May 7, 2009

Subject:  Influenza Type A H1N1 (formerly Swine Flu)
Media Update (3)

Two weeks ago, an alert was issued regarding a new influenza virus causing illness and death in Mexico and the USA.  The World Health Organization (WHO) advised
countries of a public health emergency of international concern and pandemic potential.

Global Situation

As of 1800 hours May 6, 23 countries have reported a total of 1893 laboratory confirmed cases - 92% in Mexico, the USA and Canada.   A total of 31 deaths have been
reported – 29 in Mexico and 2 in the USA.

There have been no confirmed cases of Influenza Type A H1N1 (formerly Swine Flu) in any CAREC member countries including St. Kitts and Nevis.

The Pandemic Alert level remains at Phase 5 (on a 6-point scale) meaning sustained community transmission in two or more countries in a WHO region (region of the
Americas).  Movement to Phase 6 is highly likely meaning more WHO regions are similarly involved.  Phase 6 refers to distribution and not severity of the virus.
National Situation

No suspected cases and no confirmed cases have been reported in the Federation.

National Preparedness

For there to be a local outbreak, the Influenza Type A H1N1 virus has to be imported into St. Kitts and Nevis by a human.  Measures to protect public health have been
put in place along three (3) action fronts:
Early Detection – Surveillance continues at the ports, and in public and private health facilities
Early Intervention – Case management procedures and supplies are in place at health facilities to diagnose, test and treat suspected cases.  Lab testing kits are in
stock.  An initial supply of anti-viral medication has been shipped and the consignment is expected shortly.  Anti-bacterial medications (antibiotics) are in stock.
Timely Information Sharing – Authoritative (scientific and relevant) influenza-related information continues to be disseminated to the public and other stakeholders.

Methods used include press releases, press conferences, ministerial briefings, inter-agency and intra-agency staff meetings, scientific sessions, website postings, email
correspondence, posters, fliers and pamphlets.

Current Guidance

There has been no change in the general guidance issued in the April 29 press release.  Health measures are governed by public health rationale and relevant scientific
information superintended by the WHO.  The current guidance is as follows (adapted by CMO to the local context):
Influenza Basics – The flu is spread from human to human by coughing and sneezing.  The incubation period i.e. the period from virus contact to illness is 1 to 7
days.  A person is contagious 1 day before illness and 5 days thereafter.
Prevention – Person-to-person spread is effectively prevented by covering of the nose and mouth when coughing and sneezing then immediately washing the hands
with soap and water.  Objects (e.g. toys) and surfaces (e.g. counter-tops and door knobs) should be routinely cleaned with disinfectant.  Vaccine is also effective but
will not be available for about 6 months.
Travel – There are no restrictions on international travel.  Persons who are ill with fever and flu-like symptoms should postpone their travel plans at this time.  If
travel to an affected country or area is unavoidable, vigilance must be paid to personal hygiene measures.
Mask Protection - Approved masks are for use only by persons who are more likely to be in direct contact with a case.  Such contact may occur in the conduct of
surveillance and during the delivery of medical care in a health facility or at home.
Medication Treatment - Antiviral medication does not kill the influenza virus but reduces the spread.  Medication will be reserved for the treatment of cases
diagnosed by a medical doctor.  Medication will not be used for prevention.
Lab Testing - Strict criteria govern who is to be tested, when and how.  Lab tests will be ordered by a medical doctor.  Specimens will be sent via the hospital lab to
CAREC for processing.  Results will be available within six (6) hours.

Local Public Advice

1. Do not panic. Pay attention to media information quoting authoritative sources e.g. Ministries of Health, PAHO/WHO, CAREC, CDC, Health Canada, and the UK
Health Promotion Agency.
Common Cold is not the flu. Common Cold symptoms include mild fever, runny nose, sneeze, cough and scratchy throat which resolve in 2 to 3 days.  There is
no need to rush to the hospital or clinic.
Flu symptoms include moderate to high fever, troublesome cough, sneeze, aches and pains, diarrhea, breathing difficulty, weakness and lethargy.
4. Seek medical attention for breathing difficulty, weakness and lethargy.  Otherwise stay at home and contact your personal doctor or the community health center for
advice.  Most persons with influenza will recover in about 5 days and can be cared for at home.  Flu symptoms are the same whether it is seasonal flu or a new flu.   
Practice proper hygiene measures such as:
a. Always covering of the nose and mouth when coughing and sneezing.
b. It is best to cover with absorbent tissue.  Discard the tissue in a covered trash receptacle and wash hands and face properly with soap and water.  Keep the
fingernails short.
Healthy lifestyle measures build a strong mind and body:
a. Pay attention to spiritual health (prayer, worship, fellowship, meditation).
b. Maintain a positive mental attitude – Everyone does not die, everyone will not get sick, many affected persons have already recovered.
c. Maintain good nutrition and hydration with fresh, local produce and local fluids.  Colorful fruits and vegetables should be a part of each meal.  They contain all of the
anti-oxidant vitamins and minerals needed to boost the immune system in natural form and in the correct proportion.    Do not skip meals and do not overeat.
d. Get adequate exercise such as sea- bathing and walking (three times per week).  Exercise reduces stress.
e. Get adequate sleep - adults 6 to 8 hours, teens 8 hours, young children 10 to 12 hours.
f. Avoid excess alcohol and caffeine.

Patrick Martin
Chief Medical Officer
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The Ministries of Health in St. Kitts & Nevis wish
to advise the general public that the outbreak of H1N1
(Swine) Flu in St. Kitts / Nevis is beingclosely monitored.
Information is provided below & elsewhere for guidance.
Press release #1 (26/04)   Press Rel #2 (30/04)    
Press release #3 (07/05)   Press Rel #4 (06/06)    
Press release #6 (15/07)   Press Rel #7 (27/07)
Press release #8 (21/10)   Press Rel #9 (13/12)    Press Rel #10 (13/12)
Pork Statement   Pandemic Phases.pdf   
FAQ  (WHO)   FAQ (CDC)    FAQ (SKN)    St. Kitts / Nevis Poster
Dr. Patrick Martin, Chief Medical Officer, St. Kitts - Nevis