Public Health Aspects of H1N1 VIHA Family Practice Council
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Public Health Aspects of H1N1 VIHA Family Practice Council

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Public Health Aspects of H1N1 VIHA Family Practice Council

Public Health Aspects of H1N1 VIHA Family Practice Council

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Public Health Aspects of H1N1 VIHA Family Practice Council Presentation Transcript

  • 1. Public Health Aspects of H1N1 VIHA Family Practice Council September 17, 2009
  • 2. Reassortments leading to the evolution of 2009 Influenza A H1N1 Trifonov, NEJM, July 2009
  • 3. Clinical Presentation of Initial US H1N1 Cases fever cough sore throat diarrhea vomit 0 20 40 60 80 100 percent of cases
  • 4. Influenza Like Illness Clinical Case Definition • Fever(*) AND Cough • AND at least one of: – Sore throat – coryza – Myalgia – Arthralgia – Diarrhea/vomiting *Fever may be absent in young children and seniors
  • 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 • There will be sufficient H1N1 vaccine available in Canada for everyone that needs and wants to be immunized. No one will be left out.
  • 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: Pregnancy, respiratory, cardiovascular disease, diabetes, obesity, immunocompromised – Children 2 years and under – *Aboriginal people living on reserve • Treatment of severe influenza cases – (severity may be indicated by deterioration in condition with dyspnea, tacchypnea, reduced oxygen sats, hypotension)
  • 11. Tamiflu dosing
  • 12. H1N1 and Schools • Schools can facilitate virus amplification • However, based on mild virus profile, closures of schools are not warranted. • Instead, approach is: – Attempt to exclude those with influenza until recovered – Strong emphasis on hygeine and cough etiquette – Emphasis on cleaning common surfaces