H1N1 Update 9-29-09 Cindy Cunningham John Levitow Frisbie Memorial Hospital.
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Transcript of H1N1 Update 9-29-09 Cindy Cunningham John Levitow Frisbie Memorial Hospital.
H1N1 Pandemic Timeline
• First illnesses Mexico & US 3/09• First lab confirmed case in US 4/15/09• Pandemic declared 6/11/09; Today over 140
countries reporting infection• 6/15/09 all US states, DC, Puerto Rico and US
Virgin Islands with cases• Pregnant population has highest mortality rate:
6% of those deceased
Clinical Information for H1N1
• Incubation period 1-7 days• Symptoms: Fevers, chills, headache, cough,
sore throat, difficulty breathing, muscle aches, joint pain, fatigue, vomiting and diarrhea
• Testing: Under DHHS control– Influenza-like illness– Hospitalized– High-risk patient
Influenza-like illness (ILI) & High-risk patients
• Fever– T 100F or 37.8C or
greater• Cough +/-• Sore throat
• <5 years old• >65 years old• Underlying medical
conditions• Immunosuppression• Pregnancy• <19 years old on aspirin• Nursing home/LTC
H1N1 Testing
• Limited to select populations– Specimen must meet at least one of the following
criteria to be tested. • Hospitalized patient with severe illness• Health Care Worker in consultation with health care provider• In consultation with public health as part of a cluster or outbreak• Requesting provider participates in the ILI Sentinel Provider
Network
H1N1 Testing
• Nasopharyngeal Aspirate
• Nasopharyngeal Swab (Specimen of choice)-This is what we do here. Available in Lab
• Nasopharyngeal Wash
H1N1 Testing
• Can be done in the offices• Wear a surgical mask when obtaining the
specimen.• Fill out the lab slip for H1N1 (on the portal)
Key Points from HAN 09/16
• H1N1 outbreaks have been ongoing since April 2009 – confirmed a number of school outbreaks since classes
resumed several weeks ago.• There is no current shortage of seasonal influenza vaccines
– Some manufacturers have delayed their shipments; State is monitoring the situation.
• H1N1 vaccine trials have shown excellent immunity after a single dose of inactivated vaccine for persons aged 10 and up.
H1N1 Vaccine
• Many unknowns about the vaccine:– Number of doses required for immunity– When and amount of vaccine available– Whether the seasonal & H1N1 can be administered
at the same time– Forms of vaccine available (i.e. nasal mist,
preservative free)
Vaccine Distribution
• Coordinated by CDC• CDC will distribute vaccine and supplies at no
cost• Distribution in NH will be based on application
process
Most Recent Vaccine Information
• All information changes daily:– State expects 1st shipment of vaccine does the week
of 10/05– Initial number of doses reported as 45,000 for the
state; followed by 20,000 a week– NH State Immunization Program will be assigned
liaison for each AHHR– Reports are first does may be flu-Mist
Vaccine Allocation-CDC Recommendations
• First Round– Vaccine 3 Groups:
• Pregnant women• HCW (direct patient contact & care)/EMS with direct patient
contact• Children 6m-18Yrs with medical conditions
Vaccine Allocation-CDC Recommendations
• Second Round– Vaccinate 2 additional groups:
• All children 6m-4Yrs old• Persons caring for or living with infants<6months old
Vaccine Allocation-CDC Recommendations
• Third Round– Vaccinate 3 additional groups:
• All HCW and EMS• Ages 6m-24 Yrs• Ages 24-64Yrs with medical conditions
Response to H1N1• WHO has raised it’s alert level;
– Change signifies that the likelihood of a pandemic has increased. Now Phase 6
• US has declared a public health emergency– Declaration mobilizes resources to address a public health situation– Focus has shifted to vaccine development
• State of NH: Monitoring the spread of the flu– Developing clinical guidance– Clearing house for H1N1 vaccine
• Regional EOC is not open
Community Planning
• Community response managed by Health and Safety Council of Strafford County
• FMH is the Medical Command and Control in Northern Strafford County
• Community Vaccination Clinics and Medical Surge Plan is driven by AHHR
Frisbie Preparedness
8 Planning Teams– Communications: Michelle Landry/Dee Sheing– Supplies: Brooks McQuade– Pharmacy: Marcia Montminy– Employee Health: Janice Parker
Frisbie Preparedness (cont)
8 Planning Teams– Human Resources: Carol Themelis– Hospital Care: Mary Nutter/Sally Reeves
• In-patient• ED
– Office Care: Leslie Logel– Community: John Levitow