SPECIAL EDITION: H1N1 FLU VIRUS

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1 SPECIAL EDITION: H1N1 FLU VIRUS Nisga a Healer Everything You Want to Know About the H1N1 Flu Virus Nisga a Valley Health Authority, Nisga'a Lisims Government, and the School District are monitoring the spread of the H1N1 flu virus. Teleconference calls are held regularly with Northern Health Authority to attain updates. As a result of these calls, and the updates and statistics that are provided, NVHA medical staff are convinced that the H1N1 flu virus is not the big one - the pandemic that many people believe it to be. If it was, it would be killing thousands of people all over the world, but it isn't. We are very relieved. Northern Health Authority Announcement The Northern Health Authority announced on May 15 that, "They are moving into normal operating mode, and treating the virus like the regular flu. If the World Health Organization moves it to a higher level, they can reactivate their Emergency Operations Centre." This is very reassuring news! How Does the H1N1 Flu Virus Compare to the Regular Flu? As of May 14, the 96 cases that were reported in BC have fully recovered or are recovering. There are 449 cases reported in Canada with one death in Alberta (see Table 1 on page 2). As we know from personal experience, one death from the flu is one too many, but in reality, about 1400 people in BC die from the regular flu and pneumonia (a serious complication of the flu) every year. The peak of the flu season is traditionally December to March. So what do these numbers tell us? They tell us that the H1N1 flu virus is actually less dangerous than the regular flu that we experience every year, and that the numbers of reported cases indicate that it is not the pandemic, but it is still very serious. People died from the virus, particularly in Mexico, and many more people got sick from it throughout the world. It's major! In fact, it's tragic, and as a compassionate Nation, we feel for the losses, and for the families who lost loved ones to this virus. We live in a relatively small community, and we know from first hand experience how difficult it is to lose even one person in our community. When it's from something big that we don't understand such as what occurred in Mexico when the virus first hit, it's scary as well! In our history, significant numbers of our people died from the volcanic eruption. This was staggering to our people, so we can put ourselves in their shoes very easily. Although the events aren't the same, it is very serious, and we are responding accordingly and responsibly. Scientists Decode the Genetic Make-Up of the H1N1 Flu Virus Another major fact regarding the H1N1 flu virus was the announcement made by the Public Health Agency of Canada on May 7 that, "Canadian scientists have completed work on decoding the genetic makeup of the H1N1 flu Healthy Minds, Healthy Bodies, Healthy Spirits virus." See page 3 for the story. This is wonderful news as it provides us with even greater reassurance on the development of a vaccine. Schools in BC Reopen on May 11 The school in Burns Lake, and on southern Vancouver Island reopened on May 11. They were closed by school officials. Our School District, as with all School Districts and organizations, is urging its students to practice flu preventative measures. See page 6 for the preventative measures that are being enforced worldwide. Prevention is Key to Protection However, there is concern in the community about the virus, and there should be. People don't like to be sick, especially from the flu, so the best medicine? Adopt common sense practices in your everyday lives to combat the spread of flu. Prevention is key to protecting yourself, as well as educating your children and family about the precautions that should be practiced regularly. This special edition of the Nisga'a Healer will provide you with information on what the H1N1 flu virus is, what the protection measures are to increase your understanding of the virus, and to ease your fears. Knowledge is the best defense.

2 Nisga a Healer - SPECIAL EDITION H1N1 FLU VIRUS Page 2 Cases of H1N1 Flu Virus in Canada as at May 14, 2009 The Public Health Agency of Canada (PHAC) is committed to sharing information about H1N1 flu virus (Human Swine Flu) cases with Canadians. Confirmed cases are updated once daily at 4 p.m. (EDT). The case numbers are accurate as of 3 p.m. (EDT) when the daily reports from the provinces and territories are compiled by PHAC. Any cases reported after 3 p.m. (EDT) will be reflected in the next day s count. As of May , a total of 449 laboratory-confirmed cases of H1N1 Flu Virus (Human Swine Flu) have been reported in 9 provinces and 1 territory in Canada (see Table 1 below). Table 1: Summary of laboratory-confirmed cases of H1N1 flu virus (Human Swine Flu) reported to the Public Health Agency of Canada, by the provinces and territories as of May 14, Province / Territory NEW Laboratory-Confirmed Cases as of May 14, 2009 TOTAL Laboratory-confirmed cases (including today s cases) 1 Total Deaths British Columbia Alberta Saskatchewan Manitoba Ontario Quebec New Brunswick Nova Scotia Prince Edward Island Newfoundland Yukon Northwest Territories Nunavut Total Number of deaths is included in the number of cases The web address to attain updated numbers from the Public Health Agency of Canada is

3 Nisga a Healer - SPECIAL EDITION H1N1 FLU VIRUS Page 3 PHAC News Release, May 7: Public Health Agency of Canada's National Microbiology Laboratory in Winnipeg First to Decode Genetic Makeup of Mexican and Canadian H1N1 Flu Viruses (OTTAWA) Minister of Health Leona Aglukkaq and Chief Public Health Officer Dr. David Butler-Jones today announced that Canadian scientists have completed work on decoding the genetic makeup of the H1N1 flu virus. "The world's knowledge of the H1N1 flu virus has taken a significant step forward thanks to the excellent work done at Canada's National Microbiology Laboratory," said Minister Aglukkaq. This is an important achievement for our scientists as it marks the first successful sequencing of virus samples from different countries, said Dr. David Butler-Jones, Chief Public Health Officer of Canada. Our researchers should be commended for completing this important work in less than a week. This is one of the Lab's finest hours. Genetic sequencing is the process of determining the order of the molecules that make up the DNA in each gene of an organism. This complete genetic blueprint provides important information for researchers studying the virus. The laboratory completed sequencing of H1N1 virus samples taken from Mexico, Nova Scotia and Ontario. "This takes us a big step forward in understanding how this virus works, said Dr. Frank Plummer, Scientific Director General of the National Microbiology Laboratory. Our preliminary analysis does not indicate a significant difference between the virus in Mexico and the virus in Canada. Canada's work on the virus has been submitted to GenBank -- an international, searchable database -- to allow more researchers to have access to the results and benefit from the information. Media Inquiries: Public Health Agency of Canada Media Relations (613) Également disponible en français This is a significant break-through,and scientists are working very extensively on the development of a vaccine. We will likely have a vaccine developed within 4-6 months. Take comfort in knowing that we are very close to the end of the flu season for this year.

4 Nisga a Healer - SPECIAL EDITION H1N1 FLU VIRUS Page 4 The H1N1 Flu Virus: Answers to All of Your Questions (from Northern Health Authority and the Public Health Agency of Canada) What is the H1N1 flu virus? It is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of flu in pigs. What are the symptoms? The symptoms of swine influenza in people can be similar to the symptoms of regular human seasonal influenza infection and include fever, cough, headache, general aches and fatigue. Some people with swine flu have also reported runny nose, sore throat, nausea, vomiting and diarrhea. How do people get it? Human infections with flu viruses from pigs can occur when people are in close proximity to infected pigs such as in pig production barns and livestock exhibits at fairs. Human-to-human transmission is also possible. Influenza and other respiratory infections are transmitted from person to person via the respiratory route. Coughs and sneezes release the germs into the air where they can be breathed in by others. Germs rest on hard surfaces like counters and doorknobs, where they can be picked up on hands and transmitted to the respiratory system when someone touches their mouth and/or nose. Can I get the H1N1 flu virus from eating pork? No. The H1N1 flu virus (human swine flu) is not a food safety concern. Proper cooking of pork products would kill any viruses. Additionally, swine exhibiting symptoms of influenza would not pass tests to enter into the food market. Are masks effective in preventing the spread of the H1N1 flu virus? The H1N1 flu virus is spread from person to person usually through respiratory droplets, from someone that is coughing or sneezing. Influenza is not airborne. The wearing of masks by affected persons will limit their ability to spread the virus and caregivers in the home might also benefit. However, the use by the general public in public, though a feature of many outbreaks, remains unproven. A mask on its own may not be enough to stop the spread. The best thing is to do is to cover your nose and mouth with a disposable tissue when you sneeze and wash your hands often with soap and water. It s the simplest and most effective way to prevent spreading the virus. For health professionals who are managing H1N1 flu cases in health-care facilities, N95 respirators are recommended for specific situations. Surgical masks are recommended for health-care workers as part of the national PHAC guidelines. What's the incubation period for H1N1? It's generally thought to be between 2 and 7 days. How long should people stay home from school or work if they have symptoms? For a minimum of 7 days or longer if they're not symptom-free by 7 days. What if someone in my family has tested positive for H1N1 or has flu-like symptoms? If you don't have symptoms yourself, you can still go to work/school. If you have a family member with symptoms, practice good hand-washing, cough hygiene, etc., at home. You may need to make arrangements to ensure that the ill person is kept at home and away from school/work/gatherings. If you have flu-like symptoms, stay home. Do not attend any feasts if you are sick. If you absolutely have to attend a feast, wear a mask. If your child is sick with flulike symptoms, keep your child home from school. How long can the virus live outside the body? The virus can live outside the body on hard surfaces for up to 48 hours. However, it is easily killed by hand-washing with warm water and soap or with hand sanitizer. Household disinfectants will kill the virus on household items and surfaces. If someone's infected but not showing symptoms yet, can they transmit the virus to others? It is possible that the virus can be transmitted during this time. However, the virus will spread more easily once a person is showing symptoms (coughing, etc.). This is why it's so important for people to wash their hands, cover coughs and sneezes, and stay home when ill in order to avoid spreading the virus. I recently travelled to an affected area and I have no symptoms of illness. Should I stay home from work or

5 Nisga a Healer - SPECIAL EDITION H1N1 FLU VIRUS Page 5 The H1N1 Flu Virus: Answers to All of Your Questions Continued school? No, recent travellers who are symptom-free can return to regular daily activities. It may be possible for people to spread the illness up to one day before they are ill; however, the amount of virus in a person's system at that point is very small, so the risk of transmission is low. However, once people begin to show symptoms, the amount of virus in their body increases, and transmission is much easier. Once someone shows symptoms, they should stay at home to prevent spreading the virus. Should I avoid contact with people who have recently travelled to an affected area? Returning travellers are being screened on arrival in Canada for early signs of illness. Those who are symptom-free are being advised to return to regular daily activities. Travellers who report symptoms associated with the H1N1 virus will be assessed and isolated if required. Will private sales of antivirals deplete our national stockpile? No. We have already established our national stockpile which consists of over 55 million does of oseltamivir (Tamiflu) and zanamivir (Relenza) that have been distributed to provinces and territories on a per capita basis and are stored across the country. Private sales do not impact the amount of stock within our stockpile. When will antivirals from the National Antiviral Stockpile be used? The federal government is working with provinces and territories to determine when antivirals will be released from the stockpile. The use of antivirals to treat influenza is linked to the severity of the illness. PHAC recommends that antivirals be used to treat people who have more severe illness, not people who are only mildly ill. Treatment is recommended for anyone who is at high-risk of complications of seasonal influenza. How long will a vaccine take to develop? Canada has a contract in place for the production of a pandemic vaccine. Canada will produce enough vaccine for all Canadians. Was a travel advisory issued? PHAC issued a travel health warning for Mexico. Travellers from Canada are recommended to postpone elective or nonessential travel to Mexico until further notice. PHAC issued a separate travel health notice regarding swine flu in the US and will provide updates as more information becomes available. The World Health Organization is monitoring the situation closely. Travellers should follow the same precautionary measures that are recommended to protect against seasonal influenza practicing frequent handwashing, covering coughs and sneezes, and staying home when ill. How can I stop the spread of the H1N1 flu virus (human swine flu)? Experts have determined that the H1N1 flu virus can spread from human to human. However, they have not yet determined how easily it spreads between people. Stay home from work or school if you are sick, regardless of where you have travelled, unless directed to seek medical care. Limit contact with others. Call HealthLink BC at to speak to a nurse anytime of the day or night if you have symptoms or concerns See a health care provider if your symptoms become worse, but call ahead to let them know you have fever or cough illness. Exercise commonsense precautionary measures. Where can I find more information? Fact sheets, resources and updates on the H1N1 flu virus (human swine flu) are available at the World Health Organizaton at and the BC Centre for Disease Control at Call HealthLink BC at or visit A nurse is available 24/7 if you have any questions or concerns or if you're feeling ill. Learn how to protect yourself against the flu at Is NVHA prepared? Definitely. NVHA has emergency and pandemic preparedness plans developed. It is reviewing its flu preparedness, resolving deficiencies, and strengthening the plan. The current situation with the H1N1 flu virus is providing NVHA with an excellent opportunity to practice it. Training and exercise will greatly assist in strengthening the plans.

6 Nisga a Healer - SPECIAL EDITION H1N1 FLU VIRUS Page 6 Preventing the Spread of the Flu Preventing the flu is everyone's responsibility! Influenza or the flu is a common, infectious respiratory disease that begins in your nose and throat. It is highly contagious and spreads rapidly from person to person. (photos are from a personal collection) Prevention and education are key to protecting you and your family from the spread of flu. Educate your children and family members about the common sense precautionary measures that should be practiced regularly. be asked a number of questions to clarify the extent of your illness. Avoid close contact with others who may be sick with the flu. Don't touch your eyes, nose or mouth after touching surfaces like door knobs, ATM machines and Flu Prevention Checklist light switches. Wash your hands Cover your mouth and nose with regularly. a tissue when you cough or Keep shared surface areas sneeze or cough and sneeze into clean. Doorknobs, light switches, your sleeve. Do not sneeze into telephones, keyboards and other your hands. Show your children surfaces can become how to cover up when they cough contaminated with all kinds of or sneeze. Throw your tissues bacteria and viruses. Regular away immediately. cleaning and disinfecting of these surfaces can help. Talk about staying healthy. Encourage others to follow these simple steps. Taking Care of Your Body Clean your hands often with soap and warm water or gel sanitizers or alcohol-based handcleanser. Twenty seconds of hand washing with warm water and soap helps remove bacteria and viruses. Teach your children to count to 20 while washing their hands. Healthy eating, adequate sleep and physical activity are essential to your well-being. These are usual practices that should always be maintained to keep you healthy, and to boost your immune system. Stay home if you are sick or think you might be. Call the Health Centre immediately if you feel ill, and inform the centre what your symptoms are. Call first. You will Another way to protect you and your family from the flu is to get your flu shot. It won't provide protection against a new strain of influenza, but it will help boost your Get Your Flu Shot immune system. In saying that, people who had the flu shot this flu season are more protected from the flu than those who didn't. Everyone can benefit from getting a flu shot each year. Getting the shot improves chances of having a flu-free winter and also avoids transmitting the virus through contacts with people, especially those at high risk of flu-related complications. Prevention in Schools and Daycare Centres On May 3, PHAC issued a release recommending that schools remain open. If Canada was in a severe pandemic situation, closing schools would be one of the logical strategies to slow the spread of disease. However, the current situation with H1N1 doesn't warrant closure of schools (the full story can be read on the following page). Nevertheless, it is taken very seriously by the School District, NVHA, and NLG. Be assured that NESS is enforcing these flu preventative measures in all its schools (washing hands, etc.). Notices are posted throughout the schools.

7 Nisga a Healer - SPECIAL EDITION H1N1 FLU VIRUS Page 7 Interim Recommendations Regarding Schools and Daycare Centres May 3, :00 EST This guidance is being provided by the Public Health Agency of Canada in response to the current outbreak of H1N1 flu virus (human swine flu) in Canada. This document has been developed to assist public health authorities with the public health response in Canada. This guidance is based on current available scientific evidence about this emerging disease and is subject to review and change as new information becomes available. Purpose This document provides specific recommendations regarding considerations for school and daycare centre closures in response to the current H1N1 flu virus (human swine flu) situation in Canada. It should be noted that these public health response recommendations may change as further information about the epidemiology and severity of illness of this novel virus becomes available. Background The content of this document is based on the general recommendations included in the Public Health Measures Annex (M) of the Canadian Pandemic Influenza Plan for the Health Sector which have been implemented in light of the current situation in Canada. The goal of the Canadian Pandemic Influenza Plan is to first minimize serious illness and overall deaths, and second to minimize societal disruption among Canadians as a result of an influenza pandemic. The current epidemiology of the H1N1 influenza virus infection in Canada appears to be presenting symptoms similar to seasonal influenza. Interim Recommendation In light of the goals for pandemic response in Canada, and given the current occurrence of illness similar to typical seasonal influenza, the Public Health Agency of Canada is not recommending the closure of schools and daycare centres at this time. This advice also applies even if a confirmed case is identified in a school or daycare centre. Ill students and staff should remain at home and seek medical attention as necessary. Considerations In a severe pandemic, school and daycare closures, in combination with other social distancing strategies, are potentially a valuable strategy to slow the spread of disease. With the current situation of the H1N1 influenza virus infection in Canada causing generally mild illness with symptoms similar to seasonal influenza, school and daycare closures would not be appropriate as the resulting disruption would outweigh any potential benefits. Schools and daycare centres should be encouraged to promote basic infection control practices using recommended cough etiquette like handwashing, covering one s cough and sneezes and avoiding contact with people who are sick. Ill students and staff should remain at home and seek medical attention as necessary. It is recognized that at times, local school and daycare officials may decide to temporarily close a school or daycare centre for reasons such as insufficient staff available to function safely. If an affected school or daycare centre is closed, dismissed students should be encouraged not to congregate in large numbers in other settings.

8 Contact Information: Nisga'a Valley Health Authority Call NVHA if you have any questions or concerns or if you are feeling ill. New Aiyansh PHONE: TOLL FREE: Gitwinksihlkw PHONE: (250) Laxgalts'ap TOLL FREE Gingolx TOLL FREE NVHA WEB Health Link BC Call or visit 24 hours a day/seven days a week if you have any questions or concerns or if you are feeling ill. Northern Health Authority Visit bc.ca for updates on the H1N1 flu virus. Knowledge is Power! The current situation with the H1N1 flu virus is providing NVHA with an excellent opportunity to practice its flu preparedness plan, especially for a pandemic. The spread of the H1N1 flu virus is very serious, and NVHA medical staff anticipate that it will mutate, and return by the next flu season. There will likely be a vaccine available by then. The NVHA is reviewing its flu preparedness, resolving deficiencies, and strengthening its plans between now and the next flu season. Knowledge is power, and your Health Authority is ready now for the flu, and will be better prepared before the next flu season hits us. Planning is essential, especially for a possible pandemic. It is important now more than ever, especially knowing how the H1N1 flu virus has caused us major concern. Top 20 Ways to Prepare for a Pandemic 1. Have an emergency kit on hand with medical supplies, and at a minimum, a 3 day supply of food and water for all people and pets in your household. 2. Stay informed and up-to-date. Check the Ministry of Health, Pandemic Influenza and BC Centre for Disease Control websites and read articles, watch the news, and listen to the radio. 3. Get your annual flu shot to help boost your immune system. 4. Teach your children good hygiene practices (see page 6). 5. Practice a healthy lifestyle. Eat healthy foods and get regular exercise. 6. Inform yourself about the basics of pandemic influenza. 7. Develop your own family plan to address issues such as family illness and school or daycare closures. 8. Designate an out-of-town relative or friend to act as a common contact for your family members. 9. Make a list of phone numbers of health centres, hospitals, doctors, BC Nurseline, Health Infoline, and place near the phone or on your fridge. Let family members know where the numbers are located. 10. Have a financial plan ready in case you're unable to work. 11. Have enough prescriptive medicines on hand for at least 6 months. 12. Stock over-the-counter medicines. Aspirin shouldn't be given to children 20 years or younger (risk of Reye's Syndrome). 13. If able, plan to work from home. 14. If travelling, check travel advisories. 15. If you travelled in areas where flu activity is high, monitor your health. If you exhibit any symptoms, call the BC Nurseline or your doctor. 16. If you own a business, plan for employee absenteeism, and a possible decrease in sales and revenue. 17. Ask your local government and organizations about their preparations for a pandemic. 18. Talk with neighbours, elders, and others to see if they\re preparing for a pandemic, and if they need help. 19. Talk to NVHA now to find out how you can help during a pandemic. 20. Review and revise your plans regularly and rotate food and water supplies. Knowledge is power. The NVHA is confident that this special edition answered your questions, provided you with information to protect yourself from the flu, and to prepare yourself and your family for a pandemic. Forewarned is forearmed!