H1N1 Pandemic Influenza

1
H1N1 Pandemic Influenza

• Cecil D. Price, M.D.
• Wake Forest University Student Health Service
• September 1, 2009

2
H1N1 Facts and Figures

• On July 24, 2009 official reporting of individual
  cases of confirmed and probable novel H1N1
  infection was discontinued.
• From April 15, 2009 to July 24, 2009, states
  reported a total of 43,771 confirmed and probable
  cases of novel influenza A (H1N1) infection. Of
  these cases reported, 5,011 people were
  hospitalized and 302 people died.

3
H1N1 Facts and Figures

• It is estimated that more than one million people
  became ill with novel H1N1 flu between April and
  June 2009 in the United States.
• Epidemiologic field studies in several states
  found a secondary attack rate in household
  contacts for acute-respiratory-illness (ARI) was
  18 to 19 and 8 to 12 for influenza-like-illne
  ss (ILI). ARI is defined as two or more of the
  following four symptoms fever, cough, sore
  throat, and rhinorrhea (runny nose). ILI is
  defined as fever and cough or sore throat.

4
H1N1 Facts and Figures
Novel H1N1 Confirmed and Probable Case Rate in
the United States, By Age Group
5
H1N1 Facts and Figures
Novel H1N1 U.S. Hospitalization Rate per 100,000
Population, By Age Group
6
H1N1 Facts and Figures
Novel H1N1 U.S. Deaths, By Age Group
7
Table Symptoms of hospitalized novel H1N1
patients
8
SHS H1N1 Influenza Plan

• Students will be encouraged to call if they have
  influenza-like symptoms
• Rapid Influenza Testing may be done, but this
  method will not be used to rule out H1N1
  influenza.
• We continue as a sentinel physician site, so
  samples can be sent through that process for
  testing at the State lab.

9
SHS H1N1 Influenza Plan

• Everyone entering the room with the suspected
  case will wear a surgical mask even if the
  patient is also masked.
• Perform Hand Hygiene before entering the room and
  upon leaving the room.
• For lab work involving aerosol producing
  procedures (e.g., nasopharyngeal swab), an N95
  respirator and face shield should be worn.

10
SHS H1N1 Influenza Plan

• The official CDC position is that individuals
  with H1N1 influenza without high risk medical
  conditions do not need treatment.
• Treatment for H1N1 is with Tamiflu or Relenza
• The Student Health Service will offer treatment
  for students diagnosed with H1N1 influenza who
  also have medical conditions that place them at
  risk for complications if they acquire H1N1
  influenza.

11
SHS H1N1 Influenza Plan

• Treatment is recommended for persons with the
  following conditions
• Chronic pulmonary, cardiovascular, renal,
  hepatic, hematological, neurologic,
  neuromuscular, or metabolic disorders
• Immunosuppression, including that caused by
  medications or by HIV
• Pregnant women
• Individuals under age 19 on chronic aspirin
  therapy

12
SHS H1N1 Influenza Plan

• Treatment is also recommended for individuals
  whose roommates have been diagnosed with H1N1
  influenza and who also have conditions that place
  them at high risk for complications from
  influenza.
• If possible, these exposed high risk students may
  be relocated (there are very few free spaces
  available on campus).

13
SHS H1N1 Influenza Plan

• Treatment for H1N1 is Tamiflu 75 mg BID x 5 days.
• Prophylaxis with Tamiflu is 75 mg qd as long as
  exposure continues and until vaccine is
  available.
• Tamiflu may be considered for treatment on a case
  by case basis for students who do not have a high
  risk condition.

14
SHS H1N1 Influenza Plan

• We anticipate H1N1 influenza vaccine will be
  available in mid to late October. The Benson
  Center has been reserved for November 3rd and 4th
  for this.
• The seasonal influenza vaccine clinics for
  students are scheduled for September 23-24.
• The seasonal influenza vaccine clinics for
  faculty/staff are scheduled for mid-October.

15
H1N1 Influenza

• Challenges
• Overwhelming numbers of students
• Management of students in residence halls
• Nutrition
• Personal isolation (masks for roommates/suitemates
  )
• Academic absences
• Faculty/staff illnesses affecting mission and
  services of the University