Winter Preparedness in Sutton Carolyn Moore Infection Prevention and Control Nurse Sutton CCG/Public Health, Sutton
Influenza - seasonal Poses a significant risk to all healthcare providers Key factor in NHS winter pressures Often underestimated Estimated that up to 25% of HCWs contract flu during the season
What is flu? Flu is an acute viral infection of the respiratory tract (nose, mouth, throat, bronchial tubes and lungs) Highly infectious illness which spreads rapidly in closed communities Easily transmitted by large droplets, small-particle aerosols and by hand to mouth/eye contamination from an infected surface or respiratory secretions of infected person Incubation period 1-5 days (average 2-3 days) though may be longer especially in people with immune deficiency Even people with mild or no symptoms can infect others
Features of flu Common symptoms include: Sudden onset of fever, chills, headache, muscle and joint pain A fever - 38 o C or higher or feeling feverish (not everyone with the flu has a fever) Extreme fatigue Dry cough and/or sore throat A runny or stuffy nose In young children gastrointestinal symptoms such as vomiting and diarrhoea may be seen
Symptoms of flu
How the flu vaccine works The injected flu vaccine stimulates the body's immune system to make antibodies which attack the flu virus. Antibodies are proteins that recognise and fight off germs, such as viruses, that have invaded the blood. If exposed to the flu virus after the flu vaccine, the immune system will recognise the virus and immediately produce antibodies to fight it. It may take 10 to 14 days for immunity to build up fully after the flu vaccine.
Flu vaccine effectiveness Efficacy calculated at between 50-60% for adults aged 18-65yrs, Lower efficacy in elderly although immunisation shown to reduce incidence of severe disease including bronchopneumonia, hospital admissions and mortality In 2014/15 the flu vaccine only provided limited protection against infection caused by one particular strain of flu A (H3N2) Throughout the last decade, there has generally been a good match between the strains of flu in the vaccine and those that subsequently circulated It is crucial the mismatch in winter 2014/15 does not discourage atrisk groups from having flu vaccination in future flu seasons Flu vaccination remains the best way to protect people from flu The national flu immunisation programme 2015/16
Health and social care workers HCWs are more likely to be infected than other members of the general public Evidence vaccination significantly lowers rates of flu-like illness, hospitalisation and mortality in elderly in long-term healthcare settings Reduces transmission of flu to vulnerable patients, some of whom may have impaired immunity that may not respond well to immunisation Vaccination of frontline workers also helps reduce sickness absences and contributes to keeping the NHS and care services running through winter pressures
Barriers to flu vaccine uptake in HCWs Most common reason is that HCWs do not believe that they need the vaccine personal protection Concerns about adverse reactions Concerns about vaccine efficacy Lack of access
Mythbusters The flu vaccine gave me the flu! I never get the flu so I do not need to have the vaccine The flu vaccine is not safe The vaccine does not work I do not need to have the vaccine every year I have had the flu already this year so I don t need the vaccine The flu vaccine cannot protect me against swine flu I missed the jab before December so it is not worth having it now
Key messages Much greater focus on preventing transmission Annual vaccination of health and social care workers (Duty of care)is the most effective method. It protects them & reduces risk of spreading flu to their patients, service users, colleagues and family members The code of practice on the prevention and control of infections and related guidance reminds you of your responsibilities. Employers should make vaccines available free of charge to employees if a risk assessment indicates that they are needed 11
Take back messages for your staff Duty of care as professionals to your residents to do everything in their power to protect them against infection, including being immunised against flu Getting vaccinated against flu can help protect them, their patients and family Everyone is susceptible to flu, even if you are in good health and eat well They can be infected with the virus and have no symptoms but can still pass flu virus to others including patients or residents Good infection control measures reduce spread of flu and other acute respiratory infections in healthcare settings but are not sufficient alone to prevent them Impact of flu on frail and vulnerable patients can be fatal and outbreaks can cause severe disruption in communities, care homes and hospitals Flu vaccine has a good safety record and will provide protection. The flu vaccine CANNOT give you flu.
Pregnant women All pregnant women are recommended to receive the inactivated flu vaccine irrespective of their stage of pregnancy Pregnant women are at increased risk from complications if they contract flu Having flu during pregnancy may be associated with premature birth and smaller birth size and weight Flu vaccination during pregnancy provides passive immunity against flu to infants in the first few months of life Studies on safety of flu vaccine in pregnancy show that inactivated flu vaccine can be safely and effectively administered during any trimester of pregnancy No study to date has demonstrated an increased risk of either maternal complications or adverse foetal outcomes associated with inactivated flu vaccine Women should be offered the vaccine every time they are pregnant