Modules:
1.	Introduction
2.	Influenza Viruses
3.	Seasonal, Avian, and Pandemic Influenza
4.	Influenza: the disease
5.	New Zealand pandemic planning
6.	Primary Health Care preparedness
7.	Community preparedness
8.	Anti-viral Drugs
9.	Vaccines
10.	Common Questions
11.	Resources
12.	Course Conclusion

Influenza is mainly spread by droplet transmission, therefore there is little evidence to support the use of particulate respirator masks in every face to face contact situation. However particulate masks, eye protection, gloves and gowns/aprons should be used where there is a high risk of aerosol spread of respiratory secretions eg invasive procedures - suctioning, intubation, extubation, taking of nasopharyngeal swabs, nebulising

Primary Health Care Preparedness

Infection Control Measures within a Primary Health Care Facility:

Keep your distance where at all possible
- At least a metre distance reduces the risk of exposure to droplet-spread viruses
- Where possible, try to separate patients with respiratory symptoms from other patients. What steps can your practice put in place to separate infectious patients as they arrive in the waiting room?
Hnad hygiene
- Do not touch your mouth, nose or eyes after touching any surface that may have had infected droplets on it
- Wash and dry your hands between patients
  - Rigorous, frequent hand washing and drying
  - Wash in warm water with soap. Dry hands well with paper towels.
  - If running water is not available, use an alcohol-based hand gel, eg in waiting rooms
Wear a surgical mask, eye protection and, if physical contact, gloves
- Also offer masks to the patient and any support people

Use of Masks during a pandemic:

Symptomatic patients in the practice should be directed to wear a disposable surgical mask to help prevent spread.
Ear loop masks are easier for the general public to wear
Masks must be disposed of as soon as they become moist or after any cough or sneeze, in an appropriate waste receptacle
Hands must be thoroughly washed and dried after the used mask has been discarded
Avoid touching mask whist being worn
Do not wear a mask around the neck
Disposable surgical masks are recommended for first responders and healthcare support workers

Ref: Interim Guidelines for Personal Protection and Using Personal Protective Equipment during an influenza Pandemic . Ministry of Health Sep 2005

Ventilation
- Keeping windows open where possible
- Check the air-conditioning functioning
  Picture of open windows
Promotion of appropriate cough hygiene
1. Tissues available for all rooms including waiting room
2. Waste disposal available and accessible for tissues disposal
For very close contact with an ill patient such as resuscitation have a pack ready containing: (recommend average practice keep two packs preprepared)
- Particulate Respirator Mask (eg N95/PC2000)
- Gown
- Goggles and gloves

Advise for patients who have recently travelled (PDF) from Ministry website

Video: Infection Control for Primary Healthcare practices in the Pandemic Influenza setting - January 2006

Please wait while the video loads, then click the play button on the left.

TABLE 1: SUMMARY OF PROTECTION MEASURES (from New Zealand Pandemic Influenza Action Plan Version 14 Appendix D)

Protection measure	Where applicable
Hand hygiene, cough etiquette, ventilation	Everyone, everywhere, all the time
Organisational policies	Every organisation, all the time
Physical distancing	Everyone, whenever practical
Protective barriers	In situations where regular work practice requires unavoidable, relatively close contact with the public
Disposable surgical mask	Workers in any community or health care setting who are caring for the sick (this includes first responders) Also as a possible adjunct to protective barriers
Disposable particulate respirator mask, eye protection, gloves, gown/apron	Healthcare workers participating directly in close contact patient care when there is a high risk of contact with respiratory secretions, particularly via aerosols (mostly in-patient settings).

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