Flu in South Carolina

People Living in Residential Facilities

Woman in wheelchair Do you live or work in a long-term care or rehabilitation facility, a military base, a dorm, a camp? Do you manage a prison or jail? Germs can spread more easily in residential settings, and during South Carolina’s 2009-10 flu season, we ask that you make a special effort to do all you can to slow the spread of flu.

In normal years, seasonal flu kills about 36,000 Americans and hospitalizes 200,000 each year. This year, we’re also dealing with a second, new strain of flu called novel H1N1 flu (swine flu). Novel H1N1 flu first appeared here in April 2009. It, too, is causing deaths and hospitalizations. Both novel H1N1 flu and seasonal flu can cause mild to severe respiratory illness and other symptoms.

While seasonal flu typically peaks in February and seems to thrive in cold weather and become less active in warmer weather, novel H1N1 flu spread clearly thrives in our hot Southern climate. Since it’s a new strain, we don’t know how it will behave in colder temperatures.

We urge you to follow the guidelines below and work closely with us to slow the spread and severity of South Carolina’s flu season.

Symptoms of Flu

The flu is different from the common cold. But symptoms of seasonal flu and novel H1N1 flu are very similar. When a person gets seasonal or novel H1N1 flu, one or more of these symptoms will probably come on suddenly — about 48 to 72 hours after contact with the virus:

Fever (usually high)
Headache
Extreme tiredness
Dry cough
Sore throat
Runny or stuffy nose
Muscle aches
Occasionally, stomach symptoms such as nausea, vomiting, and diarrhea.

Urgent Warning Signs

These symptoms indicate that a resident, employee or guest needs to seek medical attention immediately.

In adults:

Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting.

In children:

Fast breathing or trouble breathing
Bluish skin color
Not drinking enough fluids
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough
Fever with a rash.

High Risk Groups

Although the symptoms for seasonal flu and novel H1N1 flu are similar, the groups most at risk for each strain are different.

Seasonal Flu High Risk Groups	Novel H1N1 High Risk Groups
People over 65 years of age	Young adults 18 – 24 years of age.
Children younger than 2 years old	Children birth to 18 years of age
People of any age who have chronic medical conditions (e.g. diabetes, asthma, congestive heart failure, lung disease)	People of any age who have chronic medical conditions (e.g. diabetes, asthma, congestive heart failure, lung disease)
Pregnant women	Pregnant women

Advice for People Who Manage Residential Settings

Make a flu response plan using this information from the Centers for Disease Control and Prevention (CDC):

Protect Your Residents, Staff and Visitors

Encourage staff to learn the facts about vaccination and get vaccinated against seasonal flu and novel H1N1 flu.
Tell your employees about Web sites that can help them find DHEC flu clinics and locate clinics offered by other community providers.
Require employees to stay home if they have a fever of 100ºF or higher with a cough or sore throat.
Require staff who have the flu to remain at home until their fever has been gone for 24 hours without the use of fever reducing medications. In most cases employees with the flu will miss 3 to 5 days.
Expect and plan for higher than normal staff absences this flu season. Establish a list of on-call workers to cover for employees who are ill.
Change your policies to encourage and support rather than penalize staff who must miss work because they are ill with the flu or caring for a family member who has the flu. When symptoms are mild, the employee may not need to see a health care provider, so it’s best not to require a doctor’s excuse. Also, some employees may be forced to stay home in an outbreak due to school and child care closings. Employees who stay home when sick are helping to protect other employees, customers and the public. Allow them to do this without fear of losing their jobs.
Separate ill residents from the general residential population.
Recommend that residents and staff who have flu symptoms see their health care provider right away if they are at high risk for complications from the flu. Early treatment with antiviral medications may help lessen the symptoms. Those at high risk include:
Adults and children who have chronic conditions such as asthma and diabetes or other lung, heart, liver, blood, neurologic, neuromuscular, or metabolic disorders

Pregnant women
People aged 65 years or older
Adults and children with weak immune systems
Children younger than 5 years old
Children younger than 18 years who are on long-term aspirin treatment

Encourage residents and staff to wash their hands often with soap and water. Ask them to get into the habit of washing their hands for about as long as it takes to sing the Happy Birthday song twice.
Ask residents and staff to cover their nose and mouth with a tissue when they cough or sneeze and throw the tissue in the trash.
Encourage residents to eat a healthy diet, exercise and get plenty of rest.
Frequently wipe down commonly touched surfaces like stairway railings, telephones, and door handles. Otherwise, follow your normal housekeeping routine. Get additional information on environmental disinfection to prevent flu from the Centers for Disease Control and Prevention (CDC).
Download, post and distribute free DHEC flu materials.
Educate everyone in your facility about the dangers of giving aspirin (acetylsalicylic acid) to children or teenagers who have the flu. This can cause a rare but serious illness called Reye’s syndrome.
Dorms and camps and other group residential settings that have the option to do so may want to consider selective closings if there is a flu outbreak in your facility. This is especially true if your residents include people with chronic health conditions or pregnant women.

Vaccination

College student Flu vaccines are your residents’ and staff members’ best protection against seasonal and novel H1N1 flu.

People who are in greater danger of life-threatening health problems from novel H1N1 flu or seasonal flu, should get vaccinated as soon as possible. The CDC also urges anyone who lives or works closely with an at-risk person — to get vaccinated as soon as possible.

These Groups Need Flu Vaccines the Most

The CDC recommends that these groups get flu vaccines as soon as possible.

The list for seasonal flu is different from the list for novel H1N1 flu.

These People Should Get a Seasonal Flu Vaccine ASAP	These People Should Get a Novel H1N1 Flu (Swine Flu) Vaccine ASAP
Those age 50 and older	Pregnant women
Pregnant women	Household contacts and caregivers for babies younger than 6 months of age
Children 6 months to 18 years of age	Healthcare and emergency medical services personnel
People of any age who have chronic medical conditions (e.g. asthma, diabetes, congestive heart failure, lung disease)	All children from 6 months to 17 years of age
People who live in nursing homes and other long-term care facilities	Young adults 18 to 24 years of age
People who live with or care for those at high risk for complications from flu.	People 25 through 64 years of age who have health conditions that put them at higher risk of medical complications from flu.

Get updates on vaccine availability in South Carolina, learn more about vaccine safety , and find a flu vaccine clinic in your local area.

Also see these CDC resources on flu vaccines:

Flu Information in Other Languages:

If, after reading the information available here, you have questions about the 2009 H1N1 vaccine,
please call 1-800-27SHOTS (1-800-277-4687).

South Carolina Department of Health and Environmental Control