Blog Last Updated January 26 2010 Monitor Twitter for University updates also: www.twitter.com/uofmshs
DEBUNKING H1N1 INFLUENZA VACCINE MYTH: http://www.nbcphiladelphia.com/news/health/Debunking_H1N1_Vaccine_Myths_Philadelphia.html
UofM H1N1 video: http://www.memphis.edu/videos/embedvideo.php?movie=movs/swineflurefmovie.mov&width=640&height=496
H1N1/ILI on college campus: www.acha.org/ILI_LatestWeek.cfm
The information within this web site is provided as a courtesy of Student Health Services. We try to keep the information as accurate as possible; however, we disclaim any implied representation or warranty about its accuracy, completeness, or appropriateness for a particular purpose. You should never disregard or delay seeking medical advice because of what you have read on this Web site.
Jan. 26, 2010 - About two-three weeks before the Holiday break, SHS was seeing each day ILI/H1N1 cases numbering in the single digit, a declinefrom the double digits seen previously. After Christmas break, the number of cases each day has fallen to the low single digits and seems to have leveled off there.
The H1N1 vaccine is no longer available at the Student Health Center. However, it is still not too late to get a vaccine shot, which may be obtained from the Memphis/Shelby County Health Dept., your Primary Care Provider, or at Walgreen's or Walmart.
Nov. 4 - Do not take salicylates (aspirin) for your fever during H1N1 infection.
*Salicylates can be found in food, medication, and cosmetics. Some examples of salicylate-containing substances include:
(1) Foods that contain salicylates and salicylate-containing ingredients: - Vegetables such as alfalfa, cauliflower, cucumbers,
mushrooms, radishes, broad beans, eggplant, spinach, zucchini,
broccoli, and hot peppers
- Fruits such as apples, avocados, blueberries, dates, kiwi fruit, peaches, raspberries, figs, grapes, plums, strawberries, cherries, grapefruit, and prunes.
- Some cheeses
- Herbs, spices,
and condiments such as dry spices and powders, tomato pastes and
sauces, vinegar, and soy sauce, jams, and jellies
- Beverages such as coffee, wine, beer, orange juice, apple cider, regular and herbal tea, rum, and sherry
- Nuts such as pine nuts, peanuts, pistachios, and almonds
- Some candies, such as peppermints, licorice, and mint-flavored gum and breath mints
- Ice cream, gelatin
(2) Products that contain salicylates and salicylate-containing ingredients:- Fragrances and perfumes
- Shampoos and conditioners
- Herbal remedies
- Cosmetics such as lipsticks, lotions, and skin cleansers
- Mouthwash and mint-flavored toothpaste
- Shaving cream
- Sunscreens or tanning lotions
- Muscle pain creams
- Alka Seltzer
- Aspirin
- Acetylsalicylic acid, Beta-hydroxy acid, Salicylic acid
- Artificial food coloring and flavoring
- Benzoates
- Menthol, Mint, Peppermint, Speamint
- Magnesium salicylate, Phenylethyl salicylate, sodium salicylate
Nov. 2 - - The UofM has not received any H1N1 Influenza A vaccine from the State. At this time, UofM is not sure when we will receive our first supply that will be distributed to priority groups established by the Center for Disease Control. However, when we do receive a supply, you will be notified by email and this blog on how to register if you meet the criteria for one of these priority groups.
For the H1N1 flu, Student Health Services, for the past two weeks, has seen the number of cases of H1N1 presenting at the clinic each day leveling out to the high single digits to the low double digits. Continue to do your part by practicing good respiratory hygiene, hand washing, and social distancing.
Oct. 15. If you are pregnant and you wish to receive the H1N1 vaccine from the UofM, please check with your OB doctor beforehand, to get their approval, even though the Center for Disease Control (CDC) has approved the injectable H1N1 vaccine for pregnant women.
Oct. 14. The federal government
has released a small number of initial doses of H1N1 vaccine in the
form of a “live” vaccine given by intranasal spray. Additional doses of
vaccine in liquid injectable form, similar to the seasonal flu vaccine, are
expected to be released in the coming weeks. UofM is currently awaiting
the arrival of the injectible vaccine but expects to receive some doses sometime
in October. These initial doses will be targeted to the most high risk
populations based on CDC recommendations and the type of vaccine
supplied to UofM by the state. Initially, supplies may be limited, but
no shortage of vaccine is expected.
WHAT YOU NEED TO KNOW:
- Two types of H1N1 vaccine will be available. One is a
“live” vaccine that is a nasal spray, which the UofM will not be offering, and the other is made similar to
the seasonal flu vaccine which is an injectible form. Live vaccine is for use only in healthy
people ages 2 – 49 who are not pregnant or have no other medical
conditions. The injectible vaccine is made similarly to the seasonal
flu vaccine and has very few minor side effects.
- The
injectible vaccine will be a one-dose vaccine. Those under the age of 9 will require two doses of
vaccine 4 weeks apart.
- A pregnant woman
who gets any type of flu is at higher risk for serious health problems.
Compared with people in general who get novel H1N1 flu, pregnant women
are more likely to be admitted to hospitals and have a more serious
illness. Pregnant women should not, however, receive the nasal spray H1N1 vaccine because it is a “live” vaccine.
- Most
common side effects from the vaccine include soreness and tenderness at
the injection site. A small number of people will experience mild
headache, muscle aches, fever, and nausea or feel tired. These side
effects usually begin soon after the injection and may last 1 to 2
days.
- Breastfeeding women are also encouraged to receive both the seasonal and H1N1 vaccine.
October 13, 2009 -- When the H1N1 vaccine becomes available to the UofM from the State, you will be asked to read a Vaccine Information Statement (VIS) that was devised by the CDC. After reading it, you will then be asked to read and sign a consent form, if you desire to receive the H1N1 vaccine. Anyone under the age of 18 will need to have a parent or legal guardian sign the consent form. You will need to bring both of these forms to the vaccination site.
There will be only one VIS form. The same VIS form will apply to those 18 and over and those under 18.
To preview the VIS for the H1N1, click here: http://www.cdc.gov/h1n1flu/vaccination/slv/pdf/vis-h1n1-prelicensure.pdf
The consent forms will be posted for your review when they become available.
The injectible H1N1 vaccine will be administered by the UofM School of Nursing. The vaccine clinic site will be the Life Blood Donor Center, 2nd floor of the University Book Store. The exact times and dates and cost is not known at this time. However, the days of the week when the clinic might be open will be on Tuesdays, Wednesdays and Fridays. This will depend on how much vaccine we receive with each shipment from the State. Until we know the exact amount that we will receive, we can not give the exact times and dates.
Once UofM receives a shipment of H1N1 vaccine, we will know how many from the priority group we can vaccinate at each clinic date. If you meet the criteria for the priority group, you will be able to pre-register until the total for that shipment has been reached. Once the clinic time slots have been filled, you will have to wait until the next shipment comes in and pre-register again. The pre-registration process requires a printer. You
MUST take the form with you when you receive your vaccine.
Pre-registration benefits include:
- Greatly reduces the amount of time spent at the facility where you receive your vaccine.
- Improves accuracy.
October 7 - - The 2009-2010 flu season has the potential to be a challenging one because we will be dealing with the normal seasonal flu and novel H1N1 (swine) flu. National health officials are encouraging individuals to get both seasonal and H1N1 shots to be fully protected. The University of Memphis will offer the H1N1 influenza vaccine to students, faculty, and staff when it becomes available.
- The University of Memphis has developed a vaccine delivery plan for the H1N1 and will notify you when the H1N1 vaccine becomes available from the State of Tennessee, and provide information about how to register, site location, dates, times, cost, etc. If the vaccine is in limited supply, the priority groups will be listed and strictly adhered to.
- CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended that the following priority get the H1N1 vaccine when it is first available. If the supply is initially limited, some modifications in this listing may occur by the CDC.
- Pregnant women,
- People who live with or care for children younger than 6 months of age,
- Healthcare and emergency medical services personnel,
- Persons between the ages of 6 months and 24 years old, and
- People ages of 25 through 64 years of age who are at higher risk for novel H1N1 because of chronic health conditions or compromised immune systems.
Sept. 25. In general, the World Health Orgainzation (WHO) does not recommend the use of antiviral drugs for prophylactic purposes. For people who have had exposure to an infected person and are at a higher risk of developing severe or complicated illness, an alternative option is close monitoring for symptoms, followed by prompt early antiviral treatment should symptoms develop.
FAQ for the H1N1 vaccine: http://www.cdc.gov/h1n1flu/vaccination/vaccine_safety_qa.htm
SOME OTHER FAQs about the H1N1 vaccine:
I think I’ve had the pandemic (H1N1) 2009 influenza. Do I need to have H1N1 vaccine?
If you have definitely had pandemic (H1N1) 2009 influenza it is likely you have immunity and do not need the H1N1 vaccine. But, you can only know for certain if you had this pandemic flu if you were tested for it and the test was positive.
If you have had a flu, but were not tested, you should get the vaccination to ensure that you have good protection against the pandemic H1N1 virus. It is safe to have the H1N1 vaccine, even if you are already immune to the virus, just as it is safe to get a seasonal influenza vaccination if you’ve already had seasonal flu.
If I’ve recently had Tamiflu® or Relenza® for influenza – do I still need to be vaccinated?
Yes, you will need to be vaccinated. Tamiflu® and Relenza® are anti-viral medicines that treat infection. Anti viral drugs do not give long term protection against influenza like a vaccine does.
I was told that I had confirmed H1N1 pandemic influenza and was treated with Tamiflu® /Relenza® - do I still need to be vaccinated?
Yes, you still need to be vaccinated. People who have had pandemic influenza and were treated with antiviral medicines like Tamiflu® and Relenza® are less likely to develop protective immunity following the infection. It is important that you get vaccinated. It does not harm you to have the vaccine, even if you are already immune to the virus.
Will I get influenza from the injectable HIN1 vaccine?
No, the injectable vaccine does not contain "live" virus and cannot give you influenza.
Can I vaccinate my pets?
No. This is not an animal vaccine and there is no pandemic vaccine for animals.
Do I have to get the H1N1 vaccine?
No, the vaccine is being offered on a voluntary basis, but is strongly recommended for people in the priority group.
Should some people not be given the H1N1 vaccine?
People should not be given the H1N1 vaccine or any other influenza vaccines if they:
- have experienced anaphylaxis, a severe form of a generalized allergic reaction, following a previous dose of any influenza vaccine;
- have experienced anaphylaxis following receipt of any vaccine component; or
- have a severe allergy to eggs, including people who have experienced swelling of the lips or tongue, or had acute breathing problems of convulsions, after eating eggs.
Can I take antivirals if I’m on immunosuppressants?
Yes, it is safe for you to take antivirals.
Can I take antivirals if I have mild to moderate kidney disease?
Yes, you will be treated as any other person would be. This means you can take antivirals, if necessary. However, consult with your primary care provider beforehand.
Can I take antivirals if I have severe kidney disease?
Usually Yes. However, your primary care provider should make this decision.
Are people with asthma or other respiratory problems more at risk from influenza A(H1N1)?
You are no more likely to catch influenza A(H1N1) than anyone else. However, if you do catch a respiratory infection, including influenza A(H1N1), it will add to the breathing difficulties you may have.
What advice is there for people with asthma or other respiratory problems?
If you get influenza A(H1N1), you are at greater risk of a more severe illness. It is therefore very important that you follow good hygiene practices to protect against flu and take appropriate actions if you develop flu-like symptoms.
Can I take antivirals if I have asthma or other respiratory problems?
Yes - however your doctor will advise you as some antivirals are more suitable for those with asthma or other respiratory problems.
I have diabetes. Am I at more at risk from influenza A(H1N1)?
You are no more likely to catch influenza A(H1N1) than anyone else. However, if you do catch it, your blood glucose may increase and your diabetes treatment may need to be adjusted accordingly.
What should I do if my blood glucose increases?
If you find your blood glucose has increased, or you develop thirst and are urinating more often, call your primary care provider. If you are on insulin and testing your own blood glucose, you may be advised to do this more often so you can adjust your dose according to the results. If you start to vomit or become increasingly unwell, call your primary care provider as soon as possible.
Is there any advice for people with liver disease?
If you have liver disease you are no more likely to catch influenza A(H1N1) than anyone else. If you do catch it, antivirals are safe to take – there is no interaction between these and antivirals you may already be taking to treat hepatitis. However, the type and dose of antiviral will be decided by your doctor, so consult with your primary care provider.
Can I take antivirals if I am on epilepsy treatment?
Yes. There is no evidence that antiviral treatments affect medicines taken to control epilepsy. However, consult with your primary care provider beforehand.
Should patients with bone marrow failure diseases get the H1N1 flu shots when they become available?
It is believed the H1N1 vaccine will be safe and it is recommended. However, because of your underlying hematologic disease and its effect on your immune system, the H1N1 flu shot may not be as effective for you as it may be for other healthy individuals. This is especially true if you are taking immunosuppressive type drugs like ATG and cyclosporine.
For PNH patients, vaccination is fine if you are on Eculizumab (Soliris). If you are not receiving this drug, there is the potential for vaccination to cause activation of complement and lead to a flare up in your hemolysis. Discuss the risks and benefits with your doctor.
Pregnant Women and Breast feeding mothers
Why am I identified as a priority?
As a pregnant woman, you are more susceptible to complications of the pandemic (H1N1) 2009 influenza than the general population. This puts both you and your baby at risk. Around the world, some pregnant women who have caught this disease have miscarried, gone into premature labor or died.
Am I getting H1N1 vaccine to protect myself or my baby?
Both; vaccination will protect you and your baby. If you are vaccinated during pregnancy your baby will have protective antibodies for the first few months after birth.
Is it safe to be vaccinated at any stage in my pregnancy?
Yes. Influenza vaccines are safe during all stages of pregnancy. With seasonal flu, vaccination is normally offered in advance to women planning a pregnancy, and to pregnant women.
As a pregnant woman, you are at risk of severe complications if you catch the pandemic (H1N1) 2009 influenza, so vaccination is strongly recommended. If you are worried about the H1N1 vaccine you should discuss the potential risks and benefits of having it with your health care provider.
What are the risks to my baby and what are the risks to me?
Like all individuals receiving a vaccine, expectant mothers may experience similar side-effects, including a sore red arm, slight headache or mild temperature. H1N1 vaccine is not a ‘live’ vaccine and cannot give you or your baby influenza, and is no greater risk to you or your unborn baby than seasonal vaccine.
Should I get vaccinated if I'm beast feeding?
Yes, by getting vaccinated you are reducing your chances of getting this flu and of passing it to your baby. There is no evidence that the vaccine affects breast milk, and because it contains no live virus you will not get flu. Your immunity after vaccination will not be passed to your baby through your breast milk but babies older than six months can also be vaccinated.
I've heard there is a preservative called thiomersal in Panvax® H1N1 vaccine. Is it safe if I'm pregnant?
Yes. There is no evidence that thiomersal is harmful to pregnant women or their babies. Thiomersal is a commonly used preservative in multi-dose medicines such as H1N1 vaccine, which contains a small amount of thiomersal to keep it safe in the vials.
General questions and answers on Thiomersal: http://www.cdc.gov/h1n1flu/vaccination/thimerosal_qa.htm
Pregnant women are strongly encouraged to protect themselves and their baby by getting the vaccine CDC's questions and answers for pregnant women and the H1N1 vaccine: http://www.cdc.gov/h1n1flu/vaccination/pregnant_qa.htm
Questions and Answers on Guillain-Barre syndrome: http://www.cdc.gov/h1n1flu/vaccination/gbs_qa.htm
H1N1 (Swine) flu vaccinations are not available yet. Information on where you can get vaccinated and when will be available soon, once the the UofM has received the vaccine. Vaccine will be available to all people but priority for the initial supply is on protecting people who are most at risk of severe outcomes if they catch pandemic influenza, such as pregnant women, people with underlying medical conditions. Vaccination is especially important for people who are more at risk of severe outcomes if they catch this flu because of some underlying chronic conditions, such as:
- heart disease, excluding simple hypertension;
- asthma and COPD and other lung diseases;
- cancer;
- diabetes mellitus;
- weakened immune system (immunosuppression, including HIV/AIDS and use of immunosuppressive drugs or those receiving chemotherapy). Some immunosuppressive drugs include Azathiprine, corticosteroids, cyclosporine, tacrolimus, sirolimus, mycophenolate acid, (This is not a full list.)
- inherited blood disorder (Hemoglobinopathies, including sickle cell disease, aplastic anemia, etc.);
- chronic kidney disease, such as renal dialysis patients;
- neuromuscular disease, including muscular dystrophy and multiple sclerosis;
- chronic metabolic diseases; or
- Neurological disorders (including nervous system, brain or spinal cord)
It is looking more likely that only one vaccination shot will be required for our population group instead of two, as was originally thought.
Due to patient volume at SHS from H1N1/ILI, plan on a possible 2-hour wait time. On your visit, if the main waiting room has ten people waiting to be seen, then you can extrapolate that your wait could be about one hour; if 20, about two hours. Remember, also, that we have two additional waiting rooms, so you are only seeing one waiting room when you enter the clinic. Your patiences in this regard is appreciated.
Moreover, every day this semester, due to potential patient demand, SHS may have to stop signing in additional patients by moving the closing time from 4:30 p.m on Fridays to an earlier time. On Mondays through Thursdays, when the clinic is open until 6:00 p.m, SHS may have to stop signing in additional patients by moving the closing time up earlier than 6:00 p.m. to 5:00 p.m., or even 4:30.
If you get ill (or are already ill) and need medical care after-clinic hours, click on "AFTER-HOUR COMMUNITY CLINICS" on this blog site. If you have an emergency, or feel like you have an emergency, call 911 for help (if you can't make it to a hospital emergency department on your own or with the assistance of somebody).
If you have been diagnosed with ILI/H1N1 by a primary care provider, or you are self-isolating yourself, as advised by CDC, without having been seen by a primary care provider,
- Go to an emergency room for any of the following symptoms:
- shortness of breath
- difficulty taking a full breath
- high fever (above 103); prolonged fever for more than 3 days; or relapsed fever after being free of fever
- drowsiness
- confusion
- severe headache (not relieved with Tylenol, Ibuprofen, Aleve (no Aspirin Products), or other pain medications
- stiff neck
- persistent vomiting
- chest pain
- flu like symptoms that improve but then return with fever and worse cough.
If you have been diagnosed with H1N1 or ILI (Influenza-like illness) at the UofM SHS clinic or you are self-isolating yourself without being seen by any primary care clinic/primary care provider, three instruction/information sheets present on this blog will help you take care of yourself and will give you information to give to your caretaker and those who are/were in close contact with you.
The three sheets are (1) CLOSE CONTACT FACT SHEET H1N1/ILI; (2) PATIENT CARE INSTRUCTION/INFORMATION SHEET H1N1/ILI; (3 CAREGIVER INSTRUCTION SHEET H1N1/ILI. Stay away from school, campus and work until you are fever free for, at least, 24 hours, without taking any fever-reducing medication.
SHS will report cases as ILI, instead of H1N1 since SHS has no reliable method to test for the specific H1N1 influenza A virus in our clinic, and neither does any other primary care clinic in the country. ILI (Influenza-like illness) is defined as: Fever (>100F [37.8C], oral or equivalent) AND cough and/or sore throat (in the absence of a KNOWN cause other than influenza).
However, from official tests done by St. Jude Children's Research Hospital (a sentinel laboratory for the CDC) from the specimens that we have sent them on our ILIs, St. Jude has confirmed that the ILIs are, indeed, H1N1 (Swine) Influenza A.
Nov. 11-- SHS has had a total to 443 cases of ILI, since reporting its first cases on August 26. Please be advised that this is a low number considering that we have 21,000 students, and another 4,000 faculty and staff. However, also, keep in mind that some students are being diagnosed with H1N1/ILI by their primary care provider/walk-in clinic, or they are self-isolating themselves as recommended by the CDC without being seen by a primary care provider/walk-in clinic, so the true number is not known. SHS expects that this trend will continue.
Sept. 2 -- As a result of ongoing events related to the H1N1 virus, I [Shelby Slater, Emergency Preparedness Coordinator] am requesting members of the UofM Crisis Management Team to review all elements of Pandemic Influenza Preparedness and Response Plan http://bf.memphis.edu/crisis/crisis_mgmt_plan.pdf#page=51. Please give special attention to action items in Level 1 (current status) and Level 2; it is important for each listed department to comply with items identified within their area of responsibility, and additional items located on pages 76 and 77 of the plan.
FACULTY: It is critical for limitation of disease spread that students, faculty, and staff members with flu-like symptoms NOT attend classes, labs, or social/athletic events or go to work. The CDC currently recommends that any patient with a flu-like illness remain at home until 24 hours have passed without fever (in the absence of fever-reducing medications).
Student Health Center (and the Provost) is asking for faculty cooperation with this CDC recommended policy; it is important that students who are ill with influenza not feel pressure from faculty to attend class. The CDC also recommends that universities and colleges dismantle any policy requiring ill students or employees to provide a note or “excuse” from a health care provider. Such policies may potentially overwhelm health care providers, as they struggle to care for ill patients during times of widespread illness.
Sept. 2009 - - All faculty members have been advised by the Office of the Provost to take into account the presence of H1N1 and discourage class attendance by any student experiencing flu-like symptoms and to make alternatives available to students who must miss class due to illness. It should also be stressed that students who are free of flu-like symptoms must come to class in accordance with the class syllabus and schedule.
If a student believes that an instructor is not being reasonable about the student’s illness-related absence, the student should contact the Provost’s office with that information. Such reports may be made by phone at 901-678-2119 or by email to aharbor@memphis.edu
Sept. 2 -- From WHO: "The clinical picture of pandemic influenza is largely consistent across all countries. The overwhelming majority of patients continue to experience mild illness. Although the virus can cause very severe and fatal illness, also in young and healthy people, the number of such cases remains small. While these trends are encouraging, large numbers of people in all countries remain susceptible to infection. Even if the current pattern of usually mild illness continues, the impact of the pandemic during the second wave could worsen as larger numbers of people become infected. Larger numbers of severely ill patients requiring intensive care are likely to be the most urgent burden on health services, creating pressures that could overwhelm clinics and hospitals and possibly disrupt the provision of care for other diseases.
"Current evidence points to some important differences between patterns of illness reported during the pandemic and those seen during seasonal epidemics of influenza. The age groups affected by the pandemic are generally younger. This is true for those most frequently infected, and especially so for those experiencing severe or fatal illness.
"To date, most severe cases and deaths have occurred in adults under the age of 50 years, with deaths in the elderly comparatively rare. This age distribution is in stark contrast with seasonal influenza, where around 90% of severe and fatal cases occur in people 65 years of age or older.
"Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections. In these patients, the virus directly infects the lung, causing severe respiratory failure.
"An increased risk during pregnancy is now consistently well-documented across countries. This risk takes on added significance for a virus, like this one, that preferentially infects younger people.
"Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.
"The 2009 influenza pandemic is the first to occur since the emergence of HIV/AIDS. Early data from two countries suggest that people co-infected with H1N1 and HIV are not at increased risk of severe or fatal illness, provided these patients are receiving antiretroviral therapy. In most of these patients, illness caused by H1N1 has been mild, with full recovery.
"If these preliminary findings are confirmed, this will be reassuring news for countries where infection with HIV is prevalent and treatment coverage with antiretroviral drugs is good.
"On current estimates, around 33 million people are living with HIV/AIDS worldwide. Of these, WHO estimates that around 4 million were receiving antiretroviral therapy at the end of 2008."
Have events at UofM been canceled due to the H1N1 flu?
UofM has not canceled any events or activities due to H1N1 flu. Offices are open and classes are being held as usual. but, please, practice social distancing, respiratory hygiene, handwashing, and other recommendations made on this blog and by CDC. SHS urges you to remain vigilant if symptoms emerge, especially if you have pre-existing conditions, such as asthma, diabetes or other underlying conditions that might compromise your immunity.
SHS wants to advise everyone that personal responsibility is the first line of defense against the virus. SHS also wants you to know that SHS is prepared to medically treat students who need assistance.
If I think I might have H1N1 flu, what should I do?
It is expected that most people will recover without needing medical care. If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether testing or treatment is needed.
If you are sick with flu-like illness, the CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
Stay away from others as much as possible to keep from making others sick. Staying at home means that you should not leave your home except to seek medical care. This means avoiding normal activities, including work, school, travel, shopping, social events, and public gatherings.
If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed.
If you become ill and experience any of the following warning signs, seek emergency medical care.
In adults, emergency warning signs that need urgent medical attention include:
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness
- Confusion
- Severe or persistent vomiting
- Flu-like symptoms improve but then return with fever and worse cough
Be prepared to return home and live in self-isolation until you have no fever for 24 hours without having to take fever-reducing medication if you should become sick with H1N1 influenza A or ILI (Influenza-like infection). CDC recommend using antivirals (tamiflu and relenza) only for people at high risk of complications -- pregnant women and those with chronic conditions such as asthma, diabetes, renal disease, heart disease, etc.
Student Health Services (SHS) reminds the University community to continue taking precautions, as we have a challenge ahead of us. Keep planning, remain diligent, do your part, and keep inform by monitoring CDC, WHO, our blog and twitter.
Each department of the University should take steps to reduce the risk of infection, such as having disinfectant wipes and hand sanitizers available at convenient locations. In addition, if at all possible, faculty should
- Find ways to increase social distances (the space between people) in classrooms such as moving desks farther apart, leaving empty seats between students, holding outdoor classes, and using distance learning methods.
- Allow students, faculty, and staff at higher risk for complications to stay home. These students, faculty, and staff should make this decision in consultation with their health care provider.
- Suspend classes. This decision will be made together with local and state public health officials. The length of time classes should be suspended will depend on the goal of suspending classes as well as the severity and extent of illness.
Fact Sheet for Students, Faculty, and Staff
Action Steps for Students, Faculty, and Staff to Prevent the Spread of Flu: http://www.cdc.gov/h1n1flu/institutions/toolkit/actionstepsstudents.htm.
Posters reminding everyone of “The Three Cs -- Clean, Cover, Contain,” should be posted throughout the building. To download poster: http://www.health.gov.nl.ca/health/publications/hygiene/adult_HCOM_Influenza_Poster.pdf.
Poster for Institutions of Higher Education to Remind Sick People to Go Home: http://www.cdc.gov/h1n1flu/institutions/toolkit/pdf/StopDoYouFeelSick_8X11.pdf
CDC's and Secretary Sebelius’ recommendations for Universities:
- Modify absenteeism policies so both students, faculty members and others who are ill have no incentive to return to campus activities earlier than they should.
- End rules that require doctor’s notes to excuse absences from class or work.
- Expand or create distance learning programs for those who need to be isolated.
- Increase “social distancing” between students by moving desks further apart (6 feet most of the time).
Therefore, adjust policies to allow for higher rates of absenteeism. If students, faculty and staff become ill, they should not remain in class or in offices, where they can infect others.
In the event of high absenteeism due to influenza, faculty are asked to consider providing students with more distance-learning options via Internet tools, if possible. Ill students living within a reasonable driving distance will be encourage to return home in personal vehicles and not use public transportation. If students living in residence halls cannot leave campus, plans should be in place to temporarily isolate ill students away from healthy students.
The University's ability to stay open during high absenteeism will depend on the incidence of disease on campus, students, faculty and staff's participation in the vaccination program, and the implementation of the Pandemic Influenza Response Plan by each department.
It is important for you to realize that you need to be responsible for using good respiratory and hand-washing etiquettes. Based on recommendations from the Centers for Disease Control, SHS asks the University community to take the following precautions to stay healthy.
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue away after you use it. If tissues are not available, cough or sneeze into the crook of your arm or shoulder.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Do not share utensils, drinks, cigarettes or personal care items.
- Try to avoid close contact with sick people.
If you experience flu like symptoms, visit your primary care doctor, a walk-in clinic; students are reminded that they can visit SHS. If H1N1/ILI cases become more common, SHS will ask students to self-isolate themselves and not report to SHS, unless they have a chronic disease or they are immunocompromised from disease or medication. As of September 2, we are not at that stage yet.
PREPARE A COLD AND FLU KIT
Bring a self care kit to campus that includes:
- a thermometer
- acetaminophen (Tylenol) or ibuprofen (Advil)
- cough syrup
- bottled water, sports drinks and soups
- alcohol-based hand sanitizer
- boxes of tissues
Students, who will be living away from home this fall, are advised to pack extra hand sanitizer and soap alongside their I-pods, bedspreads, clothing, etc.
SHS encourages students and local residents alike to get the seasonal flu shot this fall. “With the likely reality that there will be two types of influenza this fall – H1N1 and seasonal flu – it is more important than ever to get vaccinated against seasonal flu.” Read further for the seasonal flu dates, times, location, etc.
In addition, the CDC recommends that, to protect against the H1N1 influenza virus, two separate immunizations will be required, separated by at least three weeks. The H1N1 vaccine is expected to be available late this fall. SHS will keep you informed when it becomes available.
AUGUST 25, 2009
To: AASCU Presidents and Chancellors
From: Ed Elmendorf, Senior Vice President of Government Affairs and Policy Analysis
Lesley McBain, Senior Research and Policy Analyst
Re: H1N1 Flu Guidance
Date: August 25, 2009
Information Advisory: As colleges and universities begin the fall semester, the prospect of widespread fall outbreaks of H1N1 flu is a matter of concern not only on campus but at the highest levels of government. AASCU is concerned that its members have access to suggested measures and strategies that help protect students and better serve to mitigate potential impact on affected institutions. This AASCU Information Advisory is sent to assist you in addressing the possible impact of H1N1 flu on your institutions and constituents.
On August 7, 2009, the President’s Council of Advisors on Science and Technology (PCAST) provided a report to President Obama on U.S. preparedness for a H1N1 outbreak in Fall/Winter 2009 that indicated as many as 30-50% of the U.S. population could potentially contract H1N1 this fall and winter. In addition, PCAST considers a “plausible scenario” one where 30,000–90,000 Americans could die from H1N1—primarily children and young adults under 25.
On August 20, 2009, the U.S. Department of Education and the Centers for Disease Control (CDC) released guidance for colleges and universities regarding the H1N1 flu virus. The CDC recommends in the guidance that institutions tailor their responses to fit “the size, diversity, and mobility of their students, faculty, and staff; their location and physical facilities; programs; and student and employee health services.” Some examples institutions might consider in developing their plans include work-study students, education majors serving as student teachers in a K-12 system, and students in off-campus internships, co-ops, or exchange programs.
Key recommendations from the CDC for the present level of H1N1 flu cases are as follows. It is important to note that these recommendations may change as the flu season progresses.
Recommendations for Residential Students
- Students who are ill with H1N1 should “self-isolate”—i.e., severely curtail their interactions with others except to seek medical care—until at least 24 hours after they no longer display fever symptoms without the aid of fever-reducing medicine.
- If possible, ill students should return home to recuperate and minimize the risk of infecting others if they live nearby and can do so without using public transportation.
- Students who cannot return home should be isolated as much as possible. (The CDC suggests students serve as “flu buddies,” pairing up to take care of each other when ill to limit contact between sick and well people, but this may not be practical for all campuses.)
- Schools with shared dormitory facilities rather than private dormitory rooms may wish to set up alternative isolation areas for sick students who cannot leave campus.
Recommendations for Commuter Students
Commuter students ill with H1N1 should practice self-isolation (whether at their own home or the home of a friend/relative) and not return to campus until they have recovered.
- Commuter students who can utilize distance-learning methods may be able to continue studies even while ill. (This also applies to resident students.)
Recommendations for Faculty, Staff, and Administration
- Faculty, staff, and administration suffering from H1N1 should follow the same self-isolation guidelines as students.
- Faculty are encouraged not to require doctors’ notes to excuse absences from class due to illness; administrators are encouraged not to require doctors’ notes to excuse absences from work. This is due to the CDC’s anticipation that students and employees may not be able to obtain doctors’ notes in a timely manner after recovering from H1N1 or other illnesses due to the burden on health care facilities.
- Facilities administrators should ensure facilities—particularly dormitories, classrooms, elevators, dining halls, and other high-contact areas—are cleaned frequently.
- Administrators and faculty are encouraged to develop distance learning strategies, flextime and remote working arrangements, and other methods of limiting face-to-face contact while maintaining operations in the event of a campus outbreak of H1N1 flu. Such planning should include course coverage for faculty and continuity of business operations for administrators and staff.
- Administrators are encouraged to tailor leave policies to accommodate the possibility of a widespread outbreak of H1N1 on campus and/or further CDC recommendations for campus closures/event cancellations in case of a major outbreak.
- Senior administrators are encouraged to discuss setting up vaccination clinics on campus when vaccine supplies for H1N1 become available (at this writing, estimated to be October 2009). AASCU will continue to monitor the situation closely and advise members as the fall flu season develops.
Information Resource Links
August 19, 2009
The CDC’s Advisory Committee on Immunization Practices has released recommendations on who should receive the H1N1 flu vaccine this fall based on susceptibility to the virus. Individuals between 6 months and 25 years of age are much more likely to contract H1N1 and all college campuses, including The University of Memphis, are likely to see high numbers of cases among students.
The H1N1 vaccine will be distributed by the federal government (FEMA) through state health departments. SHS is working closely with the Tennessee Department of Health and expects that there will be a vaccine distribution site for students at the University. It is not yet known when the vaccine will be available but it will likely not arrive before mid-October. SHS will notify all eligible individuals when vaccine becomes available. H1N1 will probably require two vaccinations, given three to four weeks apart. A complete listing of the CDC’s recommendations for H1N1 vaccination is available at http://www.cdc.gov/media/pressrel/2009/r090729b.htm.
It is possible to contract both the seasonal flu and H1N1 flu since exposure to one does not result in immunity to the other. Therefore it is very important to get the seasonal flu vaccine. SHS will be offering seasonal flu vaccinations beginning Sept. 22. Visit http://saweb.memphis.edu/health/immunization/flushots.htm for additional dates, times, locations etc.
Pandemic Planning at The University of Memphis (Posted August 7, 2009)
Individuals representing a broad spectrum of the campus community have participated in pandemic planning over the course of several years. The University has also collaborated with local and state partners to ensure that we will work together effectively in responding to a pandemic.
The University pandemic plan is intended to guide university-wide and departmental actions necessary to reduce, control and respond to the effects of a pandemic illness on the students, staff and operations of The University of Memphis.
The University pandemic plan will allow a flexible University response which can be integrated with community and state response efforts. The priorities of the Plan are to:
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Protect the health and safety of University students, faculty, staff and visitors.
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Identify pandemic-related action prompts for progressively higher levels of University response.
- Identify and implement practices and actions to limit the spread of a pandemic at The University of Memphis.
- Promote effective communication and information sharing between campus and community responders, university administration, students, faculty, staff, families and the general public.
The University continues to closely monitor reports of the H1N1 Influenza virus, previously called Swine Flu. Students, faculty and staff are encouraged to frequently check this Pandemic Preparedness website for information, updates and relevant links.
At the present time, The University is at Level One of its Influenza Pandemic Response Plan:
- Maintain daily operations
- Monitor information regarding global disease activity
- Implement Level One planning and maintain plans
- Provide information to campus community as needed through email and website updates
- Review and revise emergency policies and procedures as needed
- Maintain in contact with the state and county health departments regarding outbreak status
To view the plan: http://bf.memphis.edu/crisis/crisis_mgmt_plan.pdfn
Members of the University community who are contemplating travel abroad or returning to the U.S. are advised to consult CDC Travel Notices for updated recommendations. Many countries, including Japan and China, are screening passengers for illness due to novel H1N1 flu and may quarantine visitors with a fever or other signs or symptoms of an influenza like illness. Travelers should be prepared for delays related to H1N1 screening. Embassy and Consular Web sites are also a good source of information.
Remember, as pandemic influenza spreads globally, the chance of becoming ill away from home will increase.What should I consider before traveling during a pandemic?
The most important consideration is your health. Do you have a condition that puts you at high risk for severe disease associated with pandemic influenza? If so, you need not cancel your trip, but consult with your doctor before travel, and be sure adequate medical treatment would be available at your destination.
There are important questions to consider for all travelers:
• How good is the healthcare system at your destination?
• Are basic pharmaceuticals and antivirals available?
• Who would you call in case of emergency?
• Will I be quarantined?.
If you are studying abroad and feel sick with the flu, you should immediately go to the health clinic at the university you are attending or the nearest hospital. Please inform the international office at your host university as well as your study abroad advisor at UofM of your condition.
Students experiencing flu-like symptoms within a week before their arrival should stay at home until they are no longer contagious. The guideline is to remain at home or isolated for at least 24 hours after the fever is gone (without the use of fever-reducing medication). Fever is defined as having a temperature of 100 degrees Fahrenheit of 37.8 Celsius or greater. Students should inform their sponsoring department or program if they need to delay their arrival date.
Isolation essentially means going home and limiting contact with others. Self-isolation will help individuals with the flu to recover and prevent them from spreading the illness further.
Arriving students, faculty or staff with a febrile respiratory illness should maintain your distance from others, and students should go to Student Health Services upon arrival, while faculty and staff should go to their primary care provider. Upon arriving at the Student Health Services, please notify the receptionist that you might have the flu. (Flu-like symptoms include fever greater than 100 degrees, body aches, coughing, sore throat, respiratory congestion, and in some cases, diarrhea and vomiting.) Student Health Services can be contacted at 901-678-2287.
People WITHOUT fever do not need to be concerned. Sore throat, cold symptoms and cough, without fever are NOT signs of H1N1 influenza.
Those who are exposed to someone with H1N1 flu do not need to panic. They should be alert to their own health, so that if they start to feel symptoms they can stay away from others to prevent further spread. They do not need to stay out of work or class unless they develop illness themselves. Preventive medication is indicated only for those with very serious health problems and compromised immune systems. Pregnant women should also contact their primary care provider if they are exposed.
A good informative site that will give an idea of what is going on across the world!
http://www.internationalsos.com/pandemicpreparedness/CatLevel.aspx?li=1&languageID=ENG&catID=1&l=1
A good informative site that will give an idea of what is going on at other Universities!
Higher Education H1N1 Flu Map - v2.0. This map tracks the presence H1N1 Influenza at institutions of higher education and/or related protective actions. http://maps.google.com/maps/ms?ie=UTF8&hl=en&msa=0&msid=109878326824967605990.000468a80b7ca216e4d3a&ll=39.027719,-93.251953&spn=45.583405,61.347656&z=4
PHASE VI (August 5, 2009)
On June 11, 2009, the World Health Organization (WHO) signaled that a global pandemic of novel influenza A (H1N1) was underway by raising the worldwide pandemic alert PHASE to Phase 6. This action was a reflection of the spread of the new H1N1 virus, not the severity of illness caused by the virus. At the time, more than 70 countries had reported cases of novel influenza A (H1N1) infection and there were ongoing community level outbreaks of novel H1N1 in multiple parts of the world.
Since the WHO declaration of a pandemic, the new H1N1 virus has continued to spread, with the number of countries reporting cases of novel H1N1 nearly doubling. The Southern Hemisphere’s regular influenza season has begun and countries there are reporting that the new H1N1 virus is spreading and causing illness along with regular seasonal influenza viruses. In the United States, significant novel H1N1 illness has continued into the summer. The United States continues to report the largest number of novel H1N1 cases of any country worldwide, however, most people who have become ill have recovered without requiring medical treatment.
PLEASE KEEP READING, AS IT IS JUST AS IMPORTANT NOW AS WHEN IT WAS WRITTEN MAY 27!
Large gatherings
On the basis of what is currently known about the ongoing spread of novel influenza A (H1N1) and, as a means to prevent the further spread of disease on and off campus, universities should encourage persons with ILI to stay home and away from large gatherings. Persons who are sick should be instructed to limit their contact with other people as much as possible and to stay home after their symptoms begin and remain in self-isolation until they have been symptom-free for 24 hours. In addition, they should be reminded to use appropriate respiratory and hand hygiene. Gatherings may include graduations and commencement activities, concerts, sporting events, and other gatherings where close contact is likely between a large number of attendees.
Large university and other public gatherings offer a good opportunity for officials and event organizers to deliver key educational messages about measures attendees can take to help protect themselves and their family members from novel influenza A (H1N1) infection, including active promotion of good hygiene practices. [Monitor the University's Student Health Services Blog: www.uofmshs.typepad.com and Twitter: www.twitter.com/uofmshs
1. What is H1N1 Influenza A (Swine Flu)?
Swine flu is a respiratory disease affecting pigs that is caused by type A influenza virus. Swine influenza viruses may circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months, similar to influenza outbreaks in humans. It causes high levels of illness but low death rates in pigs.
What is unusual about the present strain?
The new strain is a hybrid of swine, human and avian flu viruses and the US Centers for Disease Control and Prevention (CDC) says it can spread from human to human but the level of virulence is not yet clear.
2. Does Swine Flu affect humans?
Swine flu viruses that cause disease in pigs very rarely affect humans. However, sporadic human infections with swine flu have occurred. Most commonly, these cases occur in persons with direct exposure to pigs but there have also be documented cases of human-to-human spread of swine flu.
3. How does Swine Flu Spread to humans?
Swine flu spread to humans mainly through contact with infected pigs, which shed the virus in their saliva, nasal secretions and feces. Limited human-to-human transmission can also occur in the same way as seasonal flu occurs in people.
4. Can people catch Swine Flu from eating pork?
There is currently no evidence to suggest that swine flu can be transmitted to humans from eating pork or pork products that have been thoroughly cooked.
5. What are the symptoms of Swine Flu in humans?
The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza. An early symptom is fever, and this is followed by cough, sore throat, runny nose and sometimes breathlessness a few days later.
6. How can human infections with swine flu be diagnosed?
To diagnose swine flu, a respiratory specimen would generally need to be collected within the first 4 to 5 days of the illness (when an infected person is most likely to be shedding the virus). However, some persons, especially children may shed the virus for 10 days or longer.
7. What medications are available to treat swine flu infections in humans?
There are four different antiviral drugs for the treatment of influenza: amantadine, rimantadine, oseltamivir, and zanamivir. While most swine flu viruses have been susceptible to all four drugs, the most recent swine flu viruses isolated from humans are resistant to amantadine and rimantadine. At this time the US CDC recommends the use of oseltamivir (Tamiflu) or zanamivir (Relenza) for treatment and/or prevention of infection with swine flu viruses.
8. Is it safe to visit countries with cases of Swine Flu and will I be quarantined when I return? What travel precautions should I take?
The State Department recommends that "U.S. citizens avoid all nonessential travel to Mexico at this time." Some tour operators and airlines across the globe have canceled flights and holiday packages to sunshine destinations like Cancun and Cozumel. To be sure, contact your operator or airline. No quarantine situation has been advised by the World Health Organization (WHO) for swine flu at this time (April 29, 2009). If you travel to areas which have cases of swine flu, you should take note of the following measures to minimize your risk of acquiring swine flu:
Avoid contact with persons with symptoms of influenza.
Avoid crowded areas and maintain good ventilation. Stay at least six feet away from individuals.
Observe good personal and environmental hygiene. Wash hands thoroughly with soap and water frequently and when they are contaminated by respiratory secretions e.g. after sneezing and coughing.
Maintain good body resistance through a balanced diet, regular exercise, having adequate rest, reducing stress and not smoking.
9. What should I do if I suspect I have swine flu after returning from a country that has cases of swine flu?
You should consult your doctor as soon as possible and inform your doctor if you have symptoms of swine flu and had recently traveled to area which have cases of swine flu.
10. What should I do if I fall ill overseas?
You should consult a local doctor as soon as possible and refrain from traveling until you are certified fit by the doctor.
11. Does influenza vaccination help prevent Swine Flu?
There is no vaccine to protect humans from swine flu. The seasonal influenza vaccine is unlikely to protect against H1N1 swine flu viruses.
12. What Can I Do to Stay Healthy?
There are everyday actions people can take to stay healthy.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
Avoid touching your eyes, nose or mouth. Germs spread that way.
Try to avoid close contact with sick people.
· Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
· If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
Q: Should we be worried about Swine Flu?
A: No - but we should take sensible precautions and stay informed. The World Health Organization has warned that the outbreak has "pandemic potential" and countries have been advised to step up surveillance and preparation in case the infection spreads rapidly.
Q: Does swine flu pose a more serious threat to pregnant women?
A: All viruses are potentially dangerous to pregnant women as their immune systems are under extra strain - but they should be fine if they eat well and keep up essential minerals.
Q: How long does the flu virus survive on surfaces?
A: The flu virus survives for roughly 24 hours on hard surfaces, two hours on soft surfaces.
Q: What is a pandemic?
A: If the flu spreads over a wide geographic area and affects a large proportion of the population it goes beyond an epidemic and becomes a pandemic.
An influenza pandemic is defined as a new or novel influenza virus that spreads easily between humans.
When new influenza viruses are introduced into the environment, humans do not have any natural immunity to protect against them.
Therefore, there is a risk that that new influenza viruses could develop into a pandemic, if the virus passes easily from human-to-human.
Q: Have humans been infected with swine flu in the past?
A: Cases of swine flu in humans usually occur after a history of exposure to pigs. For example, direct or close contact with infected pigs.
Cases of person-to-person transmission have been previously reported but are rare.
We
don’t know if this virus will cause pregnant women to have a greater
chance of getting sick or have serious problems. We also do not know
how this virus will affect the baby.