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H1N1 (swine) flu: What you need to know
Note: Information from the Centers for Disease Control (CDC), New York City Department of Health and Mental Hygiene (NYCDOH) and the New York State Department of Labor Public Employees Safety and Health (NYSDOL PESH) Bureau was used in part to prepare this fact sheet.
What is H1N1 flu?
H1N1 flu (“swine flu”) is caused by a virus similar to regular (seasonal) flu. The illness can cause fever, cough, sore throat, tiredness, aches, chills and stuffy nose. Some affected people have also reported diarrhea and vomiting. Since April 2009, it has caused outbreaks of flu-like illness among people in New York City and in many countries around the world.
H1N1 flu spreads when a sick person coughs or sneezes. You can also get infected by touching something with flu viruses on it and then touching your own mouth or nose. Persons at close contact (within six feet) with a suspected or confirmed case are known to be at higher risk of infection.
High Risk Groups
Most people recover without medication but some people are more likely to get severely ill with the flu. Those at risk include everyone over 65, under 2 or pregnant, and anyone with long-term health problems such as asthma, diabetes, lung, heart, kidney, liver or blood disorders, those on long-term aspirin therapy or those with immune compromised systems.
If you are high-risk and have flu symptoms or you have close contact with someone who has the flu, call your health care provider immediately.
Take the same precautions you would to avoid regular seasonal flu and other respiratory infections:
- Wash your hands frequently with soap and water or an alcohol-based hand cleaner.
- Avoid touching your nose, mouth or eyes.
- Try to avoid close contact with sick people. If you get sick yourself, avoid close contact with other people.
- Cover coughs and sneezes with tissues, sleeves or elbows.
When experiencing influenza like symptoms such as fever and cough:
- Stay home until your symptoms resolve, and don’t return to work or school until you have been free of fever for at least 24 hours.
- Avoid going to the hospital if you have mild flu-like symptoms such as fever and cough — even if you think you could have H1N1 flu. People with flu usually recover without medical treatment, but other illnesses can cause fever, so call your doctor if you are in doubt. You should rest, drink plenty of liquids and take the medications you would normally use to treat symptoms.
When should you go to the emergency room or hospital
You should go to the emergency room or hospital if you have severe symptoms. Severe symptoms include trouble breathing or shortness of breath (rapid breathing in children), pain or pressure in the chest or stomach, bluish skin color, dizziness or confusion, increasing fever, or vomiting that won’t stop.
What to do in your school -- school protocols
For the 2009 -2010 school year the UFT worked with the NYCDOE and New York City Department of Health to make sure schools were prepared. The following protocols were put in place.
Every school should have a school specific plan of action for flu preparedness following the guidelines below.
- If students or staff have flu symptoms (greater than 100.0° F fever, coughing, sore throat, shortness of breath, runny nose, aches, pain, vomiting or diarrhea), they should stay home until at least 24 hours after they are free of fever, without the use of fever-reducing medications.
- The school administration should inform parents that they must keep children with flu symptoms (fevers and either coughs or sore throats) at home until at least 24 hours they are free of fever, without the use of fever-reducing medications.
- Ill students (with fever and cough or sore throat or shortness of breath) should be isolated in the nurse’s office or designated satellite isolation rooms (if the medical office is crowded) until their parents arrive. These students should not be returned to the classroom, sent to the general office or guidance counselors’/deans office. They should be separated from other students and sent home immediately (when possible).
- Students who are sent home with symptoms should not return to school until at least 24 hours after they are free of fever, without the use of fever-reducing medications.
If the school has students or staff with flu symptoms:
- Staff members at risk for complications from the flu should immediately consult their physicians for preventive measures.
- Pregnant staff and other at-risk members who do not feel well should immediately see a doctor.
- The standard operating protocols for the cleaning of cafeterias, bathrooms and hard surfaces such as doorknobs should be maintained. Hard surfaces should be cleaned immediately when visibly soiled.
- There should be adequate supplies of soap and paper towels in the bathrooms.
- There should be adequate/increased ventilation — make sure windows are open as much as feasible depending on the weather and mechanical ventilation systems should provide maximum amounts of outside air.
- Chapter leaders and staff members should not interfere with the operations of the medical office. This is to ensure efficient and safe operation of the medical office. The school administration will inform chapter leaders on a daily basis about absences and activity in the medical office.
- The school administration in consultation with the NYCDOE and NYCDOHMH will make sure there is the appropriate personal protective equipment in the school.
- The NYCDOE and NYCDOHMH will plan and provide for coverage for schools that do not have a nurse or other health care personnel and coverage for school nurses who are out sick.
Administration of H1N1 nasal spray in school buildings with pregnant staff
A number of pregnant staff members have raised the concern that they are put at risk when the H1N1 flu vaccine is being administered as a nasal spray in their school building. The UFT has investigated this concern and has prepared the following information.
The flu shot is made from killed virus that alerts the body's defenses when injected into a muscle. The nasal spray contains live but weakened influenza virus that survives long enough in the nostrils to provoke that same response. Healthy people between the ages of 2 and 49 can receive the vaccine.
The Centers for Disease Control (CDC) has indicated that pregnant women should not receive nasal spray for the seasonal or 2009 H1N1 flu vaccine, but it is safe for a pregnant woman to be around a family member, a child in a classroom or any other close contact who has received the nasal spray flu vaccine. The CDC has also concluded it is safe for a pregnant woman to administer the nasal spray vaccine with no special precautions required. Nurses and doctors should wash their hands or use an alcohol-based hand-rub before and after administering the vaccine.
The nasal spray flu vaccine has not been approved for pregnant women because it is made with live, weakened virus. Since pregnant women have reduced functioning of the immune system the CDC recommended the vaccine be administered to pregnant women as the flu shot, which has no live virus. The weakened, live flu virus in the flu spray mist vaccine has never been shown to be passed to the unborn baby. Nontheless, the CDC has tkane a very prudent approach for pregnant women and others mainly because the vaccine is readily available as a shot. Persons over 50 and children under 2 years of age are also not given the vaccine as a spray mist. For obvious reasons the spray mist is recommended for children and most adults because it is much easier to give and eliminates a painful shot.
A pregnant staff member in the school building has no potential exposure to flu vaccine spray mist administered in the nurse's office. The amount administered is very small and quickly settles from the air, and will be completely diluted by the large air volume in the building. For pregnant staff members who are concerned, the following additional precautions can be taken:
1. There should be adequate amounts of outside air in occupied rooms. Make sure windows are open as much as feasible depending on the weather and mechanical ventilation systems should provide maximum amounts of outside air.
2. Keep the door to the classroom/room closed.
3. Wash your hands frequently with soap and water.
4. Nurses giving the vaccine should wash their hands before and after administering the vaccine.
From the Dept. of Health and DOE:
- Questions and Answers about Nasal-Spray Influenza Vaccines
- Preventing Influenza in New York City’s Schools: Information for Parents, Teachers, and School Principals
- General Flu Information
- Flu Information for Schools
From U.S. federal agencies:
- Flu.gov: Know What to Do About the Flu
- Flu.gov: School Planning — Updated Guidance for Schools for the Fall Flu Season
- CDC: What Pregnant Women Should Know About H1N1 Virus