national pandemic influenza preparedness plan web viewnon-moh health organizations viz. squ...
TRANSCRIPT
Sultanate of Oman Ministry of Health
Department of Communicable Disease Surveillance and Control Directorate General of Health Affairs Ministry of Health HQ Sultanate of Oman
Address for Department of Communicable Disease Surveillance amp ControlDirectorate General of Health Affairs Ministry of Health HQPO Box 393 MUSCAT 113 Sultanate of OmanFax + (968) 24 601832
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
ContentsContents2Reader Information3Acronyms3
1 Background4
2 National Preparedness Plan21 Introduction 5
22 Phases of Influenza Pandemic5
23 Declaration of Pandemic8
3 The Components of Preparedness31 Enhanced Influenza Surveillance8
32 Case detection9
33 Case investigation amp Management9
34 Laboratory Surveillance10
35 Infection control10
36 Non-Pharmaceutical interventions11
37 Pharmaceutical interventions12
38 Information Dissemination12
List of Annexure (1 to 6)13List of Algorithms (1 to 6)24
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Reader informationPolicy This is the official policy document of the Ministry of Health Sultanate of OmanDocument Purpose For information and actionTitle National Pandemic Influenza(H1N1) Preparedness PlanPublication Date 2005 revisedRevision Date May 2009Author Department of Communicable Disease Surveillance amp Control
Directorate General of Health Affairs Ministry of Health HQOther Contributors Experts from the ldquoNational Task Force on Influenza Pandemic Preparednessrdquo
The plan has been reviewed by the legal Department of Ministry of HealthTarget Audience All Director Generals Directors of the Regions Governorates and Hospitals including
the MOICs of the health centres EHCrsquos polyclinics CDCrsquos and other Ministry of Health institutions Non-MoH health organizations viz SQU Hospitals AF hospital ROP hospital PDO clinics Palace health services ISS health services all private hospitals and clinics and including those who are directly or indirectly involved in the pandemic management
Description This document outlines the framework of how the Ministry of Health Sultanate of Oman would respond to an influenza pandemic It is based on the recommendations of the World Health Organization for the national pandemic preparedness plan
Cross References Key Influenza Documents on the WHO and CDC websitesContact Details HE Dr Ali Jaffer M Suleiman Director General Directorate General of Health
Affairs Ministry of Health PO Box 393 Muscat 113 Sultanate of Omandg-hamohgovomDr Salah Al Awaidy Director Department of Communicable Disease Surveillance and Control Directorate General of Health Affairs Ministry of Health PO Box 393 Muscat 113 Sultanate of Oman awadymohomantelnetom
AcronymsAI Avian InfluenzaDCDSC Department of Communicable Disease Surveillance amp ControlFAO Food and Agriculture Organization (UN)HPAI Highly pathogenic Avian InfluenzaGF TADs Global Framework for the control of Transboundary Animal Diseases (FAOOIE)GLEWS Global Early Warning System (FAOOIEWHO)ILI Influenza Like IllnessMoAampF Ministry of Agriculture and FisheriesMoH Ministry of HealthNADSS National Animal Disease Surveillance SystemOIE Organization Mondiale de la Santeacute Animale (World Organization for Animal Health)PDO Petroleum Development OrganizationPPE Personal Protective EquipmentRADISCON Regional Animal Disease Surveillance and Control NetworkROP Royal Oman PoliceSNS Strategic National StockpileSQUH Sultan Qaboos University hospitalWHO (OMS) World Health Organization (Organization Mondiale de la Santeacute)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 3
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1 BackgroundInfluenza is one of the most common causes of febrile and respiratory illness The risk of severe illness andor death is higher among adults gt65 years old among persons of any age with underlying chronic diseases including lung or heart disease metabolic diseases and immune-suppression and among children lt2 years old Vaccination represents the major strategy to reduce the impact of influenza and is recommended for high-risk persons
Influenza viruses circulating in the population are continuously evolving (antigenic drift and antigenic shift) which requires that vaccines be redesigned and produced annually to provide the best match to the influenza strains that are circulating
Pandemics occur when novel influenza A viruses most probably derived from animal or avian influenza viruses develop ability to spread effectively among people By definition pandemics involve the circulation of strains for which almost all of the worldrsquos population lack pre-existing immunity
Influenza pandemics resemble major natural disasters It is impossible to anticipate when the next pandemic might occur or how severe its consequences might be On an average three pandemics per century have been documented since the 16th century occurring at intervals of 10ndash50 years The first pandemic of influenza of the 20th century the ldquoSpanish flurdquo began in 1918 and by the time it ended the following year by conservative estimates it had resulted in more than 20 million deaths worldwide Later pandemics in 1957 and 1968 caused far fewer deaths but still posed a substantial burden on the health care system and resulted in substantial economic costs and social disruption
Following the events which happened in Mexico and USA where in many individuals are affected by Novel H1N1 influenza virus the concerns for pandemic influenza is growing as more information are made available This novel influenza virus H1N1 is a combination (re-assorted) of Human Avian (bird) and swine influenza viruses WHO has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established As of writing this plan 11 countries have officially reported 257 cases of influenza A (H1N1) infection The United States Government has reported 109 laboratory confirmed human cases including one death Mexico has reported 97 confirmed human cases of infection including seven deaths The following countries have reported laboratory confirmed cases with no deaths - Austria (1) Canada (19) Germany (3) Israel (2) Netherlands (1) New Zealand (3) Spain (13) Switzerland (1) and the United Kingdom (8)
2 The National Preparedness Plan
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 4
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
21 IntroductionPlanning and preparedness are essential to optimally achieve the goals and objectives of a pandemic response The Main Aim of this document is to provide a national framework for an integrated countrywide response to an influenza pandemic H1N1 with clear operational plans for the response at all levels Main document National Pandemic Influenza Preparedness Plan is already prepared by Ministry of Health which has provided guidance for the preparedness so far remains valid Some modifications based on current available information about novel H1N1 virus are incorporated in this supplement plan
The objectives of this plan for an influenza pandemic H1N1 are to
Ensure optimal coordination decision-making and communication between national state and local levels
Detect influenza strains through clinical and virology surveillance of human cases Deliver antiviral drug therapy and prophylaxis and avoid inappropriate use of these agents which
may result in antiviral resistance Provide optimal medical care and maintain essential community services Communicate effectively with the public health care providers community leaders and the media
The national authorities will provide overall direction guidance and coordination while provincial (RegionsGovernorates) health affairs departments and the private medical clinics will form the front line with respect to management of ill persons and administration of interventions such as vaccine and antiviral medications and possibly community-level interventions such as isolation and quarantine
Information and guidance provided in this plan will serve as a platform for the development of plans at the regional level
22 Phases of an Influenza Pandemic In the 2009 revision of the phase descriptions WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans The grouping and description of pandemic phases have been revised to make them easier to understand more precise and based upon observable phenomena Phases 1ndash3 correlate with preparedness including capacity development and response planning activities while Phases 4ndash6 clearly signal the need for response and mitigation efforts Furthermore periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities
The current WHO phase of pandemic alert is 5
In nature influenza viruses circulate continuously among animals especially birds Even though such viruses might theoretically develop into pandemic viruses in Phase 1 no viruses circulating among animals have been reported to cause infections in humans
In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans and is therefore considered a potential pandemic threat
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 5
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In Phase 3 an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks Limited human-to-human transmission may occur under some circumstances for example when there is close contact between an infected person and an unprotected caregiver However limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemicPhase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause ldquocommunity-level outbreaksrdquo The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region While most countries will not be affected at this stage the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization communication and implementation of the planned mitigation measures is short Phase 6 the pandemic phase is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5 Designation of this phase will indicate that a global pandemic is under wayDuring the post-peak period pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels The post-peak period signifies that pandemic activity appears to be decreasing however it is uncertain if additional waves will occur and countries will need to be prepared for a second wave Previous pandemics have been characterized by waves of activity spread over months Once the level of disease activity drops a critical communications task will be to balance this information with the possibility of another wave Pandemic waves can be separated by months and an immediate ldquoat-easerdquo signal may be premature
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In the post-pandemic period influenza disease activity will have returned to levels normally seen for seasonal influenza It is expected that the pandemic virus will behave as a seasonal influenza A virus At this stage it is important to maintain surveillance and update pandemic preparedness and response plans accordingly An intensive phase of recovery and evaluation may be required
Phase changes
It is important to stress that the phases were not developed as an epidemiological
prediction but to provide guidance to countries on the implementation of activities While
later phases may loosely correlate with increasing levels of pandemic risk this risk in the
first three phases is simply unknown It is therefore possible to have situations which
pose an increased pandemic risk but do not result in a pandemic
Alternatively although global influenza surveillance and monitoring systems are much
improved it is also possible that the first outbreaks of a pandemic will not be detected or
recognized For example if symptoms are mild and not very specific an influenza virus
with pandemic potential may attain relatively widespread circulation before being
detected thus the global phase may jump from Phase 3 to Phases 5 or 6 If the rapid
containment operations are successful Phase 4 may revert back to Phase 3
When making a change to the global phase WHO will carefully consider whether the
criteria for a new phase have been met This decision will be based upon all credible
information from global surveillance and from other organizations
23 Declaration of Pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 7
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
WHO Director General has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established
3 The Components of Preparedness
One of the lessons learned from the SARS outbreaks of 2003 was the importance in the event of an incident on the scale of an influenza pandemic of strong international and national leadership and coordination and a clear national lsquocommand and controlrsquo structure
The appropriate people at all levels must have authority to make key decisions and act on them and there must be a clear chain of accountability The response to an influenza pandemic H1N1 should be on a nationwide basis and therefore clear demarcation of roles is required between all the stake holders
31 Enhanced Influenza SurveillanceSpecific objectives of this surveillance activity are to guide global prevention and controlactivities through the following actions1 Detect and confirm cases of H1N1 influenza A virus infection2 Establish the extent of international spread of H1N1 influenza A virus infection
3 Assist in the early severity assessment of the diseaseTimely surveillance information will be the key to early identification of an influenza pandemic and to the development of evidence based interventions at all stages Oman contributes to internationally co-ordinated laboratory based influenza virus surveillance which is co-ordinated by the World Health Organization (EMRO)
Monitoring influenza disease activity is important to facilitate resource planning communication intervention and investigation A high level of vigilance for clusters of cases of respiratory disease provides an early warning mechanism
Influenza is a common condition and has symptoms similar to those of many other viral respiratory infections Early detection of a new virus therefore requires clinicians as well as laboratory staff to be alert to the possibly unusual for example respiratory illness in a patient with a link to areas where a new virus has been already identified or to a person with a travel history to affected areascountries
In order to detect cases the existent surveillance mechanisms should be further strengthened at all levels The sentinel SARI surveillance at Sohar Ibra and Salalah Hospitals will continue so also the laboratory based influenza surveillance at Barka PC Amerat HC Al Khod HC and Salalah PC
The existing surveillance (ILI under the Group C) should be further strengthened as follows
Influenza like illnesses (ILI) and LRTI including pneumonia for all age groups should be monitored from all health institutions on a weekly basis ICD-10 codes for these conditions are J01 J02-03 J04 J10-11 J12-18 J20-21 and J40-42 These conditions should be reported for males and females for inpatient and outpatient by age groups (MoH Monthly Statistical Booklets ndash for Health Institution and In-patient)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 8
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
These weekly surveillance reports should be sent by all health institutes including private to the office of the Director General or Director of Health Services of the Governorates and Regions
The compiled weekly reports of the Governorates and Regions should be sent to the Department of Communicable Disease Surveillance amp Control on every Monday (international week) by e-mailfax
32 Case detectionCase definitions for infections with H1N1 influenza A Virus
Suspect Case (Refer Algorithm 1)
Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Probable case
Suspect case with an influenza test that is positive for influenza A but is unsubtypable by reagents used to detect seasonal influenza virus infection OR
Suspect case who died of an unexplained acute respiratory illness and who is considered to be epidemiologically linked to another probable or confirmed case
Confirmed case
Suspect or Probable case with laboratory confirmed H1N1 influenza A virus infection by one or more of the following tests
bull Real-time RT-PCR
bull Viral culture
bull Four-fold rise in H1N1 influenza A virus specific neutralizing antibodies
33 Case Investigation amp Management Health Institute anywhere in Oman that identifies unusual clusters of acute respiratory illness should immediately notify the Regional DGHS Regional Epidemiologist should investigate using the WHO case summary form (Annexure 4 ) if the epidemiological compatibility is decided under the guidance of Department of Communicable Diseases Surveillance and Control
Definition of clusterA cluster is defined as two or more persons presenting with manifestations of unexplainedAcute respiratory illness with fever gt38degC or who died of an unexplained respiratory illness and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 9
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
ContentsContents2Reader Information3Acronyms3
1 Background4
2 National Preparedness Plan21 Introduction 5
22 Phases of Influenza Pandemic5
23 Declaration of Pandemic8
3 The Components of Preparedness31 Enhanced Influenza Surveillance8
32 Case detection9
33 Case investigation amp Management9
34 Laboratory Surveillance10
35 Infection control10
36 Non-Pharmaceutical interventions11
37 Pharmaceutical interventions12
38 Information Dissemination12
List of Annexure (1 to 6)13List of Algorithms (1 to 6)24
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Reader informationPolicy This is the official policy document of the Ministry of Health Sultanate of OmanDocument Purpose For information and actionTitle National Pandemic Influenza(H1N1) Preparedness PlanPublication Date 2005 revisedRevision Date May 2009Author Department of Communicable Disease Surveillance amp Control
Directorate General of Health Affairs Ministry of Health HQOther Contributors Experts from the ldquoNational Task Force on Influenza Pandemic Preparednessrdquo
The plan has been reviewed by the legal Department of Ministry of HealthTarget Audience All Director Generals Directors of the Regions Governorates and Hospitals including
the MOICs of the health centres EHCrsquos polyclinics CDCrsquos and other Ministry of Health institutions Non-MoH health organizations viz SQU Hospitals AF hospital ROP hospital PDO clinics Palace health services ISS health services all private hospitals and clinics and including those who are directly or indirectly involved in the pandemic management
Description This document outlines the framework of how the Ministry of Health Sultanate of Oman would respond to an influenza pandemic It is based on the recommendations of the World Health Organization for the national pandemic preparedness plan
Cross References Key Influenza Documents on the WHO and CDC websitesContact Details HE Dr Ali Jaffer M Suleiman Director General Directorate General of Health
Affairs Ministry of Health PO Box 393 Muscat 113 Sultanate of Omandg-hamohgovomDr Salah Al Awaidy Director Department of Communicable Disease Surveillance and Control Directorate General of Health Affairs Ministry of Health PO Box 393 Muscat 113 Sultanate of Oman awadymohomantelnetom
AcronymsAI Avian InfluenzaDCDSC Department of Communicable Disease Surveillance amp ControlFAO Food and Agriculture Organization (UN)HPAI Highly pathogenic Avian InfluenzaGF TADs Global Framework for the control of Transboundary Animal Diseases (FAOOIE)GLEWS Global Early Warning System (FAOOIEWHO)ILI Influenza Like IllnessMoAampF Ministry of Agriculture and FisheriesMoH Ministry of HealthNADSS National Animal Disease Surveillance SystemOIE Organization Mondiale de la Santeacute Animale (World Organization for Animal Health)PDO Petroleum Development OrganizationPPE Personal Protective EquipmentRADISCON Regional Animal Disease Surveillance and Control NetworkROP Royal Oman PoliceSNS Strategic National StockpileSQUH Sultan Qaboos University hospitalWHO (OMS) World Health Organization (Organization Mondiale de la Santeacute)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 3
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1 BackgroundInfluenza is one of the most common causes of febrile and respiratory illness The risk of severe illness andor death is higher among adults gt65 years old among persons of any age with underlying chronic diseases including lung or heart disease metabolic diseases and immune-suppression and among children lt2 years old Vaccination represents the major strategy to reduce the impact of influenza and is recommended for high-risk persons
Influenza viruses circulating in the population are continuously evolving (antigenic drift and antigenic shift) which requires that vaccines be redesigned and produced annually to provide the best match to the influenza strains that are circulating
Pandemics occur when novel influenza A viruses most probably derived from animal or avian influenza viruses develop ability to spread effectively among people By definition pandemics involve the circulation of strains for which almost all of the worldrsquos population lack pre-existing immunity
Influenza pandemics resemble major natural disasters It is impossible to anticipate when the next pandemic might occur or how severe its consequences might be On an average three pandemics per century have been documented since the 16th century occurring at intervals of 10ndash50 years The first pandemic of influenza of the 20th century the ldquoSpanish flurdquo began in 1918 and by the time it ended the following year by conservative estimates it had resulted in more than 20 million deaths worldwide Later pandemics in 1957 and 1968 caused far fewer deaths but still posed a substantial burden on the health care system and resulted in substantial economic costs and social disruption
Following the events which happened in Mexico and USA where in many individuals are affected by Novel H1N1 influenza virus the concerns for pandemic influenza is growing as more information are made available This novel influenza virus H1N1 is a combination (re-assorted) of Human Avian (bird) and swine influenza viruses WHO has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established As of writing this plan 11 countries have officially reported 257 cases of influenza A (H1N1) infection The United States Government has reported 109 laboratory confirmed human cases including one death Mexico has reported 97 confirmed human cases of infection including seven deaths The following countries have reported laboratory confirmed cases with no deaths - Austria (1) Canada (19) Germany (3) Israel (2) Netherlands (1) New Zealand (3) Spain (13) Switzerland (1) and the United Kingdom (8)
2 The National Preparedness Plan
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 4
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
21 IntroductionPlanning and preparedness are essential to optimally achieve the goals and objectives of a pandemic response The Main Aim of this document is to provide a national framework for an integrated countrywide response to an influenza pandemic H1N1 with clear operational plans for the response at all levels Main document National Pandemic Influenza Preparedness Plan is already prepared by Ministry of Health which has provided guidance for the preparedness so far remains valid Some modifications based on current available information about novel H1N1 virus are incorporated in this supplement plan
The objectives of this plan for an influenza pandemic H1N1 are to
Ensure optimal coordination decision-making and communication between national state and local levels
Detect influenza strains through clinical and virology surveillance of human cases Deliver antiviral drug therapy and prophylaxis and avoid inappropriate use of these agents which
may result in antiviral resistance Provide optimal medical care and maintain essential community services Communicate effectively with the public health care providers community leaders and the media
The national authorities will provide overall direction guidance and coordination while provincial (RegionsGovernorates) health affairs departments and the private medical clinics will form the front line with respect to management of ill persons and administration of interventions such as vaccine and antiviral medications and possibly community-level interventions such as isolation and quarantine
Information and guidance provided in this plan will serve as a platform for the development of plans at the regional level
22 Phases of an Influenza Pandemic In the 2009 revision of the phase descriptions WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans The grouping and description of pandemic phases have been revised to make them easier to understand more precise and based upon observable phenomena Phases 1ndash3 correlate with preparedness including capacity development and response planning activities while Phases 4ndash6 clearly signal the need for response and mitigation efforts Furthermore periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities
The current WHO phase of pandemic alert is 5
In nature influenza viruses circulate continuously among animals especially birds Even though such viruses might theoretically develop into pandemic viruses in Phase 1 no viruses circulating among animals have been reported to cause infections in humans
In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans and is therefore considered a potential pandemic threat
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 5
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In Phase 3 an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks Limited human-to-human transmission may occur under some circumstances for example when there is close contact between an infected person and an unprotected caregiver However limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemicPhase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause ldquocommunity-level outbreaksrdquo The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region While most countries will not be affected at this stage the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization communication and implementation of the planned mitigation measures is short Phase 6 the pandemic phase is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5 Designation of this phase will indicate that a global pandemic is under wayDuring the post-peak period pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels The post-peak period signifies that pandemic activity appears to be decreasing however it is uncertain if additional waves will occur and countries will need to be prepared for a second wave Previous pandemics have been characterized by waves of activity spread over months Once the level of disease activity drops a critical communications task will be to balance this information with the possibility of another wave Pandemic waves can be separated by months and an immediate ldquoat-easerdquo signal may be premature
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In the post-pandemic period influenza disease activity will have returned to levels normally seen for seasonal influenza It is expected that the pandemic virus will behave as a seasonal influenza A virus At this stage it is important to maintain surveillance and update pandemic preparedness and response plans accordingly An intensive phase of recovery and evaluation may be required
Phase changes
It is important to stress that the phases were not developed as an epidemiological
prediction but to provide guidance to countries on the implementation of activities While
later phases may loosely correlate with increasing levels of pandemic risk this risk in the
first three phases is simply unknown It is therefore possible to have situations which
pose an increased pandemic risk but do not result in a pandemic
Alternatively although global influenza surveillance and monitoring systems are much
improved it is also possible that the first outbreaks of a pandemic will not be detected or
recognized For example if symptoms are mild and not very specific an influenza virus
with pandemic potential may attain relatively widespread circulation before being
detected thus the global phase may jump from Phase 3 to Phases 5 or 6 If the rapid
containment operations are successful Phase 4 may revert back to Phase 3
When making a change to the global phase WHO will carefully consider whether the
criteria for a new phase have been met This decision will be based upon all credible
information from global surveillance and from other organizations
23 Declaration of Pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 7
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
WHO Director General has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established
3 The Components of Preparedness
One of the lessons learned from the SARS outbreaks of 2003 was the importance in the event of an incident on the scale of an influenza pandemic of strong international and national leadership and coordination and a clear national lsquocommand and controlrsquo structure
The appropriate people at all levels must have authority to make key decisions and act on them and there must be a clear chain of accountability The response to an influenza pandemic H1N1 should be on a nationwide basis and therefore clear demarcation of roles is required between all the stake holders
31 Enhanced Influenza SurveillanceSpecific objectives of this surveillance activity are to guide global prevention and controlactivities through the following actions1 Detect and confirm cases of H1N1 influenza A virus infection2 Establish the extent of international spread of H1N1 influenza A virus infection
3 Assist in the early severity assessment of the diseaseTimely surveillance information will be the key to early identification of an influenza pandemic and to the development of evidence based interventions at all stages Oman contributes to internationally co-ordinated laboratory based influenza virus surveillance which is co-ordinated by the World Health Organization (EMRO)
Monitoring influenza disease activity is important to facilitate resource planning communication intervention and investigation A high level of vigilance for clusters of cases of respiratory disease provides an early warning mechanism
Influenza is a common condition and has symptoms similar to those of many other viral respiratory infections Early detection of a new virus therefore requires clinicians as well as laboratory staff to be alert to the possibly unusual for example respiratory illness in a patient with a link to areas where a new virus has been already identified or to a person with a travel history to affected areascountries
In order to detect cases the existent surveillance mechanisms should be further strengthened at all levels The sentinel SARI surveillance at Sohar Ibra and Salalah Hospitals will continue so also the laboratory based influenza surveillance at Barka PC Amerat HC Al Khod HC and Salalah PC
The existing surveillance (ILI under the Group C) should be further strengthened as follows
Influenza like illnesses (ILI) and LRTI including pneumonia for all age groups should be monitored from all health institutions on a weekly basis ICD-10 codes for these conditions are J01 J02-03 J04 J10-11 J12-18 J20-21 and J40-42 These conditions should be reported for males and females for inpatient and outpatient by age groups (MoH Monthly Statistical Booklets ndash for Health Institution and In-patient)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 8
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
These weekly surveillance reports should be sent by all health institutes including private to the office of the Director General or Director of Health Services of the Governorates and Regions
The compiled weekly reports of the Governorates and Regions should be sent to the Department of Communicable Disease Surveillance amp Control on every Monday (international week) by e-mailfax
32 Case detectionCase definitions for infections with H1N1 influenza A Virus
Suspect Case (Refer Algorithm 1)
Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Probable case
Suspect case with an influenza test that is positive for influenza A but is unsubtypable by reagents used to detect seasonal influenza virus infection OR
Suspect case who died of an unexplained acute respiratory illness and who is considered to be epidemiologically linked to another probable or confirmed case
Confirmed case
Suspect or Probable case with laboratory confirmed H1N1 influenza A virus infection by one or more of the following tests
bull Real-time RT-PCR
bull Viral culture
bull Four-fold rise in H1N1 influenza A virus specific neutralizing antibodies
33 Case Investigation amp Management Health Institute anywhere in Oman that identifies unusual clusters of acute respiratory illness should immediately notify the Regional DGHS Regional Epidemiologist should investigate using the WHO case summary form (Annexure 4 ) if the epidemiological compatibility is decided under the guidance of Department of Communicable Diseases Surveillance and Control
Definition of clusterA cluster is defined as two or more persons presenting with manifestations of unexplainedAcute respiratory illness with fever gt38degC or who died of an unexplained respiratory illness and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 9
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Reader informationPolicy This is the official policy document of the Ministry of Health Sultanate of OmanDocument Purpose For information and actionTitle National Pandemic Influenza(H1N1) Preparedness PlanPublication Date 2005 revisedRevision Date May 2009Author Department of Communicable Disease Surveillance amp Control
Directorate General of Health Affairs Ministry of Health HQOther Contributors Experts from the ldquoNational Task Force on Influenza Pandemic Preparednessrdquo
The plan has been reviewed by the legal Department of Ministry of HealthTarget Audience All Director Generals Directors of the Regions Governorates and Hospitals including
the MOICs of the health centres EHCrsquos polyclinics CDCrsquos and other Ministry of Health institutions Non-MoH health organizations viz SQU Hospitals AF hospital ROP hospital PDO clinics Palace health services ISS health services all private hospitals and clinics and including those who are directly or indirectly involved in the pandemic management
Description This document outlines the framework of how the Ministry of Health Sultanate of Oman would respond to an influenza pandemic It is based on the recommendations of the World Health Organization for the national pandemic preparedness plan
Cross References Key Influenza Documents on the WHO and CDC websitesContact Details HE Dr Ali Jaffer M Suleiman Director General Directorate General of Health
Affairs Ministry of Health PO Box 393 Muscat 113 Sultanate of Omandg-hamohgovomDr Salah Al Awaidy Director Department of Communicable Disease Surveillance and Control Directorate General of Health Affairs Ministry of Health PO Box 393 Muscat 113 Sultanate of Oman awadymohomantelnetom
AcronymsAI Avian InfluenzaDCDSC Department of Communicable Disease Surveillance amp ControlFAO Food and Agriculture Organization (UN)HPAI Highly pathogenic Avian InfluenzaGF TADs Global Framework for the control of Transboundary Animal Diseases (FAOOIE)GLEWS Global Early Warning System (FAOOIEWHO)ILI Influenza Like IllnessMoAampF Ministry of Agriculture and FisheriesMoH Ministry of HealthNADSS National Animal Disease Surveillance SystemOIE Organization Mondiale de la Santeacute Animale (World Organization for Animal Health)PDO Petroleum Development OrganizationPPE Personal Protective EquipmentRADISCON Regional Animal Disease Surveillance and Control NetworkROP Royal Oman PoliceSNS Strategic National StockpileSQUH Sultan Qaboos University hospitalWHO (OMS) World Health Organization (Organization Mondiale de la Santeacute)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 3
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1 BackgroundInfluenza is one of the most common causes of febrile and respiratory illness The risk of severe illness andor death is higher among adults gt65 years old among persons of any age with underlying chronic diseases including lung or heart disease metabolic diseases and immune-suppression and among children lt2 years old Vaccination represents the major strategy to reduce the impact of influenza and is recommended for high-risk persons
Influenza viruses circulating in the population are continuously evolving (antigenic drift and antigenic shift) which requires that vaccines be redesigned and produced annually to provide the best match to the influenza strains that are circulating
Pandemics occur when novel influenza A viruses most probably derived from animal or avian influenza viruses develop ability to spread effectively among people By definition pandemics involve the circulation of strains for which almost all of the worldrsquos population lack pre-existing immunity
Influenza pandemics resemble major natural disasters It is impossible to anticipate when the next pandemic might occur or how severe its consequences might be On an average three pandemics per century have been documented since the 16th century occurring at intervals of 10ndash50 years The first pandemic of influenza of the 20th century the ldquoSpanish flurdquo began in 1918 and by the time it ended the following year by conservative estimates it had resulted in more than 20 million deaths worldwide Later pandemics in 1957 and 1968 caused far fewer deaths but still posed a substantial burden on the health care system and resulted in substantial economic costs and social disruption
Following the events which happened in Mexico and USA where in many individuals are affected by Novel H1N1 influenza virus the concerns for pandemic influenza is growing as more information are made available This novel influenza virus H1N1 is a combination (re-assorted) of Human Avian (bird) and swine influenza viruses WHO has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established As of writing this plan 11 countries have officially reported 257 cases of influenza A (H1N1) infection The United States Government has reported 109 laboratory confirmed human cases including one death Mexico has reported 97 confirmed human cases of infection including seven deaths The following countries have reported laboratory confirmed cases with no deaths - Austria (1) Canada (19) Germany (3) Israel (2) Netherlands (1) New Zealand (3) Spain (13) Switzerland (1) and the United Kingdom (8)
2 The National Preparedness Plan
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 4
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
21 IntroductionPlanning and preparedness are essential to optimally achieve the goals and objectives of a pandemic response The Main Aim of this document is to provide a national framework for an integrated countrywide response to an influenza pandemic H1N1 with clear operational plans for the response at all levels Main document National Pandemic Influenza Preparedness Plan is already prepared by Ministry of Health which has provided guidance for the preparedness so far remains valid Some modifications based on current available information about novel H1N1 virus are incorporated in this supplement plan
The objectives of this plan for an influenza pandemic H1N1 are to
Ensure optimal coordination decision-making and communication between national state and local levels
Detect influenza strains through clinical and virology surveillance of human cases Deliver antiviral drug therapy and prophylaxis and avoid inappropriate use of these agents which
may result in antiviral resistance Provide optimal medical care and maintain essential community services Communicate effectively with the public health care providers community leaders and the media
The national authorities will provide overall direction guidance and coordination while provincial (RegionsGovernorates) health affairs departments and the private medical clinics will form the front line with respect to management of ill persons and administration of interventions such as vaccine and antiviral medications and possibly community-level interventions such as isolation and quarantine
Information and guidance provided in this plan will serve as a platform for the development of plans at the regional level
22 Phases of an Influenza Pandemic In the 2009 revision of the phase descriptions WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans The grouping and description of pandemic phases have been revised to make them easier to understand more precise and based upon observable phenomena Phases 1ndash3 correlate with preparedness including capacity development and response planning activities while Phases 4ndash6 clearly signal the need for response and mitigation efforts Furthermore periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities
The current WHO phase of pandemic alert is 5
In nature influenza viruses circulate continuously among animals especially birds Even though such viruses might theoretically develop into pandemic viruses in Phase 1 no viruses circulating among animals have been reported to cause infections in humans
In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans and is therefore considered a potential pandemic threat
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 5
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In Phase 3 an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks Limited human-to-human transmission may occur under some circumstances for example when there is close contact between an infected person and an unprotected caregiver However limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemicPhase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause ldquocommunity-level outbreaksrdquo The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region While most countries will not be affected at this stage the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization communication and implementation of the planned mitigation measures is short Phase 6 the pandemic phase is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5 Designation of this phase will indicate that a global pandemic is under wayDuring the post-peak period pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels The post-peak period signifies that pandemic activity appears to be decreasing however it is uncertain if additional waves will occur and countries will need to be prepared for a second wave Previous pandemics have been characterized by waves of activity spread over months Once the level of disease activity drops a critical communications task will be to balance this information with the possibility of another wave Pandemic waves can be separated by months and an immediate ldquoat-easerdquo signal may be premature
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In the post-pandemic period influenza disease activity will have returned to levels normally seen for seasonal influenza It is expected that the pandemic virus will behave as a seasonal influenza A virus At this stage it is important to maintain surveillance and update pandemic preparedness and response plans accordingly An intensive phase of recovery and evaluation may be required
Phase changes
It is important to stress that the phases were not developed as an epidemiological
prediction but to provide guidance to countries on the implementation of activities While
later phases may loosely correlate with increasing levels of pandemic risk this risk in the
first three phases is simply unknown It is therefore possible to have situations which
pose an increased pandemic risk but do not result in a pandemic
Alternatively although global influenza surveillance and monitoring systems are much
improved it is also possible that the first outbreaks of a pandemic will not be detected or
recognized For example if symptoms are mild and not very specific an influenza virus
with pandemic potential may attain relatively widespread circulation before being
detected thus the global phase may jump from Phase 3 to Phases 5 or 6 If the rapid
containment operations are successful Phase 4 may revert back to Phase 3
When making a change to the global phase WHO will carefully consider whether the
criteria for a new phase have been met This decision will be based upon all credible
information from global surveillance and from other organizations
23 Declaration of Pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 7
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
WHO Director General has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established
3 The Components of Preparedness
One of the lessons learned from the SARS outbreaks of 2003 was the importance in the event of an incident on the scale of an influenza pandemic of strong international and national leadership and coordination and a clear national lsquocommand and controlrsquo structure
The appropriate people at all levels must have authority to make key decisions and act on them and there must be a clear chain of accountability The response to an influenza pandemic H1N1 should be on a nationwide basis and therefore clear demarcation of roles is required between all the stake holders
31 Enhanced Influenza SurveillanceSpecific objectives of this surveillance activity are to guide global prevention and controlactivities through the following actions1 Detect and confirm cases of H1N1 influenza A virus infection2 Establish the extent of international spread of H1N1 influenza A virus infection
3 Assist in the early severity assessment of the diseaseTimely surveillance information will be the key to early identification of an influenza pandemic and to the development of evidence based interventions at all stages Oman contributes to internationally co-ordinated laboratory based influenza virus surveillance which is co-ordinated by the World Health Organization (EMRO)
Monitoring influenza disease activity is important to facilitate resource planning communication intervention and investigation A high level of vigilance for clusters of cases of respiratory disease provides an early warning mechanism
Influenza is a common condition and has symptoms similar to those of many other viral respiratory infections Early detection of a new virus therefore requires clinicians as well as laboratory staff to be alert to the possibly unusual for example respiratory illness in a patient with a link to areas where a new virus has been already identified or to a person with a travel history to affected areascountries
In order to detect cases the existent surveillance mechanisms should be further strengthened at all levels The sentinel SARI surveillance at Sohar Ibra and Salalah Hospitals will continue so also the laboratory based influenza surveillance at Barka PC Amerat HC Al Khod HC and Salalah PC
The existing surveillance (ILI under the Group C) should be further strengthened as follows
Influenza like illnesses (ILI) and LRTI including pneumonia for all age groups should be monitored from all health institutions on a weekly basis ICD-10 codes for these conditions are J01 J02-03 J04 J10-11 J12-18 J20-21 and J40-42 These conditions should be reported for males and females for inpatient and outpatient by age groups (MoH Monthly Statistical Booklets ndash for Health Institution and In-patient)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 8
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
These weekly surveillance reports should be sent by all health institutes including private to the office of the Director General or Director of Health Services of the Governorates and Regions
The compiled weekly reports of the Governorates and Regions should be sent to the Department of Communicable Disease Surveillance amp Control on every Monday (international week) by e-mailfax
32 Case detectionCase definitions for infections with H1N1 influenza A Virus
Suspect Case (Refer Algorithm 1)
Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Probable case
Suspect case with an influenza test that is positive for influenza A but is unsubtypable by reagents used to detect seasonal influenza virus infection OR
Suspect case who died of an unexplained acute respiratory illness and who is considered to be epidemiologically linked to another probable or confirmed case
Confirmed case
Suspect or Probable case with laboratory confirmed H1N1 influenza A virus infection by one or more of the following tests
bull Real-time RT-PCR
bull Viral culture
bull Four-fold rise in H1N1 influenza A virus specific neutralizing antibodies
33 Case Investigation amp Management Health Institute anywhere in Oman that identifies unusual clusters of acute respiratory illness should immediately notify the Regional DGHS Regional Epidemiologist should investigate using the WHO case summary form (Annexure 4 ) if the epidemiological compatibility is decided under the guidance of Department of Communicable Diseases Surveillance and Control
Definition of clusterA cluster is defined as two or more persons presenting with manifestations of unexplainedAcute respiratory illness with fever gt38degC or who died of an unexplained respiratory illness and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 9
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1 BackgroundInfluenza is one of the most common causes of febrile and respiratory illness The risk of severe illness andor death is higher among adults gt65 years old among persons of any age with underlying chronic diseases including lung or heart disease metabolic diseases and immune-suppression and among children lt2 years old Vaccination represents the major strategy to reduce the impact of influenza and is recommended for high-risk persons
Influenza viruses circulating in the population are continuously evolving (antigenic drift and antigenic shift) which requires that vaccines be redesigned and produced annually to provide the best match to the influenza strains that are circulating
Pandemics occur when novel influenza A viruses most probably derived from animal or avian influenza viruses develop ability to spread effectively among people By definition pandemics involve the circulation of strains for which almost all of the worldrsquos population lack pre-existing immunity
Influenza pandemics resemble major natural disasters It is impossible to anticipate when the next pandemic might occur or how severe its consequences might be On an average three pandemics per century have been documented since the 16th century occurring at intervals of 10ndash50 years The first pandemic of influenza of the 20th century the ldquoSpanish flurdquo began in 1918 and by the time it ended the following year by conservative estimates it had resulted in more than 20 million deaths worldwide Later pandemics in 1957 and 1968 caused far fewer deaths but still posed a substantial burden on the health care system and resulted in substantial economic costs and social disruption
Following the events which happened in Mexico and USA where in many individuals are affected by Novel H1N1 influenza virus the concerns for pandemic influenza is growing as more information are made available This novel influenza virus H1N1 is a combination (re-assorted) of Human Avian (bird) and swine influenza viruses WHO has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established As of writing this plan 11 countries have officially reported 257 cases of influenza A (H1N1) infection The United States Government has reported 109 laboratory confirmed human cases including one death Mexico has reported 97 confirmed human cases of infection including seven deaths The following countries have reported laboratory confirmed cases with no deaths - Austria (1) Canada (19) Germany (3) Israel (2) Netherlands (1) New Zealand (3) Spain (13) Switzerland (1) and the United Kingdom (8)
2 The National Preparedness Plan
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 4
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
21 IntroductionPlanning and preparedness are essential to optimally achieve the goals and objectives of a pandemic response The Main Aim of this document is to provide a national framework for an integrated countrywide response to an influenza pandemic H1N1 with clear operational plans for the response at all levels Main document National Pandemic Influenza Preparedness Plan is already prepared by Ministry of Health which has provided guidance for the preparedness so far remains valid Some modifications based on current available information about novel H1N1 virus are incorporated in this supplement plan
The objectives of this plan for an influenza pandemic H1N1 are to
Ensure optimal coordination decision-making and communication between national state and local levels
Detect influenza strains through clinical and virology surveillance of human cases Deliver antiviral drug therapy and prophylaxis and avoid inappropriate use of these agents which
may result in antiviral resistance Provide optimal medical care and maintain essential community services Communicate effectively with the public health care providers community leaders and the media
The national authorities will provide overall direction guidance and coordination while provincial (RegionsGovernorates) health affairs departments and the private medical clinics will form the front line with respect to management of ill persons and administration of interventions such as vaccine and antiviral medications and possibly community-level interventions such as isolation and quarantine
Information and guidance provided in this plan will serve as a platform for the development of plans at the regional level
22 Phases of an Influenza Pandemic In the 2009 revision of the phase descriptions WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans The grouping and description of pandemic phases have been revised to make them easier to understand more precise and based upon observable phenomena Phases 1ndash3 correlate with preparedness including capacity development and response planning activities while Phases 4ndash6 clearly signal the need for response and mitigation efforts Furthermore periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities
The current WHO phase of pandemic alert is 5
In nature influenza viruses circulate continuously among animals especially birds Even though such viruses might theoretically develop into pandemic viruses in Phase 1 no viruses circulating among animals have been reported to cause infections in humans
In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans and is therefore considered a potential pandemic threat
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 5
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In Phase 3 an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks Limited human-to-human transmission may occur under some circumstances for example when there is close contact between an infected person and an unprotected caregiver However limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemicPhase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause ldquocommunity-level outbreaksrdquo The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region While most countries will not be affected at this stage the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization communication and implementation of the planned mitigation measures is short Phase 6 the pandemic phase is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5 Designation of this phase will indicate that a global pandemic is under wayDuring the post-peak period pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels The post-peak period signifies that pandemic activity appears to be decreasing however it is uncertain if additional waves will occur and countries will need to be prepared for a second wave Previous pandemics have been characterized by waves of activity spread over months Once the level of disease activity drops a critical communications task will be to balance this information with the possibility of another wave Pandemic waves can be separated by months and an immediate ldquoat-easerdquo signal may be premature
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In the post-pandemic period influenza disease activity will have returned to levels normally seen for seasonal influenza It is expected that the pandemic virus will behave as a seasonal influenza A virus At this stage it is important to maintain surveillance and update pandemic preparedness and response plans accordingly An intensive phase of recovery and evaluation may be required
Phase changes
It is important to stress that the phases were not developed as an epidemiological
prediction but to provide guidance to countries on the implementation of activities While
later phases may loosely correlate with increasing levels of pandemic risk this risk in the
first three phases is simply unknown It is therefore possible to have situations which
pose an increased pandemic risk but do not result in a pandemic
Alternatively although global influenza surveillance and monitoring systems are much
improved it is also possible that the first outbreaks of a pandemic will not be detected or
recognized For example if symptoms are mild and not very specific an influenza virus
with pandemic potential may attain relatively widespread circulation before being
detected thus the global phase may jump from Phase 3 to Phases 5 or 6 If the rapid
containment operations are successful Phase 4 may revert back to Phase 3
When making a change to the global phase WHO will carefully consider whether the
criteria for a new phase have been met This decision will be based upon all credible
information from global surveillance and from other organizations
23 Declaration of Pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 7
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
WHO Director General has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established
3 The Components of Preparedness
One of the lessons learned from the SARS outbreaks of 2003 was the importance in the event of an incident on the scale of an influenza pandemic of strong international and national leadership and coordination and a clear national lsquocommand and controlrsquo structure
The appropriate people at all levels must have authority to make key decisions and act on them and there must be a clear chain of accountability The response to an influenza pandemic H1N1 should be on a nationwide basis and therefore clear demarcation of roles is required between all the stake holders
31 Enhanced Influenza SurveillanceSpecific objectives of this surveillance activity are to guide global prevention and controlactivities through the following actions1 Detect and confirm cases of H1N1 influenza A virus infection2 Establish the extent of international spread of H1N1 influenza A virus infection
3 Assist in the early severity assessment of the diseaseTimely surveillance information will be the key to early identification of an influenza pandemic and to the development of evidence based interventions at all stages Oman contributes to internationally co-ordinated laboratory based influenza virus surveillance which is co-ordinated by the World Health Organization (EMRO)
Monitoring influenza disease activity is important to facilitate resource planning communication intervention and investigation A high level of vigilance for clusters of cases of respiratory disease provides an early warning mechanism
Influenza is a common condition and has symptoms similar to those of many other viral respiratory infections Early detection of a new virus therefore requires clinicians as well as laboratory staff to be alert to the possibly unusual for example respiratory illness in a patient with a link to areas where a new virus has been already identified or to a person with a travel history to affected areascountries
In order to detect cases the existent surveillance mechanisms should be further strengthened at all levels The sentinel SARI surveillance at Sohar Ibra and Salalah Hospitals will continue so also the laboratory based influenza surveillance at Barka PC Amerat HC Al Khod HC and Salalah PC
The existing surveillance (ILI under the Group C) should be further strengthened as follows
Influenza like illnesses (ILI) and LRTI including pneumonia for all age groups should be monitored from all health institutions on a weekly basis ICD-10 codes for these conditions are J01 J02-03 J04 J10-11 J12-18 J20-21 and J40-42 These conditions should be reported for males and females for inpatient and outpatient by age groups (MoH Monthly Statistical Booklets ndash for Health Institution and In-patient)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 8
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
These weekly surveillance reports should be sent by all health institutes including private to the office of the Director General or Director of Health Services of the Governorates and Regions
The compiled weekly reports of the Governorates and Regions should be sent to the Department of Communicable Disease Surveillance amp Control on every Monday (international week) by e-mailfax
32 Case detectionCase definitions for infections with H1N1 influenza A Virus
Suspect Case (Refer Algorithm 1)
Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Probable case
Suspect case with an influenza test that is positive for influenza A but is unsubtypable by reagents used to detect seasonal influenza virus infection OR
Suspect case who died of an unexplained acute respiratory illness and who is considered to be epidemiologically linked to another probable or confirmed case
Confirmed case
Suspect or Probable case with laboratory confirmed H1N1 influenza A virus infection by one or more of the following tests
bull Real-time RT-PCR
bull Viral culture
bull Four-fold rise in H1N1 influenza A virus specific neutralizing antibodies
33 Case Investigation amp Management Health Institute anywhere in Oman that identifies unusual clusters of acute respiratory illness should immediately notify the Regional DGHS Regional Epidemiologist should investigate using the WHO case summary form (Annexure 4 ) if the epidemiological compatibility is decided under the guidance of Department of Communicable Diseases Surveillance and Control
Definition of clusterA cluster is defined as two or more persons presenting with manifestations of unexplainedAcute respiratory illness with fever gt38degC or who died of an unexplained respiratory illness and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 9
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
21 IntroductionPlanning and preparedness are essential to optimally achieve the goals and objectives of a pandemic response The Main Aim of this document is to provide a national framework for an integrated countrywide response to an influenza pandemic H1N1 with clear operational plans for the response at all levels Main document National Pandemic Influenza Preparedness Plan is already prepared by Ministry of Health which has provided guidance for the preparedness so far remains valid Some modifications based on current available information about novel H1N1 virus are incorporated in this supplement plan
The objectives of this plan for an influenza pandemic H1N1 are to
Ensure optimal coordination decision-making and communication between national state and local levels
Detect influenza strains through clinical and virology surveillance of human cases Deliver antiviral drug therapy and prophylaxis and avoid inappropriate use of these agents which
may result in antiviral resistance Provide optimal medical care and maintain essential community services Communicate effectively with the public health care providers community leaders and the media
The national authorities will provide overall direction guidance and coordination while provincial (RegionsGovernorates) health affairs departments and the private medical clinics will form the front line with respect to management of ill persons and administration of interventions such as vaccine and antiviral medications and possibly community-level interventions such as isolation and quarantine
Information and guidance provided in this plan will serve as a platform for the development of plans at the regional level
22 Phases of an Influenza Pandemic In the 2009 revision of the phase descriptions WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans The grouping and description of pandemic phases have been revised to make them easier to understand more precise and based upon observable phenomena Phases 1ndash3 correlate with preparedness including capacity development and response planning activities while Phases 4ndash6 clearly signal the need for response and mitigation efforts Furthermore periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities
The current WHO phase of pandemic alert is 5
In nature influenza viruses circulate continuously among animals especially birds Even though such viruses might theoretically develop into pandemic viruses in Phase 1 no viruses circulating among animals have been reported to cause infections in humans
In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans and is therefore considered a potential pandemic threat
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 5
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In Phase 3 an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks Limited human-to-human transmission may occur under some circumstances for example when there is close contact between an infected person and an unprotected caregiver However limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemicPhase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause ldquocommunity-level outbreaksrdquo The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region While most countries will not be affected at this stage the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization communication and implementation of the planned mitigation measures is short Phase 6 the pandemic phase is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5 Designation of this phase will indicate that a global pandemic is under wayDuring the post-peak period pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels The post-peak period signifies that pandemic activity appears to be decreasing however it is uncertain if additional waves will occur and countries will need to be prepared for a second wave Previous pandemics have been characterized by waves of activity spread over months Once the level of disease activity drops a critical communications task will be to balance this information with the possibility of another wave Pandemic waves can be separated by months and an immediate ldquoat-easerdquo signal may be premature
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In the post-pandemic period influenza disease activity will have returned to levels normally seen for seasonal influenza It is expected that the pandemic virus will behave as a seasonal influenza A virus At this stage it is important to maintain surveillance and update pandemic preparedness and response plans accordingly An intensive phase of recovery and evaluation may be required
Phase changes
It is important to stress that the phases were not developed as an epidemiological
prediction but to provide guidance to countries on the implementation of activities While
later phases may loosely correlate with increasing levels of pandemic risk this risk in the
first three phases is simply unknown It is therefore possible to have situations which
pose an increased pandemic risk but do not result in a pandemic
Alternatively although global influenza surveillance and monitoring systems are much
improved it is also possible that the first outbreaks of a pandemic will not be detected or
recognized For example if symptoms are mild and not very specific an influenza virus
with pandemic potential may attain relatively widespread circulation before being
detected thus the global phase may jump from Phase 3 to Phases 5 or 6 If the rapid
containment operations are successful Phase 4 may revert back to Phase 3
When making a change to the global phase WHO will carefully consider whether the
criteria for a new phase have been met This decision will be based upon all credible
information from global surveillance and from other organizations
23 Declaration of Pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 7
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
WHO Director General has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established
3 The Components of Preparedness
One of the lessons learned from the SARS outbreaks of 2003 was the importance in the event of an incident on the scale of an influenza pandemic of strong international and national leadership and coordination and a clear national lsquocommand and controlrsquo structure
The appropriate people at all levels must have authority to make key decisions and act on them and there must be a clear chain of accountability The response to an influenza pandemic H1N1 should be on a nationwide basis and therefore clear demarcation of roles is required between all the stake holders
31 Enhanced Influenza SurveillanceSpecific objectives of this surveillance activity are to guide global prevention and controlactivities through the following actions1 Detect and confirm cases of H1N1 influenza A virus infection2 Establish the extent of international spread of H1N1 influenza A virus infection
3 Assist in the early severity assessment of the diseaseTimely surveillance information will be the key to early identification of an influenza pandemic and to the development of evidence based interventions at all stages Oman contributes to internationally co-ordinated laboratory based influenza virus surveillance which is co-ordinated by the World Health Organization (EMRO)
Monitoring influenza disease activity is important to facilitate resource planning communication intervention and investigation A high level of vigilance for clusters of cases of respiratory disease provides an early warning mechanism
Influenza is a common condition and has symptoms similar to those of many other viral respiratory infections Early detection of a new virus therefore requires clinicians as well as laboratory staff to be alert to the possibly unusual for example respiratory illness in a patient with a link to areas where a new virus has been already identified or to a person with a travel history to affected areascountries
In order to detect cases the existent surveillance mechanisms should be further strengthened at all levels The sentinel SARI surveillance at Sohar Ibra and Salalah Hospitals will continue so also the laboratory based influenza surveillance at Barka PC Amerat HC Al Khod HC and Salalah PC
The existing surveillance (ILI under the Group C) should be further strengthened as follows
Influenza like illnesses (ILI) and LRTI including pneumonia for all age groups should be monitored from all health institutions on a weekly basis ICD-10 codes for these conditions are J01 J02-03 J04 J10-11 J12-18 J20-21 and J40-42 These conditions should be reported for males and females for inpatient and outpatient by age groups (MoH Monthly Statistical Booklets ndash for Health Institution and In-patient)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 8
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
These weekly surveillance reports should be sent by all health institutes including private to the office of the Director General or Director of Health Services of the Governorates and Regions
The compiled weekly reports of the Governorates and Regions should be sent to the Department of Communicable Disease Surveillance amp Control on every Monday (international week) by e-mailfax
32 Case detectionCase definitions for infections with H1N1 influenza A Virus
Suspect Case (Refer Algorithm 1)
Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Probable case
Suspect case with an influenza test that is positive for influenza A but is unsubtypable by reagents used to detect seasonal influenza virus infection OR
Suspect case who died of an unexplained acute respiratory illness and who is considered to be epidemiologically linked to another probable or confirmed case
Confirmed case
Suspect or Probable case with laboratory confirmed H1N1 influenza A virus infection by one or more of the following tests
bull Real-time RT-PCR
bull Viral culture
bull Four-fold rise in H1N1 influenza A virus specific neutralizing antibodies
33 Case Investigation amp Management Health Institute anywhere in Oman that identifies unusual clusters of acute respiratory illness should immediately notify the Regional DGHS Regional Epidemiologist should investigate using the WHO case summary form (Annexure 4 ) if the epidemiological compatibility is decided under the guidance of Department of Communicable Diseases Surveillance and Control
Definition of clusterA cluster is defined as two or more persons presenting with manifestations of unexplainedAcute respiratory illness with fever gt38degC or who died of an unexplained respiratory illness and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 9
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In Phase 3 an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks Limited human-to-human transmission may occur under some circumstances for example when there is close contact between an infected person and an unprotected caregiver However limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemicPhase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause ldquocommunity-level outbreaksrdquo The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region While most countries will not be affected at this stage the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization communication and implementation of the planned mitigation measures is short Phase 6 the pandemic phase is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5 Designation of this phase will indicate that a global pandemic is under wayDuring the post-peak period pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels The post-peak period signifies that pandemic activity appears to be decreasing however it is uncertain if additional waves will occur and countries will need to be prepared for a second wave Previous pandemics have been characterized by waves of activity spread over months Once the level of disease activity drops a critical communications task will be to balance this information with the possibility of another wave Pandemic waves can be separated by months and an immediate ldquoat-easerdquo signal may be premature
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In the post-pandemic period influenza disease activity will have returned to levels normally seen for seasonal influenza It is expected that the pandemic virus will behave as a seasonal influenza A virus At this stage it is important to maintain surveillance and update pandemic preparedness and response plans accordingly An intensive phase of recovery and evaluation may be required
Phase changes
It is important to stress that the phases were not developed as an epidemiological
prediction but to provide guidance to countries on the implementation of activities While
later phases may loosely correlate with increasing levels of pandemic risk this risk in the
first three phases is simply unknown It is therefore possible to have situations which
pose an increased pandemic risk but do not result in a pandemic
Alternatively although global influenza surveillance and monitoring systems are much
improved it is also possible that the first outbreaks of a pandemic will not be detected or
recognized For example if symptoms are mild and not very specific an influenza virus
with pandemic potential may attain relatively widespread circulation before being
detected thus the global phase may jump from Phase 3 to Phases 5 or 6 If the rapid
containment operations are successful Phase 4 may revert back to Phase 3
When making a change to the global phase WHO will carefully consider whether the
criteria for a new phase have been met This decision will be based upon all credible
information from global surveillance and from other organizations
23 Declaration of Pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 7
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
WHO Director General has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established
3 The Components of Preparedness
One of the lessons learned from the SARS outbreaks of 2003 was the importance in the event of an incident on the scale of an influenza pandemic of strong international and national leadership and coordination and a clear national lsquocommand and controlrsquo structure
The appropriate people at all levels must have authority to make key decisions and act on them and there must be a clear chain of accountability The response to an influenza pandemic H1N1 should be on a nationwide basis and therefore clear demarcation of roles is required between all the stake holders
31 Enhanced Influenza SurveillanceSpecific objectives of this surveillance activity are to guide global prevention and controlactivities through the following actions1 Detect and confirm cases of H1N1 influenza A virus infection2 Establish the extent of international spread of H1N1 influenza A virus infection
3 Assist in the early severity assessment of the diseaseTimely surveillance information will be the key to early identification of an influenza pandemic and to the development of evidence based interventions at all stages Oman contributes to internationally co-ordinated laboratory based influenza virus surveillance which is co-ordinated by the World Health Organization (EMRO)
Monitoring influenza disease activity is important to facilitate resource planning communication intervention and investigation A high level of vigilance for clusters of cases of respiratory disease provides an early warning mechanism
Influenza is a common condition and has symptoms similar to those of many other viral respiratory infections Early detection of a new virus therefore requires clinicians as well as laboratory staff to be alert to the possibly unusual for example respiratory illness in a patient with a link to areas where a new virus has been already identified or to a person with a travel history to affected areascountries
In order to detect cases the existent surveillance mechanisms should be further strengthened at all levels The sentinel SARI surveillance at Sohar Ibra and Salalah Hospitals will continue so also the laboratory based influenza surveillance at Barka PC Amerat HC Al Khod HC and Salalah PC
The existing surveillance (ILI under the Group C) should be further strengthened as follows
Influenza like illnesses (ILI) and LRTI including pneumonia for all age groups should be monitored from all health institutions on a weekly basis ICD-10 codes for these conditions are J01 J02-03 J04 J10-11 J12-18 J20-21 and J40-42 These conditions should be reported for males and females for inpatient and outpatient by age groups (MoH Monthly Statistical Booklets ndash for Health Institution and In-patient)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 8
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
These weekly surveillance reports should be sent by all health institutes including private to the office of the Director General or Director of Health Services of the Governorates and Regions
The compiled weekly reports of the Governorates and Regions should be sent to the Department of Communicable Disease Surveillance amp Control on every Monday (international week) by e-mailfax
32 Case detectionCase definitions for infections with H1N1 influenza A Virus
Suspect Case (Refer Algorithm 1)
Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Probable case
Suspect case with an influenza test that is positive for influenza A but is unsubtypable by reagents used to detect seasonal influenza virus infection OR
Suspect case who died of an unexplained acute respiratory illness and who is considered to be epidemiologically linked to another probable or confirmed case
Confirmed case
Suspect or Probable case with laboratory confirmed H1N1 influenza A virus infection by one or more of the following tests
bull Real-time RT-PCR
bull Viral culture
bull Four-fold rise in H1N1 influenza A virus specific neutralizing antibodies
33 Case Investigation amp Management Health Institute anywhere in Oman that identifies unusual clusters of acute respiratory illness should immediately notify the Regional DGHS Regional Epidemiologist should investigate using the WHO case summary form (Annexure 4 ) if the epidemiological compatibility is decided under the guidance of Department of Communicable Diseases Surveillance and Control
Definition of clusterA cluster is defined as two or more persons presenting with manifestations of unexplainedAcute respiratory illness with fever gt38degC or who died of an unexplained respiratory illness and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 9
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
In the post-pandemic period influenza disease activity will have returned to levels normally seen for seasonal influenza It is expected that the pandemic virus will behave as a seasonal influenza A virus At this stage it is important to maintain surveillance and update pandemic preparedness and response plans accordingly An intensive phase of recovery and evaluation may be required
Phase changes
It is important to stress that the phases were not developed as an epidemiological
prediction but to provide guidance to countries on the implementation of activities While
later phases may loosely correlate with increasing levels of pandemic risk this risk in the
first three phases is simply unknown It is therefore possible to have situations which
pose an increased pandemic risk but do not result in a pandemic
Alternatively although global influenza surveillance and monitoring systems are much
improved it is also possible that the first outbreaks of a pandemic will not be detected or
recognized For example if symptoms are mild and not very specific an influenza virus
with pandemic potential may attain relatively widespread circulation before being
detected thus the global phase may jump from Phase 3 to Phases 5 or 6 If the rapid
containment operations are successful Phase 4 may revert back to Phase 3
When making a change to the global phase WHO will carefully consider whether the
criteria for a new phase have been met This decision will be based upon all credible
information from global surveillance and from other organizations
23 Declaration of Pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 7
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
WHO Director General has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established
3 The Components of Preparedness
One of the lessons learned from the SARS outbreaks of 2003 was the importance in the event of an incident on the scale of an influenza pandemic of strong international and national leadership and coordination and a clear national lsquocommand and controlrsquo structure
The appropriate people at all levels must have authority to make key decisions and act on them and there must be a clear chain of accountability The response to an influenza pandemic H1N1 should be on a nationwide basis and therefore clear demarcation of roles is required between all the stake holders
31 Enhanced Influenza SurveillanceSpecific objectives of this surveillance activity are to guide global prevention and controlactivities through the following actions1 Detect and confirm cases of H1N1 influenza A virus infection2 Establish the extent of international spread of H1N1 influenza A virus infection
3 Assist in the early severity assessment of the diseaseTimely surveillance information will be the key to early identification of an influenza pandemic and to the development of evidence based interventions at all stages Oman contributes to internationally co-ordinated laboratory based influenza virus surveillance which is co-ordinated by the World Health Organization (EMRO)
Monitoring influenza disease activity is important to facilitate resource planning communication intervention and investigation A high level of vigilance for clusters of cases of respiratory disease provides an early warning mechanism
Influenza is a common condition and has symptoms similar to those of many other viral respiratory infections Early detection of a new virus therefore requires clinicians as well as laboratory staff to be alert to the possibly unusual for example respiratory illness in a patient with a link to areas where a new virus has been already identified or to a person with a travel history to affected areascountries
In order to detect cases the existent surveillance mechanisms should be further strengthened at all levels The sentinel SARI surveillance at Sohar Ibra and Salalah Hospitals will continue so also the laboratory based influenza surveillance at Barka PC Amerat HC Al Khod HC and Salalah PC
The existing surveillance (ILI under the Group C) should be further strengthened as follows
Influenza like illnesses (ILI) and LRTI including pneumonia for all age groups should be monitored from all health institutions on a weekly basis ICD-10 codes for these conditions are J01 J02-03 J04 J10-11 J12-18 J20-21 and J40-42 These conditions should be reported for males and females for inpatient and outpatient by age groups (MoH Monthly Statistical Booklets ndash for Health Institution and In-patient)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 8
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
These weekly surveillance reports should be sent by all health institutes including private to the office of the Director General or Director of Health Services of the Governorates and Regions
The compiled weekly reports of the Governorates and Regions should be sent to the Department of Communicable Disease Surveillance amp Control on every Monday (international week) by e-mailfax
32 Case detectionCase definitions for infections with H1N1 influenza A Virus
Suspect Case (Refer Algorithm 1)
Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Probable case
Suspect case with an influenza test that is positive for influenza A but is unsubtypable by reagents used to detect seasonal influenza virus infection OR
Suspect case who died of an unexplained acute respiratory illness and who is considered to be epidemiologically linked to another probable or confirmed case
Confirmed case
Suspect or Probable case with laboratory confirmed H1N1 influenza A virus infection by one or more of the following tests
bull Real-time RT-PCR
bull Viral culture
bull Four-fold rise in H1N1 influenza A virus specific neutralizing antibodies
33 Case Investigation amp Management Health Institute anywhere in Oman that identifies unusual clusters of acute respiratory illness should immediately notify the Regional DGHS Regional Epidemiologist should investigate using the WHO case summary form (Annexure 4 ) if the epidemiological compatibility is decided under the guidance of Department of Communicable Diseases Surveillance and Control
Definition of clusterA cluster is defined as two or more persons presenting with manifestations of unexplainedAcute respiratory illness with fever gt38degC or who died of an unexplained respiratory illness and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 9
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
WHO Director General has declared H1N1 influenza situation as an international public health emergency On 29th of April 2009 the pandemic influenza alert has been upgraded to phase5 which means the global spread (pandemic) is likely as human-to-human transmission has been established
3 The Components of Preparedness
One of the lessons learned from the SARS outbreaks of 2003 was the importance in the event of an incident on the scale of an influenza pandemic of strong international and national leadership and coordination and a clear national lsquocommand and controlrsquo structure
The appropriate people at all levels must have authority to make key decisions and act on them and there must be a clear chain of accountability The response to an influenza pandemic H1N1 should be on a nationwide basis and therefore clear demarcation of roles is required between all the stake holders
31 Enhanced Influenza SurveillanceSpecific objectives of this surveillance activity are to guide global prevention and controlactivities through the following actions1 Detect and confirm cases of H1N1 influenza A virus infection2 Establish the extent of international spread of H1N1 influenza A virus infection
3 Assist in the early severity assessment of the diseaseTimely surveillance information will be the key to early identification of an influenza pandemic and to the development of evidence based interventions at all stages Oman contributes to internationally co-ordinated laboratory based influenza virus surveillance which is co-ordinated by the World Health Organization (EMRO)
Monitoring influenza disease activity is important to facilitate resource planning communication intervention and investigation A high level of vigilance for clusters of cases of respiratory disease provides an early warning mechanism
Influenza is a common condition and has symptoms similar to those of many other viral respiratory infections Early detection of a new virus therefore requires clinicians as well as laboratory staff to be alert to the possibly unusual for example respiratory illness in a patient with a link to areas where a new virus has been already identified or to a person with a travel history to affected areascountries
In order to detect cases the existent surveillance mechanisms should be further strengthened at all levels The sentinel SARI surveillance at Sohar Ibra and Salalah Hospitals will continue so also the laboratory based influenza surveillance at Barka PC Amerat HC Al Khod HC and Salalah PC
The existing surveillance (ILI under the Group C) should be further strengthened as follows
Influenza like illnesses (ILI) and LRTI including pneumonia for all age groups should be monitored from all health institutions on a weekly basis ICD-10 codes for these conditions are J01 J02-03 J04 J10-11 J12-18 J20-21 and J40-42 These conditions should be reported for males and females for inpatient and outpatient by age groups (MoH Monthly Statistical Booklets ndash for Health Institution and In-patient)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 8
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
These weekly surveillance reports should be sent by all health institutes including private to the office of the Director General or Director of Health Services of the Governorates and Regions
The compiled weekly reports of the Governorates and Regions should be sent to the Department of Communicable Disease Surveillance amp Control on every Monday (international week) by e-mailfax
32 Case detectionCase definitions for infections with H1N1 influenza A Virus
Suspect Case (Refer Algorithm 1)
Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Probable case
Suspect case with an influenza test that is positive for influenza A but is unsubtypable by reagents used to detect seasonal influenza virus infection OR
Suspect case who died of an unexplained acute respiratory illness and who is considered to be epidemiologically linked to another probable or confirmed case
Confirmed case
Suspect or Probable case with laboratory confirmed H1N1 influenza A virus infection by one or more of the following tests
bull Real-time RT-PCR
bull Viral culture
bull Four-fold rise in H1N1 influenza A virus specific neutralizing antibodies
33 Case Investigation amp Management Health Institute anywhere in Oman that identifies unusual clusters of acute respiratory illness should immediately notify the Regional DGHS Regional Epidemiologist should investigate using the WHO case summary form (Annexure 4 ) if the epidemiological compatibility is decided under the guidance of Department of Communicable Diseases Surveillance and Control
Definition of clusterA cluster is defined as two or more persons presenting with manifestations of unexplainedAcute respiratory illness with fever gt38degC or who died of an unexplained respiratory illness and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 9
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
These weekly surveillance reports should be sent by all health institutes including private to the office of the Director General or Director of Health Services of the Governorates and Regions
The compiled weekly reports of the Governorates and Regions should be sent to the Department of Communicable Disease Surveillance amp Control on every Monday (international week) by e-mailfax
32 Case detectionCase definitions for infections with H1N1 influenza A Virus
Suspect Case (Refer Algorithm 1)
Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Probable case
Suspect case with an influenza test that is positive for influenza A but is unsubtypable by reagents used to detect seasonal influenza virus infection OR
Suspect case who died of an unexplained acute respiratory illness and who is considered to be epidemiologically linked to another probable or confirmed case
Confirmed case
Suspect or Probable case with laboratory confirmed H1N1 influenza A virus infection by one or more of the following tests
bull Real-time RT-PCR
bull Viral culture
bull Four-fold rise in H1N1 influenza A virus specific neutralizing antibodies
33 Case Investigation amp Management Health Institute anywhere in Oman that identifies unusual clusters of acute respiratory illness should immediately notify the Regional DGHS Regional Epidemiologist should investigate using the WHO case summary form (Annexure 4 ) if the epidemiological compatibility is decided under the guidance of Department of Communicable Diseases Surveillance and Control
Definition of clusterA cluster is defined as two or more persons presenting with manifestations of unexplainedAcute respiratory illness with fever gt38degC or who died of an unexplained respiratory illness and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 9
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
those are detected with onset of illness within a period of 14 days and in the same geographicalarea andor are epidemiologically linked
Triggerssignals for the investigation of possible cases of H1N1 influenza A virus arebull Clusters of cases of unexplained ILI or acute lower respiratory diseasebull Severe unexplained respiratory illness occurring in one or more health care worker(s)who provide care for patients with respiratory diseasebull Changes in the epidemiology of mortality associated with the occurrence of ILI or lowerrespiratory tract illness an increase in deaths observed from respiratory illness or anincrease in the occurrence of severe respiratory disease in previously healthy adults oradolescentsbull Persistent changes noted in the treatment response or outcome of severe lowerrespiratory illness
Close contact having cared for lived with or had direct contact with respiratory secretions orbody fluids of a probable or confirmed case of H1N1 influenza A virus For contact surveillance refer Algorithm 2
Epidemiological risk factors that should raise suspicion of H1N1 influenza A virus includebull Close contact to a confirmed case of H1N1 influenza A virus infection while thecase was illbull Recent travel to an area where there are confirmed cases of H1N1 influenza A virus
All suspected cases from any institute of the region should be transferred investigated admitted and managed at designated isolation facility (usually regional hospital) ONLY For case referrals refer Algorithm 3 For receiving referred case at designated isolation facility please follow Algorithm 4 For any H1N1 influenza A virus case please refer to Algorithm 5
34 Laboratory SurveillanceLaboratories are essential to confirm diagnosis elucidation of characteristics of the virus and to overall surveillance The capability and capacity of the Central Public Health Laboratory will soon be upgraded to identify novel influenza strains A proportion of isolates including all unusual ones from the Oman would be referred to the International Influenza Reference Laboratory at WHO-EMR Cairo for detailed identification
Details of the sample collection storage and transport are included in the algorithm 6 of this document
35 Infection controlIt is critical that health-care workers use appropriate infection control precautions when caring for patients with influenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitors The WHO infection prevention and control guidance is attached in annexure 5Ensure the availability of personal protective equipments (PPE) and laboratory supplies at the designated locations All these should be accessible round the clock to the health care staff
36 Non-pharmaceutical public health interventions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 10
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The main aim of non-pharmaceutical intervention is to prevent the spread of infection Each individual is expected to practice following general preventive measures for influenza
Avoid close contact with people who appear unwell and have fever and cough Wash your hands with soap and water thoroughly and often Practice good health habits including adequate sleep eating nutritious food and keeping
physically active
The persons who are not well should be cared for at home unless the person is seriously ill which require hospital admission keeping following guidelines in mind
Separate the ill person from others at least 1 meter in distance from others Cover your mouth and nose when caring for the ill person Either commercial or homemade
materials are fine as long as they are disposed of or cleaned properly after use Wash your hands with soap and water thoroughly after each contact with the ill person Improve the air flow where the ill person stays Use doors and windows to take advantage of
breezes Keep the environment clean with readily available household cleaning agents
The person who is unwell having high fever cough or sore throat is expected to follow following steps
Stay at home and keep away from work school or crowds Rest and take plenty of fluids Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose
of the used tissues properly Wash your hands with soap and water often and thoroughly especially after coughing or
sneezing Inform family and friends about your illness and try to avoid contact with people
If a person thinks that he requires medical attention then following is expected from him
Contact by telephone your primary health care physician or healthcare provider near your home before travelling to a health facility and report your symptoms Explain why you think you have influenza A (H1N1) (for example if you have recently travelled to a country where there is an outbreak in humans) Follow the advice given to you
If it is not possible to contact your healthcare provider in advance communicate your suspicion of infection as soon as you arrive at the facility
Cover your nose and mouth during travel
37 Pharmaceutical Interventions
VACCINE
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 11
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Currently no vaccine is available for this novel H1N1 influenza virus It is widely believed that it will require at least few months for vaccine to be developed and made available for general use No evidence is available to support the use of conventional seasonal influenza vaccine to prevent novel H1N1 influenza virus responsible for causing pandemic
ANTIVIRAL AGENTSAntiviral agents active against influenza are the only major medical countermeasure available However there are limitations to their use their effectiveness in a pandemic situation has yet to be tested and anti-viral resistance may be ndash or become ndash a problem
Oman has stockpiling the antiviral drugs required for an influenza pandemic The Ministry of Health has procured 10000 courses (10 tablets per course) for either prophylactic or therapeutic use available for the Strategic National Stockpile (SNS)
As with other resources given the possible scale of a current pandemic the drugs will need to be given in the most effective way on operational clinical and cost-effectiveness grounds taking into account the stocks available
Two drugs of the newer class of neuraminidase inhibitors (Zanamivir [Relenza] and Oseltamivir [Tamiflu]) are effective against Novel influenza H1N1 virus as per the WHO reports
38 Information DisseminationThe overall communications strategy covers the gathering collation and dissemination of information for a variety of audiences which can be divided broadly into
381 Strategic communicationsTwo way strategic communications will involve the MoH and all other governmental agencies and organisations involved in the response including the private health establishments and the international agencies The Government briefings and public information will be controlled and monitored by Director Communicable diseases surveillance and Control under the supervision of higher officials of the ministry of health
382 Professional information and guidanceRegular information bulletins to the health professionals will be issued by Director Communicable diseases surveillance and Control as required and as urgency indicates via already established routes
383 Communications with the public and the mediaMedia communications will be co-ordinated initially by the MoH PRO office They will also co-ordinate cross government communication and depending on the scale will also co-ordinate the media and public communication for the other Government Departments involved
At present only national authorities are designated as official spokesperson of the government for this pandemic
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 12
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
4 List of Annexure
Annexure 1 National Task Force (MoH)
Annexure 2 Inter-Ministerial Committee on AI
Annexure 3 National Rapid Response Team
Annexure 4 Case Notification Form
Annexure 5 Infection Control Guidelines (General)
Annexure 6 List of Algorithms
Annexure 1NATIONAL TASK FORCE (MINISTRY OF HEALTH)
National Spokespersons for Ministry of Health HE Dr Ali Jaffer M Suleiman DGHA Dr Salah Al Awaidy Director DCDSC
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 13
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Provincial Spokesperson (Governorates amp Regions) DirectorDirector General of Health Services
Name Designation Office Fax Mobile
Ministry of Health HQ
HE Dr Ali Jaffer M Suleiman (Chairman) Director General of Health Affairs 24600808 24696099 99335681
Ph Nusaiba Habib Mohd Director General of Medical Supplies 24699973 24601593 99240990
Dr Salah Al Awaidy(Focal Point)
Director Communicable Disease Surveillance amp Control 24601921 24601832 99315063
Dr Suleiman Al Busaidy Director Central Public Health Laboratory 24705943 24793699 99426288
Ms Sabah Al Bahlani Director Health Education amp Information 24562609 99332792
WHO Country Office-Oman
Dr Jihan Tawilah WHO Representative Oman 24600989 24602637
MoH and Sultan Qaboos University Hospital
Dr Mohammed Al Balushi Director Al Nahda Hospital 24835746 24831578
Dr Mohammed Al Hosni Head of Child Health Royal Hospital 24599552 24599173 99474441
Dr Yaqub Al Mahrooqi Chest Specialist Royal Hospital 99427669
Dr Abdullah Balkhair Infectious Diseases SQUH 24413355 24413419 99293797
Ms Farida Head of Nursing Al Nahda Hospital 24837511Ext 1112 24837522
Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
Dr Shyam Bawikar Advisor Epidemiologist
2460192124607524 24601832
99368327
Dr Idris Al Abaidani Surveillance Section Head 95208040
Mr Salem Al Mahrooqi National Surveillance Supervisor 99029195
Mr Bader Al Rawahi National EPI Supervisor 99430689
Annexure 2
INTER-MINISTERIAL COMMITTEE ON H1N1 INFLUENZA SULTANATE OF OMAN
Name Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 14
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Mr Ali Amer Al Kiyumi
Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
24602285 24602283 99444808
Mr Said Darwesh Al Alawi
DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
24692564 24692547 99389883
Mr Ali Said Al Hammadi Director General of Planning Ministry of Interior 24707226 24790599 99420909
Mr Mudriq Kathiem Al Moosawi Director General of Commerce amp Industry 24774100 24812030 99418909
Mr Nasr Ali Al Wahaibi Director General of Animal Wealth 2469391 24694465 99382717
Dr Salah Thabit Al AwaidyDirector Communicable Disease Surveillance and Control
24601921 24601832 99315063
Mr Mubarak Khamis Al Araimi Asst Director General of Information and Press Affairs 24697677 24521034 24602928
Mr Mussallam Salem Al Jenebi Asst Director General of Customs Royal Oman Police 24521204 24521204 99319131
Dr Sultan Eissa Al IsmailiAsst Director General of Animal Wealth amp Veterinary Services
24698512 24694465 99380316
Dr Ali Abdullah Al Sahmi Head of Veterinary Services (Focal Point)
24696300 Ext 1510 24694465 99371816
Annexure 3RAPID RESPONSE TEAMIn the event of suspected case notification of HPAI in Oman the rapid response team will initiate an epidemiological field case investigation to confirm the diagnosis and necessary interventions within 24-48 hours
The National Rapid Response Team for Avian InfluenzaName Designation Office Fax Mobile
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 15
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Salah Al Awaidy TEAM LEADER
Director Communicable Disease Surveillance amp Control (DCDSC)
24601921 24601832 99315063
Dr Suleiman Al Busaidy Director CPHL 24705943 24793699 99426288
Dr Shyam Bawikar Advisor Epidemiologist DCDSC 2460192124607524
24601832 99368327
Dr Idris Al Abaidani Section Ic Surveillance DCDSC 95224261
Mr Basim Zayed Coordinator Infection control DCDSC 99534234
Mr Salem Al Mahrooqi Surveillance Supervisor DCDSC 99029195
Dr Ali Al Sahmi Focal Point for AI Ministry of Agriculture amp Fisheries
24696300 Ext 1510
24694465 99371816
Support Team
Dr Mohammed Al Hosni Head of Paediatrics Royal Hospital 99474441
Dr Saif Al Abri Head of Medicine Royal Hospital
Dr Yaqoob Al Mahrooqi Chest disease specialist Royal Hospital 99427669
Ph Anisa Rasool Medical stores in-charge MoH 99476978
Mr Mohammed Al Farsi Logistician ampTransport DGHA 99360541
RegionalProvincial Rapid Response TeamName and Designation Office Fax Mobile
DirectorSuperintendent of Health AffairsTEAM LEADERRegional Epidemiologist OR Communicable Disease Focal Point Health inspector from the affected Wilayat
Support Team
Executive Director Regional HospitalRegional Laboratory in-chargeInfection control staff nurse Regional HospitalHOD Medicine Regional HospitalHOD Paediatrics Regional HospitalDirector of Administration DGHS Logistic support
Veterinary Doctor - Ministry of Agriculture and Fisheries
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 16
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 4
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 17
Hospital sticker
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 18
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 19
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 20
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 21
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 22
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 23
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 5Infection prevention and control in health care in providing care for confirmed or suspected A(H1N1) swine influenza patientsInterim guidance provided by WHO on 29 April 2009BackgroundThe current situation regarding the outbreaks of A(H1N1) swine influenza is evolving rapidly andcountries from different regions of the globe have been affectedBased on epidemiological data human-to-human transmission has been demonstrated alongwith the ability of the virus to cause community-level outbreaks which together suggest thepossibility of sustained human-to-human transmission Health-care facilities now face thechallenge of providing care for patients infected with A(H1N1) swine influenza It is critical thathealth-care workers use appropriate infection control precautions when caring for patients withinfluenza-like symptoms particularly in areas affected by outbreaks of A(H1N1) swine influenzain order to minimize the possibility of transmission among themselves to other health-careworkers patients and visitorsAs at 29 April human-to-human transmission of A(H1N1) swine influenza virus appears to bemainly through droplets Therefore the infection control precautions for patients with suspectedor confirmed A(H1N1) swine influenza and those with influenza-like symptoms should prioritizethe control of the spread of respiratory droplets The precautions for influenza virus with sustainedhuman-to-human transmission (eg pandemic-prone influenza) are described in detail in thedocument ldquoInfection prevention and control of epidemic- and pandemic-prone acute respiratorydiseases in health care WHO Interim Guidelinesrdquo 1This guidance may change as new information becomes availableFundamentals of infection prevention strategies1 Administrative controls are key components including implementation of Standard andDroplet Precautions avoid crowding promote distance between patients (ge 1 m) patienttriage for early detection patient placement and reporting organization of services policieson rational use of available supplies policies on patient procedures strengthening of infectioncontrol infrastructure2 Environmentalengineering controls such as basic health-care facility infrastructure 2 adequate ventilation proper patient placement and adequate environmental cleaning canhelp reduce the spread of some respiratory pathogens during health care3 Rational use of available personal protective equipment (PPE) and appropriate hand hygiene1 Available at httpwwwwhointcsrresourcespublicationsWHO_CD_EPR_2007_6enindexhtml2 For more details see Essential environmental health standards in health care GenevaWorld Health Organization 2008 Available at httpwhqlibdocwhointpublications20089789241547239_engpdfCRITICAL MEASURES1048766 Avoid crowding patients together promote distance betweenpatients1048766 Protect mucosa of mouth and nose1048766 Perform hand hygiene2Summary PrecautionsFor staff providing care to patients with suspected or confirmed A(H1N1) swine influenzainfection and for patients with influenza-like symptomsStandard3 and Droplet Precautions4 should be strengthened when working in direct contact withsuspected or confirmed A(H1N1) swine influenza infected patients Key elements1048766 use a medical or surgical mask1048766 emphasize hand hygiene and provide hand hygiene facilities and suppliesAs per Standard Precautions2 if there is a risk of splashes onto face1048766 use face protection Use either (1) a medical or surgical mask and eye-visor or gogglesor (2) a face shield and1048766 use a gown and clean gloves
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 24
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
1048766 DO NOT FORGET HAND HYGIENE AFTER PPE REMOVALAerosol generating procedures (eg aspiration of respiratory tract intubation resuscitationbronchoscopy autopsy) are associated with increased risk of infection transmission andthe infection control precautions should include using1048766 particulate respirator (eg EU FFP2 US NIOSH-certified N95)1048766 eye protection (ie goggles)1048766 a clean non-sterile long-sleeved gown1048766 gloves (some of these procedures require sterile gloves)KEY ELEMENTS FOR HEALTH CARE1 Basic infection control recommendations for all health-care facilitiesStandard and Droplet Precautions when caring for a patient with an acute febrilerespiratory illness2 Respiratory hygienecough etiquetteHealth-care workers patients and family members should cover mouth and nose with atissue when coughing and perform hand hygiene afterwards3 Infection control precautions for suspected and confirmed A(H1N1) swineinfluenza infectionPlace patient in adequately-ventilated room If single rooms are not available cohortpatients in wards keeping at least 1 meter distance between beds Standard andDroplet Precautions for all persons entering the isolation room4 Triage early recognition and reporting of A(H1N1) swine influenza infectionConsider A(H1N1) swine influenza infection in patients with acute febrile respiratoryillness who have been in an affected region within the one week prior to symptom onsetand who have had exposure to an A(H1N1) swine influenza infected patient or animal3 Standard Precautions basic precautions designed to minimize direct unprotected exposure to potentially infectedblood body fluids or secretions (wwwwhointcsrresourcespublicationsstandardprecautionsenindexhtml)4 Droplet Precautions health-care workers to wear medical mask gowns and clean gloves when providing direct carePlacement of patients with same diagnosis in designated areas may facilitate the application of infection controlprecautions35 Additional measures to reduce nosocomial A(H1N1) swine influenza virustransmissionLimit numbers of health-care workersfamily membersvisitors exposed to the A(H1N1)swine influenza patient6 Specimen collectiontransporthandling within health-care facilitiesUse Standard and Droplet Precautions for specimen collection Use StandardPrecautions for specimen transport to the laboratory Health-care facility laboratoriesshould follow good biosafety practices7 Family membervisitor recommendationsFamily membersvisitors should be limited to those essential for patient support andshould use the same infection control precautions as health-care workers8 Patient transport within health-care facilitiesSuspect or confirmed A(H1N1) swine influenza patients should wear a medicalsurgicalmask9 Pre-hospital careInfection control precautions are similar to those practiced during hospital care for allinvolved in the care of suspected A(H1N1) swine influenza patients (eg transportationto hospital)10 Occupational healthMonitor health of health-care workers exposed to A(H1N1) swine influenza patientsAntiviral prophylaxis should follow local policy Health-care workers with symptomsshould stay at home11 Waste disposalTreat any waste that could be contaminated with A(H1N1) swine influenza virus asinfectious clinical waste eg used masks12 Disheseating utensilsWash using routine procedures with water and detergent Use non-sterile rubber gloves13 Linen and laundry
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 25
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Wash with routine procedures water and detergent avoid shaking linenlaundry duringhandling before washing Use non-sterile rubber gloves14 Environmental cleaning and disinfectionClean soiled andor frequently touched surfaces regularly with a disinfectant eg doorhandles15 Patient care equipmentDedicate separate equipment to A(H1N1) swine influenza patients If not possible cleanand disinfect before reuse in another patient16 Duration of A(H1N1) swine influenza infection control precautionsFor the duration of symptoms17 Patient dischargeIf the A(H1N1) swine influenza patient is discharged while still infectious (ie dischargedwithin the period of infection control precautions see 16 above) instruct family memberson appropriate infection control precautions in the home18 Prioritization of PPE when supplies are limitedMedicalsurgical mask for the care of all A(H1N1) swine influenza patients and handhygiene are priorities419 Health-care facility engineering controlsIf available A(H1N1) swine influenza patients must be placed in adequately-ventilatedsingle rooms Aerosol-generating procedures should be performed in well ventilatedspaces20 Mortuary careMortuary staff and the burial team should apply Standard Precautions ie perform properhand hygiene and use appropriate PPE (use of gown gloves facial protection if there is arisk of splashes from patients body fluidssecretions onto staff members body or face)21 Health-care facility managerial activitiesEducation training and risk communication Adequate staffing and supplies22 Health care in the communityLimit contact with the ill person as much as possible If close contact is unavoidableuse the best available protection against respiratory droplets and perform hand hygiene
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 26
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Annexure 6
List of Algorithms
Algorithm 1 Case Action guidance
Algorithm 2 Contact Surveillance
Algorithm 3 Case Transfer Protocol
Algorithm 4 Case Arrival at the Referral Hospital
Algorithm 5 Case Management
Algorithm 6 Laboratory Investigation
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 27
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 28
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 29
Suspect human case of H1N1 Influenza A virus INITIAL CONTACT
All Health Care Institutions (Private or Government)PrimarySecondaryTertiary Care
Suspect Case definition Acute febrile respiratory illness (Fever gt 380 C) with the spectrum of disease from influenza-like illness (ILI) to pneumonia inclusive of severe acute respiratory illness (SARI) with onset
- Within 7 days of close contact with a confirmed case of H1N1 influenza A virus OR
- Within 7 days of travel to countries where one or more confirmed case of H1N1 influenza A virus were reported OR
- Resides in a community where there were one or more confirmed cases of H1N1 influenza A virus
Follow ALGORITHM 5 for Clinical Management
ConsultAdult cases
Dr (GSM ) OR Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr hellip (GSMhellip)
Compatible Case
1 H1N1 Influenza A Case Action Protocolhellip RegionGovernorate
April 2009
Inform Executive Director of the hellip HospitalDr (GSM ) for admission
and organize ambulance to transfer the case
Follow ALGORITHM 3 for case transfer protocol
If lsquoNOrsquo If lsquoYESrsquo
Infection control procedures during initial contact
(If needed consult Dr Bassim Zayed GSM 99534234)
Place surgical mask on the patient
HCWs should also use surgical mask
Place the patient away from other patients until referral
Follow ALGORITHM 6for Laboratory Investigations
Consult Dr Suleiman Al Busaidy (GSM 99426288)Dr Said Al Baqlani (GSM 99248132)
No further action
Inform DGHS amp DCDSC immediately
DirectorSuperintendent of Health Affairs (GSM hellip)Regional EpidemiologistFocal Point (GSM hellip)
Consult for Epidemiological compatibility
Dr Salah Al Awaidy (GSM 99315063) Dr Idris Al Abaidani (GSM 95224261)Dr Shyam Bawikar (GSM 99368327)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 30
Algorithm 2 Contact SurveillanceApril 2009
Investigation Team
Director of Health Affairs Epidemiologist amp Health Inspector from DGHS Team Coordinator Wilayat Health Superintendent
Follow-up of cases Wilayat Health Inspector
PPE should be worn during interview (mask gloves gown) To enlist all information of all close contacts (address movement amp contact
telephone etc) Ask amp check for fever amp severe respiratory symptoms daily for 7 days
House quarantine for 7 days from the day of close contact with the suspect case
Daily visittelephonic contact by the doctor from nearby health centrehospital for development and progress of fever ampor respiratory symptoms
Contact Advisory Restrict movements of contact (self imposed) Should not report on duty (quarantine leave) If fever develops call Focal Point in the DGHS
Dr (GSM ) OR Dr (GSM ) Provide information brochure
If the contact develops fever amp respiratory symptoms
Advise Not to visit any clinic -
Government or private Minimize contact with family
amp restrict movements Call doctor of the nearby
health centrehospital for hisher follow-up
Follow-up Doctor shouldInform the Executive Director
of the hellipHospital for Admission
If fever or respiratory signs amp symptoms present amongst
contacts
CONTACTS of suspect case of H1N1 Influenza A virus
Asymptomatic Contacts
Follow-up Doctor shouldinform amp consult to assess clinical
compatibilityAdult cases Dr (GSM ) OR
Dr (GSM )Paediatric Cases Dr (GSM ) OR
Dr (GSM )
Follow-up Doctor shouldInform amp Consult Focal Points
In DGHSDr (GSM ) OR Dr (GSM )
Inform DCDSCDr Salah (GSM 99315063) Dr Shyam (GSM 99368327)
Dr Idris (GSM 95224261)
Asymptomatic for 7 days
No further action
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 31
Suspect Case of H1N1 Influenza A virus detected in Primary Health Care institutions in Private ClinicsHospitals OR Royal HospitalSQ
University Hospital
(Epidemiologically amp Clinically Compatible)
Suspect case
Isolate case in a room Heshe should wear a surgical
mask Do not allow contact with
others (relatives) Patients documents
belongings should be collected by the health inspector
Health Care Worker
Doctorhealth inspector should wear PPE - (N95 respirator mask gown gloves) immediately
Do not carry out any procedures on the case and avoid unnecessary contact
Airport duty staff should not accompany the case to the hospital
Instruction for transfer of case
Organize ambulance with a staff nurse escort to transfer the case immediately
The ambulance staff should use PPE
Algorithm 3 Case Transfer to Referral HospitalApril 2009
To inform amp Consult
Focal points in DCDSC (Algorithm 1) AND the Directorate
Dr (GSM ) Dr (GSM )
Quarantine Hospital for HPAI in hellip
Inform Executive Director Hospital hellip Dr (GSM ) for Admission to Hospital
Contact Management Refer to Algorithm 2
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 32
Algorithm 4 Case Arrival at Referral HospitalApril 2009
Suspect case of H1N1 Influenza A virusArrival at Hospital
Ambulatory Non-ambulatory
Case received amp escorted by nurse to Triage Room on
wheel chairNurse should wear PPE
Case received amp escorted by two nurses to Triage
Room on stretcherNurse should wear PPE
DISINFECTION PROCEDURES (Applicable to ambulance stretcher wheel chair or any
other medicalnon-medical equipment used for the case during transfer)
Equipment used should be cleaned amp disinfected according to manufacturerrsquos instructions
Clean all contaminated surfaces by using Sodium hypochlorite solution prepared according to manufacturerrsquos recommendations
OR consult designated Infection Control Nurse in the referral hospital
The Case is transferred to the quarantineisolation ward immediately through the shortest possible route
Under Supervision of the Executive Director of the Hospital
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 33
Algorithm 5 H1N1 Influenza A virus Case Management April 2009
Suspect case of H1N1 Influenza A virus arrives at Hospital
ConsultantsSpecialists Adult Cases Dr (GSM ) OR
Dr (GSM )
Paediatric Cases Dr (GSM ) OR Dr (GSM )
Nursing Supervisor Pager
Examine case in full HPAI gear
Check vitals amp Oxygen saturation
StableCondition
To call technician on duty CxR (full
HPAI gear)
Executive Director of the HospitalDr to inform
Deterioration
Nursing duty Organization
(refer duty roster)
Internal MedicinePaediatrics -
Doctor on duty
Inform Anesthesiologist
on Call
Examine amp confirm the childadult in isolation room (in full HPAI gear)
Counsel family Manage on case-to-case
basis
EpidemiologistTo assess the need of
quarantine of family members amp other contacts
Recommended anti-viral Treatment
Sample collection by doctornurse
As per the national policy amp guidelines
Laboratory Investigations
Follow Algorithm 6
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 34
Algorithm 6 Laboratory Investigation of H1N1 Influenza A virusApril 2009
Hospital Laboratory Central Public Health Laboratory
General investigations for Case Management
Specific investigationsfor Diagnosis
On admission of a suspect case of H1N1 Influenza A virus in the hospital focal point should inform
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132) from CPHL Muscat
Specimens to be collected immediately
by attending Doctor in Hospital Nasopharyngeal swab Oropharyngeal swab Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Specimens to be collected during illness
by Chest specialist or Senior Physician Bronchoalveolar lavage Tracheal aspirate Collect samples in VTM refrigerate
immediately (DO NOT FREEZE)
Preserve tissue samples from the deceased in VTM amp formalin
Haematology5 ml Blood
Clinical Chemistry5 ml Blood
Note For diagnostic tests collection bottles
swabs amp VTM will be provided by CPHL amp will be coordinated by
Dr Suleiman (GSM 99426288) OR Dr Said (GSM 99248132)
DoctorNurse on duty to collect blood samples
Routine Investigations on Arrival CBC LFT SB UE CK LDH Electrolytes Blood gases Sputum Gram stain amp culture Blood culture
Inform CPHL before sending samples
Full PPE gear should be worn before taking respiratory samples from suspect case
Check-list(Must accompany samples sent to CPHL)
Name of the person taking sample (s) Datetime sample (s) taken Type of sample (s) Storage conditions (temp) Datetime of shipment to CPHL Whether duplicate samples collected Whether lsquotriplersquo packaging done Whether communicated for sample arrival Whether other samples collected for case
management If yes then provide results
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Ministry of Health Sultanate of Oman
PANDEMIC INFLUENZA H1N1 PREPAREDNESS
REGIONAL ACTION PLAN MUSANDUM GOVERNORATE
MAY 2009 DIRECTORATE OF HEALTH AFFAIRS amp DHS MUSANDAM GOVERNORATE
بتاريخ مسندم بمحافظه الوبائي الترصد لجنه اجتماع محضر
م352009
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 35
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
يوم صباح في مسندم بمحافظه الوبائي الترصد لجنه اجتماع عقد تك الموافق سالم 352009األحد بن سيف بن ناصر الفاضل برئاسه م
اللجنه ndash أعضاء وحضور الصحيه الخدمات دائرة مدير السعديبالترحيب االجتماع وبدء الحكوميه والدوائر القطاعات لكافه الممثلين هذا أهميه عن والتنويه الدائرة مدير الفاضل قبل من بالحضور
المستجدات آخر لمناقشه الفتره هذه في انعقادة وسبب األجتماعالخنازير أنفلونزا بخصوص
بخاء بواليه الصحيه الخدمات مركز رئيسه الفاضله قامت ذلك بعدمرض عن محاضره بإلقاء الشحي صوالح بن صالح بنت مريم د
ومسبباته بالمرض تعريف العرض هذا وتضمن الخنازير أنفلونزاالمصابة للحاالت المستخدم والعالج منه الوقاية وكيفيه وأعراضه
العالم بلدان بجميع اإلصابه نسب وآخر
تم حيث الموضوع حول مناقشه دارت العرض من االنتهاء وبعدإتباعه ومايمكن المرض هذا أعراض عن األعضاء بعض من االستفسار
منه للوقايه إجراءات من
على الحضور لكافه الدائره مدير الفاضل بشكر االجتماع انهى وبعدهاوكان الوبائي الترصد لجنه اعضاء اإلجتماع وحضر الفعاله المشاركه
وهم 15عددهم
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 36
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الوبائي الترصد لجنه اعضاء حضور كشف
الوظيفه االسممركز بيطريه صحيه أخصائي
الزراعهالشحي الصغر أحمد بن عدنان د
الشحي علي أحمد عبداللهمنسق البدري عبدالرزاق بن خالدكاتب الشحي حسن بن سيف
قسم رئيس علي بن حسن بن عبداللهالكمزاري
بالجمعيه إداريه عضوه الكمزاري داوود منارهخصب مركز ضابط البلوشي علي بن حسين
الشحي محمد أحمد ابراهيمصحيه خدمات مشرف الشحي عبدالله عبدالله عليصحيه توعيه اخصائي سليمان بن محمد بن داوود
الشحيبالجمعيه عضوه الكمزاري سيف صالح حليمه
خصب صحيه خدمات مشرف الشحي زيد محمد زيدمدحاء صحيه خدمات مشرف المدحاني سبيت عليالصحيه الخدمات مركز رئيس
بخاءالشحي صالح مريم د
محمود محمد زينب د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 37
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
SWINE INFLUENZA-MEETING MINUTES
On 3509 a meeting was conducted at DHSM conference room under the chairman ship of Dr Mohd Mohd Amro GhobashySupdt of Health affairs Following Health care providers of the region attended the meeting-Medical officer incharge of all HospitalsampHC except Leema HC-Infection Control incharge of all HospitalsampHCs except Leema HC-Dr Ashraf El SayedHOD (Paed)Khasab Hospital-Dr Zakaria IbrahimHOD (Med)Khasab Hospital-Dr Ashraf JamalInfection control doctor icKhasb Hospital-Mr Abdullah Juma infection control nurse icMusandum region-MCH Co-ordinator-Supdt of pharmacyampmedical stores-Acting head of Nursing
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 38
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Regional Vaccine store incharge-Dr DPShahdoctor incharge Khasab private clinic
Supdt of Health affairs welcomed all for the meeting and following points discussed-Swine influenza H1N1 is now of global concernSince its outbreak is alarmingwe as health care providers of Oman too to be prepared well enougheven though present situationin Oman is safe-Global preparedness and situation updates were informed by Dr Ghobashy-WHO recommendations and reports were shown on slides during meeting-A Lecture is made to all staffs about swine influenza on 30409 by Supdt of Health affairs in the regional lab symposium-All Hospitals and private clinics must give awareness to all staffs and enough PPE to be made available-Regional Hospital is well equipped with an isolation ward and anti viral drugs-All Hospitals and Health centers can refer the cases to regional Hospital as per the protocol-Dibba Hospital can receive from patients from Madha HC and manage the case there itself since they have the facility-Even Dibba Hospital can refer cases to Regional Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 39
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-All Hospital must follow the swine influenza A(H1N1) case Action protocol of the RegionGovernorateA copy of the same to be available in each clinic-Expressed thanks to DrAhmed madhaniMO incharge Madha HC-Dr Mariam asked to send E-mail for her the updated Algorithm-Weekly ILI report to be send to DHSM from all health institutions as it is an on going programme in Musandum region since last 3 yrs-All health institutions must send the feed back of their preparedness on swine influenza management and the name of the staff responsiblebased on Avian Influenza preparedness of Musandum Governorate-Influenza A H1N1 update Mo12 distributed to all members during the meeting-Infection control protocol in case of acute Respiratory diseases to be distributed to all clinics-There was a meeting with all Epidemic Preparedness Team on 3509 at 1130am and also Arabic lecture delivered about the same by Supdtof Health Affairs-No other points discussed-Meeting concluded at 1100 hrs
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 40
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DHSM CONTDhellipWORKSHOPS CONDUCTED ON SWINE INFLUENZA HINICATOGERIES 30409 17509STAFF NURSE 31 36SPECIALISTS 12 03MO 7 9LABORATORY 7 13PHARMACY 1DIETITAN 1DENTISTS 1OTHERS 2(IT)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 41
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KHASAB HOSPITAL
Preparation for manangement of swine influenza
AMeeting was conducted at MOIC Office on 1509 at 1210 pmThe following members were present1Dr Rakesh SharmaActg MOIC2Mr Ahmed DarwishAO3Dr Omaima A WehabMOIC Public Health4Dr Zakariya BoghdadyHOD (Med)5Dr Arshad JamalHOD(Surg)6Dr Ashraf El GazarHOD(Paed)7Mrs Amal HassanNursing supervisor8Mrs Shaikh Al KamaliMRO9Mr Bader DarwishIC PharmacyampMedical store10Dr Wael Lotfipathologist
The minutes of the meeting are as follows
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 42
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Dr Sharma Actg MOIC after welcoming participants gave a briefing on swine influenza situations as an International public health emergency and need for health care team to be ready
He delegated the responsibilities as follows1Dr Ashraf El Gazar HOD(Paed) will be responsible to check WHO website on (httpWWWwhoint) on computer twice a day in addition to being IC Communicable diseaseampPaed cases2Mr Haris Biomedical technician should ensure all ecquipments such as ventilators and defibrillator located in the treatment room of Isolation ward arew fully functional3MOIC Public Health should make a team for surveillance in community and Mr Ali Khatab to initiate necessary steps if suspectedconfirm cases come to notice4Dr Wael Lotif is responsible for investigations of all cases of ILI and LRTI including pneumonia for all age groupsWeekly reports should be sent to the supdt of health affairs5Dr Arshad Jamal HOD(surg) and Mr Abdullah Juma will be responsible for Infection control in Hospital and Polyclinic including procurement of necessary materials6Mrs Shaikha and Mr Khalid are responsible for inpatientoutpatient statistics and reporting of the same7Dr Zakaria HOD (Medicine) is responsible for training all GPs and Staff Nurses regarding swine influenza and
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 43
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
responsible for preparing detailed protocol for swine influenza management in addition to management of adult cases8Mr Bader is responsible to ensure that all the medications and equipments stocks are updated9Mrs Amal is responsible to keep ready the Swine influenza Isolation ward to receive any cases and prepare duty roster for Nursing staffs and Supervisor staff for smooth functioning of Isolation wardBAs of now the Isolation ward including treatment room with all items including ventilatordefibrillatoroxygen cylinderIV linesdisposibles and medications is filly ready in addition to two isolation rooms for patients which can be increased to three as and when need beC990 tablets of TAMIFLU 75 mg are available in medical storeDNursing Supervisor Mrs Amal has under taken detailed briefing of Nursing staff in above contextCopy of her report is attached here withEWHO website is being checked on daily basis by Dr Ashraf El Gazar and latest updated information as and when available will be circulated to all Health Care workersFDr Zakaryia has been requested to prepare presentation and conduct briefing of all doctors at the earliest in consonance with guidelines andprotocols and materials from Supdt of Health affairs under his kind guidance
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 44
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
DIBBA HOSPITAL
Preparation for management of swine influenza
INTRODUCTION Dibba Hospital is a local health institute in Musandum regionThe Hospital is provided with 40 beds and serves as primary and secondary health careThe catchment population is 6222(Annual health report 2006)Disasters have been divided in internal disaster(refers to an incident that disrupts the every dayroutine service of the medical facility itself)and External disaster(that has occurred outside the hospital and has not had a direct impact on the hospital servicecapabilities)Our external disaster plan consists of thre responsible phasesPhase 1 is an alert phaseduring which staff remains at their regular dutiesand wait for further instructions from their supervisors(MOIC and Nursing incharge in co-ordination with hospital engineer)Phase 2 is a response phase and designated staff report to supervisors or the command post for instructions
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 45
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Phase 3 is expanded response phase during which additional persons are requiredThereforoff duty staffs are called in to the hospitaland existing staffs may be relocated within the hospitalThe hospital engineer and his team will be responsible for repairing and laboratory equipments failurepotential chemical spillsand loss of radiography capabilitysuctioncommunicationlightingmedical gases and structural stabilityAlso adequatenumber of security personnelwillm report to areas of congestion to prevent thegeneral public from entering the facilityand to clear hallwaysto ensure that patient careparticularly in critical areasis not hampered Main Disaster team consists ofMOICDr Aisha Al Shehi Team inchargecontact numbers 993671572883660026836281Willayat Health SuperintendentMr Ali Abdullah GSM 99422201Physician and acting MOICActing team inchargeDr Wesam Hanna 26836793Ext 312GSM 99834319PaediatricianDr Mahmood K26836794EXT 307gsm 92726360AnaesthetistDr Amani 26836446ext 309SurgeonDr Gamal 26836446ext 311GSM 99643749Nurse ICFatima Mohd GSM 922982262683669926836109Administrative SupdtAtiqa AliGSM 92299883Onec Company representative Mr Babu GSM 92174490
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 46
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
The above team is responsible to announace the emergency situations and co operate with the main committees at regional and centaral level as well as thwe other non medical committies available in the villayatSee attached algorithamcase action protocolDGHSDuring external disaster and emergencies the following actions will be taken1Stopping all routine admissions and routine opd casesdischarge stable patients2Use the available isolation roomfor any suspected case till paitent transfer to regional hospital if needed according to regional protocol3Keep male ward room no 3ready to be used as isolation room in caseif suspecting case increasing more than two4All medical and paramedical staff should be 24 hours oncall5Ambulance to be kept 24 hours available for shiftingor transferring of patients6Suspected cases will be managed according to the swine influenza case action protocolregionalGovernorate April 2009 and according to WHO protocolinfection prevention and control in health care providing care for confirmed or suspected H1NI swine influenza patientsDibba Hospital PPE equipments currently not adequateaccordingly a formal letter have been sent to Ph Mozahead of pharmacy and medical stores at musandum region to provide as with enough N95 mask and medications like TAMIFLU
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 47
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Laboratory acting incharge Muna will follow up with centralregional lab to provide special media for swab cultureinorder to be taken in Dibba Hospital and to sent immediately for central lab for confirmationInfection control focal point of Dibba Hospital have been informed to follow up for WHO protocol implementation in providing care for confirmed or suspected swine influenza H1N1 patientsThe following stepslectures and meeting have been done in Dibba hospital since the start of phase 4 swine influenza world wide-On 29409 meeting with all HODsWillayat Health SupdtAONurse ICopdICinfection control focal pointLab ICPharmacy ICPublic health ICto discuss and update Dibba Hospital swine influenza protocol and update main team and discuss infection control plan and responsibilities-On 5509 CME conducted with all hospital staff about hand washsaves lives(WHO celebration)to encourage hand hygiene and emphasis on using the recommened protocol an d guide line for hand washOn 6509 CME conducted with all HODsGPsdepartment ICSInfection control focal point and Nurses to discuss regionallocal plan of swine influenza and infection control in health care in providing care for confirmed or suspected swine influenza H1N1Regional algorithm and WHO protocol to be strictly followed in Dibba Hospital
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 48
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
BUKHA HOSPITALPANDEMIC INFLUENZA PREPAREDNESS PLAN 2009 In view of the above and with the reference of letter no MHDHSMHHC5091048 on 6509 below mentioned are the details from our institutions with respect to the above stated topics
-ACTION PLAN-Formation of preparedness teamDr Maryam salah Al Sawaleh (Head of Willayat Health services)GSM 99319892-alsawaleh76yahoocomMOIC(Dr Maryam Salah Al Sawaleh)Mr Mohd Ahmed Mohd(AO)GSM 99006767 AnnammaVOGSM 92200751annathampyyahoocoukInfection control staff(SSN Badriya Al Dahoori)GSM 99435123Lab IC GSM 99464972XRAY ICGSM 92385011
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 49
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Educating the public about Influenza A H1N1 In this regard our doctors are providing advisory details to relevant OPD patients on their travel habitsetcaccording to the current Influenza A H1N1 trends
-Continue updating the doctors and the other staffs with the most recent WHO reports about Influenza A H1N1 and the most recent recommendations
-Three doctors and two nurses attended the awareness lecture on swine influenza conducted by Dr Mohd Mohd Amro Gobashy on 30409Orientation given to other staffs in the hospital about the disease
-H1N1 Influenza case action protocol is distributed to all the clinics and in the wards and explained to the doctors and to the staffs
-prepration of the weekly ILI reports which are forwarded to DHSM as before done since 3yrs
-Infection control protocol in case of acute respiratory disease distributed to all clinics and wards
-Use a medical or surgical mask and emphasize on hand hygiene and provide hand hygiene facilities and supplies
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 50
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
-Ensure the availability of personal protective equipments and accessible round the clock to the health care staff(surgical mask gloves and mask)
-In case of suspected cases1-Inform Head of wilayat health service (Dr Mariam Al shehi)and MOIC Nursing supervisiorand infection control nurse and other members of the preparedness team
2-suspected case to be first informed and consulted with Supdt of health affairs HOD medicine in case of adult and HOD paeds in case of children3-If the case is fitting the criteria of suspected case then to refer by ambulance with staff nurse to khasab hospital
gtsuspected case transfer1Isolate the case in the treatment room in the IPD2Heshe should wear a surgical mask3Do not allow contact with others (relatives)4patients documentsbelongings should be collected by the health care provider5Doctorhealth care provider should wear PPE(surgical maskgown gloves)6carry out only most required procedures on the case and avoid unnecessary contact
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 51
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
7Organize ambulance with staff nurse to escort the case immediately8The ambulance staff must use PPE
A lecture is given to all the staff about Influenza AH1N1 on 10509 in Bukha hospital paediatric ward at 1pmWe are planning for continues educationorientation and training of health workers and school students about the disease and the possible ep0idemic
STAFFS RESPONSIBLEDr Mariyam saleh Al sawaleh (Head of wilayat health services GSM-99319892 alsawaleh76yahoocomMOIC (DR Mariam saleh Al sawaleh)Mr Mohd Ahmed Mohd (AO) GSM 99006767Annamma VOGSM 92200751annathampyyahoocouk Infection control staff ( SSN Badriya Al Dahoori GSM99435123)x ray incharge GSM 92385011Lab incharge GSM 9946972
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 52
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
LEEMA HEALTH CENTRESWINE INFLUENZA A H1N1 PREPAREDNESS
PREPAREDNESS TEAM1Dr AHLAM Mohd khalil (MOIC)2Dr Mohanned Babiker( MO)3Mr Ali suliman Ahmed (AO)4Mr Ali Hassan Hilal (Nsg incharge)5Ms Saliamma kurian (SN)6 Ms Suma Stephen ( lan ic )
PLAN OF ACTIONAll staffs oriented and lectures given about Swine influenza and explained what to do in case of emergencyLecture given to school and discussion conducted among the students (attended 43)
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 53
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Lecture given to CSGM and explain how to orient public and avoid unnecessary panicLeema staffs vaccinated against influenzaReady to meet any emergencywhen identify the case as suspect isolate the patient with mask and staffs to wear PPENo isolataion facility in leema health centreInform Supdt of health service and focal point of communicable disease of khasab hospital Inform public health ic of khasab Arrange the transfer of the patient to regional hospitalWeekly ILI report to supdt of health affairs and the focal points
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 54
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
KUMZAR HEALTH CENTRESWINE INFLUENZA A H1N1 PREPARDNESS
Sultanate of Oman Ministry of Health
Directorate of Health Services
Musandam Governorate
Kumzar HC
H1N1 Influenza A Case Action Protocol
Suspect human case of H1N1 Influenza A INITIAL CONTACT
(In the HC seen by Doctor Nurse
Suspect Case DefinitionAcute febrile respiratory illness(fevergt38C)with the spectrum of disease from Influenza- Like Illness(ILI)to pneumonia inclusive of severe acute respiratory illness(SARI)with onset----
-Within 7 days of close contact with confirmed case of H1N1 Influenza A virusOR
-Within 7 days of travel to countries where one or more confirmed case of H1N1 Influenza A virus were reported OR
-Resides in a community where there were one or more confirmed cases of H1N1 Influenza A virus
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 55
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
If No If YesNo further action -Inform Dr on call(if seen by nurse)
-Inform
-Supdt of Health affairsDr Mohd Ghobashy (99381424)
-Dr Zainab MCH Coordinator-99468845
During initial contact Compatible case
-place surgical mask on the patient Inform Executive Director-Khasab Hospital-HCWs should also use surgical mask Dr Jolly philp(99220513)for admissionamp
-place the patient away from other patients organize suitable method to transfer the until referral patient (according to weatherampcase)-resuscitate the patient if needed
Case Transfer to Khasab Hospital
Suspect case H1N1 Influenza A virus detected inKumzar HC (by nurse or Doctor)
(Epidemiologically ampclinically compatible)
-Drhealth inspector should wear PPE-N95 respirator maskgowngloves) Suspect caseImmediately- -Inform G P on call(if Do not carry out any procedure on seen by nurse) the caseamp avoid unnecessary contact -isolate case in a roomBoatampHelicopter should not accompany - Do not allow contact the case to the hospital(also they should use PPE) withothers(relatives)
-patients documents belongings should be
Collected by the health inspector
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 56
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
Before referral inform consultSpecialist on call ( Paediatric or medicine)Dr Mohd Ghobashy ( 99381424)Dr Zainab (99468845)
Instruction for transfer of cases -Organize method of transfer according To advice of the Specialist (by boat or by air) with a staff nurse escort-Staff should use PPE
Quarantine Hospital for HPA1 in ----Inform Executive Director Khasab hospitalDrJolly Philip (GSM 99220513) for Admission to Khasab Hospital)
-
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 57
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
PPDDD
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 58
Suspect case MADHA HEALTH CENTRE
1A person with an acute respiratory illness who was a close contact to a confirmed cases of swine influenza virus infection while the case was ili or 2 Aperson with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swin e influenza or3A person with acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza within 7days of suspect cases illness onset
IF NONo further action
CONSULT FOR EPIDIMOLOGICAL COMBATIBILITYDRMOHD GHOBASHY (99381424amp26731655)DR AHMED AL MADHANI (99448498amp26739090)
CONSULT FOR CLINICAL COMPATIBILITYDR ZAKRIYA HOD MED (26730138amp26730155)DR ASHRAF HOD PAED (26730138amp26730155)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 59
CASE TRANSFER PROTOCOL
QUARANTINE HOSPITAL IN MUSANDAMKHASAB HOSPITAL
SUSPECTED CASE EPIDIMOLOGICALLY amp CLINICALLY COMBATABLE
SUSPECT CASE1ISOLATE THE CASE IN A ROOM2HESHE SHOULD WEAR A SURGICAL MASK3DO NOT ALLOW ANY CONTACT WITH OTHERS (RELATIVES)4PATIENTS DOCUMENTS BELONGINGS SHOULD BE COLLECTED BY HEALTH INSPECTOR
HEALTH CARE WORKER1DOCTORHEALTH INSPECTORMUST WEAR PPE(3M MASKGOWNGLOVES)2DO NOT DO ANY PROCEDURE ON THE CASE AND AVOID INNECESSARY CONTACT
CONTACTS INFORM DR MOHD GOBASHY (99381424) DRZAKRIYA ampDR ASHRAF (26730138)
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
مدحاء صحي مركز
حول بها المشكوك الطارئه الحاالت عن المسئوولين الموظفينالخنازير أنفلونزا
االتصال أرقام األسم الوظيفه99448498 مسؤول طبيب المدحاني أحمد د26739213 بالنيابه مسؤول طبيب إيمان د
00971507006585 تمريض مشرف السعدي عبدالله00971504345678 اإلداري المشرف محمد عبدالله
المدحاني00971503915777 الخدمات مشرف
الصحيهالمدحاني محمد علي
92440179 أسعاف سائق عبدالله علي المدحاني
حول بها المشكوك الطارئه الحاالت عن المسؤولين الموظفينالخنازير أنفلونزا
االتصال أرقام الوظيفة االسم99381424 الشؤون غباشي مشرف د
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 60
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
الصحيه26730138 الباطنيه قسم رئيس
خصبزكريا د
26730138 االطفال قسم رئيسخصب
أشرف د
99367157 مسؤول طبيبدبا مستشفى
الشحي عائشه د
26836777 األطفال قسم رئيسدباء
محمود د
26836777 الباطنيه قسم رئيسدباء
وسام د
CONTACT
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 61
CONTACT OF SUSPECT CASE1 TO CONDUCT HOME VISIT2 PPE SHOULD BE WORN DURING THE VISIT (MASK
GOWN GLOVES )3 TO ENLIST ALL INFORMATION OF ALL CLOSE CONTACTS
(ADDRESS MOVEMENT CONTACT TELEPHONE ETC)4 ASK AND CHECK FOR FEVER AND RESPIRATORY
SYMPTOMS
ASYMPTOMATIC CONTACTS IF FEVER OR RESPIRATORY SIGNS AND SYMPTOMS
HOUSE QURATAINE FOR 10DAYS FROM THE DAY OF CLOSE CONTAACT WITH SUSPECTED CASEDAILY VISIT BY THE DOCTOR TO THE HOUSE FOR THE CHECK UP ( FEVER AND RESPIRATORY SYMPROMS)CONTACTS ADVICE1RESTRICT MOVEMENT OF
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 62
IF THE CONDAACTS DEVELOPS SYMPTOMS OF FEVER AND RESPRATORY SYMPTOMSCONTACT ADVISORY1DO NOT VISIT ANY CLINICGOVTOR PVT2MINIMIZE CONTACT WITH FLY AND RESRICT MOVEMENT3 CALL DOCTOR IS THE ONE WHO IS DOING THE FOLLOW UP
FOLLOW UP DOCTOR TO INFORM AND CONCULTDR MOHD GHOBASHY
FOLLOW UP DOCTOR TO INFORM AND CONSULT
FOLLOWUP DOCTOR SHOULD CALL THE MOIC TO ARRANGE
SUSPECT CASE MADHA HEALTH CENTRE
1APERSON WITH ACUTE RESP ILLNESS WHO WAS A CLOSE CONTACT TO A CONFIRMED CASE OF SWINE INFLUENZ H1N1 VIRUS INFECTION WHILE THE CASE WAS ILL OR2A PERSON WITH AN ACRESP ILLNESS WITH ARECENT HO CONTACT WITH AN ANIMAL WITH CONFIRMED OR SUSPECT SWINE INFLUENZAH1N1 VIRUS INFECTION OR3A PERSON WITH AN AC RESP ILLNESS WHO HAS TRAVEL TO AN AREA WHERE THEREARE CONFIRMED
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-
N a ti o n a l P a n d e m i c I n fl u e n z a P r e p a r e d n e s s P l a n 2 0 0 9
M i n i s t r y o f H e a l t h S u l t a n a t e o f O m a n P a g e 63
1 THE STAFF MUST START USE PRECAUTION PROCESS (MASK GOWNGLOVESAND CLEAN USING70 ALCOHOL OR SOAP WITH WATER)2PATIENT MUST WEAR A MASK3SHIFT THE PATIENT TO THE DELIVERY WARD IMMEDIATELY4 STOP THE RELATIVES FROM COMING IN CONTACT WITH THE PATIENT5RESTRICT THE STAFF WHO ARE DEALING WITH THE PATIENT TO THE
- 1 Background
- National Spokespersons for Ministry of Health
- HE Dr Ali Jaffer M Suleiman DGHA
- Dr Salah Al Awaidy Director DCDSC
- Provincial Spokesperson (Governorates amp Regions)
- DirectorDirector General of Health Services
- Name
- Designation
- Office
- Fax
- Mobile
- Ministry of Health HQ
- HE Dr Ali Jaffer M Suleiman (Chairman)
- Director General of Health Affairs
- 24600808
- 24696099
- 99335681
- Ph Nusaiba Habib Mohd
- Director General of Medical Supplies
- 24699973
- 24601593
- 99240990
- Dr Salah Al Awaidy
- (Focal Point)
- Director Communicable Disease Surveillance amp Control
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director Central Public Health Laboratory
- 24705943
- 24793699
- 99426288
- Ms Sabah Al Bahlani
- Director Health Education amp Information
- 24562609
- 99332792
- WHO Country Office-Oman
- Dr Jihan Tawilah
- WHO Representative Oman
- 24600989
- 24602637
- MoH and Sultan Qaboos University Hospital
- Dr Mohammed Al Balushi
- Director Al Nahda Hospital
- 24835746
- 24831578
- Dr Mohammed Al Hosni
- Head of Child Health Royal Hospital
- 24599552
- 24599173
- 99474441
- Dr Yaqub Al Mahrooqi
- Chest Specialist Royal Hospital
- 99427669
- Dr Abdullah Balkhair
- Infectious Diseases SQUH
- 24413355
- 24413419
- 99293797
- Ms Farida
- Head of Nursing Al Nahda Hospital
- 24837511
- Ext 1112
- 24837522
- Department of Communicable Disease Surveillance and Control MoH HQ (Field Staff)
- Dr Shyam Bawikar
- Advisor Epidemiologist
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Surveillance Section Head
- 95208040
- Mr Salem Al Mahrooqi
- National Surveillance Supervisor
- 99029195
- Mr Bader Al Rawahi
- National EPI Supervisor
- 99430689
- Name
- Designation
- Office
- Fax
- Mobile
- Mr Ali Amer Al Kiyumi
- Nature Conservation Ministry of Regional Municipalities Environment and Water Resources
- 24602285
- 24602283
- 99444808
- Mr Said Darwesh Al Alawi
- DG of Health Affairs Ministry of Regional Municipalities Environment and Water Resources
- 24692564
- 24692547
- 99389883
- Mr Ali Said Al Hammadi
- Director General of Planning Ministry of Interior
- 24707226
- 24790599
- 99420909
- Mr Mudriq Kathiem Al Moosawi
- Director General of Commerce amp Industry
- 24774100
- 24812030
- 99418909
- Mr Nasr Ali Al Wahaibi
- Director General of Animal Wealth
- 2469391
- 24694465
- 99382717
- Dr Salah Thabit Al Awaidy
- Director Communicable Disease Surveillance and Control
- 24601921
- 24601832
- 99315063
- Mr Mubarak Khamis Al Araimi
- Asst Director General of Information and Press Affairs
- 24697677
- 24521034
- 24602928
- Mr Mussallam Salem Al Jenebi
- Asst Director General of Customs Royal Oman Police
- 24521204
- 24521204
- 99319131
- Dr Sultan Eissa Al Ismaili
- Asst Director General of Animal Wealth amp Veterinary Services
- 24698512
- 24694465
- 99380316
- Dr Ali Abdullah Al Sahmi
- Head of Veterinary Services (Focal Point)
- 24696300 Ext 1510
- 24694465
- 99371816
- Name
- Designation
- Office
- Fax
- Mobile
- Dr Salah Al Awaidy TEAM LEADER
- Director Communicable Disease Surveillance amp Control (DCDSC)
- 24601921
- 24601832
- 99315063
- Dr Suleiman Al Busaidy
- Director CPHL
- 24705943
- 24793699
- 99426288
- Dr Shyam Bawikar
- Advisor Epidemiologist DCDSC
- 24601921
- 24607524
- 24601832
- 99368327
- Dr Idris Al Abaidani
- Section Ic Surveillance DCDSC
- 95224261
- Mr Basim Zayed
- Coordinator Infection control DCDSC
- 99534234
- Mr Salem Al Mahrooqi
- Surveillance Supervisor DCDSC
- 99029195
- Dr Ali Al Sahmi
- Focal Point for AI
- Ministry of Agriculture amp Fisheries
- 24696300 Ext 1510
- 24694465
- 99371816
- Support Team
- Dr Mohammed Al Hosni
- Head of Paediatrics Royal Hospital
- 99474441
- Dr Saif Al Abri
- Head of Medicine Royal Hospital
- Dr Yaqoob Al Mahrooqi
- Chest disease specialist Royal Hospital
- 99427669
- Ph Anisa Rasool
- Medical stores in-charge MoH
- 99476978
- Mr Mohammed Al Farsi
- Logistician ampTransport DGHA
- 99360541
- Name and Designation
- Office
- Fax
- Mobile
- DirectorSuperintendent of Health Affairs
- TEAM LEADER
- Regional Epidemiologist OR Communicable Disease Focal Point
- Health inspector from the affected Wilayat
- Support Team
- Executive Director Regional Hospital
- Regional Laboratory in-charge
- Infection control staff nurse Regional Hospital
- HOD Medicine Regional Hospital
- HOD Paediatrics Regional Hospital
- Director of Administration DGHS Logistic support
- Veterinary Doctor - Ministry of Agriculture and Fisheries
- Annexure 6
-