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3 June 2009 - H1N1 Influenza 09 - Guidance for Community Care

Electronic advice on managing the H1N1 Influenza virus in the PROTECT phase, for care recipients, family, friends, visitors and visiting health professionals.

In this section:

Dear Community Care Providers

The information attached is to assist you and your staff to manage the H1N1 Influenza virus in the PROTECT phase, for care recipients, family, friends, visitors and visiting health professionals.

If you have any problems with the receipt of this email, please call Yo Landa on 02 6289 5099.

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PDF printable version of H1N1 Influenza 09 (Human Swine Influenza): Guidance for Community Care Providers. (PDF 49 KB)

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H1N1 Influenza 09 (Human Swine Influenza): Guidance for Community Care Providers

Australia is now in the Protect phase of the pandemic influenza response plan. The Protect Phase recognises that the infection with the H1N1 Influenza 09 virus is not as severe as originally envisaged within the Australian Health Management Plan for Pandemic Influenza. The H1N1 Influenza 09 virus causes a mild illness in most, severe in some and moderate overall.

The Protect Phase aims to identify and provide early treatment to those who are suffering a moderate to severe illness and the early treatment of those identified as vulnerable to severe infection. Elderly people with underlying chronic medical conditions can suffer a more severe illness when they get influenza and a more rapid deterioration, due to underlying disease, ageing of the immune system, immobility and debility.

Identifying vulnerable care recipients for whom H1N1 Influenza 09 may have severe outcomes are people with:
  • Chronic respiratory conditions including asthma and Chronic Obstructive Pulmonary Disease.
  • Persons with Morbid obesity.
  • Indigenous people of any age.
  • Persons with chronic illness predisposing to severe influenza such as:
          1. Cardiac disease (excluding simple hypertension).
          2. Diabetes mellitus.
          3. Chronic renal disease.
          4. Haemoglobinopathies.
          5. Immunosuppressed (including cancers, HIV/AIDS infection, drugs).
          Top of page6. Chronic neurological conditions.
Current information from outbreaks in other parts of the world suggests that the H1N1 Influenza 09 virus is more contagious than seasonal influenza. This means that the basic infection control principles which apply to seasonal influenza also apply to H1N1 Influenza 09. Such measures can substantially reduce the risk of being infected by or spreading the influenza virus. Infection control mechanisms apply to all care recipients, family, friends, visitors and visiting health professionals.

Careful attention to good hand hygiene and cough and sneeze etiquette combined with early identification and treatment of acute respiratory illnesses by carers will minimise the suffering associated with severe influenza in the elderly.

The attached Information Sheet is designed to assist you and your staff.
Further information about Australia’s response can be found at www.healthemergency.gov.au.

Yours sincerely

Authorised for electronic transmission

Carolyn Smith
First Assistant Secretary
Office of Aged Care Quality and Compliance
2 July 2009



Identification and Management of H1N1 Influenza 09 – Information Sheet for Community Care Providers

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Symptoms and transmission

Symptoms of H1N1 Influenza 09 are similar to the seasonal influenza infection and include:
    • Fever (and possible confusion)
    • Coughing.
    • Sore throat.
    • Headache.
    • Tiredness.
    • Runny or stuffy nose.
    • Body aches and/or joint pain.
    • Lack of appetite.
    • Diarrhoea and vomiting.
As with the normal seasonal influenza, transmission is usually spread through the following ways:
    • Respiratory spread – this is when an infected person coughs or sneezes their respiratory droplets can spread into the eyes, nose and mouth of an uninfected person. The uninfected person needs to be relatively close by – usually at a distance of less than one metre.
    • Contact spread – if an uninfected person has virus on their hands and they touch their own eyes, nose or mouth they can infect themselves. A person’s hands may be contaminated by:
          • Touching used tissues, doorknobs or other items or surfaces that an infectious person has contaminated; and/or
          • Virus present in faeces, blood or other bodily fluids.
The infectious period for a confirmed case of H1N1 Influenza 09 virus infection is one day prior to the person’s illness onset to seven days after onset.
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Treatment

It is important that a potential case of H1N1 Influenza 09 in a care recipient is identified early so that immediate steps are taken to prevent the spread of illness to any other member of the family. In the current situation with H1N1 Influenza, when a care recipient displays influenza-like symptoms as described above, encourage early involvement of his/her general practitioner to determine the course of treatment, such as the use of antivirals.

It should be noted that Public Health Units will be working closely with community service providers – such as those caring for people living in close proximity in Independent Living Units and Retirement Villages - who have confirmed cases of H1N1 Influenza 09 to give advice regarding treatment. Any specific advice provided by Public Health Units should be followed.

Prevention Measures

As with seasonal influenza, good infection control practices should be in place.

Community Care Recipients:
    • Should be reminded of the need for good hand hygiene and cough and sneeze etiquette.
    • Should be advised to avoid contact with anyone who has an acute respiratory illness wherever possible.
    • Should be supported to seek early medical care if they become ill with an acute respiratory infection.
    • If they become unwell with an influenza-like illness, if possible, should wear a surgical face mask when in contact with others.
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Community Care Workers

Community care workers at increased risk of complications from H1N1 Influenza 09 infections
Health care workers who are at increased risk of complications from H1N1 Influenza 09 and who are likely to be in direct contact with care recipients who have H1N1 influenza 09 infections, should be considered for redeployment to lower risk activities.

If redeployment is not possible, community care workers who are at increased risk of complications from H1N1 Influenza 09 infection should take all necessary infection control precautions.

For all community care workers, the following is recommended:
    • If the care recipient has an acute respiratory illness and is wearing a surgical mask, community care workers should follow normal infection control measures, paying close attention to hand hygiene.
    • If the care recipient has an acute respiratory illness and is unable to wear a surgical mask, the care worker should take additional infection control precautions when caring for the person within 1 metre distance. These include:
        • Hand washing and/or wear disposable gloves.
        • Protective eyewear and a mask should be worn for examinations or procedures that may result in coughing.
        • Administration of medication via nebulisers is not recommended. Spacers should be used where possible, and the care recipient’s health care provider should be contacted.
Follow the advice found at:
http://www.health.gov.au/internet/main/publishing.nsf/Content/F954A8BBC7BD2231CA25701A0004E724/$File/influinfo.pdf

Top of pageCare recipients with an acute respiratory illness should be cared for as follows:
    • Encourage care recipients to have a supply of infection control equipment such as tissues and/or alcohol-based hand rub.
    • Educate care recipients in cough and sneeze etiquette.
    • If possible, care for care recipients with a flu-like illness in a separate room to the rest of the household.
    • Encourage a clean household environment.
    • Be alert for severe or deteriorating illness and support the need for early medical review, particularly if in a vulnerable group.
    • Advise the care recipient if he/she goes to the Doctor’s surgery, to wait in the car, or wear a mask if one is available in the waiting room.
    • Inform care recipients and families about the reasons for restrictions and if necessary limit contact with visitors.
Staff with an acute respiratory illness should proceed as follows:
    • Do not attend work if experiencing flu-like symptoms until well.
    • Undertake frequent hand washing, or use an alcohol-based hand rub, and undertake appropriate cough and sneeze etiquette.
    • Do not work in other care environments if exposed to the virus.
    • See your doctor if your symptoms are more severe or deteriorating, or you are in a group vulnerable to severe infection.
Further information can be obtained from: Top of page

Public Health Unit Information (contact phone numbers for doctors' use only).

NSW

http://www.health.nsw.gov.au/publichealth/swine_flu.asp
Contact details for the 17 public health officers in NSW Area Health
Services areas can be found at:
www.health.nsw.gov.au/publichealth/Infectious/phus.asp

Vic

http://www.health.vic.gov.au/ideas/diseases/swine-influenza
and
http://www.health.vic.gov.au/pandemicinfluenza/general_practice.htm		1300 651 160
Or after hours through paging service
1300 790 733

Qld

http://access.health.qld.gov.au/hid/InfectionsandParasites/ViralInfections/swineFlu2009_fs.asp13432584
Or
13HEALTH

WA

http://www.public.health.wa.gov.au/3/952/3/human_swine_flu_health_providers.pm(08)9388 4830
Or after hours
(09) 9328 0553

SA

http://www.flu.sa.gov.au/Swineflu.aspx
and
http://www.health.sa.gov.au/pandemicinfluenza/		(08)8226 7177

NT

http://www.health.nt.gov.au/Centre_for_Disease_Control/index.aspx
and
http://www.health.nt.gov.au/Emergency_Management_and_Disaster_Arrangements/Pandemic/index.aspx		(08)8922 8044

Tas

http://www.pandemic.tas.gov.au/
and
http://www.pandemic.tas.gov.au/what_does_it_mean_to_you/health_sector		1800 137 450

ACT

http://health.act.gov.au/c/health?a=da&did=10098808&pid=1240874209
and
http://www.health.act.gov.au/c/health?a=da&did=11044035&pid=1242181		(02)6205 2155
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