Waterloo | Influenza Update

Dear UW Community Member:

31 August 2009

Background: As our fall term commences, recent news reports have highlighted the particular risks for an outbreak of H1N1 influenza in post-secondary institutions — dormitory housing, large classroom sizes and social gatherings. Canadian and Ontario experience of H1N1 infections over the summer has demonstrated the vulnerability of pregnant women and those with immune deficiency or chronic illness which traditionally has placed them at high risk for seasonal influenza; however, many have been surprised by the recent summer camp outbreaks in Ontario, showing how H1N1 has targeted this younger age group. Over half of the infections in Ontario to date have occurred in people below the age of 20. Most cases experienced a mild form of the illness and have recovered.

Since the initial flurry of reports following WHO declaring a pandemic of H1N1, the fact is that H1N1 has persisted as sporadic outbreaks. H1N1 is the virus which is causing influenza in Waterloo Region at this time as it is across Ontario and Canada. In the Northern Hemisphere we see seasonal influenza between October and April when the temperatures and humidity are lower. Pandemic influenza is expected to behave in unusual patterns and to target sectors of the population not normally vulnerable to seasonal flu and this is our experience with H1N1.

Fortunately the illness in its first wave has been mild in Canada and Ontario. For the recent statistics see a H1N1 weekly synthesis Aug 14, 2009, report from the Ontario Agency for Public Health Protection and Promotion. For a scholarly review of what we know about H1N1 see the White Paper on Novel H1N1 prepared for the MIT Center for Engineering Systems Fundamentals by John M. Barry. And finally an interesting perspective from a distinguished medical journal, the Lancet.

Preparing UW campus: As we approach the beginning of the fall term, I want to remind you that we are entering the usual flu season. Based on the information to date and provincial recommendation, Region of Waterloo Public Health is planning for the possibility of a “busy” flu season this fall, with the circulation of the seasonal strains and H1N1; but with the anticipation that the surge in demand will likely be one which can be absorbed by the health care system. To assist all members of our campus a self-screen questionnaire is being developed which will be posted on our website. In addition a letter will be sent to our fall term residence students by the Director of Housing. It is important that all students entering residence, as well as students living off campus, self-screen for flu symptoms before leaving home, travelling to campus and participating in orientation and other campus activities.

The seasonal influenza vaccination will be released in October. The Novel H1N1 vaccine which is being prepared for Canadians is not expected to arrive before November. Health Services is planning to offer vaccines to high risk populations as soon as it is received by our office and has scheduled flu shot clinics in the Student Life Centre for the rest of our population. Please watch for the dates on campus media and our website.

Before the vaccine is available, we may begin to see influenza illness in our Region. I have been asked “What can we do to protect our personal health and the health of our families and community?” We all need to make habitual the practice of prevention strategies highlighted in public health messaging, that is hand hygiene and cough etiquette. Please see the attached recommendations for protecting your health, what to do if you or someone you care for becomes ill, and ways work groups can reduce the risk of spreading infection called social distancing.

Self-Isolation: who do you call? After an individual first develops flu symptoms, he/she can spread the virus to others for 5-7 days. For this reason, one of the most important ways to keep our families and communities healthy is self-isolation. This means that persons who are suffering from symptoms of flu, at first sign of the flu, must stay home or if onset of illness is while at work or school, go home. Please call your manager, if you are an employee, or faculty advisor, if you are a student, to inform them. They may ask you to call the Occupational Health Nurse or Health Services. Please do not go to a medical facility without first calling, discussing your problem and receiving explicit instructions to attend. We expect that most people suffering from the flu will recover without needing to seek medical care. Health Services has established a flu hotline 519-888-4467 which will be open September 8. Region of Waterloo Public Health will be answering questions about influenza and will publish the telephone number when the line is functioning.

Antibiotics are ineffective against viruses and antivirals will only be released to high risk populations who are severely ill. Bed rest, fluids and symptomatic treatments, which you can purchase without prescription and with the guidance of your pharmacist, are the most useful measures for self-care. On Health Services website you will soon find a chart to help guide you to the appropriate level of care and for the type of symptoms which indicate a need to consult a physician. You should avoid contact with others while the infection is contagious — until your fever is gone and you are feeling better. It is common for tiredness and a cough to linger for several more weeks, but you are no longer contagious and may return to school and work even with a persistent cough.

I wish you well — that your health may be spared the impact of influenza and that your activities as a member of the University of Waterloo community are successful this 2009-10 academic year.

Sincerely,

Barbara Schumacher, MD

Director, Health Services, University of Waterloo