Influenza A H1N1


Murray Fyfe
September 22, 2009
VIHA Family Practice Rounds
Clinical Presentation of Initial US H1N1 Cases

      fever


    cough


sore throat
                                    ...
Majority (73%) of those hospitalized have one more
underlying condition (e.g. respiratory, cardiac, metabolic,
immunosuppr...
H1N1 Basic Epidemiology
•   Incubation period: 1-7 days (likely up to 4)
•   Period of communicability: ~ 7 days
•   Secon...
Surveillance Plan for H1N1
•   Detailed data collection from all hospitalized cases
•   Lab based surveillance of all subm...
H1N1 Vaccine
• Produced by GlaxoSmithKline
• Adjuvanted (AS03) single Ag, split virus
• Initial trials safe and immunogeni...
H1N1 Vaccine Priority Groups
– persons with chronic medical conditions
– pregnant women
– children 6 months to less than 5...
H1N1 Vaccine Delivery
• Expected to start in mid-November
• Physician and public health delivered
  – Physicians will have...
Tamiflu
• Commercial supply currently available
  through community pharmacies
• Provincial stockpile to be released to
  ...
Tamiflu Indictions
• Early treatment of influenza in:
  – patients with underlying conditions:,
    respiratory, cardiovas...
H1N1 Communications
• Public:
  – General mild level of illness
  – Self isolation, cough etiquette, hygeine
  – Info on s...
Fyfe2 H1n1 Presentation Sept 22 09 For Posting
Fyfe2 H1n1 Presentation Sept 22 09 For Posting
Fyfe2 H1n1 Presentation Sept 22 09 For Posting
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Influenza A H1N1 VIHA Family Practice Rounds

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Fyfe2 H1n1 Presentation Sept 22 09 For Posting

  1. 1. Influenza A H1N1 Murray Fyfe September 22, 2009 VIHA Family Practice Rounds
  2. 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. 3. Majority (73%) of those hospitalized have one more underlying condition (e.g. respiratory, cardiac, metabolic, immunosuppressed, pregancy)
  4. 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. 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. 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. 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. 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. 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. 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. 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

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