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Influenza Prevention Campaign under way

by Mary Allen, R.N., and Linda Formby, R.N.
Infection Control
Some people say we are now entering influenza season, but the truth is that flu is active throughout the year. Influenza typically occurs in the United States during the late fall through the spring season.
This year we are seeing a change in influenza patterns and cases. Influenza viruses can cause disease among persons in any age group, but the novel H1N1 virus seems to infect and cause complications in a higher percentage of children and women who are pregnant.

What is influenza?
From a family of viruses that infect the respiratory tract in humans and animals, each flu virus gets most of its characteristics from surface proteins: neuraminidase (N), hemagglutinin (H). Each N and H protein is identified by a numerical designation. So, the virus' H1N1, H3N1 and H5N2 are all variations and affect their hosts in different ways. Symptoms of influenza usually have an abrupt onset with fever, cough and body aches which may or may not be accompanied by upper respiratory secretions, chest tightness, nausea or diarrhea.

What’s so special about H1N1 (also known as swine flu)?
This is a new flu strain. Very few individuals have any immunity to H1N1.

How is it spread?
Influenza viruses are transmitted by droplets from an infected person’s cough, sneeze or speech. These droplets can then be inhaled into the upper respiratory tract of anyone within six feet. Transmission also may occur by direct (person to person) or indirect (person to object to person) contact. If an infected person coughs or sneezes, the viral cloud may remain airborne for an hour, so inhalation of flu particles occurs even when a person attempts to distance himself from others. Influenza virus can survive for 24-48 hours on solid surfaces and eight to 12 hours on porous surfaces such as paper or cloth and can be transmitted to hands, eyes, nose and mouth from these surfaces. Infected persons are most contagious during the first days of illness; however, they can be contagious even when asymptomatic up to seven or more days after onset of symptoms.

What are complications of influenza?
A complication of influenza is any disease state caused by or worsened by influenza infection. Common complications are uncontrolled asthma, pneumonia, respiratory failure, organ failure, cardiac problems and death. Influenza-associated pneumonia may occur at any age. Pneumonia in patients with influenza may be due to the influenza virus itself, a secondary bacterial infection, or a combination of both. Generally, conditions such as underlying heart or lung disease, organ transplantation, cancer, chemotherapy and diabetes predisposes patients to higher risk associated with flu. With H1N1, there seems to be a higher than expected risk of complication for women who are in any stage of pregnancy. 

Is influenza preventable?
Evidence-based methods for preventing influenza in the health care setting include:
  • Health care worker influenza vaccination
  • Meticulous hand hygiene practices, keeping hands away from the face
  • Consistent use of appropriate barriers and isolation precautions
Patients suspected of or admitted with influenza should be placed on droplet precautions at the time of arrival to the health care area.
Covering your cough has an important role in limiting the spread of influenza. Protect others by covering your mouth with a tissue when coughing or sneezing, by coughing into your elbow instead of your hands and by wearing a mask as indicated. During outbreaks, visitors may be limited in some areas.

Is there a medicine for flu?
There are treatments for some influenza viruses if caught early. The H1N1 strain is currently susceptible to Tamiflu or Relenza.
Health care workers are encouraged to take the influenza vaccine every year. This year two influenza vaccines will be offered: the seasonal flu vaccine and then the H1N1 vaccine. H1N1 vaccine will be supplied through the federal Department of Health and Human Services and S.C. Department of Health and Environmental Control (DHEC). Adults and health care workers are one of the targeted groups to receive the vaccine and will need only one dose. At this time, we do not know when we will receive the H1N1 vaccine or how much of the vaccine we will receive. It is possible that the initial supply of the H1N1 will not be enough to vaccinate all staff, so some prioritization of staff may be needed. Like the seasonal flu vaccine, it will be free of charge to staff.
The seasonal 2009-2010 flu vaccine will soon be available for staff. This year’s MUSC Flu Tent will be open from 7 a.m. to 7 p.m. Oct 14 and 15 behind the Colbert Education Center & Library, and from 7 a.m. to 4 p.m. Oct. 14 at Ashley River Tower. Additional flu vaccination sites will be available at Wellness Wednesday sites beginning Oct. 21, at 1 West ED (4 - 7 a.m.) beginning Oct. 16.
Managers may once again obtain vaccine to be administered to staff on the clinical units. Influenza vaccine will also be available at MUSC Employee and Student Health Services.
Who should take the seasonal flu vaccine?
According to Centers for Disease Control, more than 200,000 people in the U.S. are hospitalized with flu and more than 36,000 die due to flu complications. Healthy persons are not exempt from influenza morbidity or mortality. Persons especially recommended to receive influenza immunization include children, pregnant women, persons at risk for medical complications, hospitalized patients and all health care workers. All health care workers should receive the vaccine, unless there are contraindications. These contraindications may include:
  • Persons with severe allergy to chicken eggs
  • People with severe reactions to flu vaccination
  • People with previous Guillain-Barré syndrome within six weeks of getting a vaccine 
  • People who are sick and have a moderate or severe illness with a fever should wait to get vaccinated.
Is there a consent to be completed?
The Department of Health and Human Services requires vaccine recipients to review the current vaccine information, which will be provided prior to vaccination. An influenza vaccine consent form will be signed by all vaccine recipients as well. These will be available at all flu vaccination sites, as well as online at the Employee Health Web site so that staff can print and complete the forms ahead of time. Persons arriving at the vaccine tents on Oct. 14 or 15 with a completed and signed form may use the express lane.

Is there a cost for MUSC employees?
The flu vaccine is free  as an added benefit to employees of MUSC, MUHA, UMA and some contracted employees such as Sodexho, Dietary and Environmental services staff. Be sure to wear your badge to prove employment when you arrive for your vaccination.

New for 2009-10
DHEC nurses will be at MUSC, near the flu vaccine tent on Oct. 14 to provide influenza vaccinations to visitors, family members and community workers at a cost of $25. This form of vaccine is an inactivated (killed) vaccine and you will not contract flu illness from the vaccination.

What are the side effects or risks for influenza vaccination?
Most people do not experience any side effects from  flu vaccination. Some persons report soreness, redness or swelling at the administration site. A few persons may report low grade fever. If reactive symptoms do occur, they begin soon after vaccination and only last one to two days. 
You cannot get influenza from the flu shot. If you do get the flu following the vaccine, it was probably incubating at the same time.


Friday, Oct. 2, 2009

The Catalyst Online is published weekly by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. The Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, Editorial copy can be submitted to The Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.