Influenza Pandemic Preparation and Response: A Citizen's Guide

Symptoms and signs of dehydration

• Weakness
• Headache
• Fainting
• Dry mouth
• Dry skin
• Thirst
• Decreased alertness and change in consciousness
• Decreased urine output
• Darkly colored urine
• Rapidly increased heart rate upon rising to a sitting or standing position

Preventing dehydration

It is possible that potable (safe drinking) water supplies may be in short supply or not available in a disaster, so you may need to purify the water.

Here's how:

Purifying Water

You can purify water for drinking, cooking, and medical use with these methods:

• Heat it to a rolling boil for 1 minute
• Use water purification tablets
• Add 8 drops of unscented liquid bleach per gallon of water (16 drops if the water is cloudy)
• Let the bleach/water solution stand for 30 minutes.

Note that if the solution does not smell or taste of bleach, add another 6 drops of bleach and let the solution stand for 15 minutes before using.

Diet Recommendations9

A clear liquid diet is used to treat certain intestinal diseases, especially infectious diarrhea.

Patients suffering from diarrheal illnesses often experience abdominal cramping and frequent, loose stools if they eat solid foods. In addition, a great deal of water and minerals (sodium, chloride, and potassium) are lost in the watery portion of the diarrheal stool; if you are not careful this can lead to dehydration.

Patients with diarrhea have to drink considerably more fluid than usual to prevent the dehydration. This is especially important if the patient also has a fever, which in itself leads to increased loss of body water through the skin as perspiration.

Treating diarrhea

In most cases, patients with diarrhea (a common symptom of influenza) can tolerate a clear liquid diet without cramping or more diarrhea. This is because the small intestine can absorb water, minerals, and sugars fairly well even when infected.

The diet starts off with clear liquids only. As symptoms subside, simple-to-digest, low-residue foods are slowly added one step at a time.

Don't advance to the next step until the patient is completely symptom-free in the present step. If the cramps and diarrhea return as the patient progresses through each step, drop back to the previous step they tolerated.

This same Clear Liquid Diet approach is the one to use for patients who have been ill with the flu and have been too ill to eat. They will have been on Step 1 already so when they become hungry, begin them on Step 2 and advance them through the steps as above.

* Step 1: Oral Rehydration Solution (ORS), water, fruit juice, Jell-O, Gatorade or PowerAid, ginger ale, Sprite, tea.

• Step 2: Add white toast (no butter or margarine), white rice, cream of wheat, soda crackers, and potatoes without the skin.

* Step 3: To Steps 1 and 2 add canned fruit and chicken noodle soup.

• Step 4: To Steps 1 through 3 add poached eggs and baked chicken breast without skin, canned fish or meat.

• Step 5: To Steps 1 through 4 add milk and other dairy products, margarine or butter, raw fruits and vegetables and high-fiber whole grain products.

By recognizing the symptoms a patient has or the signs of the disease in the body, you can use the chart below to guide your treatment.

Here's how.

When to Seek Medical Care

When routine medical systems are unavailable, you may be required to care for family, friends, and neighbors but only do so up to a point.

It is important that you seek professional medical attention if the patient is sick enough to warrant higher level of care.

Hospitals, doctor's offices, and clinics may be overwhelmed with the number of people requesting medical care.

Not only will those with influenza be seeking care, but there will still be car accidents, surgery patients, and those needing emergency medical care that do not have influenza.

Patients with cancer, dialysis, HIV/AIDS, and other chronic debilitating medical conditions will likely experience disruption in access to vital medical services, so it's important to know when to seek additional help.

If a patient is experiencing the dangerous symptoms outlined below, they should be seen by a health care professional.

Through appropriate use of basic information at home, we can all help to reduce the demand on a potentially overwhelmed healthcare delivery system and thereby assure that our family and neighbors in most urgent need of advanced medical care have potential life-saving access to proper care and treatment.

Seek medical care if patient is experiencing any of the following

Adults

• Those who have a chronic condition or are on immuno-suppressive therapy should be monitored especially closely
• High fever for 3 or more days without improvement
• Sudden high fever with recurrence of symptoms
• Extreme drowsiness and difficulty waking
• Disorientation or confusion
• Seizures,
• Severe earache
• Shortness of breath when at rest
• Difficulty or pain in breathing
• Coughing up blood or foul-smelling sputum
• Chest pain
• Persistent vomiting or severe diarrhea not managed by standard measures
• A severe change in the ability to function, especially if elderly
• Symptoms of severe dehydration
• Blue discoloration skin, lips or nail beds
• Bleeding from nose that cannot be stopped easily through pressure
• Bloody diarrhea

Children

• Child is less than 3-months old and is ill with influenza
• Child has a chronic illness or is on immuno-suppressive treatments
• Child takes aspirin (acetylsalicylic acid) regularly
• Change in breathing pattern with increasingly labored breathing
• Excessive irritability or listlessness
• Symptoms of severe dehydration; e.g., if there is a significant reduction in urine output (less often than every 3 hours if younger than 6 months, less often than every 6 hours if older than 6 months)
• Severe difficulty breathing
• Blue lips or suddenly very pale
• Has a full or sunken fontanel (soft area on the top of a young child's head)
• Is limp or unable to move
• Appears confused
• Has a seizure
• Appears to be dehydrated

Checklist for Pandemic Response

q Understand how your life may change during a pandemic.