H1N1%20Update

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H1N1 Update

• Tina Kitchin
• Department of Human Services, SPD
• 9/24/09

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Goals

• Understand the flu
• Current status of the pandemic
• Understand the steps you can take to protect
  yourself and your clients
• Know where to turn with questions

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Influenza

• Symptoms
• Respiratory Illness, fever, headache, myalgia,
  cough
• Transmission
• Droplet (36 feet)
• Incubation
• 13 days

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Impact of Influenza Typical Year

• 1020 ill
• U.S.
• 225,000 hospitalizations
• 36,000 deaths
• Oregon
• 2,750 hospitalizations
• 450 deaths

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Influenza Virus Changes

• Antigenic drift
• Minor changes to strains each year, need new
  vaccine
• Antigenic shift
• Major reassortment, nobody has immunity

Widespread pandemic
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Generation of New Influenza A Virus Subtypes with
Pandemic Potential
Gerberding, J. L. et al. N Engl J Med
20043501236-1247
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Why worry about pandemic H1N1?
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Pandemic H1N1 worldwide

• Pandemic H1N1 is widespread
• confirmed in more than 170 countries
• Cases 296,471 Deaths at least 3,486
• WHO / CDC have stopped tracking individual
  cases
• Focus on impact (deaths)
• Circulating virus types

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Oregon status

• Oregon no longer counting every case
• Disease widespread
• Hospitalizations 139
• (about 11 counties)
• Deaths 13 (about 11 counties)
• Cases occur sporadically and in clusters
• PHD data as of 9/18

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What makes Pandemic H1N1 different?
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Hospitalizations over the summer, Oregon, 2009
as of 11 Sep 2009
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Different age distribution of Hospitalizations
as of 31 Jul 2009
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Pandemic H1N1 deaths in younger people, US
Deaths
5-24
Age Group
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Pandemic H1N1 Influenza strain Predominates
A (H1)
A (H3)
A (Unk)
B
Novel H1N1
Oct
Dec
Jan
Nov
Mar
Apr
Feb
May
Jun
Jul
through 08/01/2009
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of flu-like illnesses as of 9/12
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Influenza

• Symptoms
• Respiratory Illness, fever, headache, myalgia,
  cough
• Transmission
• Droplet (36 feet)
• Incubation
• 13 days

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Only You Can Stop the Flu

• Stay home if you are sick
• Try to stay 3 ft away from sick people
• Wash your hands or use alcohol-based hand
  sanitizer
• Disinfect contaminated and high-touch surfaces
  (door knobs, microwaves, remotes, phones, etc.)

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Vaccination

• Seasonal Vaccine
• Protects against 3 other strains for flu.
• Recommended for everyone!
• Distributed in same way as every year
• H1N1 Vaccine
• Protects only against the new H1N1 strain
• Targeted for priority groups
• Distributed only through Public Health

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Vaccination target populations
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H1N1 Vaccination Priority Groups

• High Risk people, age 25 64
• chronic pulmonary (including asthma),
  cardiovascular (except hypertension), renal,
  hepatic, cognitive, neurologic/ neuromuscular,
  hematologic, or metabolic disorders (including
  diabetes mellitus) or immunosuppression
  (including immunosuppression caused by
  medications or by human immunodeficiency virus)

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H1N1 Vaccination Priority Groups

• Health Care Worker
• nursing homes, skilled nursing facilities,
  physicians offices, urgent care centers, and
  outpatient clinics, and to persons who provide
  home health care
• Clarification from PH
• This includes ALFs/RCFs, CCRCs, AFHs, and HCWs.
  It does not include any day programs, senior
  centers, etc.

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Is the vaccine safe??????

• This is the same vaccine that is made every year
  for flu, made in the same way. Every year it
  include 3 different, new strains. This vaccine
  will just include a 4th strain. There just wasnt
  time to get it into the seasonal vaccine.
• There have been no significant side effects in
  the current trials.

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Office Implications

• Asked to plan for 40 absenteeism
• In your office
• In facilities/homes, Home Care Workers, etc.
• Possibly some interruption in supply chains,
  needed services, etc.
• Take Seriously the need for Business Continuity
  Plans
• Consider cross training now

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Protect yourself and others

• Make it easy for folks to wash their hands or use
  hand sanitizer purchase the sanitizer for
  common areas and staff who go into facilities and
  home
• Encourage people who are sick to stay home
• Get immunized for the flu as soon as it is
  available for you

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Keep In Touch

• http//www.flu.oregon.gov/
• http//www.oregon.gov/DAS/HR/flu.shtml
• http//www.dhs.state.or.us/admin/hr/h1n1/
• Look for the development of a SPD website for
  information that has been sent out, FAQs,
  policies, etc.
• SS-IM-09-048 on SNAP and H1N1

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What we need from you

• A heads-up if and when there are significant
  impacts in your office, with your providers, etc.
• Policy/Rules that you think may need to be
  relaxed if this has a significant impact
• Your ideas about how to get providers vaccinated
• A heads-up of rumors that you are hearing

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Dont Get Crazy
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• Key points
• Pandemic H1N1 flu is here few people have
  immunity
• We will likely see more illness, more
  hospitalizations
• Vaccine is our best weapon
• Challenge vaccinate 2,000,000 Oregonians
• Community Mitigation
• Stay home when sick, cover cough, wash hands
• Schools, business, health care systems need plan
  for business continuity

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• Tina Kitchin, MD, FAAP
• Tina.c.kitchin_at_state.or.us