H1N1: Are you Ready?

Daily news stories and consistent announcements regarding proper coughing and sneezing etiquette have heightened awareness of the H1N1 virus. Unlike previous flu seasons, H1N1 appears to be hitting the young and healthy, causing greater unease than in previous years. As the U.S. flu season gets into full gear in the Northern Hemisphere, the Centers for Disease Control (CDC) has acknowledged an increase in influenza cases in the United States, with widespread activity in 46 states.

A simple sneeze can cause internal panic in a bus rider or unleash concern in an otherwise healthy pregnant woman. Public transportation systems are accepting responsibility for keeping rail and bus commuters and workers protected from deadly viruses by increasing cleaning regimens and posting signs to educate riders on ways to avoid and stop the spread of germs.

The United States Department of Homeland Security (DHS) has identified the transportation sector as “one of 13 critical infrastructures that are designated essential in maintaining the nation’s continuity of operations in the event of a flu pandemic.”

Transportation as a Pandemic Vector
“This flu season, scientists expect both 2009 H1N1 flu and seasonal flu to cause more people to get sick than a regular flu season. More hospital stays and deaths may also occur,” says the CDC.

In Transportation and Pandemics, Drs. Jean-Paul Rodrigue, Thomas Luke and Michael Osterholm, see public transportation as a pandemic vector, “particularly for passenger transportation systems.”

Crowded areas and group gatherings can cause equal damage in terms of spreading the virus of a worldwide pandemic, but the infrastructure of public transportation meets much of the criteria when it comes to spreading germs quickly and efficiently.

Public transportation is responsible for millions of passenger trips daily for school children, teachers, healthcare and public safety workers, business professionals and more.

The thought process of an infected rider eager to get home is recognized in transportation and pandemics and showcases how easy an infection can spread caution. “An infected individual beginning to show symptoms is likely to cancel an outbound travel, but will do the utmost, even breaking quarantine (or warnings), to go back home. In some cases, the velocity of global transportation systems is higher than at the regional level, which paradoxically implies that a virus can spread faster at the global level — between major gateways — than at the regional level.” When SARS was at its peak, China was checking the temperatures of passengers at railway stations.

The Canadian Broadcasting Centre (CBC) spent time at the World Health Organization’s (WHO) Centre for Influenza in Melbourne, Australia, in an effort to consider how H1N1 affected the Southern Hemisphere’s flu season. Its director, Dr. Anne Kelso, acknowledged a link between the spreading of the virus and transportation’s role. The city of Melbourne failed to closed schools quickly enough and experienced an explosive outbreak.

“The virus seemed to travel along the public transport lines that kids use to get to school,” said Kelso.

The schoolchildren acted as “super spreaders” and when the schools were finally shut down, the “super spreaders” returned to their communities and the H1N1 diagnoses grew.

“Social distancing” has recently been added to the medical vocabulary as a means to reduce person-to-person transmittance of influenza, H1N1 and other viruses. The CDC estimates that “large-particle droplets” can travel only short distances (3 to 6 feet) via a sneeze or cough. “Social distancing” refers to maintaining a distance of 3 feet or more between people.

Other ways to affect person-to-person contact include asking employees to limit casual interaction; limiting face-to-face contact for deliveries or pick ups; engaging in staggered break times; and avoiding conferences or group gatherings.