4/26/2009

CDC has identified cases of swine influenza A (H1N1) virus infection in people in California, Texas and Kansas with possible cases in New York. CDC is working with local and state health agencies to investigate these cases. It has been determined that this virus is spreading from human to human.

Mexico has reported increased levels of respiratory disease including reports of severe pneumonia cases and deaths. The swine influenza viruses identified by CDC from cases in Mexico are similar to swine influenza viruses from patients in the United States, however the limited number of patients identified thus far in the US have not been severe, with only one hospitalized person. However, the CDC is concerned about these cases in the United States and the World Health Organization are concerned about continued spread of this new virus. Right now, there is no vaccine for this new virus and the current seasonal influenza is thought to be unlikely to provide protection against this new strain.

For child care providers, it would be prudent to

• First and most importantly, remind parents and enforce policies for having ill children stay at home during their illness.
• In addition, remind and inform workers not to come to work while ill.
• A child may be infectious for up to 10 days after illness onset with influenza while adults are generally infectious for 5-7 days.
• Review their plans for responding to a pandemic and make sure they are up to date.
• Know local/state plans for child care in the event of a mild or severe pandemic. This information may be available from state or local health authorities, child care licensing agencies or resource and referral agencies.
• Develop and implement a system to track illness and absence due to illness among children and staff if one is not already in place. The system should be simple and easy to maintain but should record the number of persons with various illnesses (e.g. respiratory, diarrhea, rash) by day or at least by week. (see Caring for Our Children Standards 3.001 and 3.002 for information on how to do this http://nrckids.org/CFOC/PDFVersion/Chapter%203.pdf )
• Review and implement CDC Guidelines and Recommendations for Preventing the Spread of Influenza (the Flu) in Child Care Settings: Guidance for Administrators, Care Providers, and Other Staff, (http://www.cdc.gov/flu/professionals/infectioncontrol/childcaresettings....)
• Make sure staff are familiar with the above guidelines and that they are being followed in your program. Remind child care staff to clean/disinfect frequently touched surfaces within the facility.
• Provide information to parents on steps that they could take to prevent flu. (See attached fact sheet that could be distributed to each parent or posted on a door to the facilities with providers calling attention to the posted fact sheet).
• Monitor the postings on the CDC web site about this virus to see if child care facilities should begin preparing for possible closure or changes in operation (www.cdc.gov/swineflu).
• Contact your local public health department if you have questions or suspected cases.
• Review your facilities emergency preparedness plans and consult with state and/or local health department’s pandemic plans, particularly if the number of cases escalates dramatically.

Child care and preschool programs can help protect the health of their staff and the children and families they serve by calling attention to the every day preventive actions that parents can initiate to protect their children. (Please consider posting or distributing the attached message in your child care facility).

More information on preventing the spread of influenza can be found at:

• http://www.pandemicflu.gov/plan/school/preschool.html.
• For generic information on disaster preparedness, see NACCRRA’s web site http://www.naccrra.org/for_parents/coping/disaster.php
• Additional generic planning information for schools, including examples of state and local plans, can be found on the Department of Education's website at: http://www.ed.gov/admins/lead/safety/emergencyplan/pandemic/index.html.

Preventing the Flu: Good Health Habits Can Help Stop Germs

Fact Sheet

1. Avoid close contact.
   Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
2. Stay home when you are sick.
   Stay home from work, school, and errands when you are sick. Keep sick children at home. You will help prevent others from catching the illness.
3. Cover your mouth and nose.
   Cover your mouth and nose with a tissue when coughing or sneezing. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
4. Wash your hands often.
   Washing your hands and the hands of your children often will help protect you from germs.
5. Avoid touching your eyes, nose or mouth.
   Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
6. Practice other good health habits.
   Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

There is no vaccine available at this time for the current outbreak of the Swine Flu virus, so it is important for people living in the affected areas to take steps to prevent spreading the virus to others. If people are ill, they should stay at home and limit contact with others, except to seek medical care. Healthy residents living in these areas should take the everyday preventive actions listed above.

People who live in these areas who develop an illness with fever and respiratory symptoms, such as cough and runny nose, and possibly other symptoms, such as body aches, nausea, or vomiting or diarrhea, should contact their health care provider. Their health care provider will determine whether influenza testing is needed.