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Clinical Caring in the Time of Influenza 2009

Charlotte Carneiro RN, MS COHN-S, CIC  charlotte925@comcast.net

The old saying goes - the more we know the more we know that we do not know - and in this time of seasonal and novel H1N1 flu viruses, we are in an observation mode as these viruses gear up for the 2009-2010 season.

Traditionally, in triaging in the occupational health setting, fever and sudden onset of sore throat, and cough could be the hallmark of influenza. However with 20% of the cases of influenza H1N1 presenting without fever, the triage process gets a little murky. One can be inclined to pass off significant influenza as allergies. This would lead to spread in the workplace and a disservice and potential danger to the employee.

Abundant information is available for the curious, paranoid and hypochondriac. The uninformed, "couldn't care less employee" is the worry for at risk complications. This person is not prepared and could be in danger of pneumonia. What to say to individuals who come to the clinic for symptom relief, the flu shot or just some basic information?  How much to say to improve internal locus of control, but not to frighten?

        From my clinical practice, these suggested health educations tips are offered:

  1. Check out www.cdc.gov/H1N1 or http://flu.gov
  2. Stock the medicine chest with a thermometer and anti- fever, anti-cough and decongestants, throat lozenges both adult and pediatric; not aspirin
  3. Stock the kitchen with juices, water and soup
  4. Keep the fever controlled
  5. Call your doctor or go to urgent care for uncontrolled fever at 101 or 102 degrees F and /or you are short of breath.

Instruct the employee that the goal is saving lives from pneumonia and death.  Vaccines will reduce the number of flu cases and the severity of flu cases but the vaccine is only 60-70% effective against the three types of virus in this year's seasonal influenza immunization:

A H3N2 A Uruguay 716n2007

AH1N1 A Brisbane 59 2007

B Brisbane 60 2008

The Swine flu/2009 Novel H1N1 is a mono-valent vaccine and will be offered to high risk individuals. Stay tuned for the availability and distribution.   In the meantime, follow the public service announcements, rap videos, and cartoons.  http://www.youtube.com/user/USGOVHHS   

Bubble up for safety!







Page Updated September 22, 2009

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