Introduction
There was a pandemic H1N1 'Swine Flu' virus in 2009 that had not previously been identified as a source of infections among people. The H1N1 virus originated in Mexico City in a little village called La Gloria in Veracruz. The sicknesses first appeared in Mexico City the next month, and experts tracked the ailment back to La Gloria (Rogers, 2009). More than 2000 influenza cases had been documented in Mexico City and its outskirts by the end of April. In April 2009, the new H1N1 virus surfaced in the United States, mostly in Texas, California, and New York, among other regions. On April 25, 2009, Margaret Chan, the director general of World Health Organization declared the outbreak a public health emergency that demanded international concern. After a few days of the announcement, the H1N1 virus reached Spain by individuals who traveled from Mexico by airplane. The virus then began spreading rapidly with confirmed cases of H1N1 infection occurring in the United Kingdom, Germany, Israel Austria and New Zealand (CDC, 2010). Several Canadian provinces such as Ontario, British Columbia, Nova Scotia and Alberta were also affected.
Impact of the Pandemic
Despite most of the ill persons recovering, there were H1N1-related deaths in the US and Mexico. The availability of such evidence of the pandemic virus prompted Chan and WHO on April 29 to declare a level 5 pandemic alert that called for the accelerated distribution of drugs to treatment facilities and the rapid implementation of control measures to control the viral spread. By early June 2009, there were more than 25,0000 confirmed cases and almost 140 deaths from the H1N1 flu. A sum of 74 territories and countries and had already reported laboratory-confirmed infections when WHO declared an influenza pandemic in June 2009. By August 2009, six months after the outbreak nearly 2,000 deaths had been reported globally. In mid-September, H1N1 flu activity increased dramatically in the US with 48 states getting infected (Rogers, 2009). The pandemic saw the securing of resources for the production of 120 million doses of vaccine. Nevertheless, only 11 million doses got delivered following the delays in vaccine production (CDC, 2010). As a result, a percentage of the population remained susceptible to the infection.
The H1N1 Virus
The genetic analyses of the virus indicate that it came from influenza viruses of animals and did not relate to the seasonal H1N1 viruses in humans that had been in general circulation since 1977. Moreover, the antigenic analyzes depicted that antibodies to this seasonal H1N1 did not protect against the virus. Studies, however, show that people of 65 years and older have some immunity against the pandemic virus (CDC,2010). This new virus was different from typical seasonal flu patterns because of the high levels of summer infections particularly in the Northern hemisphere and even higher levels of activity in the cooler months. The global dissemination of the virus was expedited by the unprecedented passenger travel rates characterized by the modern era. Therefore, the pandemic virus caused a respiratory disease similar to that resulting from infection with seasonal influenza (Rogers, 2009). There were international, national and local efforts to contain the virus but all in vain since it the virus was more contagious hence infecting millions.
Signs and symptoms
Persons infected with the virus experienced symptoms such as mild respiratory symptoms, such as coughing, congestion and runny nose and fever. In other cases, the symptoms were severe and included vomiting, diarrhea, chills and rare respiratory failure that was a rare symptom. The contagious nature of the H1N1 virus saw between 22 and 33 percent of the people who got close to an infected person get infected (Rogers, 2009). This measure of getting infected through contact is known as the secondary attack rate. The rate was higher for H1N1 virus than for seasonal influenza which is usually between 5 and 15 percent. The new virus has resulted in increased patterns of illnesses and death seen in influenza infections. The highest death toll has been registered among the youth, pregnant women, younger children and people with chronic lung disease (Rogers, 2009). Most of the cases have occurred following a contraction of viral pneumonia that is difficult to treat compared to bacterial pneumonia.
Treatment and prevention
The treatment of H1N1 infection comprises of the administration of the antiviral drugs, Tamiflu (oseltamivir) or Relenza (zanamivir). The spread of the virus can be controlled by taking various measures. They include wearing face masks, washing hands, and disinfecting any potentially contaminated surfaces. Nonetheless, among young children, high-risk persons and pregnant women, the prevention measure is vaccination (Rogers, 2009). At the onset of the disease, there was not any available vaccine. However, as the infection spread there was an immediate concern to establish a vaccine. Therefore, a vaccine was developed that could be inhaled or injected. A single dose was recommended for adolescents and adults while two doses were recommended for children.
Socio-economic impact on systems
The influenza outbreak can take a significant toll on the community in terms of financial resources, mortality, and morbidity. The outbreak can lead to both direct and indirect costs. The direct costs comprise the physician visits, medication, and hospitalization. On the other hand, systems such as businesses and schools would face indirect costs such as school absenteeism and work productivity loss. An influenza outbreak can lead to a substantial rise in absenteeism in the working population resulting in lost productivity (WHO,2011). Influenza can also affect the reaction time of the infected such that if one continued working reduced effectiveness would be registered. Notably, during the influenza season, families with school-aged children may experience increased illness episodes, analgesic use, febrile illnesses, parental absenteeism, school absences and secondary illnesses among family members.
Reporting protocol
Monitoring, reporting, and surveillance are critical in detecting emerging threats and determining the clinical severity, communicability, and epidemiology of the influenza outbreak. There are fundamental indicators for monitoring and reporting before and during the influenza epidemic. Some of the information that will need to be collected for preparedness for an influenza outbreak include the coverage of the region with community education on the main messages (WHO, 2011). More information will focus on the availability of resources, the different channels of health education and the number and extent of health education. Other factors of consideration will entail the total number of referrals and medication dispensed and the number of new referrals. During monitoring and reporting, the previous monitoring forms and mechanisms can be used. In cases where they do not exist, it may be vital to developing new forms to collect standard data (WHO, 2011). Notably, health experts and community leaders should lead this process alongside the local health authorities. After recording all the information, the local health jurisdiction should be immediately notified to help take action.
Prevention strategies
Community education strategies
Health protection strategies within a community setup include ensuring the provision and consumption of safe food, recreational and drinking water and adequate community sanitation (Steinberg, 2010). The local health authorities should also carry out health assessment and disease surveillance and implement the established strategies. Some of the strategies include detecting the disease clusters and outbreaks through hospital-based and community-based clinical epidemiology and laboratory surveillance networks (Steinberg, 2010). Notably, there are primary prevention initiatives can be adopted such as vector control, and immunization. Other strategies include secondary prevention strategies such as screening and treating the disease, post-exposure prophylaxis and contact tracing and management.
Patient education strategies
Patients can also be educated on various home-care prevention measures they can take as well as strategies to avoid infection and reinfection. One of the prevention methods is keeping a distance from the infected persons. If infected, one should consider covering his or her cough and sneeze. Hand hygiene and disinfecting surfaces before use can also prevent infection. Furthermore, the closed spaces need to be ventilated and the sick separated from others. Most importantly, a single caregiver should be assigned to a sick person (WHO, 2011). There are also management ways of influenza symptoms and other communicable diseases such as hydrating and providing good nutrition and recognizing the danger signs and seeking prompt care. Patients particularly mothers can also learn the importance of exclusive breastfeeding for six months. Covering such aspects in the training module will help stimulate physical growth and mental development, provide the necessary home care and prevent diseases.
References
Center for Disease Control and Prevention. (2010). The 2009 H1N1 Pandemic: Summary Highlights, April 2009-April 2010.
Rogers, K. (2009). Influenza Pandemic (H1N1) of 2009. https://www.britannica.com/event/influenza-pandemic-H1N1-of-2009
Steinberg, M. H. (2010). Evidence Review: Communicable Disease (Health Promotion).
World Health Organization. (2011). Community Case Management During an Influenza Outbreak.
