• Pandemic flu is a worldwide outbreak of influenza
• It happens when a new highly contagious strain of flu virus appears, spreads, and causes the flu worldwide
• People will have little or no immunity to this new strain

• Influenza or the Flu is a respiratory infection cased by the influenza virus
• Most people are sick for 2 to 7 days, but the cough may last for weeks
• Some people can get much sicker with complications of pneumonia , hospitalization, and even death
• People who have lung or heart problems are at greatest risk for complications

Symptoms usually start suddenly with:

• Headache
• Chills
• Dry cough

Followed by:

• Fever
• Loss of appetite
• Sore throat
• Runny or stuffy nose
• Sneezing
• Watery eyes
• Diarrhea and Vomiting (usually seen only in children)

If you are pregnant and ill with the flu call your doctor's office.

• An infected person starts spreading the virus 24 - 48 hours before they even know they are sick.
• It spreads easily from infected persons to the nose and throat of others through coughing and sneezing.
• It also spreads by direct contact with surfaces and objects, which are contaminated with the influenza virus.
• Good handwashing is the best way to prevent the spread of influenza.
• Stay 1 metre (3 feet) away from other people.

• Get a flu shot every year
• Wash your hands often.
• Stay at least 1 metre (3 feet) away from sick people.
• If you can see dirt on your hands it is best to wash with soap and warm water, otherwise you can use a hand sanitizer
• Eat well, get plenty of sleep, and exercise regularly.
• Try not to touch your eyes, nose, or mouth. These habits spread germs.
• Avoid public gatherings and crowds.
• Don't go to a doctor's office without calling ahead.
• If you have a chronic medical condition, ask your doctor about pneumococcal vaccine.

• An infected person starts spreading the virus 24 - 48 hours before they even know they are sick.
• It spreads easily from infected persons to the nose and throat of others through coughing and sneezing.
• It also spreads by direct contact with surfaces and objects, which are contaminated with the influenza virus.
• Good handwashing is the best way to prevent the spread of influenza.
• Stay 1 metre (3 feet) away from other people.
  

• Get a flu shot every year
• Wash your hands often.
• Stay at least 1 metre (3 feet) away from sick people.
• If you can see dirt on your hands it is best to wash with soap and warm water, otherwise you can use a hand sanitizer
• Eat well, get plenty of sleep, and exercise regularly.
• Try not to touch your eyes, nose, or mouth. These habits spread germs.
• Avoid public gatherings and crowds.
• Don't go to a doctor's office without calling ahead.
• If you have a chronic medical condition, ask your doctor about pneumococcal vaccine.
  

If you are sick:

• Stay home
• Keep your distance 1 metre (3 feet) away from others
• Cover coughs and sneezes with a tissue, or the forearm
• Throw tissues in the garbage immediately after use

"Social distancing" - Decreasing or avoiding contact with other people.
Social distancing may be used to slow the spread of the influenza virus.

• Restrict visitors to your home
• Cancel or postpone family gatherings, outings, or trips
• Don't shake hands, hug, or kiss when greeting people
• Spit, blow, or cough into a facial tissue, and dispose of the tissue immediately. Do not use cloth handkerchiefs
• Stock up on groceries, medication, tissues and cleaners so you do not have to shop as often. Have enough items to last 6 to 8 weeks
• Don't shop at peak times of the day. Find out which stores are open 7 days a week/24 hours per day
• Order groceries online, or over the phone
• Pay bills online, or over the phone
• Work from home, or try to work during times that avoid rush hour crowding on public transit
• Minimize contact with other people at work:
  • keep your office door closed
  • use stairs instead of elevators
  • bring your lunch to work and eat at your desk
  • cancel non-essential face-to-face meetings
  • use teleconferencing, videoconferencing, email, or fax
• If you must meet with people, stay at least one meter (3 feet) apart
• Walk, drive, or ride a bike to avoid public transportation
• Don't go to a doctor's office without calling ahead. There may be special clinics set up for people who have flu symptoms

• Influenza is highly infectious
• Travel restrictions might be imposed; however they may only slow the progression of the pandemic, allowing authorities time to strengthen their response
• Stay tuned to Cogeco channel 11 cable TV, or AM800 radio
• Look for travel updates in your local newspaper
• Contact your airline, bus, or train depot for the latest travel information updates
  

Store a 7 - 10 day supply of food, water, and health related supplies in case the stores begin to run out of supplies, or you are not able to leave the house.
Replace stockpiled canned and dry goods every year.

A family health information sheet provides all the medical information needed for each family member. It is important to think about health issues that could arise and how you and your family may be affected if an influenza pandemic occurs. You may need to provide as much information as you can about your medical history if you or a loved one needs to go to the hospital or clinic.

Create a Health Information Sheet like the one below and fill in information for each family member.

Emergency contact information is also important. Keep this information in a safe place along with the Health Information Sheet.

An emergency contact number can also be placed on a cell phone. Name the phone number ICE (in case of emergency). Most emergency services such as paramedics, police, and firefighters know to look for the ICE number on cell phones.

• Wash hands often
• Keep your distance 1 metre (3 feet) from sick people
• Stay home
• Rest
• Cover coughs and sneezes
• Throw tissues in the garbage immediately after use and keep closed until garbage pick-up day
• Drink plenty of clear fluids (at least eight, 8 ounce cups per day)
• Take pain relievers like acetaminophen or ibuprofen (Tylenol, Motrin, or Advil)
• Take cough medicine for coughs
• Gargle with warm water or suck on sugarless throat lozenges if you have a sore throat
• Use saline drops or spray decongestant to help clear a stuffy nose
• Don't drink alcohol or smoke
• Get help if you are sick and alone or if you are a single parent with sick children.
  

Basic infection control precautions will help limit the spread of Influenza.

1. Try to keep the ill person in a separate room and away from people who are well
2. Everyone in the home should wash their hands frequently with soap and warm water
3. Clean, and then disinfect surfaces in the ill person's room daily.
4. Washrooms should also be cleaned daily, and as needed
5. Make a disinfection solution at home. Mix 5 millilitres (1 teaspoon) of bleach with 495 millilitres (2 cups) of water. Keep wet on the surface for 10 minutes. Make a new solution each day. Clearly label and keep container away from children
6. Soiled dishes and eating utensils can be washed either in a dishwasher or by hand. Wash with warm soapy water, rinse, and then submerge for 45 seconds in a sink of household bleach/water solution [15 millilitres (3 teaspoons) of bleach, to 6 litres (25 cups) of water]
7. Follow label instructions thoroughly for household cleaning products
8. Laundry can be done normally
9. Garbage may be placed with your regular household waste for disposal. Ensure the garbage is closed and inaccessible until garbage collection
   

• Keep sick children home from school and daycare
• Children dehydrate easily. Make sure they are sipping fluids often
• If fevered, remove extra blankets and clothing so heat can leave the body and help lower the body temperature. Don't strip the child because shivering increases body heat, causing the fever to rise again
• Don't sponge your child with tepid (lukewarm) water, alcohol baths or rubs
• Do not put your child in a cool bath or shower. It may cause shock

Symptoms of dehydration:

• Decreased urination (less than 4 wet diapers in 24 hours)
• No tears
• Dry skin, mouth and tongue
• Sunken eyes
• Grayish skin
• Sunken soft spot (on top of an infant's head)

Call your doctof for medical advice if:

• Your child has any of the above symptoms
• Your child is under six months old and has diarrhea
• Your child has been vomiting for 4 to 6 hours

Treatment for dehydration:

• Exact mixtures of water, salt and sugar are available at drugstores in ready-to-serve solutions
• Frozen pops, water, ice-cubes, and juices made with water can also be given
• Offer liquids often, even if the child will only take small sips at a time
  

1. Confusion.
2. Poor skin elasticity. Test the skin on the forehead and over the breastbone by gently pulling up or pinching and releasing a skin fold. Normal skin should resume a flat shape immediately. If the skin remains elevated for 3 seconds or more, the person may be dehydrated.
   

   

3. Skin that feels warm and moist.
   
4. Urinating (peeing) less often and in smaller amounts.
5. Dark coloured urine.
6. Constipation.
7. Sunken eyes.
8. Feeling light-headed and dizzy when standing after sitting or lying down.
9. Feels like the heart is beating too quickly.
10. Dryness in the mouth and nose, or cracked lips.
11. Dry tongue that has visible cracks.
    

The best way to avoid dehydration is to drink plenty of clear fluids every day. The minimum required fluid intake for adults is 1,500 millilitres (6.34 cups) per day. The elderly should sip on water often throughout the day.

Always call your doctor before visiting the office so you do not infect others.

Call a doctor if you have the flu and:

• You have a chronic illness like heart or lung disease
• You do not start feeling better in 7 days
• Symptoms become worse
• You are elderly or frail
• You have an illness that affects the immune system
• You are taking medication that affects the immune system.

Special flu clinics may be set up. Your doctor may want you to go to the clinic instead of coming into the office

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or stomach
• Confusion or disorientation
• Coughing up blood
• Severe or continuous vomiting
• Extreme pain in the ear

• Fast or laboured breathing when resting
• Wheezing
• Chest pain
• Coughing up blood
• Bluish or dark coloured lips or skin
• Drowsiness so severe that the child cannot be roused
• Severe crankiness, or not wanting to be held
• Is limp or cannot move
• Has a stiff neck
• Has a seizure (convulsion)
• Symptoms improve and then suddenly become worse
• Sick and not drinking fluids
• Sick and not urinating (peeing). Should pee at least every 6 hours when awake
  

There is no proof at this time that the use of masks for the general population will offer adequate protection when the influenza virus is common in the community.

If general members of the public choose to use masks for their individual use, the following should be considered:

• They should only be used once and must be discarded if wet
• Masks should be removed by handling the strings only to avoid self-contamination
• Hands must be washed before applying and after removing a mask
• The casual use of masks may cause supply shortages for those who need to wear them
  

It is rare, but human infections can occur from direct exposure to infected chickens, ducks, turkeys, or their environments.

The Canadian Cooperative Wildlife Health Centre (CCWHC) began a live wild bird influenza survey last year. They are continuing this survey for 2006.

Groups of three or more dead birds should be reported to the Windsor-Essex County Health Unit by calling 258-2146 extension 1473. Crows, blue jays and ravens may be collected for West Nile Virus testing, other birds may be sent to CCWHC for the live wild bird influenza survey.

If the Health Unit does not need the bird for either of the tests, they will ask you to dispose of the bird yourself. Use the following methods to dispose of dead birds.

1. Dead birds should be handled using a small shovel, large tongs, or by hand only if disposable plastic or rubber gloves are worn.
   
2. Alternatively, carcasses may be placed in a puncture-resistant leak-proof plastic bag of appropriate size by inverting the bag over the hand, then grasping the carcass through the bag and wrapping the bag around the bird without touching it.
   
3. Carcasses should be buried several feet deep where they will not be disturbed, or double bagged and placed in garbage destined for a landfill.
   
4. Dispose of a dead bird so that it cannot be handled by anyone, or dug up by an animal.
   
5. People should wash their hands thoroughly with soap and water after handling birds.

If you have sick or dead farmed birds such as chickens, ducks, or geese, call your veterinarian to get a diagnosis that includes laboratory testing.

There is no evidence of anyone becoming infected by eating properly cooked eggs and poultry from infected birds. Eggshells, egg whites and yolks can become infected.

• Eggs should be cooked thoroughly [71 degrees Celsius or 160 degrees Fahrenheit] to limit the risk of avian influenza infection, and other food-borne illnesses
• Cook poultry until juices run clear and there is no visible pink meat. An internal temperature of 85 degrees Celsius or 185 degrees Fahrenheit should be reach for both whole chicken and chicken parts.
  

• Cats and dogs do not become ill from the human influenza virus but can become infected with other feline and canine viruses.
• Cats and dogs that appear ill should be seen by a veterinarian for a professional assessment

• Authorities in Germany announced on February 28, 2006 the discovery of (H5N1) avian Influenza in a domestic cat found dead
• There is no present evidence that domestic cats play a role in transmitting avian influenza viruses
• To date no human cases have been linked to exposure of a diseased cat
  

1. Wash hands thoroughly with soap and warm water for 15 to 20 seconds after handling raw poultry and eggs.
2. Wash countertops, knives and cutting boards, and other utensils with hot soapy water after each use. Then disinfect with a solution of 5 millilitres (1 teaspoon) of bleach mixed with 495 millilitres (2 cups) of water. Keep wet on the surface for 10 minutes.
3. Refrigeration and freezing does not kill influenza viruses. Cook all eggs until yolk and white are firm (never runny).
4. Casseroles and other dishes containing eggs should be cooked to an internal temperature of 71 degrees Celsius (160 degrees Fahrenheit).
5. Never eat filling, dressings, ice-cream, mousse, meringue, tiramisu, hollandaise sauce, Aioli sauce, bearnaise sauce, mayonnaise, or cookie dough made with uncooked eggs.
6. Never drink uncooked eggnog.
7. Use a food thermometer to check food temperatures.
8. Store raw eggs and poultry away from ready-to-eat foods

The annual flu shot will not protect you from avian influenza. However, if a person gets sick with seasonal influenza and is unknowingly exposed to avian influenza virus, the viruses can combine. This new mutant strain could start the next worldwide pandemic.

• People should get their annual flu shot to minimize the risk of mixing of seasonal influenza with avian influenza
• Poultry workers and any health care providers are the highest risk for coming in contact with both annual influenza and avian influenza
• The annual Influenza vaccine is provided free every fall and winter to all Ontario residents
  

Ontario Ministry of Health & Long Term Care

Hand sanitizers do not remove visible dirt and grime, and do not replace regular handwashing. Hand sanitizers should only be used when soap and clean water are not available.