OCA CIRCULAR NO. 85-2009, July 14, 2009

For the information and guidance of al! concerned, hereunder are
the medical advisory for coping with the Influenza A(H1N1) epidemic:

1. Everyone is enjoined to exercise vigilance tor potential
   occurrence of influenza A(H1N1) infection among lower court employees;
2. Influenza A(H1N1) infection is manifested by a combination of any of the following:

• Fever (38° C or higher) ;
• Sore throat
• Nasal congestion/stuffiness
• Muscle and/or joint aches.
• Loss of appetite
• Vomiting
• Diarrhea

3. Person-to-person transmission of influenza A(H1N1) virus infection is through respiratory droplets spread through coughing or sneezing.

Transmission requires proximity between persons because droplets
are not suspended in the air for so long and generally settle within
short distances (less than 6 feet).

Walking by an infected person will not necessary make one a “close contact.”

4. Two measures are very important in preventing spread of infection. These are hand hygiene and respiratory etiquette. Everyone is advised to observe these practices at home and in the workplace.

When to perform hand hygiene:

• Immediately upon arrival at work ;
• Preparing, handling, serving, or eating foods ;
• Direct contact with soiled objects/appendages (i.e. ballpen, cellphones, etc.)
• Before leaving work.

It is also advisable to build one’s immunity by making it a
habit to eat nutritious food, drinking plenty of fluids, and taking
adequate rest.

Flu shot against seasonal flu is advisable. It can enhance the body’s ability to withstand attack of flu.

Susceptibility to complications is increased among those with
concomitant illness(es), such as diabetes, COPD, or if under
chemotherapy or immunosupressants;

5. For everyone’s guidance the following terms are defined :

a. Suspected case – a person who developed “influenza-like illness” ( ILI ) who had close contact with a confirmed case of influenza A{H1N1) infection; or

a person who had traveled to an area where there are confirmed cases of influenza A(H1N1) infection and who developed ‘influenza-like illness’ ( ILI ) within ten (10) days from possible exposure to an Influenza A(H1N1) case.

b. Probable case – a person with ‘influenza-like illness’ ( ILI ) who is positive for influenza A(H1N1), but is unsubtypable by reagents used to detect seasonal influenza virus infection;

c. Confirmed case – a suspect or probable
case with laboratory confirmed influenza A(H1N1) infection by one or
more of the following tests : (1) Real-time RT-PCR (2) Viral culture, or
(3) 4-fold rise in Swine Influenza A(H1N1) virus specific neutralizing
antibodies ;

d. Close contact – a person who has no signs
and symptoms , but (1) had has cared for or lived with a probable or
confirmed case of influenza A(H1N1) while the case was active or (2) has
had direct contact with respiratory droplets, secretions, and body
fluids of probable or confirmed influenza A(H1N1) case.

6. Nasopharyngeal and oropharyngeal swabs for confirmation of influenza A(H1N1) are recommended only for:

a. persons with ‘influenza-like illness’ (ILI) who have history
of travel to a country or locality with laboratory-confirmed case(s) of
influenza A(H1N1) case, and who develop symptoms especially fever (38°C
and above), within ten (10) days from possible exposure; and/or

b. persons with ‘influenza-like illness 1 (ILI) who have close contact with a confirmed case of influenza A(H1N1) and who developed symptoms within ten (10) days from contact with the sick person.

7. In the event that an employee has fallen ill with
   manifestations of influenza-like illness ( ILI ), he/she is advised to
   immediately observe prudent measures such as:

• Stay at home and keep a safe distance from others (social distancing);
• Take adequate rest and plenty of fluids.
• Observe personal hygiene and respiratory etiquette;
• Seek appropriate medical consultation, if symptoms persist;

8. An employee with influenza-like illness especially with history
   of travel and/or possible contact with an influenza A(H1N1) may seek
   medical guidance from the nearest health center

   .

9. intake of anti-viral Tamifiu (OSELTAMMR) should be with medical supervision.
10. Outright closure of offices and workplaces with known case{s) of influenza A(H1N1) is not recommendable.

If a confirmed case is identified in a workplace, the employee
should be advised to go home and practice self-quarantine for at least
seven (7) days up to (10) days. Absence from work during this period is
subject to pertinent rules and regulations by the Civil Service
Commission. The workplace should be sanitized and the other court
personnel should monitor themselves for any of the symptoms mentioned
above.

11. Observance of hand sanitation in offices/areas frequented by
    visitors/public is strongly recommended. Alcohol dispensers should
    ideally be made available in these offices/areas.

12. Running water and soap dispensers should be readily available in lavatories.

For strict compliance.

__14__July 2009

	JOSE P. PEREZ
	Court Administrator