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kelee877
04-25-2009, 08:50 PM
This has been posted by the CDC today; people this is getting serious if they are posting this on their website;

Interim Guidance for Swine influenza A (H1N1): Taking Care of a Sick Person in Your Home

April 25, 2009 18:30 EDT
This document provides interim guidance and will be updated as needed.
Swine influenza A virus infection (swine flu) can cause a wide range of symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. People with swine flu also can have vomiting and diarrhea. Like seasonal flu, swine flu in humans can vary in severity from mild to severe.Severe disease with pneumonia, respiratory failure and even death is possible with swine flu infection. Certain groups might be more likely to develop a severe illness from swine flu infection, such as persons with chronic medical conditions. Sometimes bacterial infections may occur at the same time as or after infection with influenza viruses and lead to pneumonias, ear infections, or sinus infections.
The following information can help you provide safer care at home for sick persons during a flu pandemic.
How Flu Spreads

The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.
People with swine flu who are cared for at home should:

check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema
check with their health care provider about whether they should take antiviral medications
stay home for 7 days after the start of illness and fever is gone
get plenty of rest
drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated
cover coughs and sneezes. Clean hands with soap and water or an alcohol-based hand rub often and especially after using tissues and after coughing or sneezing into hands.
avoid close contact with others – do not go to work or school while ill
be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention
Medications to Help Lessen Symptoms of the Flu


Check with your healthcare provider or pharmacist for correct, safe use of medicationsAntiviral medications can sometimes help lessen influenza symptoms, but require a prescription. Most people do not need these antiviral drugs to fully recover from the flu. However, persons at higher risk for severe flu complications, or those with severe flu illness who require hospitalization, might benefit from antiviral medications. Antiviral medications are available for persons 1 year of age and older. Ask your healthcare provider whether you need antiviral medication.
Influenza infections can lead to or occur with bacterial infections. Therefore, some people will also need to take antibiotics. More severe or prolonged illness or illness that seems to get better, but then gets worse again may be an indication that a person has a bacterial infection. Check with your healthcare provider if you have concerns.
Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye’s syndrome. For more information about Reye’s syndrome, visit the National Institute of Health website at http://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htm (http://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htm)http://www.cdc.gov/TemplatePackage/images/icon_out.png (http://www.cdc.gov/swineflu/guidance_homecare.htm#linkPolicy)

Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.
Teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.
Children younger than 2 years of age should not be given over-the-counter cold medications without first speaking with a healthcare provider.
The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.
Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS). Examples of these kinds of medications include:
Generic NameBrand Name(s)
Acetaminophen Tylenol®
Ibuprofen
Advil®, Motrin®, Nuprin®
Naproxen
Aleve

Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. Importantly, these medications will not lessen how infectious a person is.
Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications—don’t double dose! Patients with kidney disease or stomach problems should check with their health care provider before taking any NSAIDS.
Check with your health care provider or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu.For more information on products for treating flu symptoms, see the FDA website: http://www.fda.gov/fdac/features/2005/105_buy.html (http://www.fda.gov/fdac/features/2005/105_buy.html)http://www.cdc.gov/TemplatePackage/images/icon_out.png (http://www.cdc.gov/swineflu/guidance_homecare.htm#linkPolicy).When to Seek Emergency Medical CareGet medical care right away if the sick person at home:

has difficulty breathing or chest pain
has purple or blue discoloration of the lips
is vomiting and unable to keep liquids down
has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry
has seizures (for example, uncontrolled convulsions)
is less responsive than normal or becomes confused

Steps to Lessen the Spread of Flu in the Home

When providing care to a household member who is sick with influenza, the most important ways to protect yourself and others who are not sick are to:

keep the sick person away from other people as much as possible (see “placement of the sick person at home”)
remind the sick person to cover their coughs, and clean their hands with soap and water or an alcohol-based hand rub often, especially after coughing and/or sneezing.
have everyone in the household clean their hands often, using soap and water or an alcohol-based hand rub
ask your healthcare provide if household contacts of the sick person, particularly those contacts that may have chronic health conditions, should take antiviral medications such as oseltemivir (Tamiflu®) or zanamivir (Relenza®) to prevent the flu.
Placement of the sick person

Keep the sick person in a room separate from the common areas of the house. (For example, a spare bedroom with its own bathroom, if that’s possible.) Keep the sickroom door closed.
Unless necessary for medical care, persons with the flu should not leave the home when they have a fever or during the time that they are most likely to spread their infection to others (7 days after onset of symptoms in adults, and 10 days after onset of symptoms in children).
If persons with the flu need to leave the home (for example, for medical care), they should cover their nose and mouth when coughing or sneezing and wear a loose-fitting (surgical) mask if available.
Have the sick person wear a surgical mask if they need to be in a common area of the house near other persons.
If possible, sick persons should use a separate bathroom. This bathroom should be cleaned daily with household disinfectant (see below).
Protect other persons in the home

The sick person should not have visitors other than caregivers. A phone call is safer than a visit.
If possible, have only one adult in the home take care of the sick person.
Avoid having pregnant women care for the sick person. (Pregnant women are at increased risk of influenza-related complications and immunity can be suppressed during pregnancy).
All persons in the household should clean their hands with soap and water or an alcohol-based hand rub frequently, including after every contact with the sick person or the person’s room or bathroom.
Use paper towels for drying hands after hand washing or dedicate cloth towels to each person in the household. For example, have different colored towels for each person.
If possible, consideration should be given to maintaining good ventilation in shared household areas (e.g., keeping windows open in restrooms, kitchen, bathroom, etc.).
Antivirals can be used to prevent the flu, so check with your healthcare provider to see if some persons in the home should use antiviral medications.
If you are the caregiver

Avoid being face-to-face with the sick person.
When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.
Clean your hands with soap and water or use an alcohol-based hand rub after you touch the sick person or handle used tissues, or laundry.
Caregivers might catch flu from the person they are caring for and then the caregiver might be able to spread the flu to others before the caregiver shows symptoms. Therefore, the caregiver should wear a mask when they leave their home to keep from spreading flu to others in case they are in the early stages of infection.
Talk to your health care provider about taking antiviral medication to prevent the caregiver from getting the flu.
Monitor yourself and household members for flu symptoms and contact a telephone hotline or health care provider if symptoms occur.
Using Facemasks or Respirators

Avoid close contact (less than about 6 feet away) with the sick person as much as possible.
If you must have close contact with the sick person (for example, hold a sick infant), spend the least amount of time possible in close contact and try to wear a facemask (for example, surgical mask) or N95 disposable respirator.<LI sizcache="0" sizset="11">An N95 respirator that fits snugly on your face can filter out small particles that can be inhaled around the edges of a facemask, but compared with a facemask it is harder to breathe through an N95 mask for long periods of time. More information on facemasks and respirators can be found at www.cdc.gov/swineflu (http://www.cdc.gov/swineflu)
Facemasks and respirators may be purchased at a pharmacy, building supply or hardware store.
Wear an N95 respirator if you help a sick person with respiratory treatments using a nebulizer or inhaler, as directed by their doctor. Respiratory treatments should be performed in a separate room away from common areas of the house when at all possible.
Used facemasks and N95 respirators should be taken off and placed immediately in the regular trash so they don’t touch anything else.
Avoid re-using disposable facemasks and N95 respirators if possible. If a reusable fabric facemask is used, it should be laundered with normal laundry detergent and tumble-dried in a hot dryer.
After you take off a facemask or N95 respirator, clean your hands with soap and water or an alcohol-based hand sanitizer.
Household Cleaning, Laundry, and Waste Disposal


Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.
Keep surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Wash linens (such as bed sheets and towels) by using household laundry soap and tumble dry on a hot setting. Avoid “hugging” laundry prior to washing it to prevent contaminating yourself. Clean your hands with soap and water or alcohol-based hand rub right after handling dirty laundry.
Eating utensils should be washed either in a dishwasher or by hand with water and soap.
http://www.cdc.gov/swineflu/guidance_homecare.htm

kelee877
04-25-2009, 08:52 PM
here is another one from the CDC site...it helps answer alot of those questions running around in the brain;

Interim Guidance on Antiviral Recommendations for Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection and Close Contacts

Objective:To provide interim guidance on the use of antiviral agents for treatment and chemoprophylaxis of swine influenza A (H1N1) virus infection. This includes patients with confirmed or suspected swine influenza A (H1N1) virus infection and their close contacts.
Case definitions
A confirmed case of swine influenza A (H1N1) virus infection is defined as a person with an acute respiratory illness with laboratory confirmed swine influenza A (H1N1) virus infection at CDC by one or more of the following tests:

real-time RT-PCR
viral culture
Infectious period


The infectious period for a confirmed case of swine influenza A (H1N1) virus infection is defined as 1 day prior to the case’s illness onset to 7 days after onset.
A suspected case of swine influenza A (H1N1) virus infection is defined as:
1) A person with acute respiratory illness who was a close contact to a confirmed case of swine influenza A (H1N1) virus infection during the case’s infectious period, OR
2) A person with an acute respiratory illness who traveled to or resides in an area where there are confirmed cases of swine influenza A (H1N1) virus infection.
Close contact is defined as: within about 6 feet of an ill person who is a confirmed or suspected case of swine influenza A (H1N1) virus infection during the case’s infectious period.

Acute respiratory illness is defined as: recent onset of at least two of the following: rhinorrhea or nasal congestion, sore throat, cough (with or without fever or feverishness)
High-risk group for complications of influenza is defined as: a person who is at high-risk for complications of seasonal influenza: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e717a1.htm (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e717a1.htm). However, it too early to ascertain what persons are at high-risk for complications of swine influenza A (H1N1) virus infection. This guidance will be updated as new information is available.
Clinicians should consider swine influenza A (H1N1) virus infection in the differential diagnosis of patients with febrile respiratory disease and who 1) live in areas in the U.S. with confirmed human cases of swine influenza A (H1N1) virus infection or 2) who traveled recently to Mexico or were in contact with persons who had febrile respiratory illness and were in the areas of the U.S. with confirmed swine influenza cases or Mexico in the 7 days preceding their illness onset.
Special Considerations for Children
Aspirin or aspirin-containing products (e.g. bismuth subsalicylate – Pepto Bismol) should not be administered to any confirmed or suspected ill case of swine influenza A (H1N1) virus infection aged 18 years old and younger due to the risk of Reye syndrome. For relief of fever, other anti-pyretic medications are recommended such as acetaminophen or non steroidal anti-inflammatory drugs.

Antiviral Resistance
This swine influenza A (H1N1) virus is sensitive (susceptible) to the neuraminidase inhibitor antiviral medications zanamivir and oseltamivir. It is resistant to the adamantane antiviral medications amantadine and rimantadine.

Seasonal influenza A and B viruses continue to circulate at low levels in the U.S. and in Mexico. Currently circulating human influenza A (H1N1) viruses are resistant to oseltamivir and sensitive (susceptible) to zanamivir, amantadine and rimantadine. Currently circulating human influenza A (H3N2) viruses are resistant to amantadine and rimantadine, but sensitive (susceptible) to oseltamivir and zanamivir. Therefore, at this time antiviral treatment recommendations for suspected cases of swine influenza A (H1N1) virus infection need to consider potential infection with swine influenza A (H1N1) virus as well as human influenza viruses, and their different antiviral susceptibilities.

Antiviral Treatment

Suspected Cases
Empiric antiviral treatment is recommended for any ill person suspected to have swine influenza A (H1N1) virus infection. Antiviral treatment with either zanamivir alone or with a combination of oseltamivir and either amantadine or rimantadine should be initiated as soon as possible after the onset of symptoms. Recommended duration of treatment is five days. Recommendations for use of antivirals may change as data on antiviral susceptibilities become available. Antiviral doses and schedules recommended for treatment of swine influenza A (H1N1) virus infection are the same as those recommended for seasonal influenza: http://www.cdc.gov/flu/professionals/antivirals/dosagetable.htm#table (http://www.cdc.gov/flu/professionals/antivirals/dosagetable.htm#table)
Confirmed Cases
For antiviral treatment of a confirmed case of swine influenza A (H1N1) virus infection, either oseltamivir or zanamivir may be administered. Recommended duration of treatment is five days. These same antivirals should be considered for treatment of cases that test positive for influenza A but test negative for seasonal influenza viruses H3 and H1 by PCR.</U>
Pregnant Women
Oseltamivir, zanamivir, amantadine, and rimantadine are all “Pregnancy Category C" medications, indicating that no clinical studies have been conducted to assess the safety of these medications for pregnant women. Only two cases of amantadine use for severe influenza illness during the third trimester have been reported. However, both amantadine and rimantadine have been demonstrated in animal studies to be teratogenic and embryotoxic when administered at substantially high doses. Because of the unknown effects of influenza antiviral drugs on pregnant women and their fetuses, these four drugs should be used during pregnancy only if the potential benefit justifies the potential risk to the embryo or fetus; the manufacturers' package inserts should be consulted. However, no adverse effects have been reported among women who received oseltamivir or zanamivir during pregnancy or among infants born to such women.
Antiviral Chemoprophylaxis
For antiviral chemoprophylaxis of swine influenza A (H1N1) virus infection, either oseltamivir or zanamivir are recommended. Duration of antiviral chemoprophylaxis is 7 days after the last known exposure to an ill confirmed case of swine influenza A (H1N1) virus infection. Antiviral dosing and schedules recommended for chemoprophylaxis of swine influenza A (H1N1) virus infection are the same as those recommended for seasonal influenza: http://www.cdc.gov/flu/professionals/antivirals/dosagetable.htm#table (http://www.cdc.gov/flu/professionals/antivirals/dosagetable.htm#table)
Antiviral chemoprophylaxis (pre-exposure or post-exposure) with either oseltamivir or zanamivir is recommended for the following individuals:

Household close contacts who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) of a confirmed or suspected case.
School children who are at high-risk for complications of influenza (persons with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed or suspected case.
Travelers to Mexico who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).
Border workers (Mexico) who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).
Health care workers or public health workers who had unprotected close contact with an ill confirmed case of swine influenza A (H1N1) virus infection during the case’s infectious period.
Antiviral chemoprophylaxis (pre-exposure or post-exposure) with either oseltamivir or zanamivir can be considered for the following:

Any health care worker who is at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) who is working in an area with confirmed swine influenza A (H1N1) cases, and who is caring for patients with any acute febrile respiratory illness.
Non-high risk persons who are travelers to Mexico, first responders, or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection.
http://www.cdc.gov/swineflu/recommendations.htm

night driver
04-25-2009, 09:27 PM
3 long reads but with EVERYTHING you might want:

Here is the link to CSue's FICTIONAL best guess as to how H5N1 would have played out in 2005.


http://www.curevents.com/vb/showthread.php?t=9227

CS's thread HERE on how to handle H5N1

http://www.timebomb2000.com/vb/showthread.php?t=140635


AAAAAAND the Grail:

http://www.timebomb2000.com/vb/showthread.php?t=44351


ANd yeah you COULD say I'm spamming these threads but they aer SO good and I dunno who isn't gonna click on the one I put it on.....

besides I have a HUGE level of respect for CSue's work.....