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Background

The swine influenza A (H1N1) virus that has infected humans in the United States, Mexico and elsewhere is a novel influenza A virus that has not previously caused illness in people. Not all details are known at this time, but CDC and HHS are currently investigating and taking appropriate actions to ensure the protection of port-based staff who may encounter ill individuals. Symptoms of swine flu are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have also reported diarrhea and vomiting associated with swine flu. On-going human-to-human transmission is occurring with confirmed cases identified in several states and counties.

Interim Recommendations

Recommendations in this guidance document are based on standard infection control and industrial hygiene practices and should be implemented immediately to protect workers and to delay the spread of this newly emerged influenza virus via airline travel. All airline personnel should follow the practices and instructions described below to prevent spreading infectious disease and becoming ill.

Hand Washing

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 because germs spread that way.

Cough Etiquette

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

Stay Home From Work If You Are Sick

If you get sick, CDC recommends that you stay home from work and limit contact with others to keep from infecting them.

Management of Crew Exposure After Flight Completed

Flight deck and cabin crew members and ground personnel who may have been exposed to a passenger or worker suspected of having influenza should monitor their health for 7 days after the exposure. If they become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea they should immediately take the following steps:

• Stay home except to seek medical care; do not report to work.
• Notify their employer.
• Contact their occupational health service or personal physician.
• Inform the occupational health service, clinic, or emergency room before visiting about the possible exposure to influenza.
• Do not travel, unless it is critical to travel locally for health care.
• Limit contact with others as much as possible.
• When not alone or in a public place, wear a facemask to reduce the number of droplets coughed or sneezed into the air.
• If traveling away from home, notify their employer and request assistance in locating a health care provider.
• If illness onset occurs while outside the United States, the airline’s medical consultants or overseas medical assistance companies should be contacted to assist finding an appropriate medical provider in that country.

For More Information

Interim Guidance for Airline Flight Crews and Persons Meeting Passengers Arriving from Areas With Avian Influenza http://wwwn.cdc.gov

The recent H1N1 pandemic has highlighted the importance of identifying public health measures which can help to mitigate flu virus transmission. Researchers conducted a prospective cluster-randomized trial to test whether improved hand hygiene or surgical face masks could reduce the spread of flu within households.

The researchers studied 407 people with flu-like symptoms who visited one of 45 outpatient clinics across Hong Kong within 48 hours of symptom onset, had rapid tests that confirmed infection with influenza A or B, and lived in a household with at least two other individuals, none of whom had reported flu symptoms in the preceding 14 days. The flu patients plus their household members were randomly assigned to one of three groups: control, control plus enhanced hand hygiene, and control plus enhanced hand hygiene plus face masks.

The researchers found that hand hygiene appeared to be effective at preventing household transmission of the flu virus only when implemented within 36 hours of symptom onset. These findings have important public health implications, as they suggest that non-pharmaceutical interventions can reduce flu transmission if implemented early after symptom onset.

Source:
Angela Collom
American College of Physicians