Microsoft word - action plan for human swine influenza_sep09.doc

General Advices and Action Plan for
Human Swine Influenza (Pandemic (H1N1) 2009)
1.0 INTRODUCTION
Human swine influenza (also known as pandemic (H1N1) 2009) is currently circulating among the people in Hong Kong. Even though the symptoms are relatively mild, the lack of antibodies in the human population causes the virus to spread rapidly across the city. This document aims to develop Institutional action plan to minimize the human swine influenza transmission and prevent large-scale outbreak on 2.0 BACKGROUND
Human swine influenza is influenza A virus of swine-origin that first caused human infection in Mexico and United States in March/April 2009. The virus spreads between humans in much the same way that regular seasonal influenza viruses spread, mainly by exposure to infected droplets expelled by coughing or sneezing, or through contact with objects or surfaces soiled with influenza viruses and then touching one’s nose, mouth or eyes. The infection causes a wide range of flu-like symptoms including fever, cough, headache, muscle and joint pain, sore throat and running nose. However in some cases, it also brings on vomiting and diarrhea, which are not associated with Hong Kong reported the first imported and domestic case of human swine influenza on 1 May 2009 and 10 June 2009 respectively, prompting the government to raise the alert level from “serious” to “emergency”. As of 31 August 2009, over 11,000 cases had been diagnosed in Hong Kong, of which 52 cases were severe and 6 cases were fatal. Worldwide over 210,000 cases had been confirmed in 180 countries. The current WHO phase of pandemic alert is 6, which is the highest on the scale, indicating that a global pandemic is under way. In Hong Kong the majority of patients experienced relatively mild symptoms and recovered fully within a week, even in the absence of any medical treatment. However people with underlying medical conditions, cardiovascular disease, diabetes, immunodeficiency and pregnancy belong to groups with increased risk for severe or fatal illness. Up to now no factor that can predict the pattern of severe disease has yet been identified as studies are still under way. Furthermore a seasonal influenza virus strain H3N2 accounted for almost half of the influenza infections has undergone a genetic change in Hong Kong recently. So far there is no evidence that this modified virus has become more virulent than its predecessors or it is resistant to Tamiflu. The genetic change is unrelated to the swine flu pandemic as well. However this modified virus is expected to bring more infections as cases of reduced response to antibodies generated by the vaccine recommended by the WHO have been reported. It is feared that the H1N1 virus might combine with the modified H3N2 or the seasonal influenza strain and develop drug resistance or 3.0 GENERAL
APPROACHES
The Institute’s goals are to reduce the transmission of the virus and prevent a large-scale outbreak within the campus area. They will be achieved through the „ Early identification and segregation of persons with influenza-like symptoms „ Increase the awareness of personal and environmental hygiene. 4.0 GENERAL
PRECAUTIONARY
MEASURES
Temperature
Screening
4.1.1 All staff and students are advised to measure their body temperature before entering the campus. If a fever is present, consider seeking medical attention promptly and taking rest at home. 4.1.2 The above principle is also applicable to visitors. Departments are therefore responsible for advising their visitors to take the same 4.1.3 Any staff member suspected to have a fever while on campus should contact his/her departmental general office for body temperature checking. An infrared thermometer is available in every department 4.1.4 Students and visitors can go to the Security Control Centre (A-G/F-03) for body temperature checking if they are feeling unwell. 4.2 Use of Face Mask
4.2.1 Any staff or student who experiences any influenza-like symptoms is advised to wear a face mask while on campus and on the staff/student/shuttle bus to prevent spreading the disease. 4.2.2 Face masks are available for staff and students at the Information Centre (A-G/F-08) and Security Control Centre (A-G/F-03) in case of 4.2.3 Face masks are also available for student hall residents at the reception of each student hall/quarters. 4.3 Use of Hand Sanitizer Dispenser
4.3.1 All staff and students are encouraged to clean their hands frequently using soap and water or alcohol-based handrub. Hand sanitizer dispensers are available at B1-G/F, D1-G/F, the main entrances of the student halls/quarters and outside the Security Control Centre 4.4 Maintaining Hygienic Environment
4.4.1 Disinfect the Institute’s premises with 1 in 99 diluted household 4.4.2 Ensure the shuttle services providers disinfect the school/staff/shuttle buses in the same way as 4.4.1. 4.4.3 Ensure an adequate supply of face masks, alcohol-based handrub, 4.4.4 Maintain an adequate amount of air exchange and have air filters 4.5 Information
4.5.1 Provide up to date information and guidelines about human swine influenza to staff and students via email, intranet and the (https://intranet.ied.edu.hk/CommunicableDisease/). PRECAUTIONARY MEASURES FOR SPECIAL OCCASIONS
5.1 Major Campus Events
5.1.1 The following precautionary measures will be implemented for any on-campus event/activity with over 100 participants held in an 5.1.1.1 Set up an infrared thermal imaging camera outside the event 5.1.1.2 Set up a hand sanitizer dispenser outside the event venue. 5.1.1.3 Prepare sufficient face masks for participants who need them. 5.1.2 The organizing department/unit is required to inform Estates Office (contact 2948-6269 or via email at [email protected]) at least two weeks prior to the event for the necessary arrangements. 5.2 Centrally
Administered
Examinations
5.2.1 Candidates are strongly advised not to attend an examination under 5.2.1.1 Have fever or influenza symptoms such as coughing and 5.2.1.2 Are confirmed human swine influenza patients and 5.2.2 Candidates are required to check their body temperature at home 5.2.3 A temperature checking counter will be available outside each examination venue. If a candidate is unsure of his/her temperature, he/she can get his/her temperature taken at the counter at least 15 5.2.4 Candidates are allowed to wear face masks throughout the examination, but will be required to take them off when asked to verify their identity during the taking of attendance or speaking test. 5.2.5 During the examination, if a candidate coughs and/or sneezes persistently, he/she will be asked to wear a face mask and will be arranged to take the examination at a designated corner of the 5.3 Field
Experience
5.3.1 A student’s field experience will be suspended if his/her placement school suspends all its classes. He/she should contact his/her programme office for further arrangement. ACTION PLAN FOR MANAGING CONFIRMED CASES
6.1 Patient
6.1.1 Refrain from school/work and rest at home. 6.1.2 Inform his/her Faculty/Department and Student Hall/Quarter 6.1.3 Provide the following information: 6.1.3.1 Date of onset of influenza-like symptoms; 6.1.3.3 Date of being confirmed with infection; 6.1.3.4 Classes/meeting attended since onset of symptoms. 6.2 Faculty/Department
6.2.2 Assist in identifying close contacts on campus. 6.2.3 List out all classrooms/venues used by the “case” since onset of 6.2.4 Follow the advices of the Estates Office. 6.3 Student Hall/Quarter Management Office
6.3.2 Disinfect the hall facilities using 1 in 49 diluted household bleach. 6.3.3 Advise the “case” to stay at home for treatment if he/she is a local 6.3.4 Prepare a separate room for the “case” if he/she is a non-local 6.3.5 Implement health declaration by staff and residents of affected 6.3.6 Suspend intake of new residents until the case is cleared. 6.3.7 Address the concern and emotion of staff and students. 6.4 Estates
6.4.1 Keep the Crisis Management Team informed and invoke the crisis management procedures if deemed appropriate. 6.4.2 Define the close contacts and affected places. 6.4.3 Provide advices to Department/Student Hall and close contacts. 6.4.4 Disinfect the affected places extensively using 1 in 49 diluted 6.5 Crisis Management Team
6.5.1 With the support of the Estates Office, keep staff and students informed of the latest status via email, intranet and Communicable 6.6 Close
Contacts
6.6.1 Observe personal health and seek medical attention promptly if any 6.6.2 Maintain good personal and environmental hygiene and healthy 6.6.4 Wear a face mask if worrying about being infected. ACTION PLAN FOR MANAGING OUTBREAKS
7.1 Criteria to be Considered as an Outbreak
7.1.1 The Crisis Management Team will consider giving advice on class suspension only if any of the following conditions is met: 7.1.1.1 Students’ sick leave rate due to human swine influenza 7.1.1.2 The hospitalization rate of students due to human swine 7.1.1.3 Admission of two or more students to intensive care unit due 7.1.1.4 Death of an otherwise healthy student due to human swine 7.1.2 The Crisis Management Team will consider giving advice on extra precautions to be taken by staff of affected department(s) if any of 7.1.2.1 Staff’s sick leave rate due to human swine influenza reaches the level that may seriously hamper the routine operations of 7.1.2.2 Admission of two or more staff members to intensive care unit 7.1.2.3 Death of an otherwise healthy staff member due to human 7.2 Outbreak
Students
7.2.1 If there a human swine influenza outbreak in a class, the Crisis Management Team will make recommendation to the affected department(s) on whether suspension of specific class(es) is necessary with regard to individual circumstances. 7.2.2 The general period of class suspension is 7 days. However the Crisis Management Team will consider other conditions, such as number of students affected, illness severity, the progression of the outbreak, etc, to advise whether extended suspension period is necessary. 7.2.3 Depending on the progression of the outbreak, the Crisis Management Team will also make recommendation on whether to request all other staff and students to wear face mask during class. 7.3 Outbreak
7.3.1 If there is a human swine influenza outbreak in a department, the Crisis Management Team will advise the affected department(s) on what further action(s) is necessary with regard to individual 7.3.2 The advice may include requiring all staff of affected department(s) and those in the vicinity to wear face masks at work, and compulsory measurement of body temperature for a consecutive period of 7 7.3.3 Departments are advised to develop their own contingency plan for the staffing arrangement in case of an outbreak. 8.0 GENERAL
8.1 For All Staff and Students
8.1.1 Step up hygienic practices like washing hands frequently, attending to sneeze and cough manners, keeping the environment clean and 8.1.2 Refrain from touching the mouth, nose and eyes. 8.1.3 Avoid visiting crowded or poorly-ventilated places. If it is unavoidable, step up personal hygiene and put on a face mask. 8.1.4 Pay attention to information and guidelines posted on the Communicable Disease Corner of the Institute. 8.1.5 Using a face mask incorrectly may increase the risk of transmission rather than reduce it. Proper disposal of used mask is essential to prevent spreading of the disease as well. The steps below should be 8.1.5.1 Place mask carefully to cover mouth and nose and tie securely to minimize any gap between face and mask. 8.1.5.2 While in use, avoid touching the mask. 8.1.5.3 After touching a used mask, for example when removing, clean the hands by washing with soap and water or using an 8.1.5.4 Replace a new mask as soon as the one in use becomes 8.1.5.6 Discard single-use masks after each use and dispose of 8.2 For People with Influenza-Like Symptoms
8.2.1 Wear a face mask and seek medical attention as soon as possible. 8.2.2 Rest at home. Avoid contact with others and do not go to work or 8.2.3 Cover the mouth and nose properly when sneezing and coughing. Use tissue to contain respiratory secretions and dispose of it immediately after use. Wash hands thoroughly with soap and water 8.3 For People with Chronic Diseases and Pregnant Women
8.3.1 Maintain good personal hygiene, especially handwashing. 8.3.2 Avoid contact with people with influenza-like symptoms. 8.3.3 Avoid visiting crowded or poorly-ventilated places. 8.3.4 Be mindful of influenza-like symptoms and seek medical attention as 8.3.5 Inform doctor of the medical condition during consultation on 8.3.7 Seek urgent medical attention in case any of the following symptoms 8.3.7.1 Difficulty in breathing or chest pain 8.3.7.2 Purple or blue discoloration of lips 8.3.7.3 Vomiting and unable to swallow liquids 8.3.7.4 Signs of dehydration such as dizziness when standing or 8.3.7.6 Less responsive than normal or confused 8.4 For Close Contacts with Suspected or Confirmed Case
8.4.2 Avoid visiting crowded or poorly-ventilated places. 8.4.3 Be mindful of influenza-like symptoms and seek medical attention as 8.4.4 Wear a face mask if worrynig about being infected. Travellers
8.5.1 Maintain good personal hygiene, wash hands or use an alcohol-based handrub frequently and avoid contact with sick people 8.5.2 Do not get on board when influenza-like symptoms develop. Put on a 8.5.3 Avoid going to crowded places and pay close attention to personal health after returning to Hong Kong. Seek medical attention promptly if influenza-like symptoms develop. 8.6 For Students Taking International Education Activities
8.6.1 Students who are going abroad in the near future: 8.6.1.1 Should pay attention to announcements from the HKSAR Government and the International Office of the Institute (IO). The Institue will provide updates of the human swine (https://intranet.ied.edu.hk/CommunicableDisease/) and any other important information via IO before they leave Hong Kong. For any assistance, please contact IO at (852) 2948 8.6.1.2 Should attend all briefing session/pre-departure meetings 8.6.1.3 Are advised to have comprehensive health, accident and hospitalization insurance during their participation in the programme. The policy should include coverage for expenses relating to sickness, injury, medical evacuation, accidental 8.6.1.4 Should pay close attention to their health condition. Students who have influenza like symptoms should not go abroad and should inform the programme/study visit coordinator and the 8.6.1.5 Should ensure that they are well aware of the emergency contacts at the overseas host university (OHU). 8.6.2 If students develop influenza symptoms while they are overseas, 8.6.2.1 Notify the OHU immediately and solicit assistance. 8.6.2.2 On the advice of the OHU, seek medical consultation from public clinic or hospital promptly. It is important for students 8.6.2.3 Follow the instructions as advised by the doctor. 8.6.2.4 Stay away from the OHU or school. 8.6.2.5 Inform the IO of development of the symptoms. 8.6.2.7 If fever is developed on the plane, inform the aircrew 8.6.3.1 Pay attention to announcements from the local government. 8.6.3.2 Follow local (overseas) public health guidelines, including any movement restriction and prevention recommendation. 8.6.3.3 Do not have contact with sick people. 8.6.3.4 Keep in regular contact with the IO and be aware of any 8.6.3.5 Pay close attention to personal health condition after returning to Hong Kong and seek medical attention promptly APPENDIX I: SELF SCREENING FOR HUMAN SWINE INFLUENZA
Flu symptoms: fever, cough, sore throat, headache, dizzy when standing or absence of urination APPENDIX II: STUDENT ACCOMMODATION – HEALTH DECLARATION FOR
INFLUENZA A H1N1
APPENDIX III: USEFUL CONTACTS
DEPARTMENT/UNIT
TELEPHONE
School of Continuing and Professional Education

Source: https://intranet.ied.edu.hk/CommunicableDisease/doc/actionplan.pdf