Health care workers (HCWs) caring for suspected (clinically diagnosed) or confirmed cases of. Influenza A(H1N1)v FREQUENTLY ASKED QUESTIONS

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1 Health care workers (HCWs) caring for suspected (clinically diagnosed) or confirmed cases of Questions found here: FREQUENTLY ASKED QUESTIONS What is pandemic flu? What is the difference between seasonal and pandemic flu? What is Influenza A (H1N1)v (previously known as swine flu)? How do people become infected with and how does it spread? Is it any worse than other forms of influenza? What are the symptoms of? What is the difference between suspected and confirmed cases of influenza A(H1N1)v? How do I protect myself from when at work? When should I wear a face mask? What is an FFP3 respirator and when should I wear it? How do I reduce the chance of spreading? How do I know if a patient has? How will I know if I have been in contact with a patient with Influenza A(H1N1)v? What will happen if I am a contact of through work? 1 of 5

2 What is pandemic flu? Pandemic is a term used by epidemiologists to describe infections that are spreading in the population of a number of different countries. A pandemic does not have to be a serious illness. Flu that spreads rapidly causing widespread epidemics around the world is described as a pandemic. Pandemic flu occurs when a new, highly infectious, strain of the influenza virus appears. In contrast to the ordinary or seasonal, flu outbreaks which we see every winter in the UK, flu pandemics occur infrequently - usually every few decades. What is the difference between seasonal and pandemic flu? Seasonal flu refers to the viruses that circulate in the human population and causes illness each winter. Pandemic flu occurs infrequently, when a new influenza virus emerges which is markedly different from those recently circulating in the human population, causes disease in people and spreads easily between people because they have little or no immunity to it. What is (previously known as swine flu)? Influenza A(HINI)v is a new strain of influenza, first identified in Mexico but which has spread as a result of travel to a number of countries around the world. Influenza is a viral infection which affects the respiratory tract. The H1N1 virus is commonly found in animals such as pigs and can sometimes spread from them to humans. This is what appears to have happened in this case and there is now evidence that it can spread between people. How do people become infected with and how does it spread? Infections are the result of human-to-human transmission. is spread in the same way as seasonal influenza which circulates mainly during the winter months. Influenza is primarily transmitted from person-to-person via large virus-laden droplets that are generated when infected persons cough, sneeze or talk; these large droplets can then settle on the mucosal surfaces of the upper respiratory tract (mouth or nose) or surface of the eye of susceptible persons who are near (within 3 feet (one metre)) infected persons. Transmission may also occur through direct contact or indirect contact with respiratory secretions such as when touching surfaces contaminated with Influenza virus and then touching the eyes, nose or mouth. To prevent spread, people should: Cover their nose and mouth with a disposable tissue when sneezing, coughing, wiping and blowing noses. 2 of 5

3 Dispose of used tissues in the nearest waste bin. Wash hands after coughing, sneezing, using tissues, or after contact with respiratory secretions and contaminated objects. Avoid touching their mouth, eyes and nose unless they have recently cleaned their hands. In hospitals certain procedures (particularly in the critical care setting) are more likely to generate aerosols: See link below for a list of aerosol generating procedures (AGPs) When staff are involved in these procedures on suspected or confirmed cases of they should wear the appropriate Personal Protective Equipment (PPE), including an FFP3 respirator. Is it any worse than other forms of Influenza? The current strain of H1N1 is associated with a mild form of the disease in most cases. It appears to affect younger age groups than the usual seasonal flu, possibly because older people have some immunity as a result of exposure to similar viruses in the past. What are the symptoms of? Symptoms are similar to those of seasonal influenza and cases are suspected when they have the symptoms described below in association with known risk factors (epidemiology) for exposure to the infection. Definition of clinical features and epidemiological risk factors: Confirmed case: Any person with laboratory confirmation of influenza A(H1N1)v Suspected case: Clinicians are now encouraged to diagnose cases on the basis of symptoms. The clinical diagnostic criteria are: Fever [pyrexia >38 0 C] or a history of fever and Influenza-like illness (two or more of the following symptoms: cough, sore throat, rhinorrhea, limb or joint pain, headache*) or Severe and/or life-threatening illness suggestive of an infective process. *vomiting and diarrhoea has been a feature of some of the confirmed US cases 3 of 5

4 What are the difference between suspected and confirmed cases of influenza A(H1N1)v? These terms reflect the level of confidence there is in a diagnosis of influenza A(H1N1)v. A suspected case meets the definitions of clinical and epidemiological features described above but has no laboratory confirmation. The diagnosis of a suspected case is made by clinicians on the basis of the presenting symptoms. A confirmed case has a positive laboratory test for influenza A(H1N1)v How do I protect myself from when at work? Maintain good infection control practice and adhere to local infection control policies at all times. Decontaminate your hands appropriately; before and after patient contact and after contact with potentially contaminated surfaces. Avoid touching your mouth, eyes and nose unless you have recently decontaminated your hands. To decontaminate hands use alcohol hand rub if hands are visibly clean. Use soap and water if hands are visibly soiled. Refer to your local hand hygiene policy. NB cover all cuts and abrasions with a waterproof dressing. Wear appropriate PPE according to local occupational health and safety and infection control guidance. Always wash your hands after removing any PPE. Refer to infection control guidance available at : When should I wear a surgical face mask? Use of surgical masks is appropriate when specifically involved in the care of a patient with suspected (clinically diagnosed) or confirmed influenza A(H1N1)v. Healthcare Workers assessing / caring for patients who are suspected or confirmed are advised to wear a surgical face mask when in close contact with the patient (within 3 feet (one metre)). N.B.: Face masks do not need to be worn continuously and should not be seen as a substitute for good respiratory and hand hygiene. Follow infection control guidance on the appropriate infection control measures and PPE for the type of care you are providing. Checklists for infection control precautions to minimise transmission of are available at: What is an FFP3 respirator and when should I wear it? FFP3 Respirator masks are designed to prevent infectious aerosols being inhaled or landing on the inner surfaces of your mouth or nose and are used in very specific 4 of 5

5 situations. There is a separate FAQ on the Health Protection Scotland website covering how and when to use these respirators: How do I reduce the chance of spreading Influenza A (H1N1)v? Maintain good infection control practice and hand hygiene practice: Cover your nose and mouth with a disposable single-use tissue when sneezing, coughing, wiping and blowing noses. Dispose of used tissues in the nearest waste bin. Wash hands after coughing, sneezing, using tissues, or after contact with respiratory secretions and contaminated objects. Avoid touching their mouth, eyes and nose unless they have recently cleaned their hands. Refer also to local hand hygiene policy How do I know if a patient has influenza A(H1N1)v? Patients identified as suspected (clinically diagnosed) or confirmed cases of who require admission to hospital will be nursed in a single room or a designated area with restricted access. Guidance at the entrance to the room/area will indicate the type of precautions that need to be taken. It is important to follow this guidance. How will I know if I have been in contact with a patient with Influenza A (H1N1)v? If you think / know you have been involved in the management of a suspected or confirmed case of without wearing the appropriate PPE then inform your line manager who will ensure you are followed up in accordance with local procedure. What will happen if I am a contact of through work? If you have worn the appropriate PPE it is unlikely you are at risk of contracting. If you are a contact of a suspected or confirmed case and have not worn the appropriate PPE when providing care then you will be followed up in accordance with local policy. Voluntary isolation or exclusion from work is not usually necessary for asymptomatic contacts of suspected or confirmed cases of. However, a local risk assessment will be undertaken for the contacts of all suspected and confirmed cases to determine whether any special risk exists that may indicate the need for voluntary limitation of movement, voluntary self-isolation and / or self-exclusion from work. 5 of 5