h1n1 update
DESCRIPTION
H1N1 Update. Tina Kitchin Department of Human Services, SPD 9/24/09. 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. Influenza. Symptoms: - PowerPoint PPT PresentationTRANSCRIPT
H1N1 UpdateH1N1 Update
Tina KitchinTina Kitchin
Department of Human Services, SPDDepartment of Human Services, SPD
9/24/099/24/09
GoalsGoals
Understand the fluUnderstand the flu Current status of the pandemicCurrent status of the pandemic Understand the steps you can take to Understand the steps you can take to
protect yourself and your clientsprotect yourself and your clients Know where to turn with questionsKnow where to turn with questions
InfluenzaInfluenza
Symptoms: Symptoms: Respiratory Illness, fever, Respiratory Illness, fever,
headache, myalgia, coughheadache, myalgia, cough TransmissionTransmission
Droplet (3Droplet (3––6 feet)6 feet) Incubation: Incubation:
11––3 days3 days
Impact of Influenza: Typical YearImpact of Influenza: Typical Year
10%10%––20% ill20% ill U.S.U.S.
~225,000 hospitalizations~225,000 hospitalizations ~36,000 deaths~36,000 deaths
OregonOregon ~2,750 hospitalizations~2,750 hospitalizations ~450 deaths~450 deaths
Influenza Virus ChangesInfluenza Virus Changes
““Antigenic drift”Antigenic drift” Minor changes to Minor changes to
strains each year, strains each year, need new vaccineneed new vaccine
Antigenic shift”Antigenic shift” Major reassortment, Major reassortment,
nobody has immunitynobody has immunity
Widespread pandemicWidespread pandemic
Gerberding, J. L. et al. N Engl J Med 2004;350:1236-1247
Generation of New Influenza A Virus Subtypes with Pandemic Potential
Why worry about pandemic H1N1?
• 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
Pandemic H1N1 worldwide
• 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
Oregon status
What makes Pandemic H1N1 different?
Hospitalizations over the summer, Oregon, 2009*
0
2
4
6
8
10
12
14
16
18
Specimen Collection Date
Ho
spit
aliz
atio
ns
*as of 11 Sep 2009*as of 11 Sep 2009
Different age distribution of Hospitalizations **
0
5
10
15
20
25
30
35
40
45
50
Age (years)
Ho
spit
aliz
atio
ns
Pandemic H1N1
Seasonal
*as of 31 Jul 2009*as of 31 Jul 2009
Pandemic H1N1 deaths in younger Pandemic H1N1 deaths in younger people, USpeople, US
0
20
40
60
80
100
120
140
0 - 4 25-49 50-64 >65
deaths
5-24
Age Group
De
ath
s
Pandemic H1N1 Influenza strain Pandemic H1N1 Influenza strain Predominates*Predominates*
0102030405060708090
100110120130
Iso
late
s
Oct Dec JanNov Mar AprFeb May
*through 08/01/2009*through 08/01/2009
A (H1)A (H3)A (Unk)BNovel H1N1
Jun Jul
# of flu-like illnesses as of 9/12# of flu-like illnesses as of 9/12
InfluenzaInfluenza
Symptoms: Symptoms: Respiratory Illness, fever, Respiratory Illness, fever,
headache, myalgia, coughheadache, myalgia, cough TransmissionTransmission
Droplet (3Droplet (3––6 feet)6 feet) Incubation: Incubation:
11––3 days3 days
Only You Can Stop the FluOnly You Can Stop the Flu
Stay home if you are sickStay home if you are sick Try to stay 3 ft away from sick peopleTry to stay 3 ft away from sick people Wash your hands or use alcohol-based Wash your hands or use alcohol-based
hand sanitizerhand sanitizer Disinfect contaminated and high-touch Disinfect contaminated and high-touch
surfaces (door knobs, microwaves, surfaces (door knobs, microwaves, remotes, phones, etc.)remotes, phones, etc.)
If you wake up and look like this, do not go to work.
VaccinationVaccination
Seasonal Vaccine – Seasonal Vaccine – Protects against 3 other strains for flu.Protects against 3 other strains for flu. Recommended for everyone!Recommended for everyone! Distributed in same way as every yearDistributed in same way as every year
H1N1 VaccineH1N1 Vaccine Protects only against the new H1N1 strainProtects only against the new H1N1 strain Targeted for priority groupsTargeted for priority groups Distributed only through Public HealthDistributed only through Public Health
Vaccination target populations
Pregnant women
Persons between six months and 24 years of age
People who live with or care for children younger than six months of age
Health care and emergency service personnel
People age 25 through 64 years who are at high risk for complications
60,127
1,222,286
60,006
155,467
381,141
Total Population 1, 879, 027Total Doses 3, 758, 054
H1N1 Vaccination Priority GroupsH1N1 Vaccination Priority Groups
High Risk people, age 25 – 64High Risk people, age 25 – 64 chronic pulmonary (including asthma), chronic pulmonary (including asthma),
cardiovascular (except hypertension), renal, cardiovascular (except hypertension), renal, hepatic, cognitive, neurologic/ neuromuscular, hepatic, cognitive, neurologic/ neuromuscular, hematologic, or metabolic disorders (including hematologic, or metabolic disorders (including diabetes mellitus) or immunosuppression diabetes mellitus) or immunosuppression (including immunosuppression caused by (including immunosuppression caused by medications or by human immunodeficiency medications or by human immunodeficiency virus)virus)
H1N1 Vaccination Priority GroupsH1N1 Vaccination Priority Groups
Health Care WorkerHealth Care Worker nursing homes, skilled nursing facilities, nursing homes, skilled nursing facilities,
physicians’ offices, urgent care centers, and physicians’ offices, urgent care centers, and outpatient clinics, and to persons who provide outpatient clinics, and to persons who provide home health care home health care
Clarification from PH:Clarification from PH:
This includes ALFs/RCFs, CCRCs, AFHs, and This includes ALFs/RCFs, CCRCs, AFHs, and HCWs. It does HCWs. It does not includenot include any day programs, any day programs, senior centers, etc.senior centers, etc.
Is the vaccine safe??????Is the vaccine safe??????
This is the same vaccine that is made This is the same vaccine that is made every year for flu, made in the same way. every year for flu, made in the same way. Every year it include 3 different, new Every year it include 3 different, new strains. This vaccine will just include a 4strains. This vaccine will just include a 4thth strain. There just wasn’t time to get it into strain. There just wasn’t time to get it into the seasonal vaccine.the seasonal vaccine.
There have been no significant side There have been no significant side effects in the current trials.effects in the current trials.
Office ImplicationsOffice Implications
Asked to plan for 40% absenteeismAsked to plan for 40% absenteeism In your officeIn your office In facilities/homes, Home Care Workers, etc.In facilities/homes, Home Care Workers, etc. Possibly some interruption in supply chains, Possibly some interruption in supply chains,
needed services, etc.needed services, etc. Take Seriously the need for Business Take Seriously the need for Business
Continuity PlansContinuity Plans Consider cross training nowConsider cross training now
Protect yourself and othersProtect yourself and others
Make it easy for folks to wash their hands Make it easy for folks to wash their hands or use hand sanitizer – purchase the or use hand sanitizer – purchase the sanitizer for common areas and staff who sanitizer for common areas and staff who go into facilities and homego into facilities and home
Encourage people who are sick to stay Encourage people who are sick to stay homehome
Get immunized for the flu as soon as it is Get immunized for the flu as soon as it is available for youavailable for you
Keep In TouchKeep In Touch
http://http://www.flu.oregon.govwww.flu.oregon.gov// http://www.oregon.gov/DAS/HR/flu.shtmlhttp://www.oregon.gov/DAS/HR/flu.shtml http://www.dhs.state.or.us/admin/hr/h1n1/http://www.dhs.state.or.us/admin/hr/h1n1/ Look for the development of a SPD Look for the development of a SPD
website for information that has been sent website for information that has been sent out, FAQs, policies, etc.out, FAQs, policies, etc.
SS-IM-09-048 on SNAP and H1N1SS-IM-09-048 on SNAP and H1N1
What we need from youWhat we need from you
A heads-up if and when there are A heads-up if and when there are significant impacts in your office, with your significant impacts in your office, with your providers, etc.providers, etc.
Policy/Rules that you think may need to be Policy/Rules that you think may need to be relaxed if this has a significant impactrelaxed if this has a significant impact
Your ideas about how to get providers Your ideas about how to get providers vaccinatedvaccinated
A heads-up of rumors that you are hearingA heads-up of rumors that you are hearing
Don’t Get CrazyDon’t Get Crazy
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
