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Dr. Redhwan Ahmed Al-Naggar

International Medical School (IMS)

Management & Science University (MSU)

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Q1:How often do you wash your hands?

Q2:What do you use to wash/disinfect yourhands?

Q3:What factors prevent you from washing yourhands?

Q4:Is hand washing clinically significant in

preventing spread of infection?

Q5: what is the technique for hand washing?Where do you learn it?

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A New Influenza virus, first detected in the US inApril 2009.

Swine Influenza (swine flu) is a respiratory diseaseof pigs caused by type A influenza viruses (H1N1subtype) that causes regular outbreaks in pigs.

People do not normally get swine flu, but humaninfections can and do happen.

Swine flu viruses have been reported to spreadfrom person-to-person, but in the past, thistransmission was limited and not sustained beyondthree people.

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WHO Phase 6 Pandemic (declared June 11,2009)

> 1 million cases in the U.S.> 40,617 confirmed cases in U.S.

> 263 confirmed deaths in U.S.

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This virus was originally referred to asswine flu because laboratory testing

showed that many of the genes in this new

virus were similar to influenza viruses thatnormally occur in pigs.

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Year 1918 2009

World population 1.8 billion 6.8 billion

Primary mode of

Transportation

Ships,

Railroad

Jet Aircraft,

Automobile

Time for virus to circle the

Globe

4 months 4 days

Estimated death world wide 20 million !

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Yes, CDC has determined that this new virus

is contagious and is spreading from human to

human.

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Chronic lung disease (especially asthma,COPD).

Immuno-compromised states (includingpregnancy, kidney disease, cancer).

Heart disease (other than HTN).

Diabetes Mellitus

Obesity

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Treated tap water does not pose a risk for

transmission of influenza viruses.

There have been no documented humancases of influenza caused by drinking water.

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There has never been a documented case of

influenza virus infection associated with

water exposure.

This includes swimming pools, spas, water

parks, interactive fountains and other

treated recreational water venues.

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Spread of this swine influenza A (H1N1)virus is thought to be happening in thesame way that seasonal flu spreads.

Flu viruses are spread mainly from personto person through coughing or sneezing ofpeople with influenza.

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Sometimes people may become infected bytouching something with flu viruses on itand then touching their mouth or nose.

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Infected people may be able to infectothers beginning 1 day before symptomsdevelop and up to 7 or more days after

becoming sick.

That means that you may be able to passon the flu to someone else before you

know you are sick, as well as while you aresick.

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Influenza virus is destroyed by heat.

Also, most chemical germicides are effective

against human influenza viruses such as:

Alcohol Chlorine

Hospital disinfectants

Hydrogen peroxide

Most household cleaners

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Patients with flu-like illness are asked to

wear a mask to protect other patients and

healthcare workers.

When performing an evaluation or testing

patients for flu, healthcare workers have

been advised to wear a mask.

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Until more is known about H1N1, hospitals

have been advised by CDC to use extra

precautions for patients admitted with

severe influenza.

Special Precautions are being used such as:

Private Room

Healthcare workers wear gloves, gowns, masks and goggles when taking care of sick

patients

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The symptoms of swine flu in people aresimilar to the symptoms of regular humanflu and include fever, cough, sore throat,body aches, headache, chills and fatigue.

Some people have reported diarrhea andvomiting associated with swine flu.

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Like seasonal flu, swine flu may cause aworsening of underlying chronic medicalconditions.

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The symptoms of swine flu in people aresimilar to the symptoms of seasonal flu inhumans and may include:

Fever (greater than 100F or 37.8C). Sore throat.

Cough.

Stuffy nose.

Chills. Headache and body aches.

Fatigue.

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In children

Fast breathing or trouble breathing

Bluish skin color

Not drinking enough fluidsNot waking up or not interacting

Being so irritable that the child does notwant to be held

Flu-like symptoms improve but then returnwith fever and worse cough

Fever with a rash

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In adults

Difficulty breathing or shortness of breath

Pain or pressure in the chest or abdomen

Sudden dizzinessConfusion

Severe or persistent vomiting

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Culling killing large numbers of infectedand potentially infected animals.

Quarantine putting infected farms inquarantine.

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Vaccinating birds against the virus remains controversial and contentious.

Latest normal flu vaccine for peopleinvolved in culling operations to minimizethe risk of being infected by both bird fluand human flu simultaneously

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Hand washing.

Try to stay in good general health.

Get plenty of sleep, be physically active,manage your stress, drink plenty of fluids, andeat nutritious food.

Try not touch surfaces that may becontaminated with the flu virus.

Avoid close contact with people who are sick.

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Avoid live animal markets, poultry and pig farms inaffected countries.

Always maintain high levels of personal hygiene,especially before

and after food preparation and in-out of toilets.

Regular wash your hands.

Cook pork thoroughly ( for non-Muslim).

While in an affected region, seek immediatemedical attention if you develop influenza-likesymptoms. (High Fever, body pain, coughing andred nose).

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TRAVEL HEALTH

WHO does not recommend any travelrestrictions to areas experiencing

outbreaks, including countries, which havereported, associated cases of humaninfection.

WHO does not, at present recommend theroutine screening of travelers coming fromaffected areas.

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Cover your nose and mouth with a tissue whenyou cough or sneeze.Throw the tissue in thetrash after you use it.

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.Viruses spread this way.

Try to avoid close contact with sick people.

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If you are sick, limit your contact withother people as much as possible. Do notgo to work , stay at home.

Cover your mouth and nose with a maskwhen coughing or sneezing. It may preventthose around you from getting sick. Put

your used tissue in the waste basket. Coveryour cough or sneeze if you do not have amask. Then, clean your hands, and do soevery time you cough or sneeze.

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Before any travel to affected area

Educate yourself and others traveling with

you.

Take specific vaccinations as recommended

by CDC.

Assemble travel health kit.

Check your health insurance plan

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During travel to an affected area

Avoid all direct contact with pigs and visitingthe farms.

Practice careful and frequent handwashing.

Consume thoroughly cooked food.

Seek immediate medical attention ifsymptoms occur.

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After your return

Monitor your health for 10 days.

If you become ill with high fever consult adoctor immediately.

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FOOD SAFETY ISSUES

Cook food thoroughly

Follow good hygienic practices

No pink parts for meatBuy food from safe and established

supermarkets.

Check the expiry date (if any).

Choose a clean and known restaurant fordining.

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Chicken Soup

Orange Juice

Vitamin C

Multivitamins

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Pregnant women.

People who live with or care for children

younger than 6 months of age.

Health care and emergency servicesworkers with direct patient contact.

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Children 6 months through 4 years of age.

Children 5 through 18 years of age who

have chronic conditions.

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Severe allergy to chicken eggs.

Severe reaction to flu vaccination in the

past.

Children less than 6 months of age.

Currently experiencing moderate or severe

illness with a fever (wait until symptoms

lessen).

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This virus is sensitive to Tamiflu and Relenza,two antiviral medications (only available byprescription).

It is resistant to other antiviral medications.

Treatment is recommended for All hospitalized patients with confirmed,

probable or suspected cases

Patients who are at higher risk for seasonal

influenza complicationsTamiflu and Relenza are not like antibiotics

and are most effective when used within 24-48 hours of an illness.

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Thank you for your

attention