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Prevent Influenza

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					    如何防備流感
HOW TO PREVENT INFLUENZA

     衞生署中央健康教育組
      Central Health Education Unit
        DEPARTMENT OF HEALTH

             October 2006
       What is Influenza?
Influenza (flu):
   is a highly infectious
    viral disease

   caused by various types
    of influenza viral strains
     Seasonal Influenza
In Hong Kong, the disease is more common in periods from January to March
and from July to August.

                                                             病毒株數目




                                            月份

                                             普通科診所      私家醫生




     Consultation rate of influenza-like illness and number of influenza isolates in 2004
       Influenza Pandemic
Pre-requisites for the start
  of an Influenza Pandemic

   A novel influenza virus subtype
    emerge or an old subtype re-
    emerge

   The new virus must be able to
    replicate in humans and cause
    serious illness

   The new virus must be efficiently
    transmitted from one human to
    another                             Photo: source from CDC
‘Pandemic Influenza’ vs
‘Seasonal Influenza’
When compared to localised
  “seasonal” influenza epidemic,
  the influenza pandemic:
 Spreads quicker and broader

 Usually associates with higher
  severity of illness and a higher
  death toll
 Has more serious consequences,
  greater social and economic
                                     Photo: source from CDC
  impact
The relationship with Avian Influenza
   The Hong Kong 1997
    experience and the recent
    situation in some parts of the
    world have demonstrated the
    pandemic potential of H5N1

   The threat of H5N1 to human
    health is closely related to the
    outbreaks of HPAI (Highly
    Pathogenic Avian Influenza) in
    poultry

   The surveillance of potential
    virus responsible for pandemic
    influenza is an important part
    of contingency preparedness
Preparedness Plan for Influenza
Pandemic

The Government's 3-tier
response system for handling
major infectious disease
outbreaks
   Alert Response Level



    Serious Response Level

    Emergency Response Level
Alert Response Level
Scenarios :
   Confirmation of highly pathogenic avian
    influenza (HPAI) outbreaks in poultry
    populations outside Hong Kong

   Confirmation of HPAI in Hong Kong in
    imported birds in quarantine, in wild birds, in
    recreational parks, in pet bird shops or in the
    natural environment

   Confirmation of human case(s) of avian
    influenza outside Hong Kong
Actions from Public – Alert Level



   Maintain normal way of life

   Pay attention to further announcements
    from the Government
Serious Response Level
Scenarios:
   Confirmation of HPAI outbreaks in the
    environment of or among poultry population
    in retail markets, wholesale markets, farms
    in Hong Kong due to a strain with known
    human health impact

   Confirmation of human case(s) of avian
    influenza in Hong Kong without evidence
    of efficient human-to-human transmission
Actions from Public - Serious Level

   Maintain normal way of life

   Prepare enough masks for possible
    exigencies

   Pay attention to and comply with
     guidelines issued by the Government
Emergency Response Level

  Scenarios :

     Evidence of efficient human-to-human
      transmission of novel influenza overseas
      or in Hong Kong
     Pandemic influenza
Actions from Public - Emergency Level


    Use mask appropriately

    Pay attention to and comply with
     guidelines issued by the Government
Current level ?
How to Prevent
    Avoid touching live birds and poultry and their
     droppings
    After contact with live birds and poultry, wash
     hands thoroughly with liquid soap and water
     immediately
    Poultry and eggs should be thoroughly cooked
     before eating
    Travellers returning from endemic areas should
     consult doctors promptly if they have symptoms
     of influenza after the trip. Let the doctors know
     the travel history and wear a mask to prevent
     spread of the disease
How to Prevent
   Keep the environment clean
    - Ensure good ventilation
    - Avoid visiting crowded places with poor ventilation
    - Prevent the trap from drying and disinfect drain outlets,
      pour half a litre of water into each drain outlet
      and add 1 in 99 diluted household bleach solution into the
      outlet once a week
    - Keep your home clean, wipe furniture and toilets with a
      diluted household bleach solution in the ratio of 1 in 99
      once a day
How to Prevent


8 Steps to Protect Yourself
 Individual preparedness

    Before the pandemic comes

    When the pandemic comes
Why Should We Prevent Influenza
          Changeable surface antigens of influenza viruses




                    Potential threat

                                       Antigenic shift
                                      (major changes)
 Antigenic drift
(minor changes)


                                     Emergence of
                                     pandemic strain
 Seasonal influenza

                                            Influenza
                                            pandemic
8 Steps To Protect Yourself
  Step 1    Be prepared

  Step 2    Get vaccinated

  Step 3    Keep hands clean

  Step 4    Use mask properly
8 Steps To Protect Yourself

  Step 5   Know how influenza presents

  Step 6   Manage fever well

  Step 7   Practise healthy lifestyle

  Step 8   Be resourceful
Step 1 : Be Prepared
   Follow a healthy lifestyle

   Consult a doctor for
    influenza vaccination
     Step 1 : Be Prepared
Build up good personal hygiene
  • wash hands frequently
  • cover mouth and nose with tissue
  • paper when coughing or sneezing
  • and dispose of soiled tissue paper
  • properly in a lidded rubbish bin
  • avoid touching eyes, mouth or nose
  • wear mask when symptoms of
  • respiratory tract infection develop
Step 1 : Be Prepared

                    Keep at home
                      •   Masks
                      •   Anti-pyretics for use when necessary
                      •   Thermometer
                      •   Liquid soap
                      •   Tissue paper


                    Be always ready with
                     information of family doctor &
                     other useful information
Step 2 : Get Vaccinated
   Seasonal peaks : Jan - Mar /
    Jul – Aug

   Influenza vaccination
      one of the effective means in

       preventing influenza and its
       complications

   Influenza vaccination to special
    groups is recommended
Step 2 : Get Vaccinated
 People who should                           Influenza vaccine can be
 receive influenza                             given on the same day as
 vaccination:                                  other types of vaccines
     •    Elderly persons living in
         residential care homes
     •    Long-stay residents of
         institutions for the disabled
     •    Elderly persons aged 65 years
          or above
     •    Persons with chronic illnesses
     •    Health care workers
     •    Poultry workers
     •    Children aged 6 to 23 months
     •    Pregnant women
Step 2 : Get Vaccinated
 People not suitable to
  receive influenza vaccination:

     • Allergic to eggs, neomycin, etc
     • Allergic to previous dose of influenza vaccine

     • With bleeding disorders or on warfarin
         deep subcutaneous injection
     • Suffer from acute febrile illness
        receive when recover
Step 2 : Get Vaccinated


     Two weeks after vaccination
         antibodies develop and
           provide protection

     Immunity decline over time
Step 2 : Get Vaccinated

   Yearly influenza vaccine is
     targeted on seasonal influenza
     only

   Development of a new vaccine
    which matches the pandemic
    viral strain will probably take
    several months to complete
Step 3 : Keep Hands Clean
                When Should We Wash
                Our Hands?
                   Before touching eyes, mouth & nose
                   When hands are contaminated by

                    respiratory secretion
                       e.g. after coughing / sneezing
                   After touching public installations

                   or equipment
                       e.g. escalator handrails,
                           elevator control panels,
                           door knobs
                   Before handling food or eating

                   After going to toilet
Step 3 : Keep Hands Clean
                 Steps to Good Handwashing :

                 1. Wet hands under running
                    water
                 2. Apply liquid soup and rub
                    hands together to make a
                    soapy lather
                 3. Massage all the finger tips
                    properly for at least 20
                    seconds
                 4. Rinse hands thoroughly
                    under running water
Step 3 : Keep Hands Clean
                  5. Dry hands thoroughly with
                     clean cotton towel / paper
                     towel / hand dryer

                  6. The tap may be turned off by
                     using the towel wrapping the
                     faucet

                  Note: Rub hands with 65-95% alcohol
                      solution to disinfect them when
                      hand washing facilities are not available
Step 4 : Use Mask Properly

                  A way to prevent spread of
                   respiratory tract infections

                  Surgical masks  prevent
                   spread of droplet infections
Step 4 : Use Mask Properly
   People who should
    wear mask:

     • Patients with respiratory
       infection symptoms
     • Caregivers of patients with

       respiratory infection
       symptoms
     • Visitors of clinics or hospitals
Step 4 : Use Mask Properly

Points to note about wearing a surgical
 mask :
   The mask should fit snugly over the face
   Try not to touch the mask once it is secured on
    your face. If you must do so, wash your hands
    before and after touching the mask
   When taking off the mask, avoid touching the
    outside of the mask
Step 4 : Use Mask Properly
Points to note about wearing a surgical
  mask :
 After taking off the mask, put the mask into a

  plastic or paper bag before putting it into a
  rubbish bin with a lid
 A surgical mask should be changed at least
  daily
 Replace the mask immediately if it is

  damaged or soiled
Step 5 : Know How Influenza Presents
                 Incubation period: about 1-3 days
                 Signs and symptoms of influenza:
                       Fever
                       Headache
                       Muscle ache
                       Cough
                       Sore throat
                       Runny nose
Step 6 : Manage Fever Well
                    FEVER - Symptom of underlying illness
                     (should concern about specific illness that causes
                    fever)

                    Normal body temperature
                     37℃ / 98.6℉

                     can vary 1℃- 1.5℃ normally



                    Readings taken as reference
                    under different methods of
                    measurement:
                     Rectal temperature (38℃)
                     Oral or tympanic temperature (37.5 ℃)

                     Axillary temperature (37.0 ℃, less
                      reliable)
Step 6 : Manage Fever Well
                 Self-care tips of fever:
                  Dressing in lightweight clothing
                   and using light blanket
                    facilitate escape of body heat
                  Maintaining good ventilation of

                   indoor areas
                    facilitate escape of body heat
                  Drink adequate amount of water

                  Consume nutritious and easily

                   digestible food
                  Have adequate rest
Step 6 : Manage Fever Well

                  Self-care tips of fever:
                   Check body temperature regularly
                   When taking antipyretics, one should

                    follow the instructions on the package
                    of the medication or follow the doctor’s
                    advice
                   Consult a doctor especially if symptoms

                    are persistent, severe or getting worse

                  Note:
                  General households should maintain
                  about one week’s supply of antipyretics
                  for use when necessary
Step 7 : Practise Healthy Lifestyle

                  Is one of the most effective ways to
                  prevent communicable diseases
                  Consisting:
                     Eat a balanced diet
                     Get regular exercise
                     Do not smoke
                     Have adequate rest
                   build up body resistance
Step 7 : Practise Healthy Lifestyle

                     Major components of
                     a balanced diet
                        A variety of food
                        Whole grains as the major
                         component of each meal
                        Plenty of fruits and vegetables
                        Adequate amounts of fluids
Step 7 : Practise Healthy Lifestyle
                          Eat adequate amount of
                           lean meat or beans, and
                           reduced fat dairy products
                          Avoid processed or
                           preserved food and food
                           that is rich in fat,
                           cholesterol, salt and sugar
                          Have regular meals
Step 7 : Practise Healthy Lifestyle
                      Regular exercise :
                       30 minutes every day /
                        accumulate exercise time in
                        multiple sessions not less
                        than 10 minutes each
                       Physical activity of moderate
                        intensity
                       build up cardiovascular endurance
                       enhance heart and lung functions
                       improve health
    Step 8 : Be Resourceful

   Useful websites               Medical organization hotlines

                               • 24-Hour Health Education Hotline
Department of Health


   www.dh.gov.hk                of the DH: 2833 0111
                               • ‘Influenza Pandemic’ Hotline of

Centre for Health Protection
                               the
   www.chp.gov.hk               DH: 2125 1111
                               • Tel nos. of hospitals under the HA

                                 having 24-hour emergency services
                               • Tel nos. of private hospitals having

                                 24- hour emergency services
Knowledge can alleviate fear
     Before crisis comes: Go through Influenza
      Pandemic Preparedness Kit

     During the pandemic: Information &
      government advice available through
      pamphlets, posters, websites, hotlines &
      the media
 Take Preventive Actions in
  Peace Time
 Understand ‘Influenza’

 Work Together

   Prevent the PANDEMIC

				
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