H1N1
(SWINE FLU) UPDATE FOR VESSELS
July
2009
- Since the first reported cases of a novel flu virus (H1N1) emerged in Mexico
and the United States in April 2009, the disease has spread globally. On June 11, 2009, the World Health
Organization (WHO) declared the first pandemic in 41 years. Most cases are mild and require no treatment,
but novel H1N1 influenza virus still has the potential to reappear, possibly
with increased severity, after several months time (multiple ‘waves’ are common
with pandemics).
Symptoms of novel H1N1 (swine) flu in people
are similar to the symptoms of regular human seasonal flu and include fever,
cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and
vomiting associated with novel H1N1 flu.
Currently, people are who pregnant or have underlying health conditions
appear to be at greater risk for developing a severe illness.
Also similar to human seasonal flu, the novel
H1N1 virus spreads person-to-person via respiratory droplets. That means when someone sneezes or coughs
they release the virus into the environment—potentially contaminating other
people and surfaces. If a contaminated finger or surface then comes into contact with
a person’s mucous membranes (e.g. eyes, nose, and mouth), the person can become
infected. Infected people generally can
be contagious up to 24 hours prior to developing symptoms and up to a week
after symptom onset (though this period can be longer for kids). Also, flu virus on surfaces usually remains
viable for several hours.
What
should vessels do moving forward?
Prevention
and preparedness—with a focus on good hygiene and robust planning—are two areas
to emphasize that can help mitigate the impact of any outbreak. In particular, creating an atmosphere that
encourages sound health and hygiene is the foundation of a basic flu prevention
strategy.
For instance, general guidance for vessels,
given an increased risk of contracting influenza, is as follows…
- Avoid
crowded places in locations with community transmission of flu. The
extent of avoidance should be in relation to the prevalence and perceived
danger of the given flu strain. For example, hypothetically
speaking, in a location suffering from a deadly and rapidly spreading new
form of influenza, shore movement at ports of call should be limited to
essential activities only.
- Cover
your cough with tissues or your sleeve (not your hand). Make sure
tissues are readily available aboard ship.
- Promote
regular hand-washing and provide alcohol-based hand sanitizer in common
areas.
- In
general, promote good hygiene and healthy habits.
- If
concerned about possible contamination of surfaces with respiratory
droplets from a potentially sick individual, wipe surfaces with an
EPA-approved disinfectant that’s effective against viruses (http://www.epa.gov/oppad001/chemregindex.htm).
Fumigation is not needed. Regardless, outside of the host, the
flu virus usually “dies” within 24 hrs.
- Monitor
employee health and isolate sick crew members. Also, monitor the
health of visitors coming aboard ship. When isolating someone,
consider both barrier protection and distance (at least 6 feet). The
goal is to prevent respiratory droplets from coughs and sneezes from
coming into contact with other crew members or common surfaces.
- Surgical
masks are recommended for persons with symptoms of influenza and
disposable N-95 respirators for those caring for sick crew members.
- When
flu vaccines become available, get them.
- Oseltamivir or zanamivir are the antiviral medications of choice for
influenza. Guidance for their use is available from the CDC (Interim Guidance on
Antiviral Recommendations for Patients with Novel Influenza A (H1N1) Virus Infection and Their Close Contacts).
In general, antiviral medications will reduce the severity and duration of
illness if given within 48 hours of developing symptoms. They can
also protect an individual from becoming ill if they’ve been exposed to
the respiratory secretions of someone sick with the flu. Depending
on the perceived risk of vessel crew members contracting the flu, having a
stockpile of antiviral medications aboard ship for treatment and disease
control is a reasonable mitigation strategy.
- If
a suspect H1N1 influenza case is identified aboard a ship (see Interim Guidance on Case
Definitions to be Used For Investigations of Swine-Origin Influenza A
(H1N1) Cases) the captain is required by law to report the illness to
the CDC Quarantine Station in the jurisdiction of the U.S. port where the
ship is expected to arrive (see Quarantine
Stations). If the ship will not be arriving imminently at a U.S.
port, Quarantine health authorities will assist ship officials with the
management and isolation of the suspect case and the recommendations for
other passengers and crew members.
Additionally, preparedness efforts should
focus on plans and policies related to business continuity in the event of a
major outbreak. Are there plans in place
that address staffing shortages? What
about supply or service interruptions?
Are improvements needed? Have you
taken into consideration the impact of potential disease control measures in
ports of call?
For more information on influenza
preparedness and the current novel Influenza A H1N1
outbreak:
w
United
States Flu information and updates: www.flu.gov
w
Federal
guidance for cruise and cargo ships:
o
http://www.pandemicflu.gov/travel/cleaning_vessels.html
o
http://www.cdc.gov/h1n1flu/guidance/cruiseships.htm
w
World
Health Organization: www.who.int/en/
w
United
States Department of Labor Occupational Safety and Health: www.osha.gov/Publications/influenza_pandemic.html
For help preparing for a flu pandemic, please
contact O’Brien’s Response Management Inc.
We have full-time staff members with advanced degrees in epidemiology
and ample experience developing pandemic influenza plans, trainings, and
exercises for clients—including multiple cities, counties, states, and
corporations. If interested, you can
contact us by calling +1 (281) 320-9796 or by emailing Clint Ladd (clinton.ladd@obriensrm.com)
for more information.