ALERT: H1N1 Influenza Cases Continue to Escalate - Guidance Documents on H1N1 Influenza A/Swine Flu

On June 11, 2009, The World Health Organization raised the worldwide pandemic alert level for H1N1/Influenza A/ Swine Flu to Phase 6, the highest emergency classification indicating there are community level outbreaks of H1N1 in multiple parts of the world. A pandemic is a rapid, world-wide spread of a disease which would occur when:

• There is a new influenza virus that can cause serious illness and death
• People have little natural immunity to prevent the illness and
• The virus is capable of spreading easily from person to person.

The source of the flu cases has been linked to Mexico City.  Thus far, world-wide, more than 622,500 diagnosed cases and more than 7,800 fatalities have been reported in nearly 500 countries and territories.  Within the U.S., H1N1 cases have been confirmed within every state, Washington, D.C., Puerto Rico, American Samoa, and  Guam.  Of concern, given issues associated with under-reporting, the Centers for Disease Control and Prevention (CDC) estimates ther have been between 2,500 - 6,100 fatalities related to H1N1 with the U.S.

Health symptoms associated with swine flu include:

• Fever and chills
• Body aches
• Headache
• Fatigue
• Runny nose
• Cough
• Sore throat
• Nausea
• Vomiting and/or
• Diarrhea.

If you experience any of these symptoms, you should contact your physician or health care provider for advice.

At this time, a vaccine to prevent swine flu has not been developed. However, the U.S. Centers for Disease Control and Prevention (CDC) recommends the use of the anti-virals Oseltamivir or Zanamivir for the treatment and/or prevention of infection with these swine flu influenza viruses.

Various public health organizations have recommended procedures that should be taken to slow the spread of the disease. These include:

• When coughing or sneezing, cover your mouth and nose with your arm, sleeve, or tissue (that should then be thrown away). Do not use your hand to cover your mouth.
• Wash your hands frequently- preferably with soap and water. Alcohol-based hand cleaners are also effective.
• Try to avoid contact with sick people.
• Go to the hospital for treatment only if it is an emergency. If you have developed flu-like symptoms, call your health care provider or physician for advice.
• Most importantly, stay home if you are sick. This includes keeping sick children home from child care, school, or public places like libraries and shopping malls.

CWA members who are employed as health care workers, emergency medical technicians, or as first responders should be provided additional protections. For example, when working with patients/individuals who are known or suspected to be infected with swine flu, health care workers and first responders must be provided with the protective respiratory equipment (N95 or more protective respiratory equipment, not surgical masks) as well as adequate sanitation facilities. Additional recommendations are contained below.

Remember it is the employer's primary responsibility to provide safe and healthful working conditions. Thus, CWA-represented employers should be providing the necessary education, training, and protection to ensure the Union's members are not exposed to/do not contract swine influenza while performing their assigned work.

If you have any questions regarding swine influenza or other safety and health concerns, please contact the CWA Occupational Safety and Health Department.

Below are links to key guidance documents from various government agencies and other organizations involving either swine flu, pandemic flu, or avian flu.

A Guide for Individuals and Families
Planning Checklist for Individuals and Families
Plan Now To Be Ready for the Next Pandemic

AFL-CIO

What Workers Need to Know About Pandemic Flu

• Basic Facts for Workers About Pandemic Flu
• Worker Protection and Infection Control for Pandemic Flu
• Respirators: One Way of Protecting Workers Against Pandemic Flu
• Infection Control for Health Care Workers During Pandemic Flu
• What the Union Can Do To Prepare the Workplace for Pandemic Flu

CDC/HHS Guidance

• Interim Guidance on Antiviral Recommendations for Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection and Close Contacts April 28, 2009 05:00 AM ET
• Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting April 28, 2009 02:45 PM ET
• Interim Guidance to Assist Airline Flight Deck and Cabin Crew in Identifying Passengers Who May Have Swine Influenza April 28, 2009 9:00 PM ET
• Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting April 27, 2009 07:45 PM ET
• Interim Recommendations for Facemask and Respirator Use in Certain Community Settings Where Swine Influenza A (H1N1) Virus Transmission Has Been Detected April 27, 2009 011:00 AM ET
• Interim Guidance on Antiviral Recommendations for Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection and Close Contacts April 28, 2009 05:00 AM ET
• Interim CDC Guidance for Nonpharmaceutical Community Mitigation in Response to Human Infections with Swine Influenza (H1N1) Virus April 26, 2009 11:45 PM ET
• Hospital Pandemic Influenza Planning Checklist
• Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic October (2006) 
• Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic (2008)
• Guidance on Allocating and Targeting Pandemic Influenza Vaccine (2008)
• Interim Recommendations for Infection Control in Health-Care Facilities Caring for Patients with Known or Suspected Avian Influenza May 21, 2004
• Guidance on Antiviral Drug Use during an Influenza Pandemic

OSHA

• How To Protect Yourself In The Workplace During A Pandemic 
• What Employers Can Do To Protect Workers From Pandemic Influenza 
• Healthcare Workplaces Classified As Very High Exposure Risk For Pandemic Influenza
• Protect Yourself "Pandemic Flu" Respiratory Protection 
• Respiratory Infection Control: Respirators Versus Surgical Masks 

WHO

• WHO Interim Infection Control Guideline for Health Care Facilities
• Pandemic influenza preparedness and response (2009)

Cal/OSHA

• Cal/OSHA Guidance for Employers and Employees Regarding Swine Flu Cases April 28, 2009
• Modified proposed aerosol transmissible disease standard

California Department of Health Services

• Pandemic Influenza Preparedness and Response Plan September 2006

Veterans Affairs

• VA Pandemic Flu Plan 2006