H1N1 Influenza (Swine Flu) Interim Infection Control Guidelines- Long Version

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1 Stanislaus Cunty Department f Envirnmental Resurces H1N1 Public Htline (209) H1N1 Influenza (Swine Flu) Interim Infectin Cntrl Guidelines- Lng Versin Infectin Cntrl precautins fr H1N1 Fllwing are general guidelines fr decntaminating an area that is suspected t have H1N1 influenza. These guidelines prvide a basic framewrk f respnse. This guidance may be mdified r additinal prcedures may be recmmended by the CDC, when an influenza pandemic becmes widespread in the United States r as new infrmatin abut an influenza strain becmes available. Influenza viruses can persist n nnprus surfaces fr 24 hurs r mre, but quantities f the virus sufficient fr human infectin are likely t persist fr shrter perids. Althugh the relative imprtance f virus transfer frm inanimate bjects t humans in spreading influenza is nt knwn, hand transfer f the virus t the mucus membranes f the eyes, nse, and muth resulting in infectin is likely t ccur. Hand hygiene 1, cugh etiquette and respiratry hygiene 2 are principal means f interrupting transmissin f influenza in the absence f influenza vaccine and given limited availability f antiviral medicatins. Rutine cleaning and disinfectin practices may als play a rle in minimizing the spread f influenza. Infectin Cntrl Guidelines fr H1N1 Rutine cleaning with sap r detergent and water t remve sil and rganic matter, fllwed by the prper use f disinfectants t inactivate any remaining virus are the basic cmpnents f effective envirnmental management f influenza. Reducing the number f influenza virus particles n a surface thrugh these steps can reduce the chances f hand transfer f virus. Influenza viruses are susceptible t inactivatin by a number f chemical disinfectants readily available frm cnsumer and cmmercial surces (fr mre general infrmatin abut disinfectin f envirnmental surfaces, see the CDC/ Healthcare Infectin Cntrl Practices Advisry Cmmittee (HICPAC) Guidelines fr Envirnmental Infectin Cntrl in Health-Care Facilities, available at: ). Rutine cleaning methds shuld be emplyed thrughut the area with special attentin in certain areas as specified belw: 1. Wear nn-sterile, dispsable glves that are recmmended by the manufacturer

2 f the detergent/disinfectant while cleaning the area and when handling cleaning and disinfecting slutins. Dispse f glves if they becme damaged r siled r when cleaning is cmpleted, as described in item 7 belw; never wash r reuse the glves. Eye prtectin, such as a face shield r gggles, may be required if splashing is expected. 2. Use a cmmercial prduct that is bth a detergent (cleans) and a disinfectant (kills germs). Use the cleaner first, rinse the surface thrughly, and then fllw with a disinfectant. Apply the disinfectant accrding t prcedures apprved and instructed n the disinfectant manufacturer s label. Ensure adequate cntact time fr effective disinfectin. Adhere t any safety precautins r ther label recmmendatins as directed (e.g., allwing adequate ventilatin in cnfined areas such as lavatries, and prper dispsal f unused prduct r used cntainers). Avid using prduct applicatin methds that cause splashing r generate aersls If a disinfectant is nt available, use a dilute slutin (1:100 vlume/vlume, apprximately 600 parts per millin [ppm]) f husehld chlrine bleach (5.25% r 6.00% sdium hypchlrite) t disinfect bathrm surfaces. T prepare this slutin, add ¼ cup f bleach t a galln f clean water, r 2 teaspns f bleach t a quart f clean water. Apply t a cleaned surface, preferably with a clth mistened with the bleach slutin, and allw the surface t remain wet fr at least 3 5 minutes. Use glves that prtect the hands when preparing the bleach slutin and pur bleach carefully. 4. Clean and disinfect cmmnly tuched surfaces in a facility with a detergent and disinfectant in accrdance with label instructins. Seat, seatbacks (the plastic and/r metal parts) and armrest dr handles & handrails kitchen cuntertps Phnes & TV remtes Walls, windws, windw shades & light switches Persnnel wrk areas, including cmputer mnitr, keybard & muse Sinks & faucets Bathrm surfaces, Shwers & lavatry (ies) including: dr handle, lcking device, tilet seat, faucet, washbasin, and walls. Desks, tables, chairs, benches, lckers Refrigeratr exterirs & dr handles Micrwaves The tp 5 germ ht spts are:

3 5. Any bdy fluids (e.g., vmit frm an ill individual) shuld first be first sprayed with a disinfectant and then taken up frm vertly cntaminated surfaces by using an absrbent material, which shuld then be dispsed f as described in item 7 belw. Hard, nnprus surfaces may then be cleaned and disinfected as described in item 2 abve. Large areas cntaminated with bdy fluids shuld be treated with disinfectant after remval f the bdy fluid with absrbent material, and then cleaned and given a final disinfectin. Since disinfectants are nt registered fr use n prus surfaces, any seat cvers and/r carpeting shuld be remved carefully and laundered in accrdance with the manufacturer s instructins r dispsed f after being remved as described in item 7 belw. Althugh influenza viruses can persist n prus materials, the transfer f these viruses frm sheets, bedding, and clthing is nt an efficient prcess. 6. Recmmended laundry practices: Gently gather siled clthing, bedding, and linens withut creating a lt f mtin r fluffing; fr example, d nt shake sheets when remving them frm the bed. Clean yur hands after handling siled laundry items. Use washing machine cycles, detergents, and laundry additives (like sftener) as yu nrmally d; fllw label instructins fr detergents and additives. Dry the cleaned laundry items as yu nrmally d, selecting the dryer temperature fr the types f fabrics in the lad. Line- r air-drying can be used t dry items when machine drying is nt indicated. Clean yur hands befre remving clean laundry frm the washer r dryer, especially if yu have cughed r sneezed n yur hands. 7. Dispse f siled material and glves in a sturdy, leak-prf (e.g., plastic) bag that is tied shut and nt repened. Prus materials that will be laundered can be remved in the same manner. State and lcal gvernments shuld be cnsulted fr apprpriate dispsal decisins. Barring specific state rutine slid waste r medical waste regulatins t the cntrary, these wastes are cnsidered rutine slid wastes in the cmmunity that can be sent t municipal slid waste landfills withut treatment. 8. When cleaning is cmpleted and glves have been remved, immediately clean hands with sap and water r an alchl-based hand gel. Avid tuching the face with glved r unwashed hands. The use f single use twels fr hand washing and/r paper twels that are dispsed f r clth twels that are laundered after a single use shall be practiced. 9. D nt use cmpressed air and/r water under pressure fr cleaning, r any ther methds that can cause splashing r might re-aerslize infectius material. Vacuum cleaners shuld be used nly after prper disinfectin has taken place. A cmbinatin f these precautins will give the apprpriate infectin cntrl.

4 FAQ What measures can I take t prtect against infectin? General infectin cntrl practices and gd respiratry hand hygiene can help t reduce transmissin f all viruses, including the human swine influenza. This includes: Cvering yur nse and muth when cughing r sneezing, using a tissue when pssible. Dispsing f dirty tissues prmptly and carefully Maintaining gd basic hygiene, fr example washing hands frequently with sap and water t reduce the spread f the virus frm yur hands t face r t ther peple (alchl based hand cleaners are als effective). Cleaning hard surfaces (e.g. dr handles) frequently using a nrmal cleaning prduct Making sure yur children fllw this advice Use disinfectants r sanitizers prperly by fllwing label directins t kill germs n cmmnly tuched surfaces. Avid tuching yur eyes, nse r muth. Germs spread this way. Limit clse cntact with thers wh have a cld r the flu r been ut f the cuntry Keep disinfectants ut f the reach f children. What surfaces are mst likely t be surces f cntaminatin? Germs can be spread when a persn tuches smething that is cntaminated with germs and then tuches his r her eyes, nse, r muth. Drplets frm a cugh r sneeze f an infected persn mve thrugh the air and can spread when a persn tuches these respiratry drplets frm the infected persn n a surface, like a desk, and then tuches their wn eyes, muth r nse befre washing their hands. Hw lng can viruses live utside the bdy? We knw that sme viruses and bacteria can live frm 2 t 24 hurs under certain circumstances. Decntaminatin f surfaces and frequent hand washing will help yu reduce the chance f getting cntaminated frm these cmmn surfaces.

5 1 When washing hands with sap and water: Wet yur hands with clean running water and apply sap. Use warm water if it is available. Rub hands tgether t make a lather and scrub all surfaces. Cntinue rubbing hands fr 20 secnds. Rinse hands well under running water. Dry yur hands using a paper twel r air dryer. If pssible, use yur paper twel t turn ff the faucet. Remember: If sap and water are nt available, use alchl-based hand gel t clean hands. When using an alchl-based hand gel: Apply prduct t the palm f ne hand. Rub hands tgether. Rub the prduct ver all surfaces f hands and fingers until hands are dry. ( 2 The fllwing measures t cntain respiratry secretins are recmmended fr all individuals with signs and symptms f a respiratry infectin: Cver the nse/muth when cughing r sneezing; use tissues t cntain respiratry secretins and dispse f them in the nearest waste receptacle after use; if yu dn't have a tissue, cugh r sneeze int yur upper sleeve, nt yur hands; perfrm hand hygiene (e.g., hand washing with nn-antimicrbial sap and water, alchl-based hand gel, r antiseptic handwash) after having cntact with respiratry secretins and cntaminated bjects/materials ( and )

6 References: Pandemic Flu Hme - Cntrl f Pandemic Flu Virus n Envirnmental Surfaces in Hmes and Public Places Pandemic Flu Hme - Interim Guidance fr Aircraft Cleaning When Pandemic Influenza is Suspected in a Passenger r Crew Member Center fr Disease Cntrl - Preventing Spread f the Flu in Child Care Settings abutgerms.cm Santa Clara Cunty swine flu FAQ 9%2Fattachments%2FFAQs_SwineFlu_ _eng.pdf

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