Guidance for Preventing the spread of H1N1 (swine origin)

Influenza in the Workplace

As Cases of H1N1 Flu continue to rise, employers should be familiar with simple measures to reduce the risk of infection in the workplace and prepare for the impact of illness on their operations. This guidance is intended for general workplace settings, such as offices, stores, restaurants. Additional guidance is available for health care settings and employees that perform home visits www.nyc.gov/health.

What is H1N1 Influenza?

H1N1 flu is caused by a new virus that recently emerged in Mexico and the United States and has spread throughout the world. Like seasonal flu, it causes illness that can range from mild to severe.

What are the symptoms?

H1N1 influenza symptoms appear similar to those of seasonal flu. They can include fever and a range of other symptoms such as cough, sore throat, fatigue, headache, body aches, lethargy, stuffy nose and chills. Some affected people have also reported diarrhea and vomiting.

How is the H1N1 influenza virus spread?

Like all flu viruses, H1N1 (SO) spreads mainly through respiratory droplets that are released when an infected person coughs or sneezes. People can also become infected by touching a surface with virus on it (like a door knob) and then touching their mouths or noses.

How severe is H1N1 influenza?

So far, we have no evidence that H1N flu is more or less, severe than seasonal flu. While most cases are mild and most people recover quickly without medical treatment, we are now seeing more hospitalizations and more severe illness. This is to be expected as the overall number of cases rises.

Who is at risk for complications from H1N1 influenza?

People with underlying health conditions are at the highest risk of developing severe illness from H1N1 flu. If you have underlying condition and develop flu-like illness (fever, accompanied by cough or sore throat), please call your doctor immediately to discuss treatment with antiviral medication.

Those at higher risk include:
People over 65 or under 2 years of age
People with lung disorders, such as asthma or emphysema
People with heart, kidney, liver or blood disorders
People with diabetes
People with weak immune systems due to illness or medication
Pregnant women
People on long-term aspirin therapy

How can the risk of illness in the workplace be reduced?

Most importantly, remind employees that they should not come to work if they have flu-like symptoms (fever and cough). They should not return until 24 hours after their symptoms resolve.

Encourage employees to avoid touching their eyes, noses or mouths; and to wash their hands before and after eating, after using the bathroom, and any time hands are soiled. If a workplace lacks soap and water, an alcohol-based hand sanitizer containing 60% to 95% alcohol is a good substitute. Good hand hygiene is the best protection against infection and should always be practiced after contact with frequently touched surfaces or other people's hands.

Employers should review sick leave policies to determine whether policies are up to date and adequate to address employee questions and potential absences.

Employees should review sick leave policies and be familiar with their employers' policies for handling absences prompted by illness or the need to care for household members who are sick.

Should workers wear masks to prevent the spread of the H1N1 flu?

No. Workers in general workplace settings (offices, stores restaurants, manufacturing plants) do not need to wear masks. But any worker with flu-like illness should stay home until 24 hours after their symptoms resolve.

Workers in health care settings should follow their standard procedures for infection control. Guidance for infection control in hospitals and outpatient medical facilities is posted at the Health Department's H1N1 Web page: www.nyc.gove/html/cd/cd-h1n1.shtml.

What precautions can help prevent the spread of the H1N1 influenza in offices and public places?

No special precautions are needed, but buildings managers and owners should enforce good maintenance practices.
Stock hand-washing facilities with soap and paper towels, and clean them regularly. Keep sinks, faucets, drains, toilets and plumbing in good working order. Provide wastebaskets for the use tissues and towels and empty them regularly.
Routinely clean frequently-touched surfaces such as doorknobs, door handles, common keyboards, handrails and telephones, as well as surfaces in bathrooms, cafeterias and offices.
Post signs advising employees and visitors to wash their hands frequently and to cover their coughs. The Health Department has signs available for download at www.nyc.gov/html/doh/downloads/pdf/cd/cyc-poster-comm.pdf.
Keep heating and ventilation systems in good working order, in accordance with system specifications and any applicable regulations.

There is currently no evidence that special vacuuming equipment or procedures are necessary. Upholstery, carpets, drapes and vertical surfaces don't require special cleaning unless they are visibly soiled.

What should I use to clean surfaces?

The H1N1 (SO) virus can be killed with common household or commercial detergents and disinfectants. Use general household cleaners or soap and water. As an added precaution, disinfectants can be used on frequently-touched surfaces.

If hard surfaces are visibly dirty, clean first using general cleaner or soap and water. After surface has been cleaned, apply disinfectant following product instructions.

Disinfectant wipes can be used to clean small surfaces. Discard wipes after using them.

if disinfectants are not available, use a chlorine bleach solution made by adding 1 tablespoon of bleach to a quart (4 cups) of water. Discard the solution after using it.

Never mix bleach with cleaning products - you may create hazardous vapors.

What should you tell employees who have flu-like symptoms?

Employees with flu-like symptoms, such as fever (temperature at or above 100.4 degrees fahrenheit) and cough, should stay home until at least 24 hours after their symptoms resolve. Anyone with severe symptoms should seek health care and treatment immediately.

In adults, symptoms that warrant emergency medical attention include:
Rapid breathing, difficulty breathing, or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Bluish skin color

Those with mild flu-like illness should not go to the emergency room or hospital. Those with flu-like illness who have underlying conditions should call a doctor to get treatment.

Where should you go for more information?
To get more information on H1N1 virus visit the Department of Health website at www.nyc.gov/health or call 311