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Influenza A H1N1 VIHA Family Practice Rounds

Influenza A H1N1 VIHA Family Practice Rounds

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  • 1. Influenza A H1N1 Murray Fyfe September 22, 2009 VIHA Family Practice Rounds
  • 2. Clinical Presentation of Initial US H1N1 Cases fever cough sore throat Additional symptoms: headache, coryza, diarrhea myalgia, arthralgia, fatigue and weakness vomit 0 20 40 60 80 100 percent of cases
  • 3. Majority (73%) of those hospitalized have one more underlying condition (e.g. respiratory, cardiac, metabolic, immunosuppressed, pregancy)
  • 4. H1N1 Basic Epidemiology • Incubation period: 1-7 days (likely up to 4) • Period of communicability: ~ 7 days • Secondary attack rate: 8-19% • Mode of transmission – Droplet spread – Aerosolization with certain procedures
  • 5. Surveillance Plan for H1N1 • Detailed data collection from all hospitalized cases • Lab based surveillance of all submitted specimens • Sentinel physicians • MSP data monitoring • Reporting of high absenteeism in schools/daycares • Active follow up with remote First Nations communities
  • 6. H1N1 Vaccine • Produced by GlaxoSmithKline • Adjuvanted (AS03) single Ag, split virus • Initial trials safe and immunogenic after single dose (similar vaccines from other manufactures showing similar results) • Initial shipments expected in mid- November; then weekly for about 2 months
  • 7. H1N1 Vaccine Priority Groups – persons with chronic medical conditions – pregnant women – children 6 months to less than 5 years of age – persons residing in remote and isolated settings or communities – health care workers involved in pandemic response or who deliver essential health services – household contacts or caregivers of those at high risk who cannot be immunized – populations otherwise identified as high risk
  • 8. H1N1 Vaccine Delivery • Expected to start in mid-November • Physician and public health delivered – Physicians will have a critical role in providing to their patients in a timely way • 10 dose vials – e.g. could plan for 10 patients in ½ hour block • IM injection (likely single dose) • Further information including ordering forms will be sent by mail in October.
  • 9. Tamiflu • Commercial supply currently available through community pharmacies • Provincial stockpile to be released to community pharmacies Oct 1. • Available with physician prescription – Consider providing high risk patients a prescription in advance that could be filled during fall if they develop influenza
  • 10. Tamiflu Indictions • Early treatment of influenza in: – patients with underlying conditions:, respiratory, cardiovascular disease, diabetes, obesity, immunocompromised – Pregnancy – Children 2 years and under – *Aboriginal people living on reserve • Treatment of severe influenza cases
  • 11. H1N1 Communications • Public: – General mild level of illness – Self isolation, cough etiquette, hygeine – Info on self care • Physicians – Provincial Health Officer emailed notices – VIHA MHO letters – NEW fax distribution – VIHA website