February 24, 2020

Pandemic Flu Information

Seasonal Flu vaccinations available for youth 6 months through 18 years of age for FREE at the Union County Nurses’ Office in the Union County Courthouse

Please call (605) 356-2644 to make an appointment on Tuesdays, Wednesdays, or Thursdays

FYI: Clay and Union Counties will be holding a Point of Distribution (POD) only for Union County Employees and their families. It will be held in Vermillion at the Dakota Dome on November 4th from 9 am -1 pm for the 2010-2011 flu season. Call 356-2644 for more information!

For more information on seasonal and H1N1 flu viruses visit the South Dakota Department of Health web site http://doh.sd.gov.

For the latest pandemic flu updates please go to the SD Department of Health`s Web site. Please note the World Health Organization (WHO.org) has down graded the H1N1 virus as the strain has not mutated at this time. The 2010-2011 influenza vaccine does provide a booster to the H1N1 virus, as it is still circulating. The WHO website follows all viruses and is a great source of information. The Center for Disease Control in the United States also provides up-to-date information on influenza and other diseases that threaten individuals in the United States. Their website is: cdc.gov.

Visit or contact the South Dakota Department of Health for current updates:

South Dakota Department of Health (SD DOH) Hotline number for information about H1N1 influenza virus: 1-800 592-1861

SD DOH website: http://www.doh.sd.gov/h1n1


Table of Contents

Union County Pandemic Flu Plan, the Executive Summary, and the Union County Appendix to the Plan

Pandemic Flu: What I need to know

Upcoming Clinics — POD (Point of Distribution) for Union and Clay County

Essential Contacts and Resources

Frequently Asked Questions

Guidelines: What Do I do if I have the Flu?

Personal Plan/Business Plan

Just for Kids

Union County Pandemic Flu Plan, the Executive Summary, and the Union County Appendix to the Plan

(Click the following links to open a Microsoft Word Document file)

Union County Pandemic Flu Plan

Executive Summary

Union County Appendix to the Plan

Pandemic Flu: What I need to know

You may have heard about the threat of a flu virus that circulates the world and which there is no immunity to, this is called a Pandemic Flu. It comes from a virus that usually is in birds and does not transmit easily to humans. The thing about flu viruses is they are constantly changing form. At any time, a bird virus can mutate to be a new human virus. There have been three of these viruses over the last 90 years, coinciding with various wars, WWI, Korean War, and Vietnam. Our society today interacts more than we have ever interacted in the past. It will not take a war to spread the next pandemic flu virus. Someone can be infected and spreading germs for 24 hours before they even know they are ill. One person ill on an airplane can infect hundreds of others, who then travel to their various destinations continuing to spread the new virus. Within 72 hours, a pandemic flu can start. The virus can originate anywhere at any time. Migratory birds can carry the virus worldwide. Sometimes the virus can infect swine and then mutate into a human virus. We don’t know when a pandemic flu will strike, but we know one day it will. Being an informed citizen will help our society lessen the effects of a pandemic flu on our health and economy.

“Are you Pandemic ready?” To avoid chaos and help maintain a sense of order in your life during a pandemic, prepare for a change in routine.

Stay informed: Identify reliable sources that you can count on for information about the disease and its spread.

Work: Find out how your business will operate during this crisis. The flu will typically hit our community with waves of 2-6 weeks of illness and quarantine over a period of two years.

Schools: Expect schools to be closed while the virus is present in our area.

Stay in touch: Designate a friend or relative to be an emergency contact. Always have a meeting location, in case of major disruptions.

Plan for quarantine: Stay flexible. To limit the spread of disease, you may be asked to stay home for an extended period of time. When stocking up on food and water remember to have fever medications and pet food.

Recognize flu symptoms: H1N1 Flu symptoms are the same as for seasonal flu, but may be more severe. Monitor your and your families’ health. Treat symptoms early, with rest and hydration. Anti-viral medication used in the first 48 hours of symptoms will help decrease the severity and longevity of the illness. Do not abuse these medications! Take the entire dose so you do not acquire immunity to it. Be aware of side effects, Tamiflu has been known to cause suicidal tendencies in teenagers.

Upcoming Clinics — POD (Point of Distribution) for Union and Clay County

October 19th from 1-6pm at the Elk Point Jefferson School

October 26th and 27th at the Dakota Valley Elementary School, from 4-7 pm !CANCELLED!

October 29th for all Clay and Union County youth (6 month to 18 years of age), at the Vermillion High School, in Vermillion, from 2-7 pm.

Please call the Union County Nurses` Office/SD Department of Health Office at 605-356-2644 for more information

Essential Contacts and Resources

South Dakota Department of Health (SD DOH) Hotline number for information about H1N1 influenza virus: 1-800 592-1861

SD DOH websites: http://www.doh.sd.gov/h1n1 http://doh.sd.gov/Flu/pandemic/

Union County Emergency Manager’s Office: 1-605-356-2351

Union County Nurses’ Office/ SD DOH and W.I.C. office: 1-605-356-2644


Alcester/Hudson: 934-1898


Beresford: 763-4293


Elk Point/Jefferson: 356-5950


Dakota Valley Schools: 1-605-422-3840


Center for Disease Control’s site for schools:


Center for Disease Control website: www.cdc.gov/h1n1flu

Planning for Businesses: www.takethelead.org

Planning for families: www.breadysd.com

Businesses and families: www.sdces.sdstate.edu/prepare

Iowa Public Health: 1-800-587-3005 website: www.siouxlanddistricthealth.org

Nebraska Public Health: www.hhs.state.ne.us

Minnesota Public Health: www.health.state.mn.us/divs/idepc/diseases/h1n1

Minnehaha County: http://www.siouxfallsflu.org

Siouxland District Health: http://www.siouxlanddistricthealth.org

Union County/SD DOH Nurse: available for presentations – Contact Grace Freeman at [email protected] or 605-356-2644

Why Flu Vaccination Matters: Personal Stories from Families Affected by Flu http://www.youtube.com/user/cdcflu

Frequently Asked Questions

1. Q: What is a Pandemic?

A: A pandemic is distinguished by its scope. It becomes a worldwide epidemic, or pandemic, when a disease spreads easily and rapidly through many countries and regions of the world and affects a large percentage of population wherever it spreads.

2. Q: Why are people concerned?

A: The flu virus can cause serious infections. These serious infections, such as pneumonia, can lead to hospitalization and even death. People that have weakened immune systems, such as infants, the elderly, and people with chronic health conditions are at highest risk of serious infections.

3. Q: How does a pandemic start?

A: The viruses that cause flu are constantly changing. A pandemic starts when a new strain of flu virus emerges that is different from common strains of flu. Because people have no immunity to the new virus, it can spread quickly and infect hundreds of thousands of people. Pandemic flu strains often develop when an animal or bird virus mixes with a human virus to form a new virus.

4. Q: What is the difference between ordinary flu, pandemic flu, and bird flu?

A: a) Seasonal Flu or the flu – is a contagious respiratory illness caused by the influenza virus. This virus can infect your entire respiratory system, including your nose, throat, bronchial tubes, and lungs. It can cause mild to severe illness, and at times can lead to death.

b) Avian or Bird Flu (avian influenza) – is a contagious disease in birds. It can, on occasion, cause disease in other animals, including human beings.

c) Pandemic Influenza or flu pandemics – occur at times when there is a major change in the flu virus. This can lead to a high number of cases of influenza pandemics spread rapidly and can travel around the world, because most humans will have no immunity to the pandemic virus.

d) Swine Flu-is a virus that originates in pigs to which humans have no known antibodies to. It is transferred through close contact with infected animals. A person CANNOT get the swine flu by eating pork! Pigs can also get human influenza through close contact with infected humans. Note: After the 1918 Influenza, thousands of pigs in Iowa died after becoming infected from humans.

5. Q: How do I know if I have the flu?

A: Signs and symptoms of the flu include fever, fatigue, aches, pains, chills and a cough. The symptoms of the flu can last as short as three to four days or as long as seven to ten days. The fatigue that comes with the flu can last for several weeks.

You can be infected with the flu and contagious for 24 to 72 hours before you know you are sick. You can spread the virus wherever you go during this time. It is important that you stay home while you have the flu. You will feel better sooner if you are able to get some rest.

6. Q: What is the contagious period?

A: Flu can become contagious for 24 to 48 hours before any symptoms arise and for five days after the onset of symptoms. This means you could spread the virus without knowing you are infected.

7. Q: Can I prevent the flu?

A: Flu viruses, pandemic or seasonal, are highly contagious as they are spread through the air by droplets and also by contact. There are several ways to limit your exposure to the flu. Proper hand washing technique remains the best deterrent to viruses. Wash hands in warm, soapy water vigorously for at least 15 seconds, then, rinse and dry them thoroughly. If you are sick, STAY HOME. If your immune system is at all compromised, you are much more susceptible to illnesses. Limit contact with those that are ill, using a face mask and other protective equipment if necessary. Self-isolating you and your loved ones in a severe pandemic will limit your exposure to the virus. Have a B-Ready kit together (as suggested by the South Dakota Department of Health on their http://breadysd.com website) and have non-electronic ways to entertain children. Check with your employer about working from home in this type of epidemic situation. A severe pandemic flu is rare event, but preparing for it will help in many other types of disaster situations.

8. Q: What will happen if the pandemic flu hits Union County?

A: Pandemic flu can be highly contagious. Once a pandemic flu virus arrives in our area, it will likely spread quickly from person to person. Many people will become sick and some could die. There will be a lot of pressure on our health care services but providers may be in short supply. Although the federal government stocks medicines, vaccines and medical equipment, they also would be in short supply.

Depending on how widespread the flu pandemic is our daily routines may be severely disrupted. For example, companies may have to close down some of their operations. Cities may decide to provide essential services only. Public health officials may cancel public gatherings, such as concerts and sporting events, where the flu virus can spread easily. Schools may close. Isolation (separating people from others) might be used to protect the public.

It is not possible to predict just how Union county will be affected until we know how strong the virus is.

9. Q: Who is most at risk?

A: We are all at risk of getting a pandemic flu virus. Pandemic flu will spread more quickly than ordinary flu because very few people in our community will be immune. We won’t know for sure who is most at risk until we know more about the virus. Everyone must be careful and aware.

10. Q: How many people will fall ill?

A: Of the 35% estimated to get pandemic flu, roughly half will require a visit with their family doctor or nurse practitioner. The other half will need information and advice to help them take care of themselves at home. Depending on the severity of the symptoms, others may need to be admitted to the hospital.

11. Q: So, I think I have the flu, when do I call my doctor?

A: You need to see a doctor if you have any of the following symptoms:

Difficulty breathing

Persistent fever, coughing or congestion and headaches

If you are not able to keep any fluids down

If you experience pain in swallowing

12. Q: When will there be a treatment for a pandemic flu?

A: There is currently a vaccine developed for the circulating H1N1 virus. It will be available beginning October 8th 2009 beginning with the first priority groups. As more vaccine becomes available the general public will be able to receive the vaccine through SD Department of Health Offices or their private physician. Please check newspapers for current press releases issued by the SD Department of Health or call the Hotline number listed at the top of the this page.

13. Q: When will there be a vaccine for a pandemic flu?

A: There is no existing vaccine for pandemic flu. It will take four to five months after the pandemic starts to develop a vaccine. Once scientists analyze the pandemic flu virus, a vaccine for treating local citizens can be produced. The faster we learn about a specific strain of the flu virus, the faster we can produce a vaccine that can help to prevent the spread of the flu. It’s important to remember that it will take time to do this, but our best defense is being prepared for a pandemic in the first place.

14. Q: Should I buy antiviral medication, like Tamiflu, to have in my home?

A: The Mayo Clinic advises antiviral medication only be used under a medical professional’s supervision. Antiviral medication only works at reducing symptoms of influenza when taken within 48 hours of the presence of symptoms. A full course of medication (approximately 10 days) must be taken or your body can build up a resistance to it and it will not be effective with future viruses. There are side effects with antiviral medication, as with any medication. A noted side effect with some antiviral medication in Japan has been suicidal tendencies in teenagers. Please ask you primary care physician for more information.

15. Q: Will there be a shortage of medication when a pandemic flu hits? Who will get the medication first if there is?

A: The federal government is stockpiling medical supplies and antiviral drugs (such as Tamiflu). However, there is simply not enough Tamiflu available for any country in the world to protect all their citizens.

Public health officials have recommended using available supplies of Tamiflu to first treat persons with severe infections that require hospitalization, and persons that will perform vital functions that the public will need in a pandemic. These groups include healthcare workers and emergency responders.

During a pandemic, Tamiflu is not recommended to prevent influenza infections because using the drug for this purpose requires daily doses for weeks. The limited supply of Tamiflu means that it must be saved to treat those who are severely ill.

Tamiflu is currently manufactured by one company in Switzerland. Government agencies and the manufacturer of Tamiflu are attempting to find ways to is negotiating with generic drug companies to increase production of the medicine.

16. Q: Where will I get medication if it’s available? And will it cost money?

A: There will Points of Distribution, called PODs, set-up in Union County. Union County hopes to develop a POD for the four school districts in our county. Currently, Union County is part of a Regional POD at the Dome on the campus of USD in Vermillion. All medication is part of the Strategic National Stockpile (SNS), and it will be made available FREE of CHARGE.

17. Q: Will I have to wear a mask during a pandemic flu outbreak?

A: Masks, along with disposable gloves, and gowns will be an essential part of you and your families supply kit. These three items are known as Personal Protection Equipment, or PPE . Masks will be recommended for wearing anytime you are out in the public. Influenza is an upper respiratory infection. It is spread through droplets sprayed when someone coughs, sneezes, talks, or spits. Wearing a mask will minimize germs entering sensitive mucous membranes of your nose when you breathe.

18. Q: Will schools and daycares be closed?

A: In Union County’s pandemic Flu Response Plan, closing of schools will be one of the first things done to cut down on transmission of the flu virus among the public. Licensed Day cares will also be asked to close. This will come through orders of the Governor and the State Department of Health. If needed, other places of public gathering, like churches and shopping malls will be closed too.

19. Q: When and where can I get vaccinated against the H1N1 virus?

A: The H1N1 flu vaccine, when it becomes available for the priority groups specific to each individual, will be available at the Union County Nurses Office, private providers, and at the school clinics.

Below are the tiers for the priority groups for the H1N1 vaccine. Vaccination efforts are designed to help reduce the impact and spread of novel H1N1. The key populations include those who are at higher risk of disease or complications, those who are likely to come in contact with novel H1N1, and those who could infect young infants. When vaccine is first available, the committee recommended that programs and providers try to vaccinate: pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency services personnel, persons between the ages of 6 months through 24 years of age, and people from ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.

All of the H1N1 vaccine will be free of charge, though clinics can charge an administration fee. The supply will come to South Dakota in waves each week until the supply runs out or everyone is vaccinated.

20. Q: The last swine flu vaccine (1976) was blamed for causing Guillain-Barré Syndrome in people receiving the vaccine. What is being said about this by CDC and/or is being identified in the trials?

A: As will all seasonal vaccine we expect about 1 case of BGS per 1 million people vaccinated with H1N1.

21. Q: Is the use of alcohol based hand gel safe/recommended for young children due to potential of licking hands/fingers and ingestion? Label indicated to keep out of reach of children and if swallowed seek medical attention.

A: The link to information on this is: www.sdpoison.org/index.asp?pageID=241

22. Q: Who makes the decision to close schools?

A: Decision to close schools is made by each school after consulting with, school district, DOE and DOH. See CDC Guidance for State and Local Public Health Officials and School Administrators for School (K-12) Responses to Influenza during the 2009-2010 School Year http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm. This guidance may change so check back frequently.

Guidelines: What Do I do if I have the Flu?

Signs and Symptoms of Influenza-Like Illnesses


The novel H1N1 flu virus is causing illness in infected persons in the United States and countries around the world. CDC expects that illnesses may continue for some time. As a result, you or people around you may become ill. If so, you need to recognize the symptoms and know what to do.


The symptoms of novel H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with novel H1N1 flu virus also have reported diarrhea and vomiting. The high risk groups for novel H1N1 flu are not known at this time, but it’s possible that they may be the same as for seasonal influenza. People at higher risk of serious complications from seasonal flu include people age 65 years and older, children younger than 5 years old, pregnant women, people of any age with chronic medical conditions (such as asthma, diabetes, or heart disease), and people who are immunosuppressed (e.g., taking immunosuppressive medications, infected with HIV).

Avoid Contact With Others

If you are sick, you may be ill for a week or longer. Unless necessary for medical care, you should stay home and minimize contact with others, including avoiding travel and not going to work or school, for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. If you leave the house to seek medical care, wear a facemask, if available and tolerable, and cover your coughs and sneezes with a tissue. In general, you should avoid contact with other people as much as possible to keep from spreading your illness, especially people at increased risk of severe illness from influenza. With seasonal flu, people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. People infected with the novel H1N1 are likely to have similar patterns of infectiousness as with seasonal flu.

Treatment is Available for Those Who Are Seriously Ill

It is expected that most people will recover without needing medical care.

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed. Be aware that if the flu becomes widespread, less testing will be needed, so your health care provider may decide not to test for the flu virus.

Antiviral drugs can be given to treat those who become severely ill with influenza. These antiviral drugs are prescription medicines (pills, liquid or an inhaler) with activity against influenza viruses, including novel H1N1 flu virus. These medications must be prescribed by a health care professional.

There are two influenza antiviral medications that are recommended for use against novel H1N1 flu. The drugs that are used for treating novel H1N1 flu are called oseltamivir (trade name Tamiflu ®) and zanamivir (Relenza ®). As the novel H1N1 flu spreads, these antiviral drugs may become in short supply. Therefore, the drugs may be given first to those people who have been hospitalized or are at high risk of severe illness from flu. The drugs work best if given within 2 days of becoming ill, but may be given later if illness is severe or for those at a high risk for complications.

Aspirin or aspirin-containing products (e.g., bismuth subsalicylate – Pepto Bismol) should not be administered to any confirmed or suspected ill case of novel influenza A (H1N1) virus infection aged 18 years old and younger due to the risk of Reye’s syndrome. For relief of fever, other anti-pyretic medications are recommended such as acetaminophen or non steroidal anti-inflammatory drugs. For more information about Reye’s syndrome, visit the National Institute of Health website .

Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.

Children 5 years of age and older and teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.

Children younger than 4 years of age should NOT be given over-the-counter cold medications without first speaking with a health care provider.

Emergency Warning Signs

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing

Bluish or gray skin color

Not drinking enough fluids

Severe or persistent vomiting

Not waking up or not interacting

Being so irritable that the child does not want to be held

Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

Difficulty breathing or shortness of breath

Pain or pressure in the chest or abdomen

Sudden dizziness


Severe or persistent vomiting

Flu-like symptoms improve but then return with fever and worse cough

Protect Yourself, Your Family, and Community

Stay informed. Health officials will provide additional information as it becomes available. Visit the CDC H1N1 Flu website.

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 hand cleaners are also effective.

Avoid touching your eyes, nose and mouth. Germs spread this way.

Try to avoid close contact with sick people.

If you are sick with a flu-like illness, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer, except to seek medical care or for other necessities. Keep away from other household members as much as possible. This is to keep you from infecting others and spreading the virus further.

If you are sick and sharing a common space with other household members in your home, wear a facemask, if available and tolerable, to help prevent spreading the virus to others. For more information, see the Interim Recommendations for Facemask and Respirator Use.

Learn more about how to take care of someone who is ill in “Taking Care of a Sick Person in Your Home”

Follow public health advice regarding school closures, avoiding crowds, and other social distancing measures.

If you don’t have one yet, consider developing a family emergency plan as a precaution. This should include storing a supply of extra food, medicines, and other essential supplies. Further information can be found in the “Flu Planning Checklist ”

Related Media

CDC YouTube Video: Symptoms of Swine Flu

Links to non-federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the federal government, and none should be inferred. CDC is not responsible for the content of the individual organization Web pages found at these links.

H1N1 flu: stopping the spread

PIERRE, S.D. – A pandemic is a worldwide outbreak that happens when a new flu virus develops. Because few people are immune to the new virus, it spreads easily and quickly as is happening now with the H1N1 virus. While the federal government and states are preparing for a resurgence of H1N1 with the upcoming flu season, it is important that schools, businesses, local governments, and even families and individuals do the same.

“One of the most important things any of us can do to help prevent the spread of influenza is to practice good personal hygiene,” said Doneen Hollingsworth, Secretary of Health. “Basic personal hygiene can help prevent seasonal influenza, colds and other respiratory diseases and is even more important in slowing pandemic H1N1 influenza.” Basic hygiene includes the following steps:

Wash your hands often with soap and water to protect against germs. Use alcohol-based hand gel if soap and water isn’t available.

If you cough or sneeze, cover your mouth and nose with a tissue.

Don’t touch your eyes, nose or mouth. Germs spread when you touch something that is contaminated and then touch your eyes, nose or mouth.

If you’re sick, stay home and keep your kids home when they’re sick – for at least 24 hours after the fever is gone (100ºF or great).

Practice other good health habits – get plenty of sleep, be physically active, manage stress, drink plenty of fluids, eat nutritious foods, and avoid smoking.

Get your flu shot annually to prevent seasonal flu.

In community and home settings, facemasks and respirators are generally not recommended. See http://www.cdc.gov/h1n1flu/masks.htm for details.

“And remember, just because these public health tools are old, doesn’t mean they’re not highly effective in preventing disease,” said Secretary Hollingsworth. “Our history of having vaccines and drugs to fight infections is really quite short. Much of our progress in reducing deaths in this country since the early 1900’s is due to improving hygiene practices, not to medicines.”

Stay informed about H1N1 pandemic flu at the department’s web site, http://doh.sd.gov. Information is also available from CDC at 1-800-CDC- INFO (1-800-232-4636) or the web at http://www.cdc.gov.

Personal Plan/Business Plan

Preparing for H1N1 (link will open Microsoft Word Document)


Find checklists here: www.takethelead.org

Just for Kids

Scrub Club: www.scrubclub.org

Cover your cough: http://www.cdc.gov/flu/protect/covercough.htm

Comic Book: http://www.kingcounty.gov/healthservices/health/preparedness/pandemicflu/comicbook.aspx