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Table of Contents
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Abstract
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(Last Name, Year)
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References
Center For Disease Control:http://www.cdc.gov/h1n1flu/general_info.htm
Center For Disease Control How viruses Change: Drift and Shift:
http://www.cdc.gov/flu/avian/gen-info-viruses.htm#virusoverview
Center For Disease Control: http://cdc.gov/h1n1flu 08/11/2010
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Figures
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Manual, 6th Edition.
The Cost of A High Risk
Disease
H1N1
H1N1 Education
• The influenza type A virus, known as H1N1 is a respiratory infection that was
popularly named as “swine flu”. The virus was first recognized in April 2009
and spread quickly to 74 countries worldwide. The World Health Organization
(WHO) declared the virus a global pandemic. This was the first global
pandemic in over 40 years and was listed as a global pandemic for more than
a year. The name “swine flu” means influenza in pigs and occasionally the
influenza virus can be transmitted to people who work with pigs. Very
seldom does the person who works with pigs transmit the virus to others, but
this was the case with H1N1. The virus does not spread by consuming pork.
H1N1 Education cont’d
• The 2009 H1N1 influenza virus had two genes from flu viruses that normally
circulate in pigs in Europe and Asia, plus avian and human genes. The CDC
believes that this virus resulted from antigenic shift, which as noted above is a
process through which two or more influenza viruses can swap genetic
information by infecting a single human or animal host. When antigenic shift
occurs, the virus that emerges will have some gene segments from each of
the infecting parent viruses and may have different characteristics than either
of the parental viruses, just as children may exhibit unique characteristics that
are like both of their parents. In this case, the shift most likely occurred
between influenza viruses circulating in North American pig herds and among
Eurasian pig herds. Influenza type A viruses can undergo both antigenic drift
and shift, while the influenza type B viruses only change by antigenic drift.
Decreasing the spread of H1N1 including the
economical cost
• National surveillance detected an atypical increase in influenza-like illness(ILI) in mid to late February 2009
and a further increase in early to mid April. Anecdotal reports in April of increased hospitalizations of
previously healthy young adults with severe pneumonia led to active surveillance in 23 hospitals in Mexico
City and identification of 47 such cases. Patient samples showed nonsubtypeable influenza A, identified on
April 23 as a adaptation of a pandemic influenza preparedness plan that had been developed for a virus
originating abroad.
• All educational facilities were closed beginning April 24 in Mexico City and, soon after, nationwide. Parents
were advised to keep children at home; authorities distributed educational materials for home use. By May
11, when educational facilities reopened, all schools had been thoroughly cleaned. Parents were requested to
keep ill children home; peer pressure among parents to comply was high.
• In addition to federal measures, April 27,the mayor of Mexico City suspended dine-in service in all restaurants
and similar establishments, allowing only take-out orders. Many restaurants simply remained closed. When
affected businesses were allowed to reopen on May 6,social distancing measures(e.g., avoiding
crowding)were encouraged, and hygiene measures were enforced. Grocery stores and supermarkets
remained open, with additional cashiers used to keep lines short. Persons in public places were advised to
remain separated by at least 2 m. Large gatherings were cancelled or postponed, and entertainment venues,
e.g., movie theatres, were closed. Professional sport matches were broadcast, but stadiums were closed to
the public. Churches and temples also remained closed, with religious services broadcast over radio and
television. When normal services resumed, communion cups and other shared objects were wiped with hand
gel after each use. Mass transit operated normally. Masks were provided for drivers and passengers and
buses and subway cars were cleaned frequently.
Decreasing the spread of H1N1 including the
economical cost cont’d
• Frequent hand washing and cough etiquette were promoted, and all government and private
facilities open to the public were provided with alcohol gel and other disinfectants. Due to
limited water availability in some areas or households, alcohol gel was distributed free. A
mass media campaign promoting a healthy distance discouraged greeting others by hugging
or kissing, common practice among Mexicans of all social strata. Military personnel
distributed disposable surgical masks in public places; their use was recommended primarily
for sick persons, but many healthy persons also wore them daily. Compliance with
recommendations appeared to be high, although some persons wearing masks may have
developed a false sense of security that took priority over cough etiquette and hand washing.
When commercially available masks became scarce, some persons made their own, disposal
occasionally was problematic, resulting in littering. Over time, recommendations about
cough and sneeze etiquette were followed least frequently.
• Occasional early discrepancies between recommendations from official and academic
sources (e.g., regarding mask use)led to a few critical media reports without apparent
consequence. Thousands of workplaces of all sizes in Mexico City and the rest of the country
were closed for several days, taking a huge toll on the economy. The government provided
no financial compensation to businesses or workers. The economic impact of pandemic
(H1N1) 2009 virus in Mexico during the spring is estimated as >$2.3 billion (0.3% of gross
domestic product).
• Most important among the many lessons learned in Mexico is that
preparation paid off. Although requiring adaptation, the preexisting
pandemic plan and planning process facilitated intersectoral work, decision
making and rapid development of a public communications campaign. The
availability of a national stockpile of antiviral drugs reassured the public. The
participation of the secretary of health as the spokesman demonstrated highlevel leadership. Clear and transparent communication was important
because Mexico was entering mid-term elections, and some politicians
hypothesized that the outbreak was a farce to distract Mexicans.
• The outbreak also enabled detection of some weaknesses in the Mexican health
system. In Mexico, healthcare is provided by 3 major healthcare systems; thus
compilation of epidemiologic information regarding hospitalizations was complex.
However, after a few days, a system was devised that provided the necessary
consolidated information. Laboratory capacity was inadequate for the challenges
posed by the outbreak. At the onset of the break out, the Ministry of Health had no
state-level laboratories with capabilities for influenza molecular diagnostics; all
molecular diagnosis was centralized at the National Epidemiological Reference
Laboratory in Mexico City. The Ministry of Health rapidly improved the national
laboratory network and Mexico has now 28 laboratories(1 in nearly every state) with
PCR molecular diagnostic capabilities. Although having a pandemic plan was useful,
operationalization of the plan was less smooth. For example, procedures existed to
close schools, but criteria for reopening them and the ability to reassure parents that
reopened schools were safe did not.
Patients with special medical conditions
•
2009 H1N1 and People with Asthma
• People with asthma who develop influenza – seasonal flu- are at increased risk
for serious complications and are more likely to be hospitalized. The flu may also
make chronic health problems worse. For example, people with asthma may
experience asthma attacks while they have the flu. If you have asthma, you
should follow the recommended steps for protecting yourself from the flu, and
follow an updated, written Asthma Action Plan, developed with your doctor.
Everyone with asthma who is 6 months and older should get vaccinated with a flu
shot. This includes people 65 and older. People with asthma should talk with
their health care provider now and plan what to do if they get a flu-like illness. It’s
very important that antiviral drugs be used early to treat flu in people who are
very sick (for example people who are in the hospital) and people who are sick
with flu and have a medical condition that puts them at increased risk of serious
flu complications, like asthma.
Patient’s with special medical conditions
cont’d
• Resources for pregnant women
• Take time to get vaccinated.
• Take everyday preventive actions.
• Take flu antiviral drugs if your doctor recommends them.
Health promotion
• This activity was intended to affect the positive and contain the negative
health determinants, contributing to a better control of people over their
health. Through the mass media and the distribution of brochures, posters
and fliers emphasis was made on the use of masks, frequent hand washing,
the use of alcohol gel, the “etiquette sneeze", the use of disposable tissues
and their proper and hygienic disposal, avoiding overcrowded and/or closed
places, and not leaving the home, unless it was necessary.
Health promotion cont’d
• This activity focused on two large areas. The first, and most
important one, consisted of raising the awareness of the population
by means of information dissemination through the mass media so
that, if anyone of any age had the cardinal symptoms, i.e., fever,
cough or respiratory distress (suspicious case), they would go to the
institutional healthcare services in the country.
Health promotion cont’d
• Get vaccinated against seasonal flu. Vaccination is the best protection we
have against flu. CDC is now encouraging everyone to get vaccinated against
H1N1. The vaccines to protect against H1N1 are widely available yearly.
Wash your hands often with soap and water. If soap and water are not
available, use an alcohol-based hand rub. Avoid touching your eyes, nose and
mouth. Germs spread that way. Stay home if you get sick. CDC recommends
that you stay home from work or school and limit contact with others to keep
from infecting them.
Questions
• If any questions of concerns or for more clarification you can call the CDC for
more information.
• Centers for Disease Control and Prevention
1600 Clifton Rd
Atlanta, GA 30333
• 800-CDC-INFO
(800-232-4636)
TTY: (888) 232-6348
• Contact CDC-INFO
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