Download Pandemic influenza - Tertiary Education Facilities Management

Pandemic influenza
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Patricia Coward
Principal Adviser (Occupational Health)
Occupational Health Unit
(07) 3247 9400
[email protected]
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Session overview
• What is the difference between seasonal
influenza, pandemic influenza and avian
influenza (bird flu)?
• Infection control practices to protect staff
and students in the event of pandemic
influenza
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Seasonal influenza
• Occurs each winter in Australia
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New strain each winter
• It is reasonably predictable because it is
similar to previous influenza strains
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Seasonal influenza
• Some groups are at greater risk from
seasonal influenza
Persons 65 years of age and over
• Aboriginal and Torres Strait Islander persons
aged 50 years and over
• Chronic disease
• Immunosuppression
• Residents of long-term care establishments
• Pregnant women
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Pandemic influenza
• Pandemic influenza is a severe form of
influenza that infects many people around
the world at the same time
• Occurs when a new strain of influenza
virus emerges to which no-one has
immunity
• Can occur at any time of the year and lasts
longer than seasonal influenza
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Pandemic influenza
• Causes more severe illness and death
• All people may be at risk, not just the
usual ‘at-risk’ groups
• The only predictable thing about
pandemic influenza is its unpredictability
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Previous pandemics
1918
Spanish flu
20-40 million
deaths
CFR 2-3%
1957
Asian flu
1-4 million
deaths
CFR <0.2%
1968
Hong Kong flu
1-4 million
deaths
CFR <0.2%
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Avian influenza
• Disease of birds caused by an avian (bird)
influenza virus
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Usually infects aquatic birds
Can also infect domestic birds and some
animals
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Avian influenza
• Historically, human infection with avian influenza
viruses has been rare and mild
• Human infection with the H5N1 strain of avian
influenza is rare but it can cause serious human
infection with a high death rate
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> 60%
• WHO 19th June 2008
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385 confirmed cases
243 confirmed deaths
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Avian influenza
• Children and young adults are most
at risk from H5N1
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90% of cases are < 40 years of age
52% of cases are < 20 years of age
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Avian influenza
• H5N1 is circulating in wild and domestic
bird flocks in many parts of Asia, Africa
and Europe
• H5N1 has pandemic potential
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There is concern that H5N1 could mutate to
cause the next human influenza pandemic
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Pandemic alert level
• The world is on pandemic alert level 3
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Pandemic planning
• Tertiary education facilities are at significant
risk for pandemic influenza
• Colleges and universities pandemic
influenza checklist
• http://www.pandemicflu.gov/plan/school/c
ollegeschecklist.html
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Assumptions
• A pandemic is likely to be widespread
throughout Queensland
• May last up to 12 months
• May be 2 or more pandemic waves each
lasting about 8 weeks
• Healthcare system will be overloaded
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Pandemic planning
• Social distancing within the community
• Inadequate supplies
• Significant absenteeism for a prolonged
period
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Protecting staff and students
• Vaccination
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May not be available at the start of a pandemic
• Antiviral medications
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Availability will be restricted
• Infection control
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Critical control for protecting staff and students
Based on influenza’s modes of transmission
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How is influenza spread?
• Contact transmission
Occurs when you have contact with an
infected person or a contaminated
surface
• Transfer influenza virus to your eyes,
nose and mouth via your hands
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How is influenza spread?
• Droplet transmission
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Occurs when an infected person releases
droplets containing influenza virus when they
cough, sneeze or talk
The droplets land on your eyes, mouth and
nose if you are within about 1 metre distance of
the person
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How is influenza spread?
• Airborne transmission
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Occurs when you inhale aerosols of influenza
virus
Risk for healthcare workers who perform
aerosol generating procedures
No evidence that influenza is spread through
air-conditioning systems
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Infection control for pandemic
influenza
http://www.health.sa.gov.au/infectioncontrol/
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Hand hygiene
• Regularly wash hands with soap and
water or apply alcohol-based hand rub
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Respiratory hygiene and cough
etiquette
• Cough or sneeze into a disposable tissue
• If no tissue available, cough or sneeze into
sleeve
• Perform hand hygiene after coughing and
sneezing
X
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Cleaning programs
• Regular cleaning of
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Shared surfaces
Surfaces that are frequently touched
• Cleaning agents
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Water and detergent
Alcohol-based disinfectant
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Social distancing
• Restrict non-essential face-to-face contact
• Conduct business by alternative ways that
minimise face-to-face contact
• Ensure supporting communications
systems
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Staff and students able to work from home
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Social distancing
• Where essential face-to-face contact is
required
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Sit > 1 metre apart
Hold the meeting outdoors if practicable
• Stagger start, finish and break times so
that fewer people are using workplace
facilities and public transport at the same
time
• Postpone work recreational activities
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Social distancing
• Promote spatial separation at the office
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Arrange work stations >1 metre apart
• Transparent screens at face-to-face
customer service areas
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Personal protective equipment
• Disposable gloves for tasks that involve
contact with potentially contaminated
surfaces
Vinyl, nitrile or powder-free latex gloves
• Perform hand hygiene after glove removal
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PPE
• Surgical masks for
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Staff who develop influenza illness at
work
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Contain their coughs and sneezes
Staff who have face-to-face contact
with others
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Work restrictions
• Restrict workplace entry
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Display notices at workplace entry points
advising people not to enter if they have
influenza symptoms
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Work restrictions
• Exclude sick family members from the
workplace
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Exclude infected children from family rooms
• Exclude staff who are contacts of infected
people
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Should be in quarantine for 7 days from the
time that their contact became ill
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Managing sickness at work
• If a person develops pandemic influenza
symptoms at work
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Separate the person from other workers
First aid or family room
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Managing sickness at work
• Provide the person with
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Surgical mask and tissues
Alcohol-based hand gel to sanitise their hands
and prevent contamination of their work
surfaces
• Influenza kit for managing sick workers
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Surgical masks, alcohol-based hand gel,
tissues, disinfectant, disposable gloves,
garbage bags
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Managing sickness at work
• Send the person home promptly
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Most contagious at the onset of symptoms
• Clean and disinfect the sick person’s
workstation once they have left
• Identify recent close work contacts and
advise them of the situation
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May require isolation
• Train first aid personnel
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Vaccination
• Maintain annual seasonal influenza
vaccination
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Seasonal influenza strains may continue to
circulate during a pandemic
• Encourage vaccination once a pandemic
influenza vaccine becomes available
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Stockpiling
• “The decision made now not to
stockpile means that you have made
the decision not to protect your
workers during a pandemic”
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Campus health services
• May be the first to see cases of suspected
pandemic influenza
• May have to provide care to sick students
and staff if hospitals, GPs and community
influenza clinics are overwhelmed
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International students
Students residing in student housing
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Campus health services
• Medical offices and clinics pandemic
influenza planning checklist
http://www.pandemicflu.gov/plan/healthcar
e/medical.html
• Stockpile medical consumables, including
hand hygiene products, PPE and
antivirals
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Campus health services
• Triage system to identify and separate
persons presenting with influenza
symptoms from others
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Single room with ventilation that is not
recirculated to other rooms within the facility
Shaded outdoor area
• Provide infected persons with a surgical
mask to contain coughs and sneezes
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Campus health services
• P2 respirators for healthcare workers,
clinic administrative staff and others
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Respirator fit test
AS 1715:1994 Selection, use and
maintenance of respiratory protective devices
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“In order for the designed performance to be
achieved by a respirator, it is essential the respirator
be properly fitted to the individual to whom it is
assigned”
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Campus health services
• Fit check
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User seal check performed each time
the respirator is donned
• Respirator ready
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Clean shaven
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Campus health services
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Clinic security
Infection control training
Staff fatigue and work overload
Clinic staff who may be at high risk from
acquiring pandemic influenza
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Pregnant staff
• Monitor clinic staff for influenza illness
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Campus health services
• Commonwealth Department of Health & Ageing
www.health.gov.au
• Interim Infection Control Guidelines for
Pandemic Influenza in Healthcare and
Community Settings
• Prepared and protected DVD
• Queensland Health www.health.qld.gov.au
• Pandemic Influenza – Infection Control for
Healthcare Workers DVD
• Available from the Communicable Diseases
branch of Queensland Health (07) 3234 1155
• Royal Australian College of General Practitioners
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