Tuesday, 28 April 2009 16:48
Yesterday the State Health Commissioner declared a Public Health Emergency in the Commonwealth to assist with the coordination and information dissemination associated with the swine flu outbreak. Here are some tips to help you understand what to look for.
Please remember that this event is rapidly changing and evolving and we recommend frequently checking the CDC Web site at www.cdc.gov/swineflu and the OEMS Web site at www.vdh.virginia.gov/oems for updates, more information about swine flu, CDC guidelines on infection control and more.
The swine flu is similar to the symptoms of seasonal flu which include, cough, fever, sore throat, nasal congestion and rhinorrhea. Additional symptoms include diarrhea, vomiting, headache, chills, fatigue, dyspnea, pneumonia and respiratory failure. Persons with swine flu are contagious for up to seven days after the onset of illness and possibly longer if symptomatic.Q: How do I protect myself and my family?
A: For now, take commonsense precautions. Cover your coughs and sneezes, with a tissue that you throw away or by sneezing into your elbow rather than your hand. Wash hands frequently; if soap and water aren't available, hand gels can substitute. Stay home if you're sick and keep children home from school if they are.
Q: How easy is it to catch this virus?
A: Scientists don't yet know if it takes fairly close or prolonged contact with someone who's sick, or if it's more easily spread. But in general, flu viruses spread through uncovered coughs and sneezes or - and this is important - by touching your mouth or nose with unwashed hands. Flu viruses can live on surfaces for several hours, like a doorknob just touched by someone who sneezed into his hand.
Q: In Mexico, officials are handing out face masks. Do I need one?
A: The CDC says there's not good evidence that masks really help outside of health care settings. It's safer just to avoid close contact with someone who's sick and avoid crowded gatherings in places where swine flu is known to be spreading. But if you can't do that, CDC guidelines say it's OK to consider a mask - just don't let it substitute for good precautions.
Q: Is swine flu treatable?
A: Yes, with the flu drugs Tamiflu or Relenza, but not with two older flu medications.
Q: Is there enough?
A: Yes. The federal government has stockpiled enough of the drugs to treat 50 million people, and many states have additional stocks. As a precaution, the CDC has shipped a quarter of that supply to the states to keep on hand just in case the virus starts spreading more than it has so far.
Q: Should I take Tamiflu as a precaution if I'm not sick yet?
A: No. "What are you going to do with it, use it when you get a sniffle?" asks Dr. Marc Siegel of New York University Langone Medical Center and author of "Bird Flu: Everything you Need To Know About The Next Pandemic." Overusing antiviral drugs can help germs become resistant to them.
Q: How big is my risk?
A: For most people, very low. Outside of Mexico, so far clusters of illnesses seem related to Mexican travel. New York City's cluster, for instance, consists of students and family members at one school where some students came back ill from spring break in Mexico.
PPE Guidance Modification Recommendations:
EMTs/Paramedics responding to incidents which or encountering patients who have known or suspected fever, cough and/or rash or to patients described generically as sick or with "flu like" symptoms should use a personal PPE package consisting of:
- Gloves
- Eye Protection
- Respiratory Protection (N95/N100/N100)
- Agencies should consider increasing the availability of N95/N100 masks, to include a supply accessible in both the vehicle cab and patient treatment compartment.
- Agencies with free air exchange between the cab and patient compartment should consider securing this opening when transporting high risk patients.
- Personnel should change their N95/N100 between patient contacts (the provider operating the vehicle should dispose of their N95/N100 in the patient compartment waste container prior to initiating transport and don a fresh N95/N100 prior to patient contact).
Patient Contact/Initial Incident Entry Modification Recommendations:
In order to limit the potential exposure of first response personnel, agencies should consider the option of limiting initial contact by first response personnel to high risk patients. The option of sending either one or two first responders to initiate patient contact/treatment should be considered unless patient condition requires additional manpower.
Patient Care Guidance Modification Recommendations:
- Patients meeting the criteria outlined above should be provided with either a surgical mask (if no oxygen therapy or nasal cannula oxygen therapy is initiated) or a non-re-breather oxygen mask if higher concentrations of oxygen are indicated by patient assessment/status.
- EMTs/Paramedics should enhance the patient interview to include specific inquiry as to recent travel, with an emphasis on Mexico, or contact with someone who has recently traveled to Mexico. Additionally, EMTs/Paramedics should also establish if a relationship exists with anyone who has been at or in contact with a known high risk location. This information shall be passed on to the receiving hospital.
Hygiene/Decontamination Recommendations:
- Personnel should practice aggressive hand washing/hand sanitization after all patient contacts and prior to any contact with mucous membranes (e.g. eating, drinking).
- Normal ambulance cleaning/sanitization is indicated. No special decontamination is required.
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