What is Seasonal Influenza?

Seasonal influenza, also known as the flu, is a very contagious viral disease that spreads through droplets created when an infected person coughs, sneezes, or talks. There are several viruses that cause influenza – including H1N1, H3N2, and influenza B. Influenza vaccines are available and must be received every year to be protective. Protection against infection typically begins within two-to-three weeks of immunization. It is important to note that the flu cannot be treated with antibiotics since it is caused by a virus.

The Current Trend of Seasonal Influenza in the Northern Hemisphere

The influenza season in the Northern Hemisphere generally begins in October and can last as late as May. According to the most recent influenza report from the WHO, dated Nov. 27, overall disease activity in North America continues to increase while activity in Europe remains low. The dominant circulating virus in North America is influenza A(H3N2), while influenza A(H3N2) and influenza B viruses are the primary strains circulating in Europe. Influenza A(H3N2) and influenza B viruses are covered by the traditional influenza vaccine.

Strategies to Prevent the Spread of Influenza in the Workplace:

1. Raise Awareness about Seasonal Influenza

Employees who believe they are at risk of becoming infected with influenza, and who understand the consequences associated with influenza infection, are more likely to alter their behaviors in order to reduce the risk of infection. Therefore, it is important that employers educate workers about how influenza is spread, what symptoms the flu causes, and the potential complications related to influenza infection. This information should be communicated to employees in a number of ways, such as through emails and by placing flyers or posters in high-traffic areas, to maximize visibility.

2. Encourage Proper Coughing Etiquette and Hand Washing

It is extremely important for employers not only to teach and remind employees the proper way to cover coughs and sneezes but also to remind them to regularly wash their hands throughout the flu season.

3. Keep the Workplace Clean

Since the flu can spread on contaminated surfaces or objects, it is extremely important that employers develop procedures and policies that ensure all commonly touched work surfaces, work areas, and equipment – for example, telephones, doorknobs, lunch areas, copy machines, etc. – are cleaned frequently. Routine cleaning agents are sufficient to disinfect surfaces against influenza, but employers should provide easy access to cleaning supplies.

4. Encourage Annual Flu Vaccinations

Even though the effectiveness of influenza vaccines depend on how well-matched the vaccine is to active influenza viruses, influenza vaccination remains an important additional defense against influenza infection. However, vaccination is arguably the most difficult measure to implement due to misconceptions about the influenza vaccine. For example, many people believe that the influenza vaccine makes people sick. In reality, the standard influenza vaccine contains virus that has been inactivated and is, therefore, unable to make people sick. Furthermore, many non-influenza illnesses have symptoms that can be described as flu-like. As a result, individuals may incorrectly attribute such symptoms to a recent vaccination instead of illness due to another infectious agent.

Employers should consider hosting a flu vaccination clinic at their place of business. The US CDC recommends providing vaccines to employees at little-to-no cost and promoting vaccination within the local community. If hosting a flu vaccination clinic is not plausible, employers should consider notifying their employees of local pharmacies and clinics offering influenza vaccinations. Since many pharmacies and clinics are only open during normal business hours, employers should consider allowing their employees the time to go to these clinics while still on the clock.

Conclusion

The flu can cause widespread business disruptions resulting in financial losses. Employers can mitigate such losses by implementing measures that will help prevent the spread of the influenza virus within the workplace: raising awareness about seasonal influenza, promoting proper hygiene, keeping the workplace clean, encouraging employees to receive their annual flu vaccination, and adopting flexible leave plans.

To help keep your workplace well this flu season, we’ve created this handy infographic: Top 6 Tips for Workplace Wellness this Flu Season. Download it now and share with your colleagues.

Visit a Travel Medicine Specialist

Health professionals who specialize in travel medicine are typically able to provide a level of care that often surpasses that offered by a general practitioner or family doctor who is not familiar with current, global health threats. An online directory of private travel clinics around the world can be found on the International Society of Travel Medicine website.

It is important to schedule your appointment at least four to six weeks before travel. This will ensure you have enough time to complete any vaccine series you may need and give your body time to build up immunity. During your appointment, be thorough about all potential destinations you may visit and activities you will participate in. Make sure you are apprised of all health issues relating to your itinerary and counseled on specific risks related to chronic medical conditions. And last but not least be sure to ask your healthcare provider if you are up-to-date on all routine vaccinations. These vaccinations include but are not limited to: Chickenpox (Varicella), Hepatitis A, Hepatitis B, Influenza, Measles, Mumps, and Rubella (MMR), Pertussis (Whopping Cough), Pneumococcal Pneumonia, and Tetanus and Diphtheria.

Contact Your Health Insurance Carrier

Illness and injury pose perhaps the most immediate risk while traveling abroad, especially in developing countries. According to the US CDC, more than 50 percent of international travelers to developing countries become ill during their trip. Since medical assistance abroad can be extremely expensive, it is important to ensure you have adequate health insurance.

Contact your health insurance carrier to determine if your policy will provide coverage in a foreign country. It is important to note that you may need supplemental travel insurance to ensure you are adequately covered for medical emergencies and evacuations. While traveling, carry your health providers name and contact information for emergency referral. If you have a chronic or ongoing health problem that may require treatment while abroad, be sure to also have a copy of pertinent health records.

Properly Pack Prescription and Over-The-Counter Medications

Another set of health risks includes pre-existing medical conditions, particularly chronic diseases. Chronic diseases can present challenges for travelers because of the medications required for their management. Medications that are legal in one country may be highly regulated or even wholly prohibited in another country. Failure to follow these laws can result in confiscation of medications, imprisonment for drug trafficking, and even the death penalty.

• Obtain and pack a copy of your prescription and a letter from the prescribing medical practitioner stating the name of the drug, dosage and quantity prescribed, the reason the drug is being prescribed, and the health condition for which the medication is being prescribed. While some countries will allow you to carry a 90-day supply of medication, other countries limit this to a 30-day supply or less. Therefore, a certificate/letter from your prescribing medical practitioner can be a very useful document if you have to obtain a prescription from a local medical practitioner.
• All prescription medications and any related documentation should be either carried on the person or stored in carry-on luggage, since checked luggage can be lost, misplaced, and/or delayed. Travelers should keep all prescription medications in their original, correctly labeled containers/packages with the active ingredients of the medication clearly labeled on the container for easy identification at checkpoints. Different medications should not be combined into one container. Travelers should make sure the name on the prescription, the container, and their passport match. Medications should be packed in a clear bag.
• Over-the-counter (OTC) medications should be kept in their original container and clearly labeled. They can be packed in checked luggage; however, travelers should consider packing OTC medications in their carry-on luggage, especially if the medication is needed while in flight, near the time of arrival, and/or if it is regulated by the destination country. They should be kept in their original container and clearly labeled. Pack the medication in a clear bag.

For a more in-depth look into traveling internationally with personal medication, watch iJET’s free webinar, Traveling with Medication: How to Navigate International Law

To minimize the symptoms of jet lag, travelers need to recognize that their internal clock and circadian rhythm are dependent on environmental cues, such as light. Travelers who are unaware of this often use ineffective and even harmful means to minimize the symptoms of jet lag, such as alcohol and excess amounts of caffeine. Even though there is no single treatment to combat jet lag or its effects, scientists have developed useful recommendations and guidelines to help minimize its symptoms. This blog post attempts to present simplified, best practice information, while acknowledging that a host of other information – which some may find confusing or complex – exists on the Internet.

General Guidelines for How to Minimize Jet Lag

The first question you should ask when considering what steps to take to minimize jet lag is this: How many days will I be traveling? This simple metric is useful to determine whether or not you should shift and adapt your biological clock to a destination’s local solar time. These guidelines are primarily based on a 2009 article published in Sleep Medicine Reviews – a peer-reviewed medical journal.

Traveling for 1-2 Days

When you plan to be in a destination for only one to two days, there really is no point in helping your circadian rhythm adapt to the destination time zone – by the time you become adapted to this time zone, you will arrive back at home. The general advice for this scenario is:

• Sleep when you can.
• Maintain alertness by using stimulants, such as caffeine.
• Schedule important meetings when you will have a higher propensity to stay awake; be aware that your circadian rhythm will be off, and therefore, your performance could be askew, as well.

Traveling for More Than 4-5 Days

Pre-flight preparation is necessary when you plan to be in a destination for more than four to five days, especially if it is critical that you be able to work immediately upon arrival. The primary goal of the guidelines presented below is to help shift your internal clock in the correct direction to help minimize the effects of jet lag.

These guidelines should be followed starting prior to departure and continuing for three to four days after arrival. It is extremely important to note that both light and melatonin (0.5 mg pre-flight and 3-5 mg post-flight) are used together in this protocol. Furthermore, all times are noted relative to departure location time, because that is the time your biological clock is synchronized to prior to the protocol.

How to minimize jet lag going west

When you travel westward, you are actually traveling back in time compared to the 24-hour rotation of the earth. Therefore, your internal clock needs to shift back in time to remain in sync with the 24-hour rotation of the earth.

• Avoid Bright Light during the Morning: Since light exposure in the early morning causes the internal clock to shift forward, avoid bright light during the departure location’s early morning.
• Seek Bright Light during the Evening: Since light exposure in the late evening shifts the internal clock back in time, seek bright light during the departure location’s late evening.
• Take Melatonin during the Early Morning: Melatonin should be taken during the departure location’s early morning (0.5 mg pre-flight and 3-5 mg post-flight).

How to minimize jet lag going east

When you travel eastward, you are actually traveling forward in time compared to the 24-hour rotation of the earth. Therefore, your internal clock needs to shift forward in time to remain in sync with the 24-hour rotation of the earth.

• Seek Bright Light during the Morning: Since light exposure early in the morning causes your internal clock to shift forward, seek bright light during the departure location’s early morning.
• Avoid Bright Light during the Evening: Since light exposure late in the evening shifts your internal clock back in time, avoid bright light during the departure location’s late evening.
• Take Melatonin during the Early Evening: Melatonin should be taken during the departure location’s very early evening (0.5 mg pre-flight and 3-5 mg post-flight).

What About Traveling for 3-5 Days?

The same strategies used for “Traveling More Than 4-5 Days” can be used for trips that last three to five daysto achieve partial adaptation to the new time zone, if you want to create a more favorable sleep schedule. However, it is important to note that even though adapting to solar time of the new destination is optimal, it may be very difficult to achieve in this situation because of the intermediate length of such trips.

A Few More Words on Melatonin and Light

Melatonin is not readily available in most countries. In the US, melatonin can be found over-the-counter. However, since melatonin is considered a nutritional supplement, it is not regulated by the FDA. According to the National Academy of Science, short-term use of melatonin at a daily dose less than or equal to 10 mg is safe in healthy adults who are not taking other dietary supplements or concurrent medications. The American College of Physicians recommends that melatonin be avoided by people who have asthma and people who plan to drive or operate heavy machinery within eight hours of taking it. All travelers should consult with their healthcare provider before using melatonin.

Strategies to avoid light include wearing protective eyewear, sleeping, and staying in a darkened room. Whenever possible, individuals attempting to avoid light should also avoid using electronic devices such as computers, smartphones, or televisions. Strategies to expose oneself to light include going outdoors during daylight, using special room lighting, or using a commercial light box. People taking photosensitizing agents, such as malaria medications and certain antibiotics, should use caution when using a commercial light box.

Conclusion

Jet lag is observed when a traveler arrives in a new time zone that differs widely from his or her home time zone. Because this new time zone has a different solar time, the traveler’s internal clock is not synchronized with it. Symptoms of jet lag persist until the internal clock shifts and synchronizes with the solar time in the new time zone; the ability of the internal clock to synchronize with a new solar time varies from individual to individual. Guidelines, advice, and even apps regarding the management and prevention of jet lag are readily available; however, it is easy to become overwhelmed in this sea of possibly conflicting information. The information in this blog post highlights practical, cohesive strategies that can be used to help you combat jet lag.