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H1N1 Flu

Flyer on H1N1 Webinar - December 10, 2009Update: January 10, 2010 For up-to-date information, please see www.flu.gov.

NEWS & HIGHLIGHTS

NEW ! January 10-16 is National Influenza Vaccination Week!  This is an annual national observance established to remind and encourage flu vaccinations after the holiday season and into January and beyond. Before the holidays, H1N1 dominated the news with stories of the spread of the disease and availability of the vaccination. According to the January 7 CDC news briefing by Dr. Anne Schuchat, Director of CDC’s National Center for Immunizations and Respiratory Diseases, only four states are reporting widespread flu: Delaware, Maine, New Jersey, and Virginia. Dr. Schuchat warns of complacency, however. We still don’t know what lies in the weeks and months ahead with either the H1N1 or the seasonal flu. She referred to another flu epidemic in 1957 that started off much like the H1N1 epidemic has, with a peak in deaths occurring before December and a sharp drop-off in the number of cases reported during December and January. Despite the availability of the vaccine at that time, its use was not encouraged. A second deadly peak occurred in the winter and spring of 1958. Dr. Schuchat emphasizes that we don’t know if the H1N1 epidemic will peak again or not, but cautions that the best way to hedge bets is by continuing to urge everyone to be vaccinated.

1957-1958 Flu Epidemic Mortality Chart

The vaccine is now widely available across the country at health clinics, drug stores, doctor’s offices, etc. Seniors—who had been advised to wait until the higher risk populations were vaccinated—are now being urged to get the vaccination since it is available.

So… if you and your family members have not yet been vaccinated, now is the time to do so. It might seem an odd way to “celebrate” a national observance, but it could be key to more entertaining celebrations later in the year!

Each day of National Influenza Vaccination Week highlights the importance for a specific target group:

Sunday, January 10         Kickoff
Monday, January 11        General audience and health care workers
Tuesday, January 12       People with chronic health conditions that put them at high risk of serious influenza-related complications
Wednesday, January 13  Children, pregnant women, and caregivers of infants less than 6 months old
Thursday, January 14      Young adults (19-24 years old)
Friday, January 15           Seniors
Saturday, January 16       Wrap up

For ideas, resources, media kits, and other useful materials—many of which are appropriate for general use past NIVW, go to:  http://www.flu.gov/news/nivw.html

Of special note is Families Fighting Flu, Inc., a non-profit organization dedicated to families and health care providers whose child has died or suffered serious complications because of the flu. Check out their website at: http://www.familiesfightingflu.org

For a podcast that gives information to parents about children with high-risk conditions and the flu:  http://www2c.cdc.gov/podcasts/player.asp?f=393367

 

December 21, 2009, Volume 11, Edition 52

– MONDAY MORNING MEMO –

4) NON-SAFETY-RELATED, VOLUNTARY RECALL OF SOME LOTS OF H1N1 PEDIATRIC VACCINE
Sanofi Pasteur has voluntarily recalled some lots of H1N1 pediatric vaccine in pre-filled syringes.  Post delivery testing of the vaccines by the manufacturer showed that they were less potent than the pre-specified limit.  There are no safety concerns with these four lots of H1N1 vaccine, which all successfully passed pre-release testing for purity and safety.  The Centers for Disease Control and Prevention (CDC) reports that the potency of the four lots of the vaccine is only slightly below the specified range, and is still expected to be effective in stimulating a protective response despite the slight reduction in the concentration of antigen.  Providers do not need to re-administer doses to those who received vaccine from these lots.  However, this underscores the importance of children under 10 years of age receiving the recommended two doses of H1N1 vaccine approximately one month apart.  For more information, go to the CDC Web site at http://www.cdc.gov/h1n1flu/vaccination/syringes_qa.htm


 The Good, The Bad, and The “Too Soon to Call” News

The Good News: The vaccine supply is up, and is available for at least the priority groups. And the number of cases of H1N1 has dropped in many areas across the country, as a glance at flu.gov’s map will show. Go to http://www.flu.gov/whereyoulive/healthmap to view the map. (The darker the color, the more widespread the H1N1 virus.)

The Bad News: More people have been hospitalized or have died from the H1N1 flu as of November 14th than usually happens in an entire usual flu season—and the flu season runs through May.  H1N1 continues to hit younger people harder than the elderly. There have been nearly 10,000 deaths from H1N1—1,100 from children, and 7500 from younger adults. Fifteen percent of the country—roughly 1 in 6 people—have been infected by the H1N1 virus thus far.


The “Too Soon to Call” News: While the fact that the number of cases has dropped is good, experts are concerned that this may just be a temporary lull in the number of cases, especially with 5+ months to go in the flu season. Dr. Thomas Frieden, CDC Director, in a recent press conference stated:


This is still a good window of opportunity to be vaccinated.  I can certainly understand that many people might say well there′s been so much disease and it's going down so much, why get vaccinated now?   But the fact is we don't know what the future will hold.   Just as in a usual flu season, you get vaccinated because you think it might be a bad flu season.   The vaccine is likely to protect you.   That′s really the situation we′re in now.   We are at the beginning of December.   Flu season lasts until May.   And we don't know what the future will bring in terms of H1N1 influenza.   We might have a lot more cases.   We might have few.   There′s still spread going on now.   And it's likely if there are more cases that it will be different in different parts of the country.   It′s a different country, with different patterns of disease over the past season.   


So What Should We Do? If you (or your children) are in the priority group, get vaccinated. Watch the vaccine availability in your area on the www.flu.gov site. Dr. Frieden sums it up:
So I hope that all who are interested in being vaccinated will be vaccinated.   It′s the best way to protect yourself and your family from illness, serious illness, hospitalization or death.   And even if you wouldn′t become severely ill, it will protect from you being out sick from school or work for a week.   The more people who are vaccinated, the more people who will be protected from  influenza, the fewer cases we'll have in the future, the less likely we will be to have a third wave or more cases in the weeks and months to come.   


And Tips for Those with Chronic Medical Conditions: The www.flu.gov website has a page devoted to those with health conditions that includes the following chart of flu-outbreak tips for those with chronic medical conditions:
If you have a chronic medical condition, during a flu outbreak you should:

Get a written record of the kind of chronic disease(s) you have and the treatment you are receiving. Keep this information with you at all times.

Prepare a typed or printed list of all medications usually taken and the times of day they are taken. Also include necessary medical supplies or equipment such as syringes, strips, lancets if you have diabetes, or oxygen if you have COPD

Keep the name, phone number, and office address of your doctor or health care provider with you at all times.

If you use medications for your condition, continue taking those medications even if you become sick with the flu, unless your doctor or health care provider says otherwise

Be alert to changes in your breathing, especially if you have heart failure, congestive heart disease or COPD. Promptly report changes to your doctor or health care provider

Inform family members or close friends of your medical condition.

Family Voices and the Centers for Disease Control (CDC) sponsored a webinar on December 10th, H1N1 and Your Child with Special Health Care Needs, presented by Dr. Georgina Peacock of CDC. To listen to this recorded call simply click on this link https://www323.livemeeting.com/cc/familyvoices/view?id=9KSTGJ. You will be must enter your name and organization; no Recording Key is required.

This webinar will provide you with information to better understand the symptoms, prevention and treatment of the H1N1 flu for the high-risk population of children with special health care needs. Please visit the H1N1 Webinar page for more information.

The US Department of Health and Human Services is asking for help in spreading the word about H1N1—the virus, how to lessen your risk of getting it, important vaccine updates, etc. HHS has provided a letter that can be shared with family, friends, co-workers, in newsletters, etc., and has also asked that if you share the letter in newsletters, blogs, or websites, that you let HHS know so they will have an indication of how the information is being used. Send an email to Sharon Ricks at sharon.ricks@hhs.gov.

HIGHLIGHT ! Google has created an online flu shot map resource to help you find where vaccinations are being offered in your area. Just enter your zipcode or city, state and google will list the locations providing the H1N1 vaccine or the seasonal flu vaccine. Google even provides a map to those locations.

HIGHLIGHT ! Check out new resources on staying healthy while you are traveling during this holiday season.

Seasonal and 2009 H1N1 Flu: For Parents Who Have Children Or Adolescents With High-Risk Medical Conditions HIGHLIGHT ! The CDC has posted 2009 H1N1 Flu Information for People with Disabilities and Their Caregivers or Personal Assistants that includes a good overview of special considerations for people (and children) with disabilities. Of special note:

What about providers of home and community-based services and those providing support services in day and residential programs for people with disabilities?
Providers of home and community-based health-related services (personal care attendants, direct support staff, paraprofessionals, itinerant therapists and others providing ADL support) who have close and consistent contact with people with disabilities and those providing healthcare support services in day and residential programs for people with disabilities should be considered in the same priority as “health care personnel.”

This puts these caregivers in the priority grouping for vaccinations as they become available.

STATUS of H1N1

The Centers for Disease Control continues to monitor the H1N1 virus—its spread, any changes in the virus, and demographics of the people infected with this virus. The 11/24/09 update included the following:

  • Invasive Pneumococcal Disease: The Denver metro area is seeing an increase in the number of serious cases of Invasive Pneumococcal Disease (IPD), which appears to be linked to the H1N1 virus. Adults between 20 and 59 are hardest hit (62% of cases). The CDC continues to monitor this.
  • Adverse Effects Monitoring: The CDC is also monitoring reported adverse effects from the H1N1 vaccination. As of November 20, 3182 adverse effects had been reported, and 94% of these are mild (such as injection-site swelling). These numbers are consistent with adverse effects of the seasonal flu vaccination. Because of potential concern over whether the vaccination might trigger Guillain-Barré syndrome (GBS), the CDC is tracking GBS cases as well. To date, there are no indications that the H1N1 vaccination is linked to GBS cases.
  • Changes in H1N1 virus strain: There have been some minor changes in the H1N1 virus strain in Norway and other isolated areas. So far, the vaccine continues to be effective against all of these strains.
  • H1N1 Hospitalizations and Asthma: People with asthma are at higher risk for H1N1 complications and hospitalization. From April 15 through October 27, 32% of people hospitalized with H1N1 had asthma. Thirty percent of adults hospitalized with H1N1 had asthma, and 35% of hospitalized children with H1N1 had asthma.
  • H1N1 Hospitalizations and Deaths by Age Group:
    • Age Group Hospitalizations (% of total) Deaths (% of total)
    0-4 years 19% 3%
    5-18 years 25% 14%
    19-24 years 9% 7%
    25-49 years 24% 33%
    50-64 years 15% 32%
    65+ years 7% 12%
    Total cases 4958 lab-confirmed 292 lab-confirmed

Check out an AAP report on these high risk categories.

What Can You Do?

Get Vaccinated!
  • Keep checking www.flu.gov for updates on when and where supplies of the vaccine will be available.
  • If you or your family members fall in the “high risk” categories, actively seek out the vaccine as soon as it becomes available. High risk categories include pregnant women, children/youth/adults from 6 months to age 24, people over age 25 with certain health conditions.
  • If you are a caregiver for anybody falling in these high risk categories, it is important for you to receive the vaccination as well.
  • Even if you do not fall in the high risk groups, you may still wish to receive the vaccination.
Prevent the Spread!
  • Probably the single most important thing you can do to prevent the spread of this virus is to wash your hands and keep them away from your face. Teach your children to wash their hands—and help them as needed.
  • Cover your mouth with a tissue if you cough or sneeze—and teach your children to do so, too.
  • If you do get sick, stay away from crowds and especially those people at high risk for the disease.
Seek Treatment
  • Mom’s wisdom applies for the H1N1 flu: stay home, get plenty of rest, and drink lots of clear liquids to prevent dehydration.
  • Be on the alert for signs of more serious complications of the flu requiring medical treatment: Emergency Warning Signs - If you become ill and experience any of the following warning signs, seek emergency medical care. [from Flu.gov]
      • Emergency warning signs in children:
    • Fast breathing or trouble breathing
    • Bluish or gray skin color
    • Not drinking enough fluids
    • Severe or persistent vomiting
    • Not waking up or not interacting
    • Being so irritable that the child does not want to be held
    • Flu-like symptoms improve but then return with fever and worse cough

      • Emergency warning signs in adults:
    • Difficulty breathing or shortness of breath
    • Pain or pressure in the chest or abdomen
    • Sudden dizziness
    • Confusion
    • Severe or persistent vomiting
    • Flu-like symptoms improve but then return with fever and worse cough
  • CDC suggests staying home for 24 hours after fever subsides; the 7 day exclusion does not apply any longer, unless it is a health care provider.
Stay Informed
  • Check out the websites below, especially www.flu.gov for updates on the virus and the vaccine availability.
  • Help your children learn healthy habits for keeping them well. Make it a family priority!

CDC Toolkit for Providers of Children with High Risk Conditions RESOURCES

General Resources:

Drugs/Vaccines:

Resources for Families, Parents, Pregnant and Breastfeeding Women:

Resources for Children and Teens:

Resources for Children with Special Health Care Needs:

Resources for Communities, Organizations, and Schools:

Resources for Health Care Providers:

Tips to Help You Keep Healthy While Traveling:

Imagine you are the H1N1 flu virus, determined to take over the world…. If you could create a situation to make that goal as easy as possible, what would you do? How about arranging for large groups of people to be in cramped places, traveling from one area to another, at a time when these same people have added stresses on their energy levels and immune systems?

That’s a pretty accurate description of this time of year, isn’t it? Between Thanksgiving travel and preparation, followed by December holiday shopping, traveling, and the typical accompanying stress, the conditions are perfect for H1N1 spread.

The CDC has recently unveiled its 2009 Travelers’ Health Campaign to try to thwart the H1N1’s “plan” for world domination. It’s basically common sense advice, and you’ll likely see it in the form of posters in airports, train stations, and seaports throughout the upcoming year.

CDC Ad - Prevention can be travel-sizedThe CDC campaign encourages travelers to remember four important steps:

  • Travel only when you feel well. This is so important, and not just to prevent the spread of disease from one location to another, but also to allow you to fully recover. And, if you are sick, the risk of other family members in your household is much greater as well.
  • Wash your hands often. Use soap and warm water and sing yourself a round of “Happy Birthday” while you wash. Teach your children—and help them as needed—to wash well and frequently. Show them how to use paper towels to cut off the water and open doors—and then trash them—to prevent picking up those pesky germs.
  • Cover your coughs and sneezes with a tissue or your sleeve. This helps keep the germs out of the air and off your hands as well. Help your child learn these habits as well.
  • Get a flu vaccination if you are in the priority group (pregnant women, children and young adults to age 24, people from 24-65 with underlying health conditions, caregivers and medical emergency service personnel). Note that the CDC also considers caregivers for children and adults with disabilities to be part of the priority group for vaccinations.
Let’s add “not getting sick with H1N1” one of the things we can all be thankful for this season!









 


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