Work instructions if you become ill or exposed

Individuals who pose a risk of infecting others as a result of personal illness with H1N1 Flu (Swine Flu) or who have been exposed through direct caregiving may not enter IBM work environments until the risk ceases.

Please be sure Integrated Health Services receives notification as soon as possible about an illness or exposure concern. Immediate action may be needed to evaluate next steps associated with these issues. If you are unable to notify IHS yourself, please contact your manager to handle in your behalf. To reach an IHS representative, please refer to the local IHS team to whom you would report workplace health concerns. Please see below for specific instructions:

Illness
If you have been diagnosed with H1N1 Flu or have symptoms of this illness including fever and cough, sore throat or body aches you are not permitted to come into any IBM work environment (including customer). This restriction applies for a minimum of seven calendar days following the onset of symptoms or at least 24 hours after symptoms have resolved, whichever is longer.

For all other (non-influenza) illnesses and symptoms, the above requirement does not apply. Contact your manager or Integrated Health Services (for IBM employees) and follow the normal return to work practices.

Exposure
Management of H1N1 Flu exposure situations can vary based on the nature of exposure, country requirements and business considerations. In some circumstances, individual risk assessments may be required. Integrated Health Services should participate in those risk assessments.

Travel from an H1N1 Flu affected community/country:
IBM is not requiring anyone to self quarantine at this time as a result of travel.
NOTE: Self quarantine means restricting entry to IBM work environments for 7 calendar days from the last date of exposure (including offices, meetings, customer locations, etc.)
Some countries may impose a period of self quarantine. In such cases, country regulations apply.
Some customers may require a period of self quarantine. In such cases, a business unit decision along with IHS consultation is appropriate.

Caregiver Exposure
If you are directly caring for someone who is ill with H1N1 flu (such as a small child or incapacitated adult) and have had prolonged periods of close face to face contact such as during feeding or bathing the person, it may be possible for you to transmit the illness to someone else just prior to becoming ill yourself. Because of this, you are restricted from coming into an IBM work environment (including customer) for seven days from the date you stop providing direct care. During this time period, you should conduct daily self screening for illness symptoms and fever.
In all other circumstances, exposed individuals may come into the workplace unless otherwise directed by the local/country health department or customer/client instructions. The exposed individual should conduct self screening for illness symptoms and fever daily for seven days from the last date of exposure.

Self screening
Individuals are asked to perform H1N1 Flu illness self screening following exposure to a confirmed or suspected case.

To conduct self screening, please perform the following steps:

Step One: Check whether you have symptoms of illness including fever and cough, sore throat or body aches.

Step Two: Check your temperature using a standard, good quality thermometer following the manufacturer’s instructions.

Step Three: If you have symptoms as described in Step One or you have a temperature greater than 100.4o F or 38o C, you must not go into the workplace.

You should:

Notify your manager that you are unable to report to work.
Contact an IHS representative; please refer to the local IHS team to whom you would report workplace health concerns.
Contact your health care provider for further health instructions, especially if you are at higher risk for complications.
Refer to the guidance in Work Instructions if You Become Ill or Exposed.

Stop the spread of H1N1 Flu

This virus spreads from person-to-person, probably in much the same way that seasonal influenza viruses spread, through coughing and sneezing. Cough etiquette and hand washing are essential to stopping the spread and preventing exposure to the virus.

Wash Hands:

Before eating or preparing food.
After coughing, sneezing, or blowing your nose.
After using restroom facilities.

Handwashing Technique
Wash your hands with soap and water for 20 seconds. Rinse well, with hands held downward. Dry with a paper towel, then use the towel to turn off the faucet.
For health reasons, IBM is only recommending hand sanitizers be present in work areas when soap and water are not available. Though hand sanitizers can be effective in killing some germs, they are less effective than soap and water for removal of germ containing debris on the hands that can be deposited when coughing and sneezing.

Avoid touching your eyes, nose or mouth.
Germs often spread when a person touches something contaminated and then touches their eyes, nose or mouth.

Go home if you get sick at work
Ill individuals should leave the work environment immediately or as soon as possible. Inform your manager or lead that you are ill and need to leave the workplace. Keep at least 1 meter/3 feet from others to protect them from getting sick. Practice cough etiquette. Cover your mouth and nose if coughing or sneezing, using tissues and disposing of them properly. Wash your hands afterward.


For tips on how to stay healthy while traveling, please check the Online Swine Flu Help. For country specific advisories and mandatory quarantine or restrictions on community movement for those who exhibit H1N1 illness symptoms or were exposed to ill travelers, please refer to International SOS Country Guides (see Closures & Quarantine, Airport Screening or Travel Restrictions) or country government agencies such as embassies and state departments.

H1N1 Flu Facts from the World Health Organization (WHO)

H1N1 is now the dominant flu strain in most parts of the world. Studies have detected no signs that the virus has mutated to a more virulent or lethal form.
The pandemic will persist in the coming months as the virus continues to move through susceptible populations.
The symptoms of H1N1 flu are similar to the symptoms of seasonal flu and may include fever, cough, headache, body aches, chills, fatigue, sneezing, sore throat and runny nose. A significant number of people who have been infected with this new H1N1 virus also have reported diarrhea and vomiting.
The overwhelming majority of patients continue to experience mild illness.
At higher risk of serious complications from H1N1 flu are people age 65 years and older, children younger than 5 years old, pregnant women, and people of any age with chronic medical conditions (such as asthma, diabetes, heart disease or immunosuppressed).

While this is a new health problem that may cause concern, there are many actions you can take to protect yourself, your family and the workplace.

Swine flu vaccine ready, enters Europe

Global pharma major Novartis Friday announced it is ready with a swine flu vaccine and has started first deliveries to governments in Europe, giving hopes to people in many parts of the world.
"Novartis has already started first deliveries of pandemic vaccines under quarantine to governments in Europe, despite the initially low yields with the current production seed strain provided by the World Health Organisation (WHO). A new seed strain could provide higher volumes," the company said in a statement issued in Switzerland.


The company announced that Focetria®, the Novartis Influenza A(H1N1) 2009 monovalent vaccine, Friday received a positive opinion from the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMEA).


The company has started first deliveries of pandemic vaccines under quarantine to European countries, which means the vaccine is now ready with the governments but only after getting the formal approval the governments can start vaccination.


"The positive opinion clears the way for European Union approval in all 27 member states as well as in Iceland and Norway. Today's announcement marks a significant milestone in bringing a pandemic vaccine to market in Europe," the company added.


"Only three months after the declaration of the pandemic by the WHO, Novartis was able to ship the first batches of our pandemic vaccine under quarantine to governments in Europe pending EU approval," said Andrin Oswald, CEO of Novartis Vaccines and Diagnostics.


This CHMP positive opinion paves the way for EU approval, which will allow governments to begin their vaccination campaigns with the goal of reaching more patients before the rapidly spreading virus reaches them, Oswald added.


The pharma major, however, did not give details of the number of doses it has despatched or the countries which have received the first deliveries.


More than 150 countries have been affected by the new millennium's first pandemic. It has taken hundreds of lives across the globe.


In India, the virus has killed 286 people and infected more than 9,200 people till Sep 25.

Pvt hospitals still not ready for Swine flu

More than a week after Delhi Government's second deadline expired on September 15, private hospitals are yet to open doors to influenza A H1N1 patients.

Delhi reported 2,079 cases - 80 new cases - and 9 deaths till Wednesday evening. While most of the hospitals claimed to be ready and waiting for the state health department's approval, State Health Minister Kiran Walia said they were not.

"Our experts are going on a round of private hospitals virtually every day, and there are minor things that are hampering the approval process like system of ventilation," said Walia. "These hospitals aren't used to the concept of isolation and mostly work in a centralised system.

We may delay it by a few days but absolute compliance is a must. We can't cut corners and risk lives of people," she said.

"Our set-up is ready and we have conveyed this to the health department. Now, we are waiting for their inspection," said B.K. Rao, chairman of Sir Ganga Ram Hospital.

"Our infrastructure is in place, but we are awaiting formal approval from the government," said the Moolchand Medcity spokesperson. Similar reactions were given by Indraprastha Apollo Hospital, which said the hospital was waiting for the second inspection before starting the facility for swine flu patients.

On August 12, Principal Secretary (health) J.P. Singh issued a circular directing "all 200-bed non-government medical institutions/hospitals to set up a 10-bed isolation treatment facility with 15 days". The direction was issued under section 2 of the Epidemic Disease Act, 1897, which empowers the state government to take special measures and prescribe regulations in case of a dangerous epidemic disease.

"The step was taken as a precautionary measure in case the disease takes epidemic shape," said Singh. The hospitals had asked for more time and the state government extended the deadline by 15 days.

But none of the wards were functional

H1N1 vaccine data shows no side effects

Early data on the H1N1 vaccines show the vaccines to be highly effective with no adverse effects. Two peer-reviewed articles now published in the online first addition of new England Journal of medicine, which has the preliminary data of the monovalent H1N1 vaccine, have shown that the vaccines are working in a large number of healthy adults.

The two rivals, Greenberg et al and Clark et al, describe preliminary data on the immunogenicity of the influenza A (H1N1) 2009 monovalent vaccine. This data has been awaited, as governments, public health officials, and other stakeholders respond to the first influenza pandemic in over 40 years.

The study by Greenberg et al. shows that a single dose of nonadjuvanted vaccine containing the usual 15 �g of hemagglutinin (HA) antigen is immunogenic, or creates immunity, in a high proportion of healthy young and middle-aged adults. The study was conducted in Australia during a time when the virus was circulating, and one participant had laboratory-confirmed infection with the 2009 H1N1 virus.

The report evaluates immunogenicity and safety of the vaccine 21 days after the first of two scheduled doses is given. A total of 240 subjects, equally divided into two age groups, less than and over 50 years of age, underwent randomisation to receive either 15 �g or 30 �g of hemagglutinin antigen by intramuscular injection. No deaths or serious adverse events were reported, but mild discomfort like headaches were reported in a few cases.

The study by Clark et al, involving 175 adults between 18 to 50 years of age, to test the monovalent influenza A/California/2009 (H1N1) surface-antigen vaccine, concluded that the vaccine generates antibody responses within 14 days after a single dose is administered. The antibody tier protection was higher in those who had received two doses of the same vaccine.

China's mass swine flu vaccination

China is to become the first country in the world to start a mass swine flu vaccination programme for its population following a big surge in the number of cases.

No one's died yet from the virus in China but the authorities there describe the situation as 'grim'.

The big rise coincides with the start of the school year and the approaching winter.

Quentin Somerville reports.