Pandemic Preparedness. Hand Care

AGENDA H1N1 Hard Surface Disinfection Hand Care Pandemic Preparedness

WHAT IS HUMAN INFLUENZA? A highly contagious respiratory infection Can occur in children or adults of any age Associated with fever and often respiratory complications It is spread person-to-person An infected person could be contagious Up to 24 hours before symptoms begin Up to 7 days after symptoms begin Each year a new vaccine is produced based on: the previous year s flu and strains circulating in other parts of the world the coming year s expected or predicted flu strains 2008-09 vaccine did not include the 2009 H1N1

HOW IS H1N1 TRANSMITTED? Droplet transmission Large droplets generated by sneezing, coughing or talking Occurs over a distance of up to 3-6 feet Contact transmission Direct touching an infected human Indirect touching an object that an infected human touched or contaminated with droplets Airborne transmission Due to small droplet nuclei, distance traveled is unknown

HUMAN INFLUENZA Each year approximately 5% to 25% of the population in the US, Canada or Quebec get the flu 36,000 people die from the flu in the U.S. 4,000 people die from flu in Canada Each year flu appears in the Northern Hemisphere: Nov - Apr Southern Hemisphere: May - Oct

HOW LONG DOES IT SURVIVE? Stainless steel and plastic = Survives 24-48 hours = Transferred to hands up to 24 hours Cloth, paper, tissues = Survives 8-12 hours = Transferred to hands up to 15 minutes Hands = Survives up to 5 minutes Increase frequency of disinfection and hand hygiene!

SYMPTOMS OF H1N1 VS COLD Symptom Cold H1N1 Flu Fever Fever is rare with a cold. Fever is usually present with the flu in up to 80% of all flu cases. A temperature of 100 F or higher for 3 to 4 days is associated with the H1N1 flu. Coughing A non-productive (non-mucus producing) cough is usually A hacking, productive (mucus- producing) cough is present with the H1N1 flu (sometimes referred to as dry often present with a cold. cough). Aches Slight body aches and pains can be part of a cold. Severe aches and pains are common with the H1N1 flu. Stuffy nose is commonly present with a cold and Stuffy Nose typically resolves spontaneously within a week. Stuffy nose is not commonly present with the H1N1 flu. Chills Chills are uncommon with a cold. 60% of people who have the H1N1 flu experience chills. Tiredness Tiredness is fairly mild with a cold. Tiredness is moderate to severe with the H1N1 flu. Sneezing Sneezing is commonly present with a cold. Sneezing is not common with the H1N1 flu. Sudden Symptoms Headache Cold symptoms tend to develop over a few days. The A headache is fairly uncommon with a cold. H1N1 flu has a rapid onset within 3-6 hours. The flu hits hard and includes sudden symptoms like high fever, aches and pains. A headache is very common with the H1N1 flu, present in 80% of flu cases. Sore Throat Sore throat is commonly present with a cold. Sore throat is not commonly present with the H1N1 flu. Chest Discomfort Chest discomfort is mild to moderate with a cold. Chest discomfort is often severe with the H1N1 flu.

H1N1 PANDEMIC Emergence of H1N1 Swine Flu: WHO (World Health Organization) raises the pandemic level to 6. 177 countries have officially reported 414,000 cases of H1N1 infection, including 5000 deaths (12262 cases in Canada and 89 deaths), as of October 17, 2009. Expected percentage of people in a pandemic that will get the virus High risk (pre-existing health condition) 0-18 years old 19-64 + 65 Non high risk (no major health problem known) 0-18 years old 19-64 + 65 3.4% 10.9% 10.4% 19.7% 6.2% 5.9%

PROTECTION AGAINST H1N1 CDC recommends the following to help prevent contamination: 1) Cover your nose and mouth with a tissue when you cough or sneeze. 2) Use your sleeve in the absence of a tissue. 3) Throw the tissue in the trash after you use it. 4) Wash your hands often with soap and water, especially after you cough or sneeze. Hand sanitizers are also effective. 5) Avoid close contact t with sick people. 6) Avoid touching your eyes, nose or mouth. Germs spread this way. 7) If you get influenza-like like illness symptoms, stay home from work or school except to seek medical care and limit contact with others to keep from infecting them. 8) Disinfect frequently touched surfaces (phone, doorknob, ob, light switches, etc ).

AGENDA H1N1 Hard Surface Disinfection Hand Care Pandemic Preparedness

HARD SURFACE DISINFECTION Disinfect frequently touched surfaces to stay healthy. Health Canada, EPA and CDC have stated that any disinfectant with claims against any of the Influenza strains would be effective against H1N1 strain. Use the correct dilution and use the product in accordance with the manufacturer s instructions (i.e. dwell time). Surfaces being disinfected must be left wet with product for the entire duration of their dwell time. Failure to do so may mean the germs have not been killed.

HOW TO DISINFECT 1. Put on protective gloves. 2. Dilute product using Avmixx Dilution Control Dispenser. 3. Spray Disinfectant on a cloth. 4. The treated surfaces must remain wet for 10 minutes prior to wiping the excess liquid. 5. Once the cloth is soiled, turn over or rinse clean.

HARD SURFACE DISINFECTION 80% of infections are spread when someone touches a germ-ridden surface. Disinfect critical touch points including: Telephones Keyboards Desks Doorknobs Faucets Flushers Elevator buttons

CRITICAL TOUCH POINTS - WASHROOMS

CRITICAL TOUCH POINTS - LOBBY

CRITICAL TOUCH POINTS - OFFICE

CRITICAL TOUCH POINTS - CAFETERIA

CRITICAL TOUCH POINTS CONFERENCE ROOM

AVMOR HARD SURFACE DISINFECTANTS Balance Plus Basix Effective against Influenza A Effective against Influenza A 2089257001 (4x1.8L) 2089278001 (4x4L) 1245257001 (4x1.8L) 1245278001 (4x4L) EP66 Effective against Influenza A 1997257001 (4x1.8L) 1997278001 (4x4L) Quanet Effective against Influenza A 1233278003 (4 x 4L) Leminee 64 Effective against Influenza A 1923278001 (4x4L) 1923334001 (20L) Sani Stuff Effective against Influenza A 2036278001 (2 x 4L)

AGENDA H1N1 Hard Surface Disinfection Hand Care Pandemic Preparedness

HAND CARE: DID YOU KNOW? Handwashing is easy to learn and incredibly effective at stopping the spread of disease causing germs. Dr. David Butler Jone, Canada s Chief Public Health Officer, recommends handwashing as one of the 12 pain free ways to a healthier life. 83% report washing their hands after using the bathroom in their home. 77% report washing their hands before handling or eating foods. 32% report washing their hands after coughing or sneezing. 68% of respondents of the Soap and Detergent Association s (SDA) 2006 Survey do not wash their hands long enough to effectively remove germs and dislodge dirt. Good hand hygiene is proven to benefit health. Source: http://www.foodsafety.gov/~dms/fsehandw.html html

HAND CARE: HOW TO PROTECT YOURSELF? Clean your hands regularly. Wash your hands with soap and water, and dry them thoroughly. Use a hand sanitizer if you don t have immediate access to soap and water. How do I wash my hands properly? Washing your hands properly takes about as long as singing "Happy Birthday" twice.

AVMOR HAND SANITIZERS X3 Alcohol-Free Hand Sanitizer Effective against H1N1 2102163001 (12 x 75mL) 2102178002 (12 x 250mL) 2102250001 (4 x 1L) 2102278001 (2 x 4L) Alpet E3 Santizing Lotion 1141278001 (4 x 3.6L) Citrus Hand Sanitizer 1196166002 (12 x 114mL) 1196180001 (12 x 473mL) 1196198004 (12 x 800mL)

AVMOR HAND SOAPS EP71 Foaming Hand Soap 2055218001 (4 x 1L) 2055278001 (4 x 4L) Antimicrobial Foaming Hand Soap 2056218001 (4 x 1L) 2056278001 (4 x 4L) Luxury Foaming Hand Soap Biomaxx Antimicrobial Hand Soap 2054278001 (4 x 4L) EP72 Liquid Hand Soap 2057198001 (12 x 800mL) 2057278001 (4 x 4L) 1216198012 (12 x 800mL) 1216198013 (6 x 800 ml)

AVMOR DISPENSERS X3 Hands Free Dispenser 0000024129 (6 x 1) 0000024219 (6 x 1) - metallic X3 Manual Dispenser 0000024128 (12 x 1) Biomaxx Foam Hands Free Dispenser Biomaxx Foam Manual Dispenser 0000024004 (6 x 1) 0000024003 (12 x 1) Biomaxx Dispenser 0000011770 (12 x 1) Biomaxx Dispenser Hands Free 0000024227 (6 x 1)

AVMOR DISPENSER STANDS Metal Stand for Hands Free Dispenser 0000024226 (2 x 1) PVC Stand for Hands Free Dispenser 0000024199 (1 x 1)

AGENDA H1N1 Hard Surface Disinfection Hand Care Pandemic Preparedness

PANDEMIC PREPAREDNESS Early Preparation (Phases 1-2 ) Communication Establish a centralized emergency communication plan. Develop policies, procedures, programs and materials. Educate employees - Factual information is available at www.flightflu.ca, www.combattezlagrippe.ca, www.cdc.gov, www.hc-sc.gc.ca, www.phac-aspc.gc.ca Prepare a pandemic checklist. Staff and Suppliers Identify a pandemic coordinator and/or team. Identify essential employees and other critical inputs required to maintain business operations by location and function during a pandemic. Outline a back-up plan. Establish policies for flexible worksite. Establish reintegration guidelines. Encourage employees to receive the annual flu shot. Building Procedures Place hand sanitizer dispensers at all entrance and exits to your building/offices with accompanying signage (e.g. X3 Hand Sanitizer / Avmor Citrus Hand Sanitizer). Identify products or services that will be essential or in increased demand.

PANDEMIC PREPAREDNESS Preparing and intervention (Phases 3-5) Communication Build organization awareness and educate staff on the flu, including symptoms Instruct staff on policies: For example, if you are sick stay home, sick leave, etc. Refuse access: Communicate and train staff on when access may be refused Emergency training: Train all employees and contractors on what is expected of them. Hold regular meetings (daily, weekly or monthly) to inform staff of current situation. Staff and Suppliers Designate a first responder (and 2 backups) to respond to any employee who falls ill. Monitor personnel working in close proximity to those who test positive. Consider staggered or flex schedules. Request/obtain emergency plans of suppliers and contractors. Ask employees to be aware of public activities that may put them at risk (e.g. large public gatherings). Building Procedures Bulk order enough personal preparedness equipment (PPE) for all employees for a 12 week pandemic period; surgical masks, disinfectant spray or surface wipes, hand sanitizer. Ensure staff clean their own workstations, including phone, mouse and keyboard daily

PANDEMIC PREPAREDNESS Intervention and Response (Phase 6) Communication Place signage at all entrance/exits and loading docks restricting access into the building. Regularly communicate to all employees the change of status to response. Staff and Suppliers Prohibit sick employees from entering workplace. Disinfection: Encourage employees to disinfect their workspace Independent work: Encourage employees to work independently in their own offices. Preventative measures: Where meetings are needed, all employees should wear a surgical mask, eye protection, and sanitize their hands before and after the meeting. Manage health related issues: Designate one person and one back up to manage health related issues. Train one person and one back up on first responder equipment. Issue personal preparedness equipment (PPE) to contractors and suppliers visiting the building, as well as service technicians to be used while in public. Public exposure: Encourage employees to track exposure. Building Procedures Restrict building access. Designate one individual to monitor entrance/exits for visitors. Provide signage or posters at entrances if personnel is unavailable.

PANDEMIC PREPAREDNESS Recovery (Post Pandemic) Communication Communicate and hold post event meeting Possible Delays Caused by a Pandemic Continuity of service during a pandemic situation: No services will be missed, unless the customer s business is closed. Only delays may be expected. Assuming that all customer businesses are open: 15% service absenteeism: No service delays expected. 30% service absenteeism: Possibility of 3-5 day delay. 50% service absenteeism: Possibility of 7-10 day delay.

PANDEMIC PREPAREDNESS - CHECKLIST

INFLUENZA PREVENTION: THE BARE ESSENTIALS Wash hands often and thoroughly. Sanitize hands in lieu of handwashing. Cough and sneeze into a tissue or your sleeve not your hands. Disinfect common touch points regularly.

WEBSITE RESOURCES Quebec s officialwebsite http://www.pandemiequebec.gouv.qc.ca/en/news/news.aspx. WHO www.who.int CDC www.cdc.gov Public Health Agency of Canada www.phac aspc.gc.ca

QUESTIONS For additional information contact Avmor at 800-387-8074 or visit our websites www.avmor.com / www.avmorgreen.com