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Status report – A/H1 N1 Flu

08-09-2009-


DEPARTMENT OF SOCIAL AFFAIRS AND HEALTH


1/ EPIDEMIOLOGICAL SURVEILLANCE:

- Until 8th July 2009, cases were identified by biological tests which confirmed the presence of the A/H1 N1 virus.

In the Principality of Monaco, only two known cases were reported.

- Since then, biological testing of possible cases has not been carried out except for serious cases or group cases.

In the Principality no severe case or group case has been reported.

Circulation of the virus is therefore a reality but for the moment limited to beneath the epidemic threshold.

- From 1st September 2009, monitoring the development of the epidemic has been based on the declaration of consultations for flu symptoms by doctors and hospital services.

2/ IMPLEMENTATION OF A PREVENTION AND ANTI-FLU PANDEMIC PLAN

The Principality is included in the French departmental Plan to prevent and combat the flu pandemic and as such has taken part in the meetings of the departmental operational unit since it was set up at the end of April.

Moreover, the Authorities in the Principality have been implementing the following specific measures since the beginning of the epidemic:

- measures to take care of patients by emergency and specialised hospital services, and as from 23rd July, by general practitioners, hospital care being reserved exclusively to severe cases;

- information to the general public via the press and posters in transit areas and hotels;

- information to health professionals and emergency services;

- creating an emergency stock of masks and antivirals:

· 170.000 type FFP2 protection masks and 130,000 extra masks on order,

· 500,000 surgical masks,
· 500 antiviral treatments

- providing emergency service staff, health professionals, schools, crèches and leisure centres, as well as establishments welcoming the public with FFP2 and surgical masks;

- setting up a distribution plan for masks in order to supply administrative services and entities in the event of an epidemic;

- updating continuity plans for public services in order to identify priority and uninterruptible missions and the means necessary to achieve them;

- sending a circular note to companies to inform their director on the need to update their own continuity plan for their business and envisage sufficient protection measures for their employees who are in contact with the public in the event of an epidemic.

3/ ORGANISATION OF A VACCINATION CAMPAIGN:

The Principality, like France, is preparing a vaccination plan in order to make it available to the whole population.

These measures will be operational at the end of September.

The vaccination campaign will only be implemented upon the decision of the Health Authorities.

Two principles have been endorsed:

- the vaccination will be voluntary;

- the vaccination campaign will be activated once the vaccine has received marketing authorisation following the clinical trials which are currently under way.

The Principality will be supplied with vaccines by the French Authorities.

Vaccinations will be given:

- in two vaccination centres located in town:

· on the premises of the Office of Occupational Medicine,
· in the sports hall of the Louis II Stadium,
by several mobile teams that will visit schools, crèches and community premises.

Vaccination priorities will be defined according to the opinion of the Health Authorities.

Within the context of the vaccination plan, an individual tracking plan will be set up.

DEPARTMENT OF THE INTERIOR – NATIONAL EDUCATION

The academic year will begin as usual.

The Monegasque Department of National Education has prepared and is preparing itself calmly.

The key-words are:

- Responsibility,
- Prevention,
- Anticipation,
- Pragmatism,
- Information.

The specific plan set up by the Department of National Education, Youth and Sport is as follows:

- heads of public and private school as well as those of the Caroline Library, the National Education Information Centre, the Day Leisure Centre and the Louis II Stadium were briefed and informed at a meeting held on Wednesday 2nd September 2009; the following specific instructions were given to them:

- while the school year will begin as usual, any absence will be carefully monitored in order to be kept informed of any suspicion of flu; an update on the number of absences will be made on a daily basis in each school, in collaboration with the Department of National Education.

- School heads have also been asked, as soon as their first meetings take place at the beginning of the school term, to inform all the teachers and staff on the conduct to adopt and the individual and collective protection measures to prevent the virus spreading:

. teachers will therefore incorporate into their timetable as soon as the first week of term begins information sessions for pupils in order to inform them of the "preventive measures" (cf enclosed);

. they will send any pupil with "suspicious" signs to the school matron and air the premises on a regular basis;

. the cleaning staff will be asked to pay particular attention when cleaning the premises; they must also make sure that there is sufficient soap and paper towels;

. the matron will be responsible for setting up a special area where any individual(s) may be isolated while waiting to go home.

- School heads were also informed of the course of action should cases of suspected flu be detected: “any pupil or staff member presenting symptoms compatible with the flu on their arrival or developing them during the day must be immediately isolated from the rest of the school community in the specially reserved area”. An explanation was also given on the various masks to be worn.

- School heads have been asked to inform the Department of National Education of any suspect cases immediately.

- Should the epidemiological situation worsen (i.e. at least 3 confirmed cases in the same class and in the same week), appropriate measures will be implemented in order to protect the children, their families and all the members of the teaching community and to limit the virus from spreading. It goes without saying that these measures may lead to the closure of classes or schools on the Government's decision once the epidemiological situation has been assessed in close cooperation with the Department of National Education, Youth and Sport and the Department of Health and Social Affairs. In any event, the decision to close a class or school will be adapted to each situation on an individual basis, class by class, school by school (consequently: no systematic measures);

- With this in view, families are asked to make the necessary arrangements in advance for child minding facilities as no collective facilities will be set up in order to prevent contamination.

- Should a class or school be closed, teaching will continue. Contact with pupils and families (and information) will be made via electronic or postal mail, as well as posters in front of schools.

- It has been decided that, if the Governmental authorities decide to proceed with the vaccination, the latter will be given in schools for all the school community (pupils, teachers, staff working in the school) on a voluntary basis. A survey will be conducted among families at the beginning of the school year to find out their intention in principle, which will be confirmed when the time comes (a medical questionnaire will be filled out by parents who wish their children to be vaccinated);

- The Department of National Education, Youth and Sport will issue all the necessary information on the situation to parents via a paper distributed to pupils at the beginning of the school year. This information bulletin, designed for prevention purposes, will also list the specificities of influenza A, its symptoms and the “preventive measures” which will also be repeated in schools on a regular basis.

- Finally, families are asked not to send their children to school if their condition resembles flu and to consult their family doctor.

- The Department of the Interior (Department of National Education, Youth and Sport) and the Department of Social Affairs and Health are in daily contact to monitor changes in the situation and enable the Government to take the appropriate measures, if applicable.
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