george a. ralls m.d. dave freeman health services department september 1st, 2009 influenza update
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George A. Ralls M.D.Dave Freeman
Health Services DepartmentSeptember 1st, 2009
INFLUENZA UPDATE
• Brief History
• Current Situation
• Disease Projections
• Mitigation Efforts
• CDC Guidelines
H1N1 INFLUENZA
PRESENTATION OUTLINEH1N1 INFLUENZA
• Brief History
• Current Situation
• Disease Projections
• Mitigation Efforts
• CDC Guidelines
• March & April of 2009– New form (Novel) of
Influenza found to cause disease in Mexico and Southern US
– Spread rapidly across North America
• By May 2009 “Swine Flu” identified in many areas of the world
H1N1 INFLUENZA
• Symptoms of H1N1 are similar to those of seasonal flu:• Fever • Cough • Sore throat • Runny or stuffy nose • Body aches • Headache• Chills • Fatigue
H1N1 INFLUENZA
• On June 11th, 2009 the WHO declared a worldwide pandemic (pandemic level 6)
– Uncontained community level transmission in many areas of the world
H1N1 INFLUENZA
• Symptoms no worse than seasonal flu
• Most patients recovered with no treatment
• Case mortality rate low• Deaths in predisposed
patients
Reassuring early trends
H1N1 INFLUENZA
PRESENTATION OUTLINE
• Brief History
• Current Situation
• Disease Projections
• Mitigation Efforts
• CDC Guidelines
• Estimated over 1 Million infected in US since outbreak
– 8843 Hospital Admissions
– 556 deaths
H1N1 INFLUENZA
PRESENTATION OUTLINE
• Brief History
• Current Situation
• Disease Projections
• Mitigation Efforts
• CDC Guidelines
Deaths attributed to pneumonia and influenza are low and within bounds for what is expected in
the summer
PRESENTATION OUTLINE
• Brief History
• Current Situation
• Disease Projections
• Mitigation Efforts
• CDC Guidelines
• Delivered in October or earlier?• Distributed from FDOH Central
Pharmacy• Coordinated through CHDs• Requires 2 shots – 28 days
apart• Priority groups for vaccinations
H1N1 Vaccine
• Pregnant women• People who live with or care for children
younger than 6 months of age• Healthcare and emergency medical
services personnel• Persons between the ages of 6 months
and 24 years old• People ages of 25 through 64 years of
age who are at higher risk because of chronic health disorders or impaired immune systems
H1N1 Vaccine
Priority Groups
• Brief History
• Current Situation
• Disease Projections
• Mitigation Efforts
• CDC Guidelines
H1N1 INFLUENZA
H1N1 INFLUENZA
CDC Guidelines• Parents & caregivers• Pregnant women• Clinicians• Businesses & employers• Schools, colleges & universities• Persons with chronic conditions• Travelers & travel industry
• Sick persons should stay home• Expect sick employees to be out for
about 3 to 5 days in most cases• Ensure that your sick leave policies are
flexible• Do not require a doctor’s note for
workers who are ill with ILI to validate their illness or to return to work
Employer Guidelines
H1N1 INFLUENZA
Employees who are well but who have an ill family member at home
with influenza can go to work
Should monitor their health status closely & stay home if they become ill
H1N1 INFLUENZA
Employer Guidelines
CDC recommends people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F), or signs of a
fever without the use of fever-reducing medications
Persons NOT working in a Healthcare Setting
Exclusion Period
H1N1 INFLUENZA
• Review and revise COOP• Mass Vaccination for Priority
Employees • Employee Workplace Policies
– Hygiene– Social Distancing– Don’t come to work when sick
• Personal Protection Equipment
Work Force Protection
H1N1 INFLUENZA
• Cough or sneeze into tissue and throw it in trash or use upper arm if no tissue available
• Wash hands for 15-20 seconds or use alcohol-based hand gel often
• Keep hands away from eyes and mouth unless hands were washed
• Get a pneumonia shot if in high risk group: prevents secondary infections after the flu
• Avoid others if you are sick or if they are sick
• Develop an Individual/family plan
What Can You Do Now?
• Monitoring CDC and WHO influenza response recommendations and activities
• 25% of the SNS stockpile of antiviral drugs, personal protective equipment, and respiratory protection devices has been recieved – 25% additional coming soon
• State and local public health agencies have been developing, exercising, and revising their mass vaccination plans since 2001
What is Florida Doing?
• Orange County is reviewing and updating its response plan
• Surveillance for influenza is ongoing
• Currently working with local public health and hospital partners to identify gaps in preparedness and response
• Incident Management Team is organized and overseeing planning process
What is Orange County ESF8 Doing?
SUMMARY
• Rapidly developing situation• Develop good habits now• Cover your cough• Wash your hands• Avoid touching your face• Follow advice of public health officials
• Talk to a healthcare provider about “Flu” shots• Stay informed
www.cdc.govwww.flu.gov