Swine Flu Information

These guidelines have been developed based on the best evidence available. As more information becomes available, these guidelines will be updated.

Issued August 28, 2009

1. Introduction

The pandemic (H1N1) 2009 influenza virus (pH1N1) has rapidly spread across the world. In Ontario, the majority of confirmed cases of the pandemic strain have been reported in healthy young adults and most cases have been mild. People between 5 and 24 years of age comprise a larger proportion of cases compared to other age groups. Younger children are most at risk of acquiring infection, presumably due to difficulty in maintaining routine practice in hand hygiene and appropriate coughing /sneezing etiquette.

It is essential, as part of the development of a comprehensive, scaled and integrated series of public health measures, to have strategies in place to prevent the spread of disease in the school-based setting. However, it is important to note that these strategies are not necessarily new but rather a reinforcement of the existing infection prevention and control practices to prevent or reduce the spread of influenza and procedures for dealing with staff, students or volunteers who become ill.

Schools and education staff play an important role in protecting the health of students, staff and local community members, through their educational role, their own modeled health behaviours and their informed decision-making.

For the purpose of this guidance document, schools refer to institutions providing kindergarten to grade 12 education programs to children and adolescents in group settings.

Influenza-like Illness

Influenza-like illness (ILI) is the acute onset of respiratory symptoms with fever and cough and one or more of the following symptoms: sore throat, muscle aches, joint pain, or weakness. In children under 5, gastrointestinal symptoms may also be present and fever may not be prominent.

To continue reading, download the attached PDF document.

 

The attached presentation was used at the AIAI Elders Gathering in Batchewana First Nation on August 5, 2009.

TO: ONTARIO FIRST NATIONS COMMUNITES
FROM: HEALTH CANADA, FIRST NATIONS AND INUIT HEALTH
SUBJECT:H1N1 FLU AND LARGE GATHERINGS
DATE: JUNE 24th, 2009

The H1N1 flu virus is widespread across Ontario. This notice describes measures to prevent the spread of the virus within a community. The decision to use these measures should be made on a case-by-case basis in collaboration with health authorities, based on the severity of illness in the community. Issues to consider are the need to reduce spread within and between communities and the strain on community resources which are needed to respond to the outbreak. If the outbreak causes only mild illness these measures may not be necessary.

First Nations Leadership may wish to consider:

  • Cancelling or postponing large social gatherings in the community, including church services, sporting events, summer camps, powwows and jamborees
  • Asking all members of the community to avoid all non-essential travel

If a large or other public gathering is going to be held, event organizers should consider the following:

  • Have you communicated and consulted with chief and council and health centre staff in order to evaluate and manage any risks to health with regards to the upcoming event?
  • Are you able to make widely available at the event hand washing facilities with soap and running water, hand sanitizers and tissues?
  • Have you considered providing participants with health promotion materials on infection control?
  • Have you encouraged those who are not feeling well to stay at home?

Visit the following web-site or call the toll-free line for information regarding the H1N1 flu virus, infection control practices, how to care for family members and how to avoid contracting the virus.

TO: ONTARIO FIRST NATIONS COMMUNITES
FROM: HEALTH CANADA, FIRST NATIONS AND INUIT HEALTH
SUBJECT: H1N1 FLU INFORMATION PHONE LINE
DATE: JUNE 17, 2009

First Nations and Inuit Health - Ontario Region has established a toll-free line that will address general enquiries about H1N1 from community members. The phone number will be answered from 9am to 6pm EST seven days a week. The number is:

1-877-365-3623

The phone line is an excellent source of information regarding the H1N1 virus, infection control practices, how to care for family members and how to avoid contracting the virus. Community members should be encouraged to call this number for general information rather than the nursing station or health centre.

The phone line does not replace the current communication processes in place between Health Canada and First Nation communities. It will also not provide medical advice to individuals or provide community specific information regarding spread of the virus.

Attached is a poster with the toll-free number. Please ensure that the number is well advertised throughout your community in common areas such as the band office, store and community centre.

TO: ONTARIO FIRST NATIONS COMMUNITIES
FROM: HEALTH CANADA, FIRST NATIONS INUIT HEALTH, ONTARIO REGION
SUBJECT: FIRST NATIONS H1N1 FLU CASES
DATE: JUNE 16, 2009

The H1N1 flu virus is widespread in Ontario and cases have now been reported on reserve. There is a concerted effort with the Public Health Agency of Canada, First Nation partners and the province to ensure a comprehensive and coordinated response to these cases.

Treatment protocols are being implemented, extra resources are being mobilized and we are continuing to work with provincial authorities to ensure that First Nations have equal access to quality care and treatment. In addition:

  • We are providing regular updates to health professionals on reserve about the management of cases and contacts of H1N1 as well as infection prevention and control practices.
  • We have enhanced surveillance to monitor influenza like activity
  • We are obtaining advice from Ontario provincial scientific experts on the care and treatment of H1N1 cases and contacts on reserve in Ontario
  • We will continue to post the latest information on the H1N1 flu pandemic on the First Nations pandemic website: www.pandemic.knet.ca . Some information is available in Cree, Oji-cree and Ojibway.
  • We will continue to provide assistance to communities with pandemic planning.

We are working with health staff in communities and with First Nation leadership to ensure they are equipped to respond. We will continue to provide assistance to communities in pandemic planning and response. If you require assistance with your pandemic plan, please contact Dr. Geoff Dunkley, Community Medicine Specialist (email: geoff_dunkley@hc-sc.gc.ca, phone: 613-954-2408).

We would like to remind communities about the importance of practicing good hand hygiene and practicing proper respiratory etiquette by coughing in their arm or sleeve. At this time, we recommend that you keep doing what you normally do if you are well but if you are sick with flu like symptoms to stay at home and talk to a health professional.

It is important to clarify that the level 6 pandemic declared by the World Health Organization is determined by the geographical spread of the H1N1 virus and is not related to the severity of the illness, which the WHO has indicated as "moderate". While we are all taking the situation seriously, an emergency has not been declared in Ontario.

 

Frequently Asked Questions

HIN1 Flu in First Nations Communities
June 16, 2009

What is an outbreak?

An outbreak in a community will be declared by the Regional Community Medicine Specialist for Health Canada, First Nations and Inuit Health, in collaboration with the community leadership, based on the number and distribution of cases in the community.

Is there a travel restriction?

H1N1 has generally been a mild illness and is already widespread throughout Ontario. Because of this, travel restrictions have not been put in place. More effective than travel restrictions for the prevention of the spread of H1N1 is to ensure that people who have flu-like symptoms remain at home until they are well, and for others to practice good hand washing techniques. An individual community may decide to impose a travel restriction to or from the community, but this decision lies with the leadership of that community, based on their circumstances.

The World Health Organization has declared a level 6 pandemic. What does this mean?

On June 11, 2009 the World Health Organization (WHO) officially declared a pandemic. This decision was due to growing evidence that the H1N1 virus is now easily being transmitted to and among humans, resulting in increased and sustained spread of the virus in the general population in at least 2 WHO regions of the world. A level 6 pandemic is determined by the geographical spread of the H1N1 virus and is not related to the severity of the illness, which the WHO has indicated as "moderate".

The decision to invoke all or part of the provincial pandemic plan, which includes First Nations communities in Ontario lies with the Chief Medical Officer of Health of Ontario through the provincial emergency response process. Individual communities may still choose to implement their own community pandemic plan, based on their specific circumstances.

 

Download the attached poster. (English and French)

Flu symptoms are: cough and fever, runny nose, sore throat, body aches, fatigue and lack of appetite

Protect yourself and others:

  • Wash your hands often and thoroughly in warm, soapy water or use hand sanitizer
  • Cough and sneeze in your arm, not your hand
  • Keep common surfaces and items clean and disinfected
  • Stay home if you're sick.

Contact a health care provider if your symptoms worsen

KNOWLEDGE IS YOUR BEST DEFENCE

For general enquiries:
1-877-365-3623
OR
H1N1-questions-Ont@hc-sc.gc.ca

WWW.PANDEMIC.KNET.CA

 

TO: ONTARIO FIRST NATIONS COMMUNITIES
FROM: HEALTH CANADA, FIRST NATIONS INUIT HEALTH, ONTARIO REGION
SUBJECT: WORLD HEALTH ORGANIZATION DECLARATION
DATE: JUNE 11, 2009

On June 11, 2009 the World Health Organization (WHO) officially declared a pandemic. This decision was due to growing evidence that the H1N1 virus is now easily being transmitted to and among humans, resulting in increased and sustained spread of the virus in the general population. The decision to move to Phase 6 was the result of increasing spread of the virus worldwide with sustained community level outbreaks. It should be noted that a pandemic has not been declared in Canada nor in the Province of Ontario.

While the WHO's declaration of the pandemic should not have a major impact on the day to day activities in our communities, it will set in motion a set of actions in pandemic plans from WHO down to national, provincial and local governments, as well individual hospitals and clinics. We strongly encourage all communities to review and update their pandemic plans. If you require assistance, please contact Dr. Geoff Dunkley, Community Medicine Specialist (email: geoff_dunkley@hc-sc.gc.ca, phone: 613-954-2408)

We remain dedicated to protecting the health of First Nations populations in Ontario. We are working with provincial authorities to ensure First Nations have equal access to care and treatment and that the unique considerations in our populations, such geographic isolation and higher burden of chronic disease is taken into account. In addition:

  • We are providing regular updates to health professionals on reserve about the management of cases and contacts of H1N1 as well as infection prevention and control practices. Your Zone Communicable Disease Nurse is also available to provide support to your community.
  • We are obtaining advice from Ontario provincial scientific experts on the care and treatment of H1N1 cases and contacts on reserve in Ontario
  • We will continue to post the latest information on the H1N1 flu pandemic on the First Nations pandemic website: www.pandemic.knet.ca
  • We will continue to provide assistance to communities with pandemic planning. A pandemic planner will be in place shortly at one of the PTOs to provide further assistance to First Nations communities in Ontario with pandemic planning

We continue to recommend that individuals practice frequent handwashing and proper respiratory etiquette by coughing or sneezing into your arm or sleeve. If others are sick with flu like symptoms you should try and maintain a distance of at least 2 meters (6 feet) away from them. If you are sick with flu like symptoms, please contact your health care provider for further guidance.

 

To: Ontario First Nation Communities

From: Health Canada, First Nations Inuit Health, Ontario Region

Subject: H1N1 Cases and Severe Respiratory Illness in Manitoba

Date: June 9, 2009

Manitoba Health has confirmed H1N1 in its First Nations communities. It has also reported an increase in patients with severe respiratory illness requiring intensive care. Some of the affected patients are of Aboriginal descent. H1N1 is a new influenza A virus which first appeared in Canada at the end of April 2009. To date, over 2,000 H1N1 flu cases have been reported in every province and territory of Canada except Newfoundland. The vast majority of cases have mild symptoms resembling seasonal flu.

Download the attached document to read the complete letter.

TO: NAN First Nations, Tribal Councils and NAN Members
FROM: Deputy Grand Chief Alvin Fiddler
UPDATE RE: H1N1 Influenza A Virus

Tuesday, June 2, 2009 @ 4:00 pm.

In response to a news story released by the Winnipeg Free Press "Suspected H1N1 flu outbreak hits reserve", NAN would like to reaffirm that although there are seven community members of the St. Theresa Point First Nation presenting with flu‐like symptoms, these cases have NOT been confirmed as the H1N1 Influenza A virus.
NAN is working closely with the Regional Community Medicine Specialist from the First Nations and Inuit Health, Ontario Region (FNIH‐OR), Health Canada office to address this issue.

I spoke directly with Chief David McDougall of St. Theresa Point First Nation, Manitoba this afternoon via conference call. I offered support to Chief McDougall and the St. Theresa Point First Nation community members on behalf of NAN. Chief McDougall stated that part of St. Theresa Point First Nation's community action involves advising community members of the following: encouraging infection control practices, recommending minimizing inter‐community travel and congregating in large groups. Chief McDougall stated he will keep NAN informed via communications with myself.

I also spoke with Dr. Geoff Dunkley, Community Medicine Specialist, with FNIH‐OR, Health Canada. Dr. Dunkley reported that they are actively investigating and testing all potential cases of Influenza A, not just the H1N1 virus. Because of the severity of the cases in St. Theresa Point First Nation, it is likely that these are not H1N1 cases as H1N1 cases are usually mild.

NAN will continually provide regular updates to its member First Nations communities via the NAN website. NAN would also encourage its First Nations community members to talk to their CHN, and to continue visiting the Ontario First Nations Pandemic website for updated information: http://pandemic.knet.ca/. FNIH‐OR (Health Canada) Communiqués from Valerie Gideon, Regional Director will continue to be sent out to all First Nations communities regularly. Please call Sarah Perrault, Public Health Policy Analyst if you have any concerns or questions at 807 625 4913 (direct line) or you may email her at sperrault@nan.on.ca .

NAN encourages its member First Nations to continue infection control measures to protect yourself and your family, by: washing hands thoroughly with soap and water, using hand sanitizer, cough and sneeze in your arm of sleeve, and receiving an annual flu shot. Keep doing what you normally do; however if you are sick, stay home. Talk to your community health nurse/health professional if you experience severe flu‐like symptoms.

UPDATED September 2009

The attached document answers these common questions about H1N1 Flu Virus (Human Swine Flu)

  • What is H1N1 Flu Virus (Human Swine Flu)?
  • What are the symptoms?
  • How is it spread?
  • When is the H1N1 flu virus contagious?
  • What should I do if I feel sick?
  • Who is at higher risk?
  • What is the difference between vaccines and antivirals?
  • When will this year's flu vaccines be ready?
  • Who should be tested for the H1N1 flu virus?
  • What actions can I take to protect myself and others?

The handout is available in 4 languages; English, Ojibway, Cree and Oji-cree.