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Latest H1 N1 Influenza Preparedness (J&K)


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H1N1 Influenza Preparedness Presentation for Jammu and Kashmir, India.

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Latest H1 N1 Influenza Preparedness (J&K)

  1. 1. Preparedness of the Health Department for Type A (H1N1) Influenza SM Kadri ( Status Report) 28 th August 2009 Directorate of Health Services, Kashmir
  2. 2. Surveillance (Air Travelers): Entry point surveillance was started immediately after WHO raised the alert level from 3 to 5 . (The current level is 6) <ul><li>Srinagar airport: </li></ul><ul><ul><li>Surveillance cell was established at the airport with doctors & paramedics screening all the passengers coming from abroad. </li></ul></ul><ul><ul><li>The airport officials were sensitized/oriented about the new threat </li></ul></ul><ul><ul><li>Surveillance activities were started from May 1 </li></ul></ul><ul><li>Leh airport: </li></ul><ul><ul><li>Surveillance was started from May 3, 2009 </li></ul></ul><ul><li>The following information is recorded at the airport: </li></ul><ul><ul><li>Personal particulars including seat number & flight number </li></ul></ul><ul><ul><li>Country of origin and transit </li></ul></ul><ul><ul><li>Any history of respiratory illness </li></ul></ul><ul><ul><li>All history of visits during the last 15 days </li></ul></ul><ul><ul><li>Destination </li></ul></ul><ul><ul><ul><li>Full address with contact numbers </li></ul></ul></ul>
  3. 3. Surveillance (Surface Travelers): Yatris & Others <ul><li>Qazi Gund :( Two entry point Surveillance Centres were established on June 18, 2009) </li></ul><ul><ul><li>Emergency Hospital Building, Qazi Gund </li></ul></ul><ul><ul><li>Mir Bazar, FCI Building, Qazigund </li></ul></ul><ul><ul><ul><li>Doctors involved: DHO Kulgam, BMO Qazigund, Medical Superintendent Kulgam District Hospital </li></ul></ul></ul><ul><ul><ul><li>Overall Monitoring: CMO Kulgam </li></ul></ul></ul><ul><li>Baltal: </li></ul><ul><ul><li>Established June 20, 2009 </li></ul></ul><ul><ul><li>Doctors involved: </li></ul></ul><ul><ul><ul><li>DHO Ganderbal, </li></ul></ul></ul><ul><ul><ul><li>Medical Superintendent SDH Kangan, BMO Kangan </li></ul></ul></ul><ul><ul><ul><li>Overall Monitoring: </li></ul></ul></ul><ul><li>Pahalgam: </li></ul><ul><ul><li>Started July 2, 2009s </li></ul></ul><ul><li>Information sought from passengers: </li></ul><ul><ul><li>Personal particulars </li></ul></ul><ul><ul><li>City of origin </li></ul></ul><ul><ul><li>Time since left the city: </li></ul></ul><ul><ul><li>Cities of transit: </li></ul></ul><ul><ul><li>Destination in Valley: </li></ul></ul><ul><ul><li>Contact & address numbers in Valley </li></ul></ul><ul><ul><li>Yatris were provided all emergency numbers in case they developed: </li></ul></ul><ul><ul><ul><li>Fever </li></ul></ul></ul><ul><ul><ul><li>Sore throat </li></ul></ul></ul><ul><ul><ul><li>Coughs/colds </li></ul></ul></ul><ul><ul><ul><li>Difficulty in breathing </li></ul></ul></ul><ul><ul><ul><li>Other unusual symptoms </li></ul></ul></ul><ul><ul><ul><li>Surveillance Closed on 5.8.09 </li></ul></ul></ul>
  4. 4. Doctors & paramedics screening patients at Srinagar Airport <ul><li>Dr Masarat Rasool </li></ul><ul><li>Dr Zahida Parveen </li></ul><ul><li>Dr Asima Nazir </li></ul><ul><li>Dr Yasmeen Iqbal </li></ul><ul><li>Dr Ghulam Rasool </li></ul><ul><li>Dr Mahboob Hussain </li></ul><ul><li>Mr Farooq Ahmad Hakim, Sr Pharmacist </li></ul><ul><li>Mr Parvez Ahmad, Sr Pharmacist </li></ul><ul><li>Mr Owais Ahmad, Health Educator </li></ul><ul><li>Mr Mohammad Ashraf Dar, Sr Health Inspector </li></ul><ul><li>Mr Rafiq Ahmad Dar, Health Educator, </li></ul><ul><li>Mr Nissar Ahmad, NO </li></ul><ul><li>Monitoring of airport is done by: </li></ul><ul><li>S M Kadri, Public Health Specialist </li></ul><ul><li>Weekly meetings held at DHSK: </li></ul><ul><li>1) Dr M. A. Wani , Director Health Services, Kashmir </li></ul><ul><li>2) Dr Riyaz Ahmad , DDHS (HQ) </li></ul><ul><li>3) Dr Bashir Gaash , Epidemiologist, Nodal Officer </li></ul><ul><li>4) Dr S M Kadri , Public Health Specialist </li></ul><ul><li>Daily Reports Sent Electronically to: </li></ul><ul><li>1) Dr Dhariwal , National Project Officer, IDSP, Delhi </li></ul><ul><li>2) Dr Ashok Kumar , CBHI, New Delhi </li></ul>
  5. 5. Surveillance Teams <ul><li>Divisional Level RRTs comprise of the </li></ul><ul><li>Epidemiologist, Dr Bashir Gaash (Nodal Officer) </li></ul><ul><li>Public Health Specialist (Dr S M Kadri) </li></ul><ul><li>Microbiologist, Dr Kaisar </li></ul><ul><li>Physician (Dr Nissarul Hassan) </li></ul><ul><ul><li>All trained by the National Institute of Communicable Diseases, Delhi (NICD) </li></ul></ul><ul><li>RRTs have been constituted at the district levels which comprise of </li></ul><ul><ul><li>District Health Officer </li></ul></ul><ul><ul><li>Physician </li></ul></ul><ul><ul><li>Medical Officer In-charge of the District Laboratory and </li></ul></ul><ul><ul><li>District-level Community Health Officer </li></ul></ul><ul><ul><ul><li>All have been trained in prevention & control of Type A H1N1 influenza </li></ul></ul></ul>
  6. 6. Update of H1N1 Influenza Screening: 28 August 09 <ul><li>Kashmir Division </li></ul><ul><li>Total no of passengers : 30,992 </li></ul><ul><li>Passengers Screened at H1N1 Flu center at Saant Nagar – 345 (Since 21 st Aug 09) </li></ul><ul><li>Passengers Screened at Lower Munda (National High way ) till date 27,183 </li></ul>
  7. 7. Control Room: Coordination & Evaluation Cell <ul><li>Established at the Directorate of Health Services, Kashmir, Srinagar, </li></ul><ul><li>on May 2, 2009 </li></ul><ul><li>The contact numbers have been publicized widely: </li></ul><ul><ul><li>0194-2452052 (Director Health Services, Kashmir) </li></ul></ul><ul><ul><li>0194-2454707 (Dy Director Health Services, HQ) </li></ul></ul><ul><ul><li>0194-2440283 (State Surveillance Officer, IDSP) </li></ul></ul><ul><ul><li>Daily monitoring is done by: </li></ul></ul><ul><ul><ul><li>Director Health Services, Kashmir (Ph: 94190 </li></ul></ul></ul><ul><ul><ul><li>Dy Director Health Services, Kashmir (Ph:9419017716) </li></ul></ul></ul><ul><ul><ul><li>Epidemiologist, Directorate of Health Services (Ph: 9419089018) </li></ul></ul></ul>
  8. 8. Emergency Coordination Cell/Control Room (Gausia Hospital) <ul><ul><ul><li>Established in Srinagar on 2 May 2009 </li></ul></ul></ul><ul><ul><ul><li>Liaison Officer : </li></ul></ul></ul><ul><ul><ul><li>Dr Dildar, DHO Srinagar </li></ul></ul></ul><ul><ul><ul><li>Emergency Contact Numbers : </li></ul></ul></ul><ul><ul><ul><li>Dr Dildar (DHO): 9419005151 </li></ul></ul></ul><ul><ul><ul><li>Dr Shawkat , Nodal Officer Isolation Ward, SMHS Hospital: 9419962001 </li></ul></ul></ul><ul><ul><ul><li>Dr Munir , 2 nd nodal officer, SMHS Hospital: 9419005930 </li></ul></ul></ul><ul><ul><ul><li>Dr Aejaz Mustafa , Nodal Officer, Isolation Ward, SKIMS: 9419415331 </li></ul></ul></ul><ul><ul><ul><li>Dr Farooq , 2 nd Nodal Officer, 9419415196 </li></ul></ul></ul><ul><ul><ul><li>6 persons have been kept with one ambulance at the Emergency coordination cell (24x7): </li></ul></ul></ul><ul><ul><ul><li>Contact numbers: 2452499; 9419005151 </li></ul></ul></ul>
  9. 9. Lab Tests for Confirmation <ul><li>47 samples collected </li></ul><ul><li>Positive 10 till date in Kashmir Division </li></ul><ul><li>Specimens </li></ul><ul><ul><li>nasopharyngeal swab, </li></ul></ul><ul><ul><li>throat swab , </li></ul></ul><ul><ul><li>nasal swab, </li></ul></ul><ul><ul><li>Wash/aspirate/ tracheal aspirate </li></ul></ul><ul><li>Transported at 4C to NICD within 48 hours </li></ul><ul><li>Transported by air (Indian airlines, 2 pm flight; collected by NICD from Delhi Airport </li></ul><ul><li>Overnight samples stored at Epidemic section Barzulla </li></ul>
  10. 10. Management of a suspected case: <ul><li>Arrangements made for immediate shifting of suspects to the isolation wards of hospitals ( SKIMS, SMHS). </li></ul><ul><li>Ambulances & staff kept in readiness at the airport as well as the coordination cell at Srinagar. </li></ul><ul><li>Isolation wards/Ventilatory support in full readiness at SMHS Hospital & SKIMS </li></ul><ul><ul><li>(13 beds kept for isolation) </li></ul></ul><ul><li>SMHS: </li></ul><ul><ul><li>Nodal Officer: </li></ul></ul><ul><ul><li>Dr Shaukat Ahmad Dar , Medical Officer Casualty Department . </li></ul></ul><ul><ul><li>Isolation beds: 9 </li></ul></ul><ul><li>SKIMS: </li></ul><ul><ul><li>Nodal Officer: </li></ul></ul><ul><ul><li>Dr Aejaz Mustafa , Asstt Professor, ED & Dr Fayaz Ahmad , ED </li></ul></ul><ul><ul><li>Isolation beds: 4 </li></ul></ul><ul><ul><li>Facilities in readiness: </li></ul></ul><ul><ul><li>Ventilator, Defibrillator </li></ul></ul>
  11. 11. Dealing with a suspected case <ul><li>If the case is detected at the airport: </li></ul><ul><ul><li>Immediate shifting to hospital </li></ul></ul><ul><ul><li>Co-passengers to be screened </li></ul></ul><ul><ul><li>Attendants/companions to be provided instructions to minimize chances of contracting/spreading infection in the community </li></ul></ul><ul><ul><li>Medical staff at airports has already been oriented and trained to deal with suspected cases of influenza </li></ul></ul><ul><ul><ul><li>(Responsibility: </li></ul></ul></ul><ul><ul><ul><li>Surveillance Team at Airport; </li></ul></ul></ul><ul><ul><ul><li>I/C Dr S M Kadri) </li></ul></ul></ul><ul><li>If the case is detected at home/ hotel/ houseboat </li></ul><ul><ul><li>Sample collection on site </li></ul></ul><ul><ul><li>Home quarantine till lab results </li></ul></ul><ul><ul><li>If lab shows +ve, </li></ul></ul><ul><li>Immediate shifting to hospital isolation </li></ul><ul><ul><li>All contacts will be screened </li></ul></ul><ul><ul><ul><li>(Responsibility: </li></ul></ul></ul><ul><ul><ul><li>Emergency Control Room, </li></ul></ul></ul><ul><ul><ul><li>Dr Dildar/Dr Yasmeen) </li></ul></ul></ul>
  12. 12. Trainings conducted in 2008-09 Category trained Trained in Number Trained Venue of training <ul><ul><li>Nodal team </li></ul></ul>Avian Influenza 7 National Institute of Communicable Diseases, Delhi District Health Officers and District Physicians Avian Influenza 25 National Institute of Communicable Diseases, Delhi Doctors Avian Influenza 249 Regional Institute of Health & Family Welfare, Dhobiwan Community Health Officers, Health Educators, MPWs Avian Influenza 755 Regional Institute of Health & Family Welfare, Dhobiwan
  13. 13. Trainings conducted in 2009-10 Category trained Trained in Date Number Trained Venue of training <ul><ul><li>CMOs, DHOs, DIOs, BMOs, </li></ul></ul>Type A H1N1 influenza 11 May 2009 110 Regional Institute of Health & Family Welfare, Dhobiwan Physician specialists, Pediatricians 14 May 2009 45 Regional Institute of Health & Family Welfare, Dhobiwan Incharge Medical Officers PHC 15 May 09 87 Regional Institute of Health & Family Welfare, Dhobiwan Community Health Officers (CHOs) 16 May 2009 125 Regional Institute of Health & Family Welfare, Dhobiwan Health Educators 17 May 2009 117 Regional Institute of Health & Family Welfare, Dhobiwan MPWs (Male & Female) 19 May 2009 252 Regional Institute of Health & Family Welfare, Dhobiwan
  14. 14. Logistics (Drugs, sample kits, masks) <ul><li>Antiviral drugs: </li></ul><ul><ul><ul><li>Tamiflu (oseltamir) for treatment/prevention </li></ul></ul></ul><ul><ul><ul><ul><li>2000 tablets with epidemiologist </li></ul></ul></ul></ul><ul><li>Masks (Triple Layer) </li></ul><ul><ul><ul><li>Triple layered masks </li></ul></ul></ul><ul><ul><ul><li>Provided to the concerned surveillance officers </li></ul></ul></ul><ul><li>Masks (N95) </li></ul><ul><ul><ul><li>Stocked </li></ul></ul></ul><ul><li>Compact PPE: </li></ul><ul><ul><ul><li>Stocked </li></ul></ul></ul><ul><li>Stocked at: </li></ul><ul><li>Epidemic Section, </li></ul><ul><li>Barzulla </li></ul>
  15. 15. Health Education: <ul><li>1) Pre-pandemic Health Education : </li></ul><ul><ul><li>Published in newspapers on daily basis (since May 2, 2009) </li></ul></ul><ul><ul><li>Broadcast & telecast from Electronic Media on daily basis (since May 2, 2009) </li></ul></ul><ul><ul><li>Technical material for Doctors & Other Health Workers being prepared </li></ul></ul><ul><ul><li>2) Material being prepared: </li></ul></ul><ul><ul><li>Pandemic messages & instructions </li></ul></ul><ul><ul><li>Post-pandemic messages & instructions </li></ul></ul>
  16. 16. Emergency augmentation required : <ul><li>Additional funds for: </li></ul><ul><ul><li>POL </li></ul></ul><ul><ul><li>Trainings </li></ul></ul><ul><ul><li>Refreshments </li></ul></ul><ul><ul><li>TA/DA </li></ul></ul><ul><ul><li>IEC Activities </li></ul></ul><ul><ul><li>(Currently there is no POL for H1N1 Surveillance) </li></ul></ul><ul><li>Equipments: </li></ul><ul><ul><li>Ventilators </li></ul></ul><ul><ul><ul><li>*Shortage of ventilators may be taken up with EMR </li></ul></ul></ul>