June 12, 2009 H1N1 INFLUENZA U PDATEOn June 11, 2009, the World Health Organization (WHO) raised the global pandemic level from Phase 5 to Phase 6 signalling that a global pandemic is underway with sustained human to human transmission in several WHO countries. To countries with no H1N1 cases yet, this means that spread to their country is imminent, but to Canada, the influenza has already been spreading for some time. As of June 11, 2009 there were 1 638 confirmed cases of H1N1 Influenza in Ontario. Ten people who have the H1N1 flu virus were in hospital as of June 9, a number of whom have underlying medical conditions. The WHO decision is based upon geography rather than severity of the illness, therefore the decision does not mean anything new in Ontario at this point. Following the WHO announcement on June 11, 2009, Ontario MOHLTC issued a new health notice explaining impact of the announcement in Ontario, that existing guidelines and reduction to lab testing for non-high risk individuals will continue unchanged. Since most cases in Ontario remain mild and are being considered equivalent to the regular flu, Ontario is attempting to turn its focus from identifying mild cases (and focusing on counts) to focusing on prevention of spread and monitoring for severity and ensuring that those individuals under 2, over 65, or with underlying medical conditions receive priority for lab testing and obtain appropriate care. This approach will ensure that Ontario remains ready to respond with its ready pandemic plan should the H1N1 become more severe and it also means that severe cases receive faster attention and treatment. OPSEU members should continue to be vigilant in their workplaces to ensure that precautions are in place to prevent spread of H1N1 and that the guidelines for Emergency Departments, Ambulatory Care, and Long-Term Facilities are being adhered to. The changing focus in lab testing means that many mild cases of H1N1 will no longer be specifically diganosed, therefore we need to assume that the numbers will be under-estimated and use precautions wherever we go, and ensure that workplaces adopt precautions that prevent spread. While basic precautions include hand-washing, disinfectant, staying home if sick, signage, passive monitoring, and good housekeeping, there are other recommendations that OPSEU Joint Health and Safety Committees or health and safety representatives might make to enhance prevention. Examples include suggesting ways to change the work process to prevent spread, such as conference calling instead of meeting, or re-defining work priorities in ways that make sense in particular workplaces.
Below are the most current documents:
NEW! June 11, 2009 Important Health Notice
Guidance for Management of Patients with Influenza-like Illness (ILI) in Ambulatory Settings
Guidance for Management of Patients with Influenza-like Illness (ILI) in Emergency Departments
Important Health Notice
Quick Reference: May 19th Updates to H1N1 Flu Virus Guidance Documents (these are now replaced for ambulatory and emergency management in the above two documents, but is still useful for guidance in long term care settings)
Guidance for Influenza-like-illness (ILI) Management in Long Term Care (LTC)
Screening Tool for Influenza-like-illness (ILI) in Health Care Settings (both ambulatory and emergency)
Signage for Ambulatory Settings
Occupational Health and Safety Requirements for the Health Care Sector
Information on the use and fit-testing of N95 Respirators
Ministry of Health and Long Term Care H1N1 Flu Virus (Human Swine Flu) site has regular updates and links to other useful sites
Ontario’s Agency for Health Protection and Promotion provides regularly updated information on H1N1 Flu (Human Swine Flu)
OPSEU’s “A Healthcare Workers Guide to Pandemic Influenza”
