday." Rinse and dry with paper towels or air dry. Remember to use a paper towel to open the bathroom door.


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