Swine Flu Precautions

St. Luke's Reminds Public about Swine Flu Precautions and Latest Recommendations

Jeffrey A. Jahre, MD, FACP

Bethlehem, PA (6/19/2009) – Jeffrey Jahre, MD, St. Luke's Senior Vice President for Medical and Academic Affairs and Chief, Infectious Diseases, reminds the community that the H1N1 or swine flu virus is still prevalent. He encourages the public to continue to follow precautions to prevent further spread of the highly-contagious form of flu.

Basic Precautions

Some very basic precautions should be observed, as with any infectious disease:

• Cover your nose and mouth with a tissue when coughing or sneezing.
• Wash your hands often with soap and water or with alcohol based cleaners if not visible soiled.
• Avoid touching your eyes, nose or mouth.

As a further precaution to protect other patients and health care workers, people who present to St. Luke's emergency departments with flu-like symptoms will be required to wear a surgical mask.

"The H1N1 flu is very contagious. Approximately 30 percent of susceptible individuals coming into close contact with someone with influenza may themselves develop this strain of influenza," Dr. Jahre said. "Therefore, all patients with upper respiratory symptoms will be asked to wear surgical masks until they are treated and released home or else diagnosed to not have influenza."

Dr. Jahre noted that the H1N1 virus doesn't affect all patients the same, with approximately 20 percent without the high fever indicative of influenza. Some patients also do not report the body aches associated with ‘flu.

"Traditional flu strikes very young, old or those with impaired immune systems. The H1N1 flu differs from the traditional influenza in striking younger populations, with most cases occurring between the ages of 5 and 24. This has occurred because H1N1 is a new strain in a population without natural immunities to it," said Dr. Jahre. "We will continue to track this flu virus to see if it mutates into a different form as we come into the fall flu season."

"Fast Swab" Testing in Progress

Following the recommendations of the CDC, St. Luke's Emergency Departments, St. Luke's urgent care centers and family/internal medicine physicians are currently testing patients for the traditional flu or influenza A strain with “fast swab” testing. Because the traditional flu season has ended and influenza A is "out of season," any positive influenza A rapid swab results are considered to be positive for H1N1.

In response to the traditional flu season's end, the Pennsylvania State Public Health Department has now set updated guidelines for laboratory testing for H1N1. This means only some specimens for patients diagnosed with positive influenza A swabs will be sent to the state labs for further testing.

The cases for state testing of H1N1 now include the following for positive influenza A:

• In cases where patients require hospitalization
• In institutional settings where confirmation will aid clinical and public health decision making (summer camps, correctional facilities, group home settings, long term care facilities)
• In health care workers
• In age groups that have low incidence of the disease (infants below 12 months and in persons 65 or over)

CDC Recommendations

St. Luke's continues to follow the recommendations of the CDC which include the following for patients with suspected or confirmed H1N1 swine flu:

• Patients exhibiting symptoms should immediately alert personnel at hospitals, the physician's office or urgent care center so the medical personnel may make proper precautions.
• Appropriate patients who exhibit symptoms will be tested with traditional nasal or throat cultures. Patients will wear masks over nose and mouth.
• The patient will be placed in respiratory isolation until determination of the virus. This means a room with negative pressure air handling that is not shared within the hospital. Positive test results are shared with state laboratories and the CDC. Patients are treated as appropriate.

The disease responds well to anti-virals like Tamiflu ® and Relenza ® for patients whose results are positive for the virus, according to the CDC. Patients are responding well to anti-virals as long as they are treated within the first 36- 48 hours of the onset of symptoms, explained Dr. Jahre. However, those medications are not currently recommended to be used prophylactically, or as a preventive measure, according to Dr. Jahre.

Dr. Jahre recommends seeing a family physician or urgent care center as a first step if you or a family member feels ill.

Dr. Jahre said, "Please be aware that adults with this flu may be infectious a day before the onset of onset of symptom to approx a week later. Children may be infectious up to a week or more afterwards."