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The Facts about Flu | Food poision | Hygenic Food Preparation | Immunisation

The Facts about Flu

What Is Flu? (Influenza)

Influenza is a lot more than a bad cold. It is a distinct illness caused by a virus and is very contagious. The influenza virus spreads through the air from a cough or a sneeze and you simply breathe it in. The person you catch it from may even seem well at the time. And you can pass it on before you realise you have influenza. So to protect yourself and others, be immunised every year well before the influenza season starts.

How Serious Is It?

Influenza affects people differently but it should always be handled with care. The symptoms are like a severe cold with added muscle aches, fever and weakness. A normally strong and healthy adult or child will be over it in a week. But some people are prone to complications from influenza and then it can lead on to pneumonia, to hospitalisation and may threaten their life.

Am I in Danger if I Catch Flu?

Talk to your doctor about the complications you could face from influenza. As a general rule, a flu shot every year is recommended to protect:

• Anyone with diabetes, heart or lung conditions, kidney or liver disease.
• Everyone with a weakened immune system.
• All people working in nursing homes or with immuno-suppressed patients. This is to protect their patients.
• All residents of nursing homes or hostels.

How Can I Protect Myself?

A new vaccine is ready now to prevent the influenza viruses expected to cause illness this year. Even if you take medications for high blood pressure, diabetes or other conditions, the vaccine is very safe.

Can I Get Flu from The Vaccine?

The vaccine is prepared to protect you and is a safe and effective vaccine. It cannot give you a "dose" of the flu because it contains no live organisms. A slightly sore arm or mild fever, tiredness or muscle aches could occur, but they soon pass.

If you have an acute illness, delay being immunised. Also if you are allergic to eggs and egg products you need to discuss this with your doctor.

Should I Wait Until Winter?

No, it is now time to see your doctor to ask for your yearly flu vaccine.

Timing is important and the early months of autumn, between March and May are ideal. If you have missed that period, immunisation is still worthwhile as late as August. The vaccine takes effect in about two weeks and then protects you right through the influenza season.

Do I Need a Flu Shot Every Year?

Yes. You need the flu vaccine yearly because it is adjusted each year to protect you from the current strains of influenza.
 

What Is Pneumococcal Pneumonia?

Pneumonia is a lung infection and is one of the leading causes of death by infectious disease in Australia. One very serious type of pneumonia called pneumococcal pneumonia is caused by a bacteria that normally lives in the upper respiratory tract. It can flare up when the system is weakened by influenza but can follow other infections too and is recognised by coloured phlegm, chest pains and difficulty in breathing. Fortunately pneumococcal pneumonia can be prevented by immunisation.

Do I Need to Be Immunised?

Anyone who is at greater risk from influenza also needs the protection of a pneumococcal pneumonia immunisation. It is recommended for:

• Anyone with diabetes, heart or lung conditions, kidney or liver disease.
• Everyone with a weakened immune system.
• All residents of nursing homes or hostels.

When Is It Best Given?

While pneumococcal pneumonia immunisation can be done at any time of year, it is good to be protected before winter starts. You can have your pneumococcal pneumonia immunisation at the same time as this year's flu shot and both are recommended. Ask your doctor about pneumococcal pneumonia immunisation when you go for your flu vaccine.

How Long Does It Last?

The pneumococcal pneumonia vaccine stays the same and will protect you for at least 5 years. It is very effective. You cannot get pneumonia from the vaccine. Some people will have a mild reaction such as a sore arm or slight fever for a few days.

Any Other Questions?

See your local doctor, pharmacy or health centre or Immunisation Unit Department of Human Services-telephone (03) 9637 4144

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Food Poisoning - and How to Prevent It

Changing lifestyles in the modern world have resulted in an increased demand for ready-to-eat foods, fast foods and dining out. This change in demand has, in turn, brought with it new and increased problems. One of these is the risk of bacterial food poisoning.

This pamphlet briefy explains what food poisoning is, why it occurs, and the steps that should be taken by people involved in food preparation and service to prevent it.

How Does Food Poisoning Occur?

Usually, it takes large numbers of food poisoning bacteria to be present in food in order to cause illness. However, given the right conditions, bacteria can multiply very rapidly. These conditions include:

• Time- In ideal conditions, one bacterium can multiply to 2,097,152 within seven hours.

• Temperature - Food poisoning bacteria grow best in the temperature range 5 degrees C - 60 degrees C.
  (See side diagram.) This is called the temperature danger zone.
  Food should not be left in the temperature danger zone.

• Nutrients - Bacteria need their own food source to grow and multiply. The types of foods which bacteria prefer include dairy products, egg products, meat and poultry, smallgoods (not including salami), processed meat and chicken products, fish, shellfish and fish products.

  Because bacteria multiply rapidly in these foods, they are known as high risk foods. High risk foods which have been contaminated with food poisoning bacteria and then left in the temperature danger zone can cause food poisoning to anyone who consumes them.

• Water - Without moisture, the growth of bacteria slows down and may stop. Drying is an effective form of food preserving.

How Does Food Become Contaminated?

Food is contaminated through poor handling and storage and through lack of personal hygiene by the people who prepare and serve it. Food poisoning bacteria is very widespread. It can be found in the soil, on animals and on people. Because of this, it is possible for foods such as raw meat, poultry and vegetables to contain these bacteria from the start.

A common way that food can become contaminated, is through cross contamination. This can occur in two ways:

• During food preparation, hands, utensils and equipment such as cutting boards can become contaminated with bacteria from raw food. If these utensils, equipment and hands are then used to prepare ready-to-eat or cooked food, without first being thoroughly washed, then this food can become contaminated with bacteria from the raw food. As this food is not cooked again before being consumed, the bacteria in it will not be killed by cooking.

• During storage, bacteria from raw food can contaminate ready-to-eat or cooked food if the later are not stored separately. If they are stored in the same refrigerator, raw food should always be stored in the lowest part of the refrigerator and ready-to-eat or cooked food on the shelves above. This prevents liquids from the raw food dripping on to the cooked food. Store food in clean non-toxic washable containers or cover with foil or plastic film.

How Can Food Poisoning Be Prevented?

Food poisoning can be prevented by:

(1) Preventing food from becoming contaminated.

(2) Preventing the bacteria in the food growing and multiplying.

We can think of food poisoning as being a chain of circumstances:

• There must be bacteria on the food.
• The bacteria have the right conditions to grow warmth (between 5 degrees C and 60 degrees C), moisture and food.
• The bacteria have time to grow and multiply.

If this chain of events can be broken, food poisoning can be prevented.

Some of the ways of breaking this chain are:

• Making sure your hands are clean before handling food.
• Thoroughly washing all equipment used for preparing raw foods.
• Storing raw foods below cooked foods in the refrigerator.
• Making sure food is served as soon as possible after preparation.

Some Common Food Poisoning Bacteria

Salmonella
Commonly found in: meat, poultry, eggs and egg products.

Symptoms: nausea, stomach cramps, diarrhoea, fever and headache.

Onset: 6-72 hours after consuming contaminated food. Symptoms can last from 3 - 5 days.

Bacillus
Commonly found in: Cereals, rice, meat products, packet soups.

Symptoms: nausea, vomiting, diarrhoea and stomach cramps.

Onset: 1-6 hours after consuming the contaminated food. Symptoms usually last no longer than 24 hours.

Note: These bacteria produces spores which are not killed during cooking. When cooked food containing these spores, has been left in the temperature danger zone, the spores produce toxins (poisons) in the food which can cause food poisoning.

Staphylococcus aureus
Commonly found in: Meat and poultry dishes, egg products, mayonnaise-based salads, cream or custard filled desserts.

Symptoms: acute vomiting, nausea, occasionally diarrhoea and cramps.

Onset: 30 minutes-8 hours after consuming the contaminated food. Symptoms usually last about 24 hours.

Note: These bacteria produce toxins in food. The toxin is not destroyed during cooking so correct storage of food before and after cooking is essential. These bacteria is commonly found on the skin and in the nose and mouths of healthy people.

Therefore, it is important that you maintain high standards of personal hygiene when working with food. People with open cuts or wounds on their hands and arms must ensure that the injury is completely protected by a waterproof bandage.

Other common food poisoning bacteria include:

• Clostridium perfringens.
• Vibrio parahaemolyticus.
• Listeria monocytogenes.

Important:

If you think you may have food poisoning, report it to your doctor. It is important that you also report it to your local council health department as soon as possible. Retain any left over food which you believe may have caused you to become ill

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Hygenic Food Preparation and Handling

Food naturally contains bacteria and some food may contain food poisoning bacteria which can make you sick. Food needs to be handled correctly to ensure that it does not become contaminated, and that the bacteria already in the food do not have an opportunity to multiply.

If this occurs, the result can be food poisoning. Food poisoning is a very serious matter, both for the person affected, and for the business which supplied the food.

One case of food poisoning can close down a business.

If you have a job which involves handling food, you have an important responsibility to the public to prevent food becoming contaminated with bacteria. This not only protects the health of the public, it also protects your business, your reputation as a food handler, your job and you.

Cross Contamination

Raw food contains bacteria, including bacteria which can cause food poisoning. If raw food is cooked thoroughly, to over 60 degrees C, most of these bacteria will be killed. However, if raw food comes into contact with other food which has already been cooked, or is ready-to-eat, the bacteria can transfer to this food and cause food poisoning. This is called cross contamination.

For this reason, it is very important to keep raw food totally separate from cooked and ready-to-eat food during preparation and storage.

Preparing Food

Separate utensils, chopping boards, bowls etc. should be used in the preparation of raw food and ready-to-eat or cooked food. If it is not possible to use separate equipment, the equipment must be thoroughly washed in hot water and detergent and sanitised in between use.

Thoroughly wash all fruit and vegetables in clean water before use, to remove soil, bacteria, insects and chemical residues.

Handling Food

Everyone has bacteria on their bodies, whether they are healthy or ill. Even healthy people can spread bacteria onto food through touching it with their hands.

 If food must be touched by hand, make sure you wash your hands thoroughly. Raw food which is to be cooked can be safely handled with bare hands, but for cooked or ready-to-eat food, utensils such as tongs, spoons, spatulas or disposable gloves should be used. If you are using gloves change them at least once per hour. If the gloves become torn or contaminated, or if you take them off, don't try to use them again-throw them away and put on new gloves. Wash your hands before putting on the new gloves. Never use the same gloves you used with raw food with cooked or ready-to-eat food, and never clean while wearing gloves and then touch food.

Food handlers' lack of personal hygiene can cause food to become contaminated. 

Cooking/Heating Food

Bacteria multiply rapidly in the temperature range between 5 degrees C and 60 degrees C. For this reason, this temperature range is known as the temperature danger zone. It is very important that food spends the shortest possible time in this temperature range.

 Food should be cooked as quickly as possible. Make sure all foods, particularly those of animal origin, are cooked thoroughly. This will kill most bacteria.Food should be cooked from a thawed state, to ensure that it is cooked through. Where it must be cooked from a frozen state, take extra care to make sure that the food is cooked right through, and that its internal temperature reaches at least 60 degrees C.

Cooling Food

Food just taken out of the oven, should spend no longer than one hour at room temperature. This food should then be placed in the refrigerator, to make sure that the temperature drops to below 5 degrees C as fast as possible. Large portions of food cool faster when put into shallow trays no deeper than 10cm or divided into smaller portions.

Freezing and Thawing Food

While frozen food is thawing, bacteria in it start multiplying. If the food is re-frozen, the bacteria do not die, and are still there when the food is thawed again. When you re-thaw the food, it is likely to have higher levels of bacteria. For this reason, you should never re-freeze thawed food.

When thawing food, place it in the bottom part of the refrigerator to ensure that it remains cold throughout the thawing process and does not contaminate other food. Microwave ovens can be used to thaw food, provided the food is cooked immediately afterwards.

Food that is to be frozen, should be packaged into small portions to allow it to freeze and thaw in the shortest possible time.

Packaging and Serving Prepared Food

Food packaging material must be clean, durable and non-toxic. Choose packaging material which is suitable for the food to be packaged, and will stand up to the storage conditions you intend to use. Store surplus packaging material away from the food preparation area to avoid contamination.

Unused food containers should be stored upside down to avoid dust and dirt getting into them. Check that containers are clean before using them. Do not re-use single use containers.

When serving food, take care to ensure that all cutlery, crockery and drinking straws used are protected from contamination. Use only clean, undamaged crockery and cutlery.

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Immunisation

Measles
Measles is a serious and highly contagious viral disease which causes fever, rash, runny nose, cough and sore red eyes. Measles can sometimes lead to dangerous complications such as pneumonia. About one child in 2,000 who contracts measles will develop inflammation of the brain. For every ten children who become affected in this way, one will die and four will have permanent brain damage.

Measles can be caught through coughs and sneezes from an infected person.

Measles still causes deaths in Australian children. A rare condition called SSPE can develop in children several years after a measles infection. SSPE rapidly destroys the brain and is always fatal.

Mumps
Mumps causes fever, headache and inflammation of the salivary glands. Occasionally it causes an infection of the membrane covering the brain, but permanent side effects are rare. The disease can also cause permanent deafness.

Mumps can be caught through coughs and sneezes from an infected person.

About one in five adolescent or adult males who contracts mumps develops a painful inflammation and swelling of the testicles. Males with this condition generally recover completely, but on rare occasions it may cause infertility.

Rubella
This is a mild childhood disease but it can also affect teenagers and adults. The disease causes swollen glands, joint pains and a rash on the face and neck which lasts two to three days. Recovery is always speedy and complete.

Rubella can be caught through coughs and sneezes from an infected person.

Rubella is most dangerous when a woman catches it in the first 20 weeks of pregnancy. This can result in serious abnormalities in the newborn baby. Deafness, blindness, heart defects and intellectual disabilities can occur.

Rubella is highly contagious and the best way to protect expectant mothers and their babies is to ensure that women are immunised before they become pregnant, and to immunise all children to stop the spread of this infection.

Measles/Mumps/Rubella (MMR) Immunisation
There are two brands of MMR vaccine currently available, MMR II and Priorix. The MMR vaccine contains small amounts of each of the viruses at a reduced strength and a small amount of an antibiotic. MMR II also contains a small amount of pig gelatin which acts as a stabiliser. Priorix, the other brand of MMR vaccine, does not contain pig gelatin. Components of pig gelatin are used in the early stages of manufacture of this vaccine but are removed in subsequent stages. Those with religious objections to pig products may request the Priorix brand of vaccine.

The vaccine protects children against all three diseases and is usually given at 12 months of age. A second dose of the vaccine is given between four and five years of age. Anyone with a severe allergy to eggs should seek medical advice before being immunised with MMR vaccine.

Women of child bearing age, especially those considering pregnancy, should see their doctor and have a blood test for rubella. The blood test will show if another MMR immunisation is needed. If you do require another MMR immunisation, a further blood test should be done after immunisation to ensure that the vaccine has provided protection. Women should not have the vaccine if they are already pregnant or might become pregnant within two months. It is important that women have a rubella blood test before each pregnancy to check that the level of protection is still adequate.

Possible Side Effects of MMR
Reactions to MMR vaccine are much less frequent than the complications of the diseases. The most common reactions are feeling unwell, a low grade fever and possibly a rash around six to eleven days after immunisation. People who develop the rash during this time are not infectious to others.

Occasionally, the person immunised may develop a mild swelling of the facial glands about three weeks after immunisation from the mumps component of the vaccine.

More serious reactions to the vaccine, such as inflammation of the brain, are very rare and probably occur at the rate of one in a million doses, or less.

Common Side Effects can be Reduced by:

• Ensuring extra fluids are drunk.
• Not overdressing.
• Placing a cold, wet cloth on the sore injection spot.
• Taking (or giving your child) paracetamol to reduce any discomfort (note the recommended dose for age).

If reactions are severe or persistent, or if you are worried, contact your doctor or hospital.

Pre-Immunisation Checklist
Before immunisation, tell the doctor or nurse if you or your child:

Pre-Immunisation Checklist
Before immunisation, tell the doctor or nurse if you or your child:

	Have had any other immunisations in the last month.
	Are unwell on the day of immunisation.
	Have had severe reaction to any vaccine.
	Have any severe allergies.
	Are taking steroids of any sort (for example, cortisone).
	Have had immunoglobulin or a blood transfusion in the last three months.
	Have a disease or are having treatment which causes low immunity (for example, leukaemia, cancer, HIV/AIDS, radiotherapy or chemotherapy).
	Live with someone who has a disease or is having treatment which causes low immunity (for example, leukaemia, cancer, HIV/AIDS, radiotherapy or chemotherapy).
	Have a condition of the central nervous system which is still being investigated.
	Are pregnant or planning to become pregnant within two months of immunisation.

Your doctor or clinic staff should be told about these conditions because immunisation may need to be given differently.

Recommended Immunisation Schedule

Age	Immunisation
2 months	Diphtheria/tetanus/pertussis vaccine Oral polio vaccine Hib (Haemophilus influenzae type b) vaccine* (HibTITER or PedvaxHIB)
4 months	Diphtheria/tetanus/pertussis vaccine Oral polio vaccine Hib vaccine (HibTITER or PedvaxHIB)
6 months	Diphtheria/tetanus/pertussis vaccine Oral polio vaccine Hib vaccine (HibTITER)
12 months	Measles/mumps/rubella vaccine Hib vaccine (PedvaxHIB)
18 months	Diphtheria/tetanus/pertussis vaccine Hib vaccine (HibTITER)
Prior to School Entry 4-5 years	Diphtheria/tetanus/pertussis vaccine Oral polio vaccine Measles/mumps/rubella vaccine
Year 7 at school one month later 6 months after 1st dose	Hepatitis B vaccine (1st dose) Hepatitis B vaccine (2nd dose) Hepatitis B vaccine (3rd dose)
Prior to leaving school 15-19 years	Adult diphtheria/tetanus vaccine Oral polio vaccine
Every 10 years	Adult diphtheria/tetanus vaccine
Post-partum for non-immune women	Measles/mumps/rubella vaccine or Rubella vaccine
Over 50 years (Aboriginal & Torres Strait Islander people)	Pneumococcal vaccine (every 5 years) Influenza vaccine (annual)
Over 65 years	Pneumococcal vaccine (every 5 years) Influenza vaccine (annual)
* Children receive EITHER HibTITER at 2, 4, 6 & 18 months OR PedvaxHIB at 2, 4 & 12 months.

 
We gratefully acknowledge the contribution of the Department of Health & Aged Care to this information.

Bad Diseases • Good Vaccines • Be Immunised

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