September 2009
This guidance is based on current information aGuidance for Churches on Pandemic (H1N1) 2009 (Swine Flu)
September 2009
This guidance is based on current information and is subject to change based on ongoing surveillance and continuous risk assessment. This document gives general advice, recognising that practices may differ in detail for different Churches and in different situations e.g. hospitals and homes for the elderly. Churches may therefore tailor this advice to their specific requirements.
Background
Pandemic (H1N1) 2009 influenza, previously known as influenza A (H1N1) or swine flu is an influenza virus that can cause respiratory infection. Seasonal flu is a familiar infection in Ireland during the winter months. The illness caused by the flu virus can be mild or severe. Pandemic (H1N1) 2009 influenza is similar in many ways to the seasonal flu virus, but as it is a new type of flu most people have little or no immunity to it. This allows it to spread more widely and affect more people than seasonal flu.
The symptoms of pandemic influenza are like those of seasonal flu. There is usually sudden onset of fever (≥38oC) and cough or sore throat. Other symptoms can include runny nose, limb or joint pain, headache, vomiting or diarrhoea.
Flu viruses are spread by people with influenza mainly through coughing or sneezing. Sometimes people may become infected by touching something – such as a surface or object – with flu viruses on it and then touching their mouth, nose or eyes.
GENERAL RECOMMENDATIONS FOR ALL
Those with flu symptoms are dispensed from their Sunday obligation to attend Mass. If members of the congregation, priests or other ministers feel ill and display influenza-like symptoms they should stay at home. It is recommended that those with flu symptons stay at home for seven days from the onset of illness to avoid spreading infection to others.
Most with pandemic flu recover from the illness by staying at home, treating the fever and keeping hydrated. This pandemic flu has caused a mild, self-limiting illness in most cases. The illness caused by pandemic (H1N1) influenza can be treated in most instances by self-isolation at home, use of anti-fever medication (such as paracetamol or ibuprofen) and hydration with plenty of drinks. Make sure you have some one to care for you or look in on you. Contact the HSE 24 hour Flu Information Line Free phone 1800- 94 11 00 for up to date recorded information. People with severe symptoms or who are in one of the groups at higher risk for developing complications should contact their GP by telephone.
Those considered to be at higher risk are people with: chronic lung, heart, kidney, liver or neurological disease; immunosuppression (whether caused by disease or treatment); diabetes mellitus; people aged 65 years and older; children <5 years (children <2 years are at higher risk of severe complications); people on medication for asthma; severely obese people; pregnant women, or people with haemoglobinopathies such as sickle cell disease or thalassemia.
The spread of infection can be reduced by the following:
Stay at home for 7 days if you are ill with flu
Cover your cough or sneeze with a tissue
If no tissues are available, cough or sneeze into your upper arm
Dispose of used tissues in a waste bin
Wash your hands frequently with soap and water or an alcohol based hand gel (children should be supervised)
Avoid touching your eyes, nose or mouth
Churches should take the following actions:
• Advise the clergy and congregation not to attend if they are ill
• Make sure that the clergy and congregation have information about the symptoms of flu and how to prevent it by displaying posters prominently in the church
• Have a plan for how the church will continue its activities in the event of members of the clergy becoming ill with flu
• Provide bins for disposal of tissues at church gatherings
• Ensure all hard surfaces that are frequently touched, such as door handles, hand rails, taps, are cleaned regularly with a household detergent or antiseptic wipes.
• Ensure hand-washing facilities, including soap and disposable towels, are well maintained
• Supply tissues and hand-washing gel at church services/gatherings.
Clergy administrations to sick laity should be carefully managed
Requests for clergy to visit those suffering from influenza should be made first by phone. Common sense and good hygiene practices apply. A face mask should be worn by the visitor if coming into close contact with a sick person. The visitor should clean their hands with soap and water or an alcohol hand gel immediately after the visit. Only carry essential items from visit to visit, e.g. mobile phone, pens, and clean such objects after the visit.
Support should be considered for those most vulnerable
Consideration should be given to home support and community support systems, especially for those who are:
Ill
Living alone
In need of food
SPECIFIC RECOMMENDATIONS
At the present moderate stage of H1N1 influenza spread:
Sign of Peace
Shaking hands while exchanging the ‘Sign of Peace’ involves a low risk of spreading the virus by hand to hand contact. Of course, members of the congregation who are unwell should in the first instance not be attending Mass/Church. We suggest for the moment that the Sign of Peace may be continued but that on each occasion the priest invites the congregation, if they so wish, to carry out an alternative Sign of Peace without hand contact (such as smile/ nod/ bow), as those with risk factors/ or with individual health conditions may not wish to give/receive the Sign of Peace}. The practice of shaking hands on greeting and departure at church gatherings may also need to be curtailed for both clergy and laity.
Holy Water Fonts
We advise that holy water fonts may continue to be used. Hygienic upkeep of the fonts is needed, including frequent changing of the water followed by cleaning of the font with a household detergent based cleaner (such as washing up liquid).
Holy Communion
Priests, deacons and extraordinary ministers of Holy Communion should wash their hands or use antiseptic gel before and after distribution. The reception of Holy Communion in the hand is preferable under these current circumstances because reception on the tongue carries a greater risk of passing on infection than shaking hands. No one is to be refused communion because they wish to receive on the tongue. Should reception on the tongue occur, those distributing Holy Communion need to give careful attention to avoid the possible passing on of infection through proper hand washing or the use of antiseptic gels to sanitise their hands.
Holy Communion- receiving from the chalice
The Reception of Holy Communion under both kinds for all members of the congregation is always preferable. However under present circumstances it is suggested that the practice of everyone receiving from the chalice be temporarily suspended. Those with a gluten intolerance should be invited to receive from a separate chalice with attention paid to the careful wiping of the vessel with purificators before being offered to the next person. This practice can also be followed for concelebrants.
Cancellation of Mass/Church
There are no proposals at this stage of the pandemic for cancellation of large gatherings, such as Mass, and ceremonies should carry on as normal. If the situation changes, national advice will be issued from the National Public Health Emergency Team.
Arrangements for parochial activities on parish premises should observe the commonsense provisions set out above. Notices formally stating any guidance or changes in practice should be clearly displayed, and appropriate leaflets circulated.
Further sources of information
HSE 24 hour Flu Information Line Free phone 1800 94 11 00
Advice is available from the HSE on its website http://www.swineflu.ie
Advice is available from the Health Protection Surveillance Centre website, and posters and leaflets are available to print http://www.hpsc.ie
Contact Details for HSE Departments of Public Health (and counties they cover)
HSE North West
Tel 071‐9852900
Donegal
Leitrim
Sligo
HSE Midlands
Tel 057 9359891
Longford
Westmeath
Offaly
Laois
HSE South
Tel 021 4927601
Cork
Kerry HSE MidWest
Tel 061 483338
Clare
Limerick
Tipperary North
HSE North East
Tel 046 9076412
Cavan
Monaghan
Louth
Meath
HSE SouthEast
Tel 056 7784124
Tipperary South
Waterford
Kilkenny
Carlow
Wexford
HSE East
Tel 01 635 2000
Kildare
Dublin
Wicklow HSE West
Tel 091 775 200
Mayo
Roscommon
Galway
nd is subject to change based on ongoing surveillance and continuous risk assessment. This document gives general advice, recognising that practices may differ in detail for different Churches and in different situations e.g. hospitals and homes for the elderly. Churches may therefore tailor this advice to their specific requirements.
Background
Pandemic (H1N1) 2009 influenza, previously known as influenza A (H1N1) or swine flu is an influenza virus that can cause respiratory infection. Seasonal flu is a familiar infection in Ireland during the winter months. The illness caused by the flu virus can be mild or severe. Pandemic (H1N1) 2009 influenza is similar in many ways to the seasonal flu virus, but as it is a new type of flu most people have little or no immunity to it. This allows it to spread more widely and affect more people than seasonal flu.
The symptoms of pandemic influenza are like those of seasonal flu. There is usually sudden onset of fever (≥38oC) and cough or sore throat. Other symptoms can include runny nose, limb or joint pain, headache, vomiting or diarrhoea.
Flu viruses are spread by people with influenza mainly through coughing or sneezing. Sometimes people may become infected by touching something – such as a surface or object – with flu viruses on it and then touching their mouth, nose or eyes.
GENERAL RECOMMENDATIONS FOR ALL
Those with flu symptoms are dispensed from their Sunday obligation to attend Mass. If members of the congregation, priests or other ministers feel ill and display influenza-like symptoms they should stay at home. It is recommended that those with flu symptons stay at home for seven days from the onset of illness to avoid spreading infection to others.
Most with pandemic flu recover from the illness by staying at home, treating the fever and keeping hydrated. This pandemic flu has caused a mild, self-limiting illness in most cases. The illness caused by pandemic (H1N1) influenza can be treated in most instances by self-isolation at home, use of anti-fever medication (such as paracetamol or ibuprofen) and hydration with plenty of drinks. Make sure you have some one to care for you or look in on you. Contact the HSE 24 hour Flu Information Line Free phone 1800- 94 11 00 for up to date recorded information. People with severe symptoms or who are in one of the groups at higher risk for developing complications should contact their GP by telephone.
Those considered to be at higher risk are people with: chronic lung, heart, kidney, liver or neurological disease; immunosuppression (whether caused by disease or treatment); diabetes mellitus; people aged 65 years and older; children <5 years (children <2 years are at higher risk of severe complications); people on medication for asthma; severely obese people; pregnant women, or people with haemoglobinopathies such as sickle cell disease or thalassemia.
The spread of infection can be reduced by the following: Stay at home for 7 days if you are ill§ with flu
Cover your cough or sneeze with a tissue§
If no tissues are§ available, cough or sneeze into your upper arm
Dispose of used tissues in§ a waste bin
Wash your hands frequently with soap and water or an alcohol§ based hand gel (children should be supervised)
Avoid touching your eyes,§ nose or mouth
Churches should take the following actions:
• Advise the clergy and congregation not to attend if they are ill
• Make sure that the clergy and congregation have information about the symptoms of flu and how to prevent it by displaying posters prominently in the church
• Have a plan for how the church will continue its activities in the event of members of the clergy becoming ill with flu
• Provide bins for disposal of tissues at church gatherings
• Ensure all hard surfaces that are frequently touched, such as door handles, hand rails, taps, are cleaned regularly with a household detergent or antiseptic wipes.
• Ensure hand-washing facilities, including soap and disposable towels, are well maintained
• Supply tissues and hand-washing gel at church services/gatherings.
Clergy administrations to sick laity should be carefully managed
Requests for clergy to visit those suffering from influenza should be made first by phone. Common sense and good hygiene practices apply. A face mask should be worn by the visitor if coming into close contact with a sick person. The visitor should clean their hands with soap and water or an alcohol hand gel immediately after the visit. Only carry essential items from visit to visit, e.g. mobile phone, pens, and clean such objects after the visit.
Support should be considered for those most vulnerable Consideration should be given to home support and community support systems, especially for those who are:
Ill
Living alone
In need of food
SPECIFIC RECOMMENDATIONS
At the present moderate stage of H1N1 influenza spread:
Sign of Peace
Shaking hands while exchanging the ‘Sign of Peace’ involves a low risk of spreading the virus by hand to hand contact. Of course, members of the congregation who are unwell should in the first instance not be attending Mass/Church. We suggest for the moment that the Sign of Peace may be continued but that on each occasion the priest invites the congregation, if they so wish, to carry out an alternative Sign of Peace without hand contact (such as smile/ nod/ bow), as those with risk factors/ or with individual health conditions may not wish to give/receive the Sign of Peace}. The practice of shaking hands on greeting and departure at church gatherings may also need to be curtailed for both clergy and laity.
Holy Water Fonts
We advise that holy water fonts may continue to be used. Hygienic upkeep of the fonts is needed, including frequent changing of the water followed by cleaning of the font with a household detergent based cleaner (such as washing up liquid).
Holy Communion
Priests, deacons and extraordinary ministers of Holy Communion should wash their hands or use antiseptic gel before and after distribution. The reception of Holy Communion in the hand is preferable under these current circumstances because reception on the tongue carries a greater risk of passing on infection than shaking hands. No one is to be refused communion because they wish to receive on the tongue. Should reception on the tongue occur, those distributing Holy Communion need to give careful attention to avoid the possible passing on of infection through proper hand washing or the use of antiseptic gels to sanitise their hands.
The Reception of Holy Communion under both kinds for all members of the congregation is always preferable. However under present circumstances it is suggested that the practice of everyone receiving from the chalice be temporarily suspended. Those with a gluten intolerance should be invited to receive from a separate chalice with attention paid to the careful wiping of the vessel with purificators before being offered to the next person. This practice can also be followed for concelebrants.
Cancellation of Mass/Church
There are no proposals at this stage of the pandemic for cancellation of large gatherings, such as Mass, and ceremonies should carry on as normal. If the situation changes, national advice will be issued from the National Public Health Emergency Team.
Arrangements for parochial activities on parish premises should observe the commonsense provisions set out above. Notices formally stating any guidance or changes in practice should be clearly displayed, and appropriate leaflets circulated.
Further sources of information
HSE 24 hour Flu Information Line Free phone 1800 94 11 00
Advice is available from the HSE on its website http://www.swineflu.ie
Advice is available from the Health Protection Surveillance Centre website, and posters and leaflets are available to print http://www.hpsc.ie
Contact Details for HSE Departments of Public Health (and counties they cover)
HSE North West
Tel 071‐9852900
Donegal
Leitrim
Sligo
HSE Midlands
Tel 057 9359891
Longford
Westmeath
Offaly
Laois
HSE South
Tel 021 4927601
Cork
Kerry HSE MidWest
Tel 061 483338
Clare
Limerick
Tipperary North
HSE North East
Tel 046 9076412
Cavan
Monaghan
Louth
Meath
Tel 056 7784124
Tipperary South
Waterford
Kilkenny
Carlow
Wexford
HSE East
Tel 01 635 2000
Kildare
Dublin
Wicklow HSE West
Tel 091 775 200
Mayo
Roscommon
Galway