2009 H1N1 and Seasonal Influenza Frequently Asked Questions (FAQs)

• Influenza illness is a contagious disease caused by the influenza virus.
• Every year, a few different viruses circulate that cause influenza illnesses, and these are the seasonal influenza viruses.
• This year there is a new influenza virus, called 2009 H1N1 influenza virus.  It has also been referred to as “novel H1N1 influenza virus” or “pandemic” influenza virus and was formerly called “swine flu.”  It is different from the seasonal flu viruses.
• 2009 H1N1 is considered more dangerous because it is very different from other recently circulating viruses and more people are susceptible to it.  In addition, it has proven dangerous to younger people, while seasonal influenza virus is usually more dangerous to older people.

• Symptoms of the flu include fever, cough, sore throat, body aches, headache, chills, tiredness, vomiting, and diarrhea.
• Collectively, these symptoms make up a syndrome known as influenza-like illness (ILI).

• Cover your nose and mouth with a tissue when you cough or sneeze.  Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
• Avoid touching your eyes, nose or mouth.  Germs spread that way.
• Get the seasonal flu vaccine and the 2009 H1N1 flu vaccine.
• Stay home if you get sick and limit your contact with others to keep from infecting them.
• Follow public health advice.

• If you are at work or school, then put on a surgical mask.  Notify your supervisor if you are an employee or the individual(s) you would normally be required to notify under the school’s attendance policy if you are a student.  (Contact your Student Affairs dean if you have a question.) Most important, go home. 
• Rest.
• Drink clear fluids.
• Cover coughs and sneezes. Clean hands with soap and water or an alcohol-based hand rub often and especially after using tissues and after coughing or sneezing into your hands.
• Keep away from others as much as possible.  Consider wearing a surgical mask – if available and tolerable – when sharing common spaces with others.
• Use medications to control fever, such as ibuprofen, acetaminophen or naproxen, but NOT aspirin.
• Most people ill with influenza will recover without complications, but you may want to check with your health care provider about whether you should take antiviral medications and any special care you might need for pregnancy or a chronic health condition, such as diabetes, heart disease, asthma, or emphysema.
• Be watchful for emergency warning signs (please see below).
  
  

• If you can, go home until you can return to school or work, as noted below.
• If you stay in the residence hall, you should stay in your own room.
• Arrange with a roommate or friend to make sure you have food, fluids, needed medications, tissues and alcohol-based hand wash.

• In adults, emergency warning signs that need urgent medical attention include:
  • Any severe life-threatening allergies.
  • Difficulty breathing or shortness of breath.
  • Pain or pressure in the chest or abdomen.
  • Sudden dizziness.
  • Confusion.
  • Severe or persistent vomiting.
  • Flu-like symptoms improve but then return with fever and worse cough.

• You can return at least 24 hours after your fever is gone, without the use of fever-reducing medicines, except as noted below. For these purposes, a fever is defined as having a temperature of 100^oF (37.8^oC) or higher.
• If you work in an area where severely immunocompromised patients are provided care, you should stay out of work for seven (7) days after your illness began or until your symptoms resolve, whichever is longer, or you may be reassigned.
  

• You can return at least 24 hours after your fever is gone, without the use of fever-reducing medicines.  For these purposes, a fever is defined as having a temperature of 100^oF (37.8^oC) or higher.
• If you have no fever, you should stay out of work at least three to five days for symptoms to improve.

• Wash your hands frequently.
• Get the flu vaccines.

• Pregnant women are at increased risk for complications from ALL flu viruses, including seasonal and 2009 H1N1 Influenza. Therefore, flu vaccination is recommended every year for pregnant women, and even more so this year.
• It seems that the 2009 H1N1 Influenza virus is especially dangerous for pregnant women and there have been more reports of complications and deaths of pregnant women infected with this virus.

• Pregnant women are at increased risk for complications from ALL flu viruses, including seasonal and 2009 H1N1 Influenza. Therefore, flu vaccination is recommended every year for pregnant women, and even more so this year.
• It seems that the 2009 H1N1 Influenza virus is especially dangerous for pregnant women and there have been more reports of complications and deaths of pregnant women infected with this virus.

• There are two vaccines this year:
  1. A SEASONAL flu vaccine that covers three different flu viruses (but NOT the 2009 H1N1 flu virus), which is only one dose.
  2. A vaccine for the 2009 H1N1 influenza A virus, which may require two doses.

UMDNJ uses thimersol-free single dose vaccines whenever possible and Flu-Mist is thimersol-free.

• More information on thimerosal can be obtained from
  The Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/h1n1flu/vaccination/thimerosal_qa.htm
  NJ PIES (UMDNJ Flu Hotline) at 800-222-1222

• No, the seasonal flu viruses are different from the 2009 H1N1 virus and so both vaccines are needed to best protect against the flu.

• Each campus Occupational Medicine/Employee Health service will announce vaccination sites and times for their respective faculty, staff and post-doctoral associates and each Student Health Service will announce vaccination sites and times for the students on each campus.
  
  

• Nothing. Flu vaccines are FREE for ALL UMDNJ faculty, staff, fee-paying students and post-doctoral associates.

• Probably not. Supplies of seasonal flu vaccine are running low and some campuses have run out. However, we may receive more seasonal flu vaccine. Watch here for more information.

• You should NOT get the seasonal flu vaccine if you have any of the following:
• Any severe life-threatening allergies.
• Egg allergies.
• A severe allergy to any vaccine component.
• Guillain-Barré Syndrome.
• Moderately or severely ill – you should wait until you recover.

• Yes, there are two vaccines this year. A “seasonal” flu vaccine protects against three different flu viruses, but NOT the 2009 H1N1 flu virus. The 2009 H1N1 virus is considered more dangerous because it is very different from other recently circulating viruses and more people are susceptible to it. In addition, it has proven dangerous to younger people and pregnant women, while seasonal influenza virus is usually more dangerous to older people.

• Regarding inactivated flu vaccines (“the shots”), people can get them at the same time. If given at different times, there is no required time delay between them.

• The State of New Jersey has lifted target group restrictions on the vaccine so that now ALL UMDNJ faculty, staff, and students can be vaccinated with the 2009 H1N1 Influenza Vaccine.
• On the campuses, we will use only the injected vaccine for pregnant women, healthcare and emergency workers, people 19 to 24 years old, people who live with or care for an infant less than 6 months old, and children and people 25 to 64 years old who have certain chronic medical conditions.
• When the 2009 H1N1 Influenza vaccine is on campus, faculty and staff can get if from the campus Occupational Medicine or Employee Health Service, and students from the Student Health Service.

H1N1 Vaccination Shedule

• The State of New Jersey has lifted target group restrictions on the vaccine so that now ALL UMDNJ faculty, staff, and students can be vaccinated with the 2009 H1N1 Influenza Vaccine. Please contact your campus Occupational Medicine/Employee Health/Student Health Services office to find out more information, including times and dates of vaccinations and clinics.

• Pregnant women.
• Children between 6 months and 18 years of age.
• Healthcare workers, including faculty, staff, housestaff and students who have direct contact within 6 feet of patients in Obstetrics, Pediatrics, the Emergency Department or the Emergency Medical Service.
• Other health care workers, including faculty, staff, housestaff and students who have direct contact within 6 feet of pregnant patients or patients ages 18 years or less.

• It appears that the 2009 H1N1 Influenza vaccine has the same safety profile as the seasonal flu vaccines that we've been using for years.

• All adults, all adolescents and children aged 10 years or greater will need only one dose of 2009 H1N1 Influenza vaccine. Children 9 years old and younger will need two doses.

• Yes, the vaccination will feel the same. Adults, adolescents and children aged 10 years or greater will need only one dose of 2009 H1N1 Influenza vaccine. Children 9 years old and younger will need two doses.

• When available, the 2009 H1N1 flu vaccine will be FREE for ALL UMDNJ employees and students, based on guidance from the Centers for Disease Control and Prevention and the New Jersey Department of Health and Senior Services (to be determined).

• The Centers for Disease Control and Prevention (CDC), in its 5 August 2009 Guidance for Institutions of Higher Learning, is currently NOT recommending that institutions cancel or dismiss classes or other large gatherings.
• Unless otherwise advised by the CDC or state or local health authorities, UMDNJ plans to keep all schools and classes open to the extent possible, primarily based on faculty availability.
• Deans should monitor faculty resources through their departments.
• Since schools have different capabilities to maintain classes through on-line resources, and the requirements of each school differs based on the needs of clinical learning, each Dean is responsible for the decision to cancel class(es) and/or to close a school in consultation with the Office of Academic Affairs.

• Yes, the Dean can consult with the Office of Academic Affairs about modifications of the academic calendar if a school is closed due to 2009 H1N1 influenza, but that can only be decided based on the circumstances at the time.

• Your dean or the dean’s designee.  Generally, all students in NJDS, NJMS, RWJMS, SN and SOM are considered clinical.  Students in SHRP who take at least one course designated as clinical are also clinical.

• The standard attendance and absence rules of the School or Program currently apply, including the need for a doctor’s note in certain circumstances.  However, the University will be flexible if pandemic flu warrants and manage exceptions on a case-by-case basis.
  

• Yes, all students at NJDS, NJMS, RWJMS, SN and SOM, and SHRP students who register for a clinical course MUST be immunized each year with the current influenza vaccine unless there is a documented medical contraindication or bona fide religious belief or practice (for more detailed information on vaccination requirements, see the UMDNJ policy Student Immunizations & Health Requirements). This year, students have until JANUARY 31, 2010, to be vaccinated with H1N1 influenza vaccine and fulfill the Student Immunization and Health Requirement for influenza prevention. Although there was a delay in obtaining H1N1 flu vaccine, we now have sufficient doses for all clinical students.
  

• You are advised to get seasonal influenza vaccine if possible. However, since seasonal influenza vaccine is not currently widely available, this requirement is not currently being enforced.

• The deadline for meeting the influenza vaccination was delayed until January 31, 20010. If you do NOT meet this UMDNJ requirement, your school will determine if you may continue with your program.
  

• Both the seasonal and 2009 H1N1flu vaccines are highly recommended, but not required, for students in the SPH, GSBS and nonclinical students in SHRP.  You may get the vaccine, but may have to wait, depending on availability.

• Yes, you can contact the Student Wellness Program on your campus for free confidential help.

• Yes, the current Sick Time policy states that accrued sick time benefits are to be used when an employee is sick.  Therefore, sick days will be charged.  Human Resources will be flexible if pandemic flu warrants and manage exceptions on a case-by-case basis.
• The more important point is that if you have the flu or flu-like symptoms, you should not come to work in order to avoid spreading the virus.

• You may have other time to use such as vacation or Float Holidays.  In such events, your supervisor should contact HR-Labor Relations for consultation again, on a case-by-case basis.

• Managers and supervisors should not deviate from current call-in sick practices and procedures. In other words, when an employee calls in sick, a manager or supervisor should refrain from asking the employee specific questions such as “Do you have flu-like symptoms?”
  
  
• If, however, emergent circumstances arise where the manager or supervisor believes that he or she has an emergent need to ask a staff member who is calling in sick a question or questions, the manager or supervisor should contact the Office of Labor Relations, which may reach out to the Office of Legal Management for appropriate legal guidance, if necessary.  Such emergent matters should be handled on a case-by-case basis.

• Yes, an Incident Report must be completed by your supervisor if you believe that an on-the-job exposure has occurred and/or if you believe that you have an illness or injury causally related to the work environment.
  

• No, infectious diseases common in the general population are NOT generally compensated under the state’s Workers’ Compensation law.
• Therefore, since flu is prevalent in the community, you should seek treatment if needed under your own health care insurance plan as you would for any cold, flu or other similar illness.
• For individual claims, however, compensability will be considered based upon the merits and nature of the particular occurrence.

• Yes, you are provided the same employee health services as other employees.

• Yes, you can contact the Employee Assistance Program on your campus for free confidential help.
  

• A surgical mask prevents the sick person who is wearing it from spreading bacteria and viruses to other people and the environment. 
• An N-95 respirator protects the wearer from being exposed to bacteria and viruses from other people who are sick.

• Many types are available and can be interchanged.

• In order to accommodate many different sizes and shapes of faces, different N-95 respirators are commonly available at UMDNJ and include:
• 3M 1870 (one size)
• 3M 1860 (small or regular).
• Tecnol Fluidshield duckbill (small or regular).
• North 7130.

• No, you should only wear an N-95 respirator for which you have passed a fit test.

• Before using an N-95 respirator, a person MUST have an initial medical evaluation, be trained and be fit tested.

• If you provide care to patients with influenza or influenza-like illness (ILI), or are at risk of potential exposure to any respiratory pathogen as part of your work or studies, then you should be fit tested for an N-95 respirator to protect yourself. To do so, you must first be medically evaluated (using a specific questionnaire), and then be trained and fit tested. If it has been over one year since your last fit test for an N-95 respirator, you must be re-fit-tested. Speak with your supervisor if you have any concerns.

• Try to maintain a distance of six (6) or more feet from the ill person.
• Keep your interactions with the ill person as brief as possible.
• Ask the ill person to cover coughs and wear a surgical mask.
• You both should wash hands or use alcohol-based hand sanitizer, especially after a cough or sneeze.
• Speak with your supervisor if you have any questions about workplace exposure.

• Clinical students with potential contact to patients with flu-like illness should contact either their campus Student Health Service or RWJMS Employee Health Services on the New Brunswick/Piscataway campuses at 732-445-0123 to complete the mandatory medical evaluation for fit testing and schedule the required N-95 respirator fit testing.

• If it has been over one year since your most recent fit test for an N-95 respirator and you continue to have potential contact with patients with flu-like illness, then you should contact either your campus Student Health Service or EOHSI on the New Brunswick/Piscataway campuses and must be fit tested again with an N-95 respirator.

• A person with facial hair that interferes with the tight fit of an N-95 respirator cannot be fitted for such a respirator.
• The alternative acceptable respirator is a Powered Air Purifying Respirator (PAPR).
• If you need a PAPR for protection, you should speak with your supervisor if you are an employee or with your Student Affairs dean if you are a student.
• Some employees are required to be clean-shaven so that they can wear an N-95 respirator.

• Check with your supervisor to find out if and when training and N95 respirator fit testing will be available.
• EOHSS is providing fit testing "Train-the-Trainer" programs during the month of October. Click here for more information.

• Contact your campus Physical Plant Work Control Center  http://10.32.7.38:8080/archibus/schema/ab-products/workplace/portal/ab-wr-request.axvw  and request a work order for 3M Avagard-D #9222 alcohol-based hand wash dispensers to be installed.
• Be aware that there are Fire Code restrictions, since the alcohol is flammable.  The dispensers must be:
• At least 48 inches apart.
• Clear of electrical outlets (at least 24 inches away).
• Only manually activated.
• Not placed in a corridor with less than 72 inches clearance.
• Not in a carpeted area unless the area is fully sprinklered.
• The stations will be resupplied by Environmental Services and will be charged back to your budget.
• If there is a shortage, the Physical Plant Work Control Center will suggest alternatives, such as Purell.

• On September 8, 2009, CDC issued new guidance regarding the use of the antiviral medications oseltamivir (Tamiflu) and zanamivir (Relenza).  For details, please see:  http://www.cdc.gov/h1n1flu/antiviral.htm  
• Generally, treatment with antiviral medications is NOT necessary for persons who are not at higher risk of complications or do not have severe illness.
• Some people are at increased risk of influenza complications and are prioritized for treatment with influenza antiviral drugs this season. They include:
  • People hospitalized with suspected or confirmed influenza.
  • People with suspected or confirmed influenza who are at higher risk for complications, including adults 65 years and older, children younger than 5 years old, pregnant women and people with certain chronic medical, such as  diabetes, heart disease, asthma or emphysema, or immunosuppressive conditions.
• People younger than 19 years of age who are receiving long-term aspirin therapy
• For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).
• You may want to check with your health care provider about whether you should take antiviral medications and any special care you might need.

• Call NJ PIES 1-800-222-1222 or go to www.flu.gov

• Go to www.umdnj.edu/flu
• If you have a question and want to speak with someone, you have many resources as a UMDNJ student, faculty member, staff member or post-doctoral associate, including, but not limited to:
• Your supervisor.
• Your Student Health Service.
• The Occupational Medicine/Employee Health Service for your campus.
• The Infection Control department at UH or UBHC.
• Human Resources.
• Student Affairs.
• Risk and Claims Management Department.
• Office of Emergency Management.
• Environmental and Occupational Health and Safety Services Department.