CIPD - Swine flu and bird flu

Health, safety and well-being

Revised September 2009

This factsheet gives introductory guidance. It:

explains what swine flu is and its dangers
explains what bird flu is and its dangers
considers how employers should respond to the threat and pandemic outbreak.

What is swine / bird flu?

The flu viruses that cause the forms of swine flu and bird flu that can be transmitted between human are different but both are potentially fatal and both have the potential to spark a flu pandemic.

Swine flu

Swine flu is a respiratory disease which infects pigs, commonly caused by the H1N1 strain of influenza type A. There are regular outbreaks among herds of pigs, where the disease causes high levels of illness but is rarely fatal. The current pandemic has been caused by a version of the H1N1 virus which contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.

According to the World Health Organisation (WHO) people usually get swine influenza from infected pigs. However, in some previous human cases, there has been no contact with pigs or with environments where pigs have been kept. Human to human transmission has occurred in some instances but has in the past been limited to people in close contact with each other or within closed groups of people.

The current pandemic started with an outbreak of swine fever in Mexico in April 2009 which swiftly spread until the WHO declared a global flu pandemic on 11 June.

The Health Protection Agency (HPA) estimated that there were 55,000 new cases of swine flu in the UK during the week ending 12 July 2009, though this had fallen to an estimated 30,000 new cases in the first week of August. The number of new cases continued to decline during August. In the week to 10 September an estimated 3,000 people caught the virus, which was down from 5,000 the week before and 130,000 at the outbreak’s height.

It is expected that there will be a second and more serious wave of swine flu during the autumn or winter so it is important that employers don’t relax their guard after the initial first wave appears to have subsided with less disruption than was originally expected.

What are the symptoms?

Patients with swine flu typically have a fever or a high temperature (over 38°C / 100.4°F) and two or more of the following symptoms:

unusual tiredness
headache
runny nose
sore throat
shortness of breath or cough
loss of appetite
aching muscles
diarrhoea or vomiting.

How worried should people be?

The vast majority of cases of swine flu in the UK have been mild with a small number of more severe cases leading to 75 deaths so far.

The Government estimates that by May 2010 up to 30% of the population could have experienced symptoms of pandemic swine flu.

Is there a cure?

There are no vaccines that contain the current swine influenza virus causing illness in humans. It is not known whether current human seasonal influenza vaccines can provide any protection, but testing has shown that the antiviral drugs oseltamavir (Tamiflu) and zanamivir (Relenza) appear to be effective against the human swine influenza H1N1 strain. Both of these drugs are currently being offered to people with swine flu.

A new swine flu vaccine is expected to arrive in October with priority groups to receive the first doses. The earliest doses of the vaccine are to be given to at-risk groups in the following order:

People aged between six months and 65 years in the clinically at-risk groups for seasonal flu.
Pregnant women, subject to licensing by the European Medicines Agency, which will indicate whether it can be given throughout pregnancy or only at certain stages of pregnancy.
Household contacts of people with compromised immune systems.
People aged 65 and over in the current seasonal flu vaccine clinical at-risk groups.

Is it safe to eat pig meat?

There is no evidence that swine flu can be transmitted through eating meat from infected animals. However, it is essential to cook meat properly. A temperature of 70C (158F) would be sure to kill the virus.

Bird flu

Bird flu or avian influenza is a highly contagious viral disease affecting mostly chickens, ducks, turkeys, quails and other birds. It can be caused by any one of about 20 different strains of the influenza virus.

It is the highly pathogenic H5N1 strain of the disease that is potentially dangerous for humans. The H5N1 strain re-emerged in South East Asia in 2003, before spreading to Europe and Africa. It has led to a number of deaths in various countries across South East Asia including China, Vietnam and Indonesia. Beyond South East Asia, Turkey, Egypt and Nigeria have also suffered human fatalities from the disease.

An outbreak of the H5N1 strain of the disease led to a mass cull of turkeys at a Bernard Matthews farm in Suffolk in February 2007 and a dead swan in Fife was found to have the disease in April 2006. To date no humans have contracted the disease in the UK.

The H5N1 strain can only be caught as a result of direct contact with infected birds. However, there is concern that at some point it could combine with the human flu virus and create a new and much more dangerous flu which can be transmitted between humans raising concerns of a flu pandemic.

How dangerous is it?

Severe infections can lead to pneumonia, acute respiratory distress, viral pneumonia, and other severe and life-threatening complications.

Since late 2003 to date more than 160 people have been killed by the H5N1 strain of disease which is endemic in poultry across parts of Asia. The World Health Organisation (WHO), which is working to limit the spread of the H5N1 strain of the disease in Turkey, has stressed the importance of people understanding the danger of contact between humans (particularly children) and infected poultry. However, it has confirmed that so far there have been no cases of bird flu being transmitted between humans.

According to the US Centres for Disease Control, the three great flu pandemics of the 20th century were the result of genetic material from bird flu viruses becoming incorporated into human flu viruses. This led to a far more dangerous virus which was able to rapidly spread worldwide. An example is the Spanish flu pandemic of 1918-1919 which caused an estimated 40-50 million deaths worldwide.

At present there is no effective vaccine but it is hoped that anti-viral drugs may help fight the symptoms of the disease. A stockpile of 14.6 million courses of anti-viral drugs (Tamiflu) is being built up by the UK government.

The number of reported cases of the H5N1 strain among humans is rising. By the end of 2006, the number of human deaths from the disease had more than doubled compared to the previous year. The mortality rate had also risen to almost 60%.

How can employers respond to the threat of a flu pandemic?

Cabinet Office general guidance relating to the swine flu pandemic advises large businesses to plan for employee absence levels of up to 12%, rising to 25% in the event of school closures. However these figures don’t include normal absence levels for non-pandemic related ill health. Our guide Risk and business continuity management advises employers to plan for pandemic-related staff absences of at least 25% rising to 50% to cope with a worst case scenario, such as the virus changing and becoming more virulent leading to higher than anticipated infection rates.

Go to our Risk and business continuity management guide

Employers should:

Be prepared by developing a contingency plan.
Have strategies to maximise the amount of home-working that is possible by staff.
Investigate ways of increasing use of video links and teleconferencing which can help limit the amount of face-to-face contact.
For service/customer facing organisations, explore the possibility of increasing the amount of online transactions as well as self-service options for customers.
Have in place plans that will enable the organisation to operate on a skeleton staff.
Identify key roles that must be carried out and identify those individuals who have a wide range of skills who can fulfil more than one function.
Ensure that procedures are developed to ensure smooth handovers for employees who are filling in for colleagues in unfamiliar roles. It may be necessary to provide additional training and a risk assessment if individuals are moving to roles where there may be a healthy and safety risk.
Stay up to date on the advice and guidance issued by the Department of Health (DoH), the Health Protection Agency (HPA) and the Health Safety Executive (HSE) – see Useful contacts section below.

What advice should employers give their staff?

Communicate clearly to employees that they need to take precautions to try and minimise the spread of infection and advise them on what to do if they think they may have caught the virus.
It is likely that pandemic flu, like seasonal flu, will spread from person to person by someone:

touching or shaking the hand of an infected person and then touching their mouth, eyes or nose without first washing their hands.
touching surfaces or objects that have become contaminated with the flu virus and then touching their mouth, eyes or nose without first washing their hands
spreading the virus by coughing or sneezing.

The key prevention messages are:

always carry tissues
use clean tissues to cover your mouth and nose when you sneeze
bin the tissues after one use
wash your hands with soap and hot water or a sanitizer gel often.
In short ‘catch it, bin it, kill it’.

Employers should send home anyone who starts to feel or exhibit flu-like symptoms. They should be advised to phone the National Pandemic Flu Service (if they are in England) or their GP (if they are in Scotland, Wales or Northern Ireland) and told not to return to work until the symptoms have cleared and they feel well enough to return.

Employees should be told that if they develop symptoms while not at work, they should:

inform their employer to let them know they are ill and stay at home
check their symptoms using the National Pandemic Flu Service or call their GP (depending on where they live – as above)
not come to work until they are fully recovered.

If swine flu is confirmed, they should ask a healthy friend or relative to visit their GP to pick up a document entitling them to antiviral medication They will then need to pick the medication up at a collection point as advised by the GP (a local pharmacy or similar).

People should call their GP if:

they have a serious underlying (existing) illness
they are pregnant
they have a sick child under one year old
their condition suddenly gets much worse, or
their condition is still getting worse after seven days (five for a child).

Up to date information on the flu pandemic and the different advice for people in England, Wales, Scotland and Northern Ireland, can be found from the various services listed below under Useful contacts.

Useful contacts

The National Pandemic Flu Service can be accessed by phone on 0800 1 513 100 (Minicom: 0800 1 513 200)
Directgov – pandemic flu information
Department of Health: pandemic flu
Health and Safety Executive: pandemic influenza
Health Protection Agency: swine influenza
World Health Organization: swine influenza
World Health Organization: pandemic preparedness

Swine flu and bird flu