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Thursday November 12, 2009

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1112 New recommendations on H1N1 vax for children [Prince Edward Island]--New recommendations on the H1N1 vaccine dosage for children between 3 years and 9 years of age were announced today by the Public Health Agency of Canada.

The updated national recommendations from the Public Health Agency of Canada reflect findings from clinical trial results from Europe that suggest that a single half-dose of adjuvanted H1N1 flu vaccine for healthy children may provide an acceptable level of protection from infection from the H1N1 Flu virus.

“Today’s announcement from the federal government is good news,” says Health Minister Doug Currie. “This means that most children in PEI who are between three and nine years of age will not need to return for a second shot at this time.”

The updated recommendations include three components:

• Children between 6 months of age and under 3 years of age should receive two half-doses of adjuvanted H1N1 flu vaccine, administered at least 21 days apart.

• Children with significant chronic health conditions who are between 3 years of age and nine years of age should receive their first half-dose of the H1N1 flu vaccine as soon as possible, which most Island children in this age category have been offered the vaccine here in PEI. These children should receive a second half-dose of the H1N1 flu vaccine once immunization of other priority groups has been completed.

• Healthy children over 3 years of age should only receive a single half dose of the H1N1 vaccine and do not need to return for a second shot for now. This recommendation may be updated as more information becomes available.

“We are pleased to see national guidance from the Public Health Agency of Canada on vaccine dosage for children because this allows us to continue making the most appropriate decisions to best protect children in PEI,” said Dr. Heather Morrison, Chief Health Officer for Prince Edward Island. “Details around clinics for those who should receive a second shot, will be announced in the near future.”

The updated recommendations and the studies they are based on have been reviewed with the Canadian Paediatric Society. The new guidance reflects the need to adopt a prudent approach to protecting younger children with weaker immune systems and children with underlying medical conditions.

For further information on upcoming clinics, the public should watch for advertisements, visit www.gov.pe.ca/flu or call 1-888-748-5454 for the most up-to-date information on immunization clinics.

 

1112 Quebec facilite la vaccination des jeunes du milieu scolaire [Quebec]--"Pour vacciner un maximum de jeunes de 5 à 19 ans dans le moins de temps possible, la vaccination dans les centres de vaccination de masse constitue le moyen le plus efficace et le plus efficient."

 

C'est ce qu'a rappelé aujourd'hui le ministre de la Santé et des Services sociaux, le docteur Yves Bolduc, lors de la conférence de presse quotidienne donnée par les autorités de la santé publique et de l'Organisation de la sécurité civile du Québec.


Pour faciliter la vaccination des jeunes qui fréquentent un établissement scolaire du primaire ou du secondaire, une offre de transport scolaire sera proposée à toutes les régions du Québec.

 

"Les parents seront informés notamment par les écoles des modalités prévues dans leur région concernant la vaccination des enfants", a affirmé le docteur Bolduc, qui invite les parents à être attentifs aux informations qui circuleront dans leur région via les médias locaux, les centres de santé et de services sociaux et les intervenants du milieu scolaire de leur territoire.

 

Par ailleurs, le ministre a rappelé que les parents qui souhaitent faire vacciner leur enfant contre la grippe A(H1N1) pourront également se présenter dans les centres de vaccination de leur région en fonction du calendrier en vigueur.

 

"Aucun enfant de moins de 14 ans ne sera vacciné sans le consentement de ses parents", a-t-il précisé.


Le ministre a mentionné que certaines régions pourraient mettre en place des initiatives particulières tenant compte des caractéristiques de leur territoire.

 

"Par exemple, une faible densité de population dans une communauté rurale éloignée pourrait justifier, aux yeux des autorités régionales, le choix d'une mesure distincte. Il y aura une mixité de formules et une flexibilité dans la mise en oeuvre de cette mesure", a insisté le docteur Bolduc.

 

Il a encore une fois rappelé à quel point il est important, pour les citoyens, de se tenir au courant des stratégies régionales en matière de vaccination, ne serait-ce que pour éviter des déplacements inutiles.

 

"J'invite les parents à porter une attention spéciale aux consignes qui leur seront
transmises par les écoles où sont inscrits leurs enfants", a-t-il réitéré, remerciant du même coup la population pour son excellente collaboration au succès de la campagne de vaccination.


Le coordonnateur gouvernemental en sécurité civile, monsieur Michel C. Doré, précise que l'orchestration d'une telle opération de transport nécessite l'implication de nombreux partenaires :

 

"Les organisations régionales de sécurité civile de l'ensemble du Québec coordonneront toute demande de soutien provenant du ministère de la Santé et des Services Sociaux et du ministère de l'Education, du Loisir et du Sport."


Les précisions concernant la séquence de vaccination pour chaque région sont accessibles sur le site www.pandemiequebec.gouv.qc.ca  Il est aussi possible d'obtenir tous les renseignements nécessaires en communiquant avec Services Québec, au numéro unique 644-4545, accessible par les indicatifs régionaux 418 et 514 ou, sans frais, par le 1 877. Précisons que cette ligne est complémentaire à celle d'Info-Santé 8-1-1, qui assure une réponse aux questions liées au domaine de la santé physique.
 

 

1112 Nine H1N1 cases currently hospitalized with severe respiratory illnesses [Manitoba]--Manitoba Health advises the province has received 36,500 doses of vaccine with adjuvant this week. This vaccine has been distributed to the regional health authorities (RHAs).

In addition, Manitoba received 9,200 doses of vaccine without an adjuvant from Australia last week, which was shipped to the RHAs. This is being targeted initially to pregnant women in the province.

Manitoba has also received 39,900 doses of Canadian-made vaccine without an adjuvant. The province received approvals this morning to pre-position this vaccine in regional health authorities, so it will be shipped out today. Once this vaccine is licensed, the province will review information from the Public Health Agency of Canada (PHAC) on how it can be used to provide further direction to regional health authorities.

Manitoba has been advised that it will receive 43,500 does of adjuvanted vaccine next week. As of Nov. 11, Manitoba had received and distributed a total of 269,200 doses of vaccine. At the end of the day Tuesday, nearly 200,000 shots had been given to Manitobans. All vaccine has been sent to RHAs to administer through clinics and by appointment.

H1N1 Flu Shots
The H1N1 flu shot is now available to all Manitobans aged six months to under 18 years, in addition to the first priority groups. Manitoba has observed an increase in emergency-room and health-care provider visits for school-aged children with influenza-like symptoms. Immunizing this group should also reduce the risk of and help to address concerns about severe illness and death in school-aged children. Providing H1N1 flu shots to school-age children should help reduce the spread of disease to others and help protect all family members who may be at risk.

Manitoba will be following PHAC’s vaccine dosage recommendations for children, which were announced earlier today:
· Children between six months of age and under three years of age should receive two half doses of adjuvanted H1N1 flu vaccine, administered at least 21 days apart.
· Children with chronic health conditions who are between three and nine years of age should received their first half dose of the H1N1 flu vaccine as soon as possible. They should also receive a second half doses of the vaccine. The interval between the two half doses should be a minimum of 21 days.
· Healthy children between three and nine years of age should only receive a single half doses of the H1N1 vaccine and do not need to return for a second vaccine for now. This recommendation may be updated as more information becomes available.

RHAs are adapting their clinics based on the supply and demand for vaccine, reaching the priority groups and other geographic and population realities of each RHA. Manitobans are encouraged to contact their RHA for up-to-date flu clinic information.

H1N1 Flu
As of yesterday, there were nine individuals hospitalized in intensive care with severe respiratory illnesses, and five were on ventilators. Two have been confirmed to have H1N1 flu.

To date, the individuals who are in intensive care reflect the same risk factors that caused severe illness in the spring during the first wave of the pandemic flu. The individuals are in the first priority group for vaccine, comprising those Manitobans who would benefit the most from getting the H1N1 shot now:
· children aged six months to under five years old;
· anyone of Aboriginal ancestry (First Nations, Métis or Inuit);
· disadvantaged individuals (for example, the homeless);
· people living in remote or isolated areas;
· people under 65 with a chronic medical condition or other risk including severe obesity, substance abuse or alcoholism;
· anyone with a weakened immune system or those who live with or care for them;
· those who live with or care for infants under six months old;
· single parents or anyone solely responsible for a dependent;
· health-care workers and medical first responders; and
· pregnant women.

During the week of Nov. 3 to 9, Manitoba Health reported 225 additional lab-confirmed cases of H1N1 bringing to 291 the total number of known cases confirmed since Oct. 6 when the second wave of H1N1 flu began. Lab-confirmed cases do not reflect the actual number of people with the illness, nor do the numbers indicate the seriousness of disease any individual may experience.

Additional measures to help prevent flu infections:
· Cover your cough by coughing into your elbow or sleeve or use a tissue to cover your nose and mouth when coughing or sneezing. Place the tissue in the garbage.
· Wash your hands often with soap and water, especially after coughing or sneezing. Hand sanitizers may also be effective.
· Reduce the spread of germs. Limit touching your eyes, nose or mouth.
· Maintain your health by making healthy food choices, being physically active and getting enough sleep.

Manitobans are reminded to watch for signs of severe illness. If you or a family member has any of the following symptoms, go directly to an emergency room, nursing station or health-care provider or call 911:
· shortness of breath or difficulty breathing,
· severe or worsening symptoms,
· dehydration,
· drowsiness or confusion,
· fever in an infant under three months old, and
· any signs of serious illness in a child under five years of age.

Manitobans are encouraged to contact their nearest health-care provider or visit the nearest health-care centre if they have flu symptoms and risks for severe illness or are concerned they may need care, especially if symptoms are severe or worsening. Early treatment (within 24 to 48 hours) may be very important.

More information on H1N1 flu is available at www.manitoba.ca/flu or Health Links–Info Santé at 788-8200 or 1-888-315-9257 (toll-free).

 

 

1112 Since Nov 3, another 202 new severe cases of H1N1 in the province [British Columbia]--British Columbia continues to monitor and respond to the spread of the pandemic H1N1 flu virus. Since Nov. 3, there have been 202 new severe cases of H1N1 identified in B.C. – 96 in Fraser Health, 47 in Vancouver Coastal Health, 44 in Interior Health, 11 in Northern Health and four on Vancouver Island – with eight new deaths, including three in Vancouver Coastal Health, three on Vancouver Island and two in Fraser Health.

 

The majority of lab-confirmed cases in B.C. have been mild or moderate in severity, with the patients either having already recovered or currently recovering.

 

In total, BC Centre for Disease Control (BCCDC) has confirmed 601 severe H1N1 cases in British Columbia since April 2009, including:
Two hundred and sixty-two in Fraser Health, including eleven deaths.
One hundred and thirty in Interior Health, including three deaths.
Twenty-five in Northern Health.
One hundred and fifty-seven in Vancouver Coastal Health, including five deaths.
Twenty-seven on Vancouver Island, including four deaths.

To date, 23 laboratory-confirmed H1N1 cases in B.C. are reported to have died. In 22 of those cases, there were underlying medical conditions.

 

British Columbians can use the Flu Clinic Locator at www.immunizebc.ca to find out where to get the H1N1 vaccine. If there are no clinics posted in a particular area, people can call their public health unit or family physician to find out where and when they can get vaccinated.

Currently, the people who will benefit most from pandemic H1N1 immunization, and who need and want to get vaccinated, are now able to receive that vaccine should they choose to do so. These groups include:

· Persons under the age of 65 with chronic conditions
· Pregnant women
· Persons – including First Nations – living in remote and isolated settings or communities
· Children 6 months to less than 5 years of age
· Health-care workers, with priority given to those involved with the pandemic response, in delivery of essential health services and those in critical functions and direct patient care roles
· Household contacts and care providers of infants less than 6 months of age, and of persons who are immunocompromised

People who fall into these groups AND for whom the seasonal flu vaccine is normally recommended will be able to receive both shots at the same time, if the seasonal vaccine is available in their area. People who do not fall into these groups are asked to put off receiving the H1N1 vaccine for a few weeks to allow those at most risk to get their vaccine first.

Beginning in late-November or early-December, everyone else who needs and wants the H1N1 vaccine will be recommended to receive it. Public notification will happen at this time so that everyone is aware the vaccine is available to them.

 

 

1112 FDA expands use of H1N1 vax to include infants and children [Rockville MD]--The U.S. Food and Drug Administration has approved the use of the CSL Limited’s 2009 H1N1 influenza vaccine to include children ages 6 months and older. This vaccine was previously approved only for use in adults, ages 18 years and older.

“Because children are among those most vulnerable to the 2009 H1N1 virus, having a broader range of children’s vaccines available is an important step in responding to the H1N1 outbreak,” said Margaret A. Hamburg, M.D., commissioner of food and drugs.

The company’s 2009 H1N1 vaccine is manufactured and tested using the same well-established licensing processes that have been in place for many years for the company’s seasonal flu vaccine. The expanded approval also covers the company’s seasonal flu vaccine.

The approval was based on a study of the company’s seasonal flu vaccine in children showing the vaccine's safety and efficacy in inducing antibodies to protect against influenza. These efficacy findings supported approval under FDA's accelerated approval regulation, which helps safe and effective medical products for serious or life-threatening diseases to become available sooner to the public.

Common adverse events experienced by children after administration of seasonal and H1N1 vaccines typically include pain, redness and swelling at the injection site as well as, in some cases, irritability, loss of appetite and drowsiness.

As with any medical product, unexpected or rare serious adverse events may occur. FDA is collaborating with the U.S. Department of Health and Human Services, including the Centers for Disease Control and Prevention, and other government agencies to enhance the capacity for adverse event safety monitoring during and after the 2009 H1N1 vaccination program.

Because CSL’s seasonal and H1N1 monovalent vaccines contain a small amount of egg protein, they should not be administered to anyone allergic to eggs or egg products.

The vaccines will be available in single-dose, preservative-free, pre-filled syringes and in multi-dose vials that contain thimerosal, a mercury derivative, as a preservative.

Both vaccines are manufactured by CSL Ltd. of Australia.

 

 

1112 First H1N1-related death in the city this fall [Boston MA]--A 65-year-old Boston man is the first death linked to 2009 H1N1 influenza (swine flu) in Boston this fall, the Boston Public Health Commission said today.

“It is with great sadness that we have learned of the death of a Boston resident from illness associated with H1N1. We extend our deepest sympathy to his family and friends,” said Barbara Ferrer, executive director of the Boston Public Health Commission. “While most cases of H1N1 in Boston and nationwide have been less severe, this news demonstrates how serious influenza can be,” she said.

The patient, who had multiple underlying health conditions, was hospitalized Oct. 14. He tested positive for Influenza Type A and died Oct. 31. Boston health officials were notified Nov. 9 that state laboratory test results came back positive for H1N1.

The patient’s death is the fifth attributed to H1N1 influenza in Boston and the 14th in Massachusetts since the pandemic began in the spring.

Based on national data, Boston health officials said certain groups of people are at higher risk of getting the 2009 H1N1 flu. These groups include infants, children, and young adults up to the age of 24, pregnant women, healthcare and emergency medical services workers, and people 64 and under with chronic underlying health conditions, such as asthma, diabetes, and heart disease. These people should call their doctor if they have any concerns.

Boston health officials also recommend that everyone take the following steps to reduce their risk of illness:

* Get vaccinated against seasonal flu and H1N1 flu when vaccine becomes available.
* Cover your mouth when you cough, either with your upper sleeve or a tissue.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand sanitizers are also effective.
* Try to avoid close contact with sick people.
* If you are sick with a fever and cough or sore throat, stay home for 24 hours after you have stopped taking fever-reducing medication or for four days – whichever is longer.

To stay informed of the latest developments on H1N1 flu, visit bphc.org/flu.

 

 

1112 Heavy rains causing Midlands-area sewage problems [Columbia SC]--Several wastewater utilities in the greater Columbia area have reported spills of untreated and partially treated sewage discharges resulting from problems associated with heavy rains over the last two days, the S.C. Department of Health and Environmental Control announced today.

“The problems involve sewer system overflows, pump station failures, line breaks and treatment plant overloads due to the heavy rainfall,” said Harry Mathis, director of DHEC’s Region 3 Environmental Quality Control which serves Richland, Lexington, Newberry, Fairfield, Chester, York and Lancaster counties. “Since some of these discharges are ongoing the volume of the overflows has not yet been determined. These discharges are entering the Broad, Saluda and Congaree Rivers at Columbia. DHEC is posting warning signs at popular access areas for these three rivers. The public is advised to avoid contact with waters around and downstream of obvious overflows and limit recreational activities in the Broad, Saluda and Congaree Rivers.”

Mathis said sewer system overflows can occur whenever a sewer collection line is damaged, clogged, or overloaded due to heavy rains. Urban streams and rivers are especially susceptible due to their location near sewer collection systems. The presence of pollutants, especially fecal coliform, is always a potential in urban streams and rivers. Personnel from Midlands-area utilities are responding to the discharges.

Mathis said anyone seeing an overflowing sewer line should contact their local wastewater utility.

 

 

1112 Weekend H1N1 vax clinics expanded to cover people with underlying health conditions [New York NY]--The Health Department announced today that it is further expanding its weekend H1N1 vaccination clinics to cover a broader range of New Yorkers. Starting this weekend – November 14th and 15th – vaccine will be available at temporary centers in all five boroughs for anyone 4 to 24 years old, anyone who is pregnant, anyone in close contact with newborns, and people age 25 to 64 with a medical condition that makes influenza more dangerous.

The weekend clinics, launched on November 7th in all five boroughs, are designed primarily to vaccinate middle and high school students, along with elementary school students who have not been vaccinated by private providers or in their schools. Because the first weekend’s clinics did not reach capacity, the City is opening the weekend clinics to adults with underlying health conditions as well. The expansion means that the following groups will now be able to receive vaccine at the weekend clinics:

  • Pregnant women
  • Anyone 4 years through 24 years of age
  • Persons 25 through 64 years of age who have underlying health conditions that increases risk of severe illness or complications*
  • Anyone who lives with or cares for children less than 6 months old

*These conditions include asthma, diabetes, chronic heart and lung conditions, kidney failure, or a weakened immune system.

The weekend vaccination clinics will continue over four weekends in November and December. Each weekend vaccination center is designed to accommodate up to 500 people per hour and will be open from 9 AM to 6 PM on Saturdays and from 9 AM to 5 PM on Sundays, but lines are possible. Anyone under 18 must present a signed parental consent form and anyone under 16 must be accompanied by a parent or guardian.

To prevent overcrowding and long lines, City officials are asking eligible New Yorkers to find the date and location of the vaccination center nearest their home, and report to that site on the appropriate weekend. People with computer access can find their designated weekend site by typing their zip code into the locator at nyc.gov/flu. Schedules and locations are also available through 311.

 

1112 Clinics to vax up to 3,000 high-risk people [Delaware]--Delaware's Division of Public Health (DPH) will hold three H1N1 influenza vaccination clinics Nov. 20, 21 and 22 to vaccinate up to 3,000 people who are at highest risk for influenza and have not yet obtained a vaccination.

The vaccinations will be administered by an eight person team from the federal government that is traveling to states to assist with vaccinations of the highest-priority groups. Delaware is the first state to hold these clinics.

Only eligible persons with appointments will be vaccinated in the clinics, which will be held at Delaware Technical & Community College campuses in each county. Delawareans eligible to receive the vaccine include:

  • Infants and children 6 months to 4 years of age
  • Pregnant women
  • Those 5 to 64 years of age with chronic conditions diagnosed and documented by a physician. Individuals must have had regular medical follow-up or been hospitalized during the preceding year. Chronic conditions include heart disease (except high blood pressure), diabetes, asthma and other diseases of the lung, kidney and liver disease, neurological or neuromuscular disorders, blood disorders, cancer and weakened immune systems due to cancer treatment, medications and HIV/AIDS

"With thousands of children being vaccinated in schools this month and increased supplies of vaccine reaching the medical community in recent weeks, we are making progress in Delaware's H1N1 vaccination campaign," said Dr. Karyl Rattay, director of DPH. "These clinics are an opportunity to vaccinate a large number of people in a short period of time with help from the federal government. But the reality is there are many people in the highest risk groups for H1N1 that have not been able to be vaccinated yet, so we are targeting those priority populations with these clinics."

Appointments for these clinics can be made by phone on Monday, Nov. 16 between 7 a.m. and 8 p.m. To schedule an appointment, Delawareans in the priority groups described above should call 1-866-408-1899. Appointments are provided on a first-come, first-served basis to those eligible, and will only be taken on the 1-866-408-1899 phone line.

Callers can schedule up to six appointments for family members or others on one call, with the appointments at one site or at different sites. Those with appointments should bring their confirmation number and photo identification.

People who do not meet the clinic criteria should consult their private physicians.

Next week's H1N1 vaccination dates and locations are:

  • Fri., Nov. 20, from 1 p.m. – 8 p.m. – DTCC/Terry Campus, Dover
  • Sat., Nov. 21, from 9 a.m. - 4 p.m. – DTCC/Stanton Campus, New Castle
  • Sun., Nov. 22, from 9 a.m. - 4 p.m. – DTCC/Owens Campus, Georgetown

A second set of clinics will be held in mid-December, and DPH will accept second shot appointments for children under 10 years old next week. Eligible Delawareans who call for an appointment Nov. 16 and cannot be accommodated in the Nov. 20-22 clinics will also be scheduled for the December clinics.

For additional information about both H1N1 and seasonal vaccines, please see our website at www.flu.delaware.gov

 

1112 Health officials recommend parents check children's vax records to verify whether booster dose of Hib vax is required [North Dakota]--The North Dakota Department of Health wants parents to know about a change in recommendations for Haemophilus influenzae type b (Hib) vaccine.


Because of production shortages in recent years, the Centers for Disease Control and Prevention (CDC) previously had recommended that health-care providers defer the routine Hib vaccine booster dose. In a change effective immediately, the CDC now recommends that children ages 1 year through 4 years (before their fifth birthday) who did not receive a booster dose for Hib because of the shortage should now receive a booster. The booster dose of Hib vaccine is usually given at 12 to 18 months of age. A complete series of Hib vaccine is either three or four doses, depending on the type used. Parents of children younger than 5 should contact their child’s health-care provider or local public health unit to determine if their child requires a booster dose.
 

“Hib disease is a serious infection caused by a bacteria. Children can get Hib disease by being around other children or adults who may have the bacteria and not know it,” said Molly Sander, Immunization Program manager. “If the bacteria spreads into the lungs or bloodstream, Hib can cause serious problems. Before Hib vaccine, Hib disease was the leading cause of bacterial meningitis among children younger than five.”


Meningitis is an infection of the brain and spinal cord coverings that can lead to lasting brain damage and deafness. Hib disease also can cause pneumonia; severe swelling of the throat; and infection of the blood, joints, bones and covering of the heart. It also can lead to death.


Since Hib vaccines were introduced, the incidence of invasive Hib disease in infants and children in the U.S. has decreased by 99 percent. Hib is one of only two vaccines that are more effective at providing immunity than natural infection is; the other is tetanus vaccine. Although the Hib vaccine prevents only one form of meningitis, it has nearly eliminated what was once the most common cause of bacterial meningitis in infants and children in the United States.

 

 

1112 Expanded H1N1 vax availability for all target populations [Louisiana]--Louisiana Department of Health and Hospitals Secretary Alan Levine and State Health Officer Jimmy Guidry, M.D., announced today that the 2009 H1N1 vaccine is now available by appointment in Louisiana for all groups recommended to receive the vaccine (target groups) through more than 350 health care providers statewide, including parish health units.

 

For the first time, people aged 25 through 64 years who have chronic health conditions associated with higher risk of medical complications from influenza can now get the H1N1 vaccine. DHH has also launched a revamped www.FightTheFluLA.com Web site and a H1N1 flu shot locator that allows target group residents across the state to find locations offering the H1N1 vaccine.

"With enough vaccine now available to vaccinate members of all our target populations, we are offering protection from the virus to those who need it most," Secretary Levine said. "The updated www.FightTheFluLA.com web site will serve as a valuable tool for residents looking not only for information about the H1N1 virus, but public locations where they can receive their vaccination as well. We encourage all those in our target groups to call first and see if the correct formulation of the vaccine for their target group is available, and then to make an appointment to receive it."

Parish health units statewide have received initial doses of the H1N1 vaccine, in addition to all federally-qualified health centers, rural health clinics, and many private providers who have agreed to vaccinate the target groups in the state. All target populations can now receive the vaccine. Target groups include:

  • Pregnant women
  • Health care and emergency medical services personnel
  • People from the ages of 6 months to 24 years
  • People who live with or care for children younger than 6 months of age
  • People from ages 25 through 64 years who are at higher risk for flu complications because of chronic health disorders or compromised immune systems

"By getting these initial doses out to the parish health units, we are providing another avenue for vaccination for residents whose providers did not register to administer the vaccine," said Dr. Guidry. "Vaccination is the best preventive tool we have to fight the spread of the flu. As we move forward, more and more providers and public locations such as clinics and pharmacies will receive the vaccine."

While non-elderly adults with chronic medical conditions are included in the target groups for H1N1, adults over the age of 65 are not included in the initial target groups. According to the U.S. Centers for Disease Control and Prevention (CDC), people 65 and older are the group that is least likely to get infected with H1N1. Adults over age 65, however, will be offered the vaccine at no cost at parish health units when the campaign opens up to the general population in four to six weeks.

DHH has also launched a new version of its Fight the Flu website that includes an H1N1 flu shot locator, in addition to the most up-to-date guidance and information regarding the H1N1 virus and vaccine. The locator provides a list and map of vaccination providers by ZIP or parish. The website will continue to be updated with additional features, including podcasts, a public question and answer feature, and updated public H1N1 flu shot locations. The new website also includes public service announcements regarding the importance of H1N1 vaccination.

Fight the Flu public service announcements are now running on television and radio stations in every TV viewing area and radio market of the state, as well as on regional cable TV networks and statewide radio networks. Print public service messages are also running in more than 70 newspapers and health care magazines throughout Louisiana. The Department is also working with faith-based and community-based organizations to educate more residents on prevention and the importance of vaccination.

The vaccine shipments to parish health units are made up of the multi-dose vial and single-dose adult formulations, which are appropriate for pregnant women and non-elderly adults with chronic medical conditions. Residents in these target groups are encouraged to contact their private provider first to make an appointment to receive vaccine, or a local parish health unit to make an appointment to receive the vaccine. Residents can find their parish health unit at the new www.FightTheFluLA.com‘s flu shot locator.

The H1N1 vaccinations at PHUs will come at no cost to patients. Insurance companies, Medicaid and Medicare may be charged a minimal administration fee. PHUs have initially received, at minimum, the following numbers of vaccine.

  • 100 doses of H1N1 vaccine appropriate for children six months to 35 months of age.
  • Between 100 to 200 single-dose syringes of H1N1 vaccine, appropriate for those two years and older.
  • Between 100 to 200 multi-dose vials of H1N1 vaccine, appropriate for those two years and older.

DHH, through the Department of Education, is also working with school districts across the state to finalize plans for school-based H1N1 flu clinics to vaccinate children against H1N1 flu. These will be one-day events in schools or school districts so that children, with parental consent, can get the vaccine. The first clinics should start in one to two weeks, and more details about the clinics will follow.

With the number of doses available nationally doubling in the past two weeks, Louisiana has seen a similar rise in doses allocated, allowing for the state’s vaccination campaign to begin allocating doses to parish health units. The state has now ordered 578,000 doses of the vaccine, the entire amount allotted to the state by the CDC. The CDC reports that as of Wednesday, November 4, 390,000 doses have been shipped to the state, compared to 258,000 one week earlier.

DHH’s Fight the Flu campaign aims to keep Louisianians healthy by promoting immunizations and good hygiene to prevent the spread of the seasonal flu and the H1N1 virus. For more information on flu activity in Louisiana, including guidance for families and medical professionals, visit www.FightTheFluLA.com or follow the campaign at www.twitter.com/FightTheFluLA.

 

1112 Quantities of seasonal flu vax diminishing [Kentucky]--Kentucky Department for Public Health officials announced today that most of the seasonal influenza vaccine manufactured for this season has already been given, due to earlier, increased demand nationwide. Individuals in recommended groups for seasonal flu vaccine—including those over 65, pregnant women and people with chronic health conditions—should check with health care providers in their area to see if seasonal flu vaccine is still available.


"In many cases seasonal flu vaccine was given as soon as the vaccine arrived, in the months of September and October," said William Hacker, M.D., commissioner of DPH. "While vaccine manufacturers produced more seasonal flu vaccine than last year, we have learned that it will ultimately not be enough to meet the increased demand, though some limited quantities should still become available. At this point we are still not seeing seasonal flu circulating, but we do encourage those at highest risk for complications from seasonal flu to check for vaccine availability with health care providers."


The increased demand for the seasonal flu shot is thought to be tied to heightened awareness of flu activity due to the emergence earlier this year of the new 2009 H1N1 flu strain (swine flu), which the seasonal vaccine does not protect against. Seasonal flu vaccine is highly recommended for: children age 6 months to 19 years old; pregnant women; people 50 years old or older; people of any age with chronic health problems; people who live in nursing homes and other long-term care facilities; health care workers; caregivers of or people who live with a person at high risk for complications from the flu; and out-of-home caregivers of or people who live with children less than 6 months old. While seasonal flu is not yet circulating in Kentucky, the virus is expected to make an appearance later this fall or winter.  


The vaccine against 2009 H1N1 (swine flu) is also in limited supply, but unlike seasonal flu vaccine, more is being produced and gradually increasing amounts are expected over the coming weeks and months. Individuals should check with their local health departments or other health care providers to see if they are in a target group for the swine flu vaccine and should receive it as soon as it is available in their community.  Target groups for this vaccine differ somewhat from those targeted for the seasonal flu shot.
 

Individuals may also want to talk to their health care provider about whether they should receive the pneumococcal vaccine. This vaccine protects against pneumococcal pneumonia, a relatively common complication of the flu, and is widely available. The Centers for Disease Control and Prevention's Committee on Immunization Practices (ACIP) now recommends this vaccine for all people 65 years and older and for persons 2 to 64 years of age with certain high-risk conditions. A single revaccination at least five years after initial vaccination is recommended for people 65 years and older who were first vaccinated before age 65 years, as well as for people at highest risk, such as those who have no spleen, and those who have HIV infection, AIDS or malignancy.
 

Visit http://healthalerts.ky.gov for information on seasonal flu, swine flu and flu vaccine in Kentucky, or follow KYHealthAlerts on Twitter. Kentucky's toll-free influenza hotline number is 1(877)843-7727, and operates from 8 a.m.-10 p.m. daily EST.     

 

 

1112 More H1N1 deaths confirmed as more vax arrives in state [Arkansas]--The number of confirmed deaths from the H1N1 flu since August 1 has now risen to 18, according to reports by the Arkansas Department of Health (ADH). Additional vaccine supplies for protection against H1N1 flu are arriving in the state, and more is on the way. People in all of the higher risk groups can begin to check with their providers to get protection from the H1N1 flu. Over 900 facilities in the state have requested H1N1 vaccine, and vaccine is currently being shipped to some of those providers.

The Centers for Disease Control and Prevention (CDC) has said that certain groups of people at higher risk should receive vaccine first:

  • pregnant women,
  • persons who live with or provide care for infants less than 6 months of age (e.g., parents, siblings, and daycare providers),
  • health-care and emergency medical services personnel,
  • persons aged 6 months--24 years, and
  • persons aged 25--64 years who have medical conditions that put them at higher risk for influenza-related complications.

James Phillips, M.D., Infectious Disease Branch Director at ADH, said that plans for the second round of mass vaccination clinics to offer free H1N1 vaccine are being made now, and a complete listing of clinics that have been scheduled is posted at www.healthyarkansas.com .

While more than half of the scheduled school clinics have already occurred, there are still school clinics planned in many locations around the state where children K-12, pregnant women, and siblings of school-aged children can get both H1N1 and seasonal flu vaccine. Parents of school-aged children should check the health department website or local school district offices for details.

Children under 10 need a second dose of H1N1 vaccine at approximately four weeks following the first dose. Children under 9 years of age who have never received flu shots before this year will also need a second dose of seasonal vaccine at that time as well. Most school districts are not planning to hold booster dose clinics for those younger children, so parents need to make plans to provide the second doses for their children.

“We know that parents are concerned now about the second doses, or booster doses, that their children under 10 years of age need to get at about four weeks following the first dose they received,” Phillips said. ”We want parents to know that their children do have some immunity from their first dose, and in the coming weeks, booster doses may be available at pediatricians’ offices, mass flu clinics, or through other private providers. Parents are encouraged to check these various outlets.”

For more information on the flu or for clinic locations, visit our website at www.healthyarkansas.com.

 

1112 State recommends continued prioritization of H1N1 vax [Wisconsin]--The Department of Health Services (DHS) announced today that it is asking public health organizations and private health care providers to spend the next week aggressively targeting a subset of individuals most-at-risk of serious health complications from the H1N1 virus. On Thursday November 19th, DHS will expand the vaccine target group to include those between the ages 19-64 who have underlying medical conditions which put them at higher risk for influenza-related complications.

"It is critically important during a time of limited vaccine to aggressively target those individuals who are most-at-risk. Recent public vaccination clinics focused on those most-at-risk have been very successful; however, we still have some work to do in order to reach more of these individuals," said State Health Officer Dr. Seth Foldy. "While the vaccine supply has steadily increased during the past two weeks, we still do not have enough vaccine in the state to support large-scale mass vaccination efforts."

For the next week, public and private providers are asked to focus on:

  • Pregnant women
  • Persons who live with or provide care for infants age 6 months or younger (examples: parents, siblings, daycare providers)
  • Health-care and emergency medical services personnel who have direct contact with patients or infectious material
  • Children aged 6 months - 4 years
  • Children and adolescents aged 5-18 years who have chronic medical conditions that put them at higher risk for influenza-related complications.

Beginning November 19th, the targeted sub-population will be expanded to include:

  • All persons aged 19-64 who have underlying medical conditions that put them at higher risk for influenza-related complications.

Public health organizations and private health care providers will have the flexibility to move into the expanded group sooner, if their vaccine supply is adequate to meet demand for those most-at-risk. During the next few weeks, DHS will continue to monitor the vaccine supply and work with local public health and health care systems in determining their success in reaching the target populations. This analysis will help in assessing when an adequate vaccine supply exists that will allow Wisconsin to extend vaccinations to other groups.

 

1112 Additional H1N1 flu death announced [Topeka Kansas]--A 48 year-old woman from the Topeka metropolitan area has died from infection with the H1N1 influenza virus, the Kansas Department of Health and Environment (KDHE) announced today. This death brings the total number of confirmed deaths from the pandemic strain statewide to 18.

The woman’s infection was confirmed in the KDHE laboratory on November 10, and her death was reported to KDHE on November 7. The woman did not have any underlying health conditions that placed her at greater risk for severe complications of influenza.

KDHE Secretary Roderick Bremby and Dr. Jason Eberhart-Phillips, Kansas State Health Officer, expressed sympathy and offered their deepest condolences to the family.

“Even healthy adults are susceptible to severe complications of the pandemic H1N1 flu virus,” said Dr. Eberhart-Phillips. “Every death due to H1N1 or its complications reminds us all of the need to wash hands, cover coughs and sneezes, stay home when sick until at least 24 hours after fever breaks, and get vaccinated when we are able.  We must do these things not only to protect ourselves, but each other.”
The pandemic H1N1 vaccine has started to arrive in Kansas, but at this time in very limited quantities. Certain individuals are recommended to receive the vaccine earlier.  For more information on vaccine prioritization, please visit
www.kdheks.gov/H1N1/H1N1_Vaccine.htm.

Up-to-date information on H1N1 vaccination clinics being held across the state can be found by going to www.kdheks.gov and clicking on “Where can I receive the H1N1vaccine?”

It is important to note that the number of deaths confirmed to be caused by pandemic H1N1 influenza under-represents the true number of deaths.  The great majority of all influenza or pneumonia-related deaths that occur (pneumonia is the most common severe complication of influenza) do not have a confirmatory lab result associated with them.  For more information on mortality due to influenza-like illness in Kansas, please review KDHE’s Epidemiology and Surveillance Weekly Status Report available at http://www.kdheks.gov/H1N1/H1N1_Epi_Reports.htm.

The symptoms of infection with the pandemic H1N1 virus are similar to the symptoms of seasonal flu and include fever of 100 degrees or greater, body aches, coughing, sore throat, respiratory congestion, and in some cases, diarrhea and vomiting.  Most people who have been ill with pandemic H1N1 influenza have recovered without medical treatment.

However, some people develop serious complications that require hospitalization or may lead to death.  Although serious complications are more likely among persons with certain underlying chronic health conditions, this pandemic influenza virus has caused serious complications and deaths among persons without such factors.  Unlike typical seasonal influenza, the 2009 H1N1 virus is causing a greater disease burden among adolescents and young adults.  Severe illness from H1N1 virus infection can even occur among relatively young, healthy persons.

KDHE is no longer accepting specimens from everyone who sees a doctor with symptoms.  In non-hospitalized cases, confirmatory testing does not affect treatment and advice given to patients by health care providers. 

Most children and adults with the flu who are generally in good health will recover without needing to visit a health care provider.  Some people may want to call their health care provider for advice on how to care for the flu at home.

Individuals who experience severe illness or who are at high risk of complications from H1N1 influenza infection, including children less than 5 years of age, adults 65 years of age and older, pregnant women, and persons with chronic medical conditions (including asthma, diabetes, heart disease, and other conditions), should contact their health care provider.

Until people are able to be vaccinated against the virus, individuals are encouraged to take the following steps to reduce its spread:

  • Wash your hands thoroughly with soap and warm water or use an alcohol-based hand sanitizer to get rid of most germs and avoid touching your eyes, nose and mouth.
  • If you become sick, stay home until at least 24 hours after fever or signs of fever without the use of fever-reducing medications, in order to avoid spreading illness to co-workers and friends.
  • Cough or sneeze into a tissue and properly dispose of used tissues.  If you do not have a tissue, cover your cough or sneeze with your elbow and not your hands.  
  • Stay healthy by eating a balanced diet, drinking plenty of water and getting adequate rest and exercise.

KDHE has established a phone number for concerned Kansans to call with questions about the 2009 H1N1 influenza A virus.  The toll-free number is 1-877-427-7317.  Operators will be available to answer questions from 8 a.m. – 5 p.m. Monday through Friday.  Persons calling will be directed to press “1” on their touch-tone phone to be directed to an operator who can answer questions.

Kansans with questions about the virus can email H1N1fluinfo@kdheks.gov.  Information is also available from KDHE at www.kdheks.gov.

 

1112 Province expands H1N1 vax program to include first responders [Ontario]--Ontario is opening its H1N1 immunization program to first responders (police and firefighters), frontline institutional correctional workers, and people aged 65 and over who live in institutions like long-term care homes. A small number of ministry staff who are directly involved in the pandemic response will also be immunized this week. 

Ontario received 395,000 doses of adjuvanted vaccine on Monday. The adjuvanted vaccine can be used this week and allows for the limited expansion of the immunization program. An additional 375,000 doses of unadjuvanted vaccine produced by GlaxoSmithKline was also received on Monday.  Authorization of this product for use by federal regulators is expected later this week.  

First responders frequently attend emergency health situations with emergency medical services. Frontline institutional correctional workers are in closed settings where the risk of outbreaks is higher.  And while adults aged 65 and older seem to have more protection against getting H1N1 flu than the general public, they are more vulnerable to serious complications and death if they do contract the disease.

Ontario will continue to immunize the six priority groups with a special focus on pregnant women, who are at higher risk of severe disease from H1N1 infection. People in priority groups who have not yet been immunized should come forward and get their H1N1 flu shot.

 

1112 Québec dévoile la séquence de vaccination prévue pour le deuxième groupe de population [Quebec]--Après avoir vacciné avec succès le premier groupe de population, composé des travailleurs de la santé et des services sociaux et des personnes à risque de développer des complications, notamment les femmes enceintes et les personnes de moins de 65 ans atteintes d'une maladie chronique, le gouvernement du Québec a dévoilé aujourd'hui la séquence de vaccination prévue pour le deuxième groupe de population.

 

"Nous avons établi une séquence de vaccination en trois temps en fonction de critères épidémiologiques. Dans un premier temps, les personnes de cinq à 19 ans seront vaccinées, suivies de celles âgées de 65 ans et plus qui ont une maladie chronique. Dans un troisième temps, nous vaccinerons les personnes de 20 ans et plus." C'est ce qu'a déclaré aujourd'hui le directeur national de la santé publique, le docteur Alain Poirier, lors du point de presse quotidien sur la gestion gouvernementale de la pandémie de grippe A(H1N1). Le coordonnateur gouvernemental en sécurité civile, monsieur Michel C. Doré, était également présent.


Pour chaque région, des précisions seront apportées au cours des prochains jours concernant le début de la vaccination pour chacune de ces catégories, et le docteur Poirier a invité tous les citoyens à y être attentifs.

 

"Le gouvernement met à la disposition de la population une information à jour sur la campagne de vaccination, et c'est une responsabilité de chacun de se tenir au fait des développements de l'opération. Je recommande à tout le monde de consulter le site www.pandemiequebec.gouv.qc.ca avant de se présenter dans un centre de vaccination, afin d'éviter les déplacements inutiles", a expliqué le directeur national de la santé publique.


Le docteur Poirier a profité de ce point de presse pour rappeler que des équipes volantes vont se déplacer pour offrir le vaccin aux personnes à mobilité réduite, comme celles vivant en centre d'hébergement et de soins de longue durée ou en résidence d'hébergement, ou les personnes lourdement handicapées. Les équipes volantes se rendront également dans les ressources pour personnes itinérantes.

 

"Dès le début de l'opération, nous avions prévu ce service essentiel, sachant bien que pour certains citoyens, il est très difficile, voire impossible de se déplacer afin de se rendre dans un centre de vaccination. Toutes ces personnes seront par ailleurs soumises à la même séquence de vaccination que le reste de la population", a précisé le directeur national de la santé publique.


"Dans les prochains jours, il est possible que la campagne de vaccination soit un peu ralentie en raison de la diminution appréhendée du nombre de vaccins disponibles. Le cas échéant, chaque région émettra ses directives à la population afin d'éviter que les citoyens se présentent inutilement dans les centres de vaccination", a expliqué le docteur Poirier, tout en rappelant la priorité du gouvernement, qui est de "vacciner le plus de gens dans le plus court laps de temps possible, tout en conservant de très hauts standards de qualité et de sécurité."


Dans le contexte de l'implantation de cette nouvelle offre de vaccination, "les organisations régionales de sécurité civile (ORSC) coordonnent les actions des différents partenaires afin de faciliter l'opération et de mettre au point les détails logistiques que peut nécessiter la vaccination de certaines clientèles", a mentionné le coordonnateur gouvernemental en sécurité civile, monsieur Michel C. Doré.

Les précisions concernant la séquence de vaccination pour chaque région sont disponibles dans le site www.pandemiequebec.gouv.qc.ca. Il est aussi possible d'obtenir tous les renseignements nécessaires en communiquant avec Services Québec, au numéro unique 644-4545, accessible par les indicatifs régionaux 418 et 514 ou, sans frais, par le 1 877.
 

 

1112 H1N1 vax groups expanded [Nova Scotia]--Nova Scotia's H1N1 vaccination campaign has been expanded to include three new groups, Dr. Robert Strang, the province's chief public health officer, announced today, Nov. 10.

People in the following groups will now be eligible to receive H1N1 vaccine:

-- people younger than 65 with chronic medical conditions
-- people living with, or providing care in the home for, infants less than six months of age, people living with those at high-risk who cannot be immunized (for example, those with anaphylaxis or severe egg allergies), and those who are immunocompromised and may not respond to vaccine;
-- people who work in residential-care facilities, community-based option and small-option homes, group homes and developmental residences.

The following groups are still eligible to be immunized:
-- pregnant women, and women up to four weeks postpartum and their partner
-- women who have just given birth, and their partner
-- children aged six months to younger than five years old
-- children 19 or younger with chronic medical conditions for which they receive regular medical attention, including morbid obesity
-- people living on First Nations communities
-- health-care workers in district health authorities, long-term care facilities and home-care agencies who provide direct care to patients. This includes family physicians, family practice nurses, pharmacists and pharmacy technicians.

"If you're in one of these priority groups, I urge you to get vaccinated against H1N1 as soon as possible," said Dr. Strang. "If you're not, I again ask for your patience and your understanding."

The province's goal continues to be to protect those most vulnerable and decisions are based on nationally agreed upon target groups, epidemiology, the quantity of vaccine available and delivery logistics.

"In addition, Public Health Services in the district health authorities are working with physicians over the next few days to find ways to involve them in the vaccination of these groups," said Dr. Strang.

Nova Scotians are reminded that clinics will not be open tomorrow, Nov. 11, Remembrance Day. District health authorities will now offer clinics six days a week.

The province will also offer vaccine to more people, based on risk, as soon as supply allows.

For a fact sheet with details on the new groups eligible for vaccination, visit
www.gov.ns.ca/h1n1 , or call HealthLink 811.

 

 

1112 O'Leary flu assessment site closed due to low numbers [Prince Edward Island]--The Public is advised that the O’Leary Influenza assessment site at the Beechwood Family Health Centre will be closed after Tuesday, November 10. A decision was made to close the assessment site due to low numbers of people arriving to the site.

West Prince residents who are experiencing influenza-like symptoms are asked to go to the Urgent Care Centre at Community Hospital in O’Leary or the Emergency Department at Western Hospital in Alberton. Regular hours at the Urgent Care Centre in O’Leary will be 8 a.m. to 8 p.m., Monday to Friday, with an 8 a.m. to 4 p.m. schedule on Remembrance Day and Saturdays. The centre is closed on Sundays.

The H1N1 situation in West Prince will be monitored and the assessment site in O’Leary will be reactivated if the need arises.

 

 

1111 Governor declares disaster for Kodiak storms [Alaska]--Governor Sean Parnell has declared a state disaster related to the 2009 Kodiak Island storm. The state will fund eligible emergency-response costs, eligible permanent repair work, and long-term solutions for the landslide and road erosion damage from the storms.

“The Kodiak Island Borough did a great job handling the initial response to the flooding and minimized the impact on the people of Kodiak,” said Governor Parnell. “This disaster declaration will help fund the emergency response costs and infrastructure repair projects that will restore the community to pre-disaster condition.”

Beginning in early October, the Kodiak Island Borough received substantial rainfall, causing floods, landslides and erosion that clogged culverts and washed out roads. Heavy rains and flooding continued through the month.

The Kodiak Island Borough, Kodiak Electric Association, City of Kodiak and the Alaska Department of Transportation made emergency repairs and took protective measures on roadways and other critical infrastructure.

The disaster declaration activates the state’s Public Assistance program, which will help state, tribal, and local governments, as well as certain private nonprofit organizations, with repairing infrastructure damage.

Governor Parnell has directed the Division of Homeland Security and Emergency Management to request a federal Joint Preliminary Damage Assessment, the first step in a request for federal disaster assistance.

The Kodiak Island Borough requested a state disaster declaration on October 16.

A copy of the disaster declaration is available at: http://www.gov.state.ak.us/pdf/DisasterDecKodiak_Nov4-2009.pdf.

 

1111 More than 1,000 hospitalized for ILI since Sept 1 [Oregon]--Since Sept. 1, 2009, 1,015 people have been hospitalized in Oregon with influenza-like illness; 33 people have died in 12 Oregon counties. People who are at high risk for severe illness and complications from the flu should seek medical advice as soon flu symptoms appear. Antiviral therapy early in an influenza-like illness may reduce the severity of the symptoms and additional complications.


“People in high-risk groups such as pregnant women and people with underlying health conditions should talk to their health care provider as soon as they develop symptoms, especially fever,” says Mel Kohn, M.D., M.P.H., Oregon public health director.
 

Private drug manufacturers are steadily shipping the H1N1 influenza vaccine into Oregon, with larger shipments arriving each week. The U.S. Centers for Disease Control and Prevention (CDC) has allocated another 139,400 doses expected by Friday, Nov. 13, bringing the cumulative total to enough doses to vaccinate 24 percent of the priority group.


The priority group includes population groups designated by the CDC: pregnant women, children and young people aged 6 months to 24 years, health care providers, people caring for infants under 6 months, and people with underlying health conditions. Oregon added front line law enforcement and safety workers to the priority group to ensure that we have adequate public safety workers to keep Oregonians safe.


Kohn says that people in the priority group, especially those with underlying health conditions, are encouraged to find the vaccine. “Local heath departments are balancing the dose allocation to both public clinics and private health care providers to ensure equal access to the vaccine,” says Kohn.


Flu clinics operate locally with the assistance of county public health departments. The Oregon Public Health Division surveys the counties on a regular basis and keeps information current at www.flu.oregon.gov and the Oregon Public Health flu hotline of 1-800-978-3040.

 

 

1111 Two more flu-related deaths reported [Wyoming]--According to the Wyoming Department of Health, influenza was associated with the recent deaths of two more Laramie County residents

The two men were both elderly and had underlying health conditions associated with higher risk of severe illness. One died last week; the other about three weeks ago.

These are the seventh and eighth flu-related deaths reported to the department since the emergence of H1N1 flu in Wyoming. Four reported deaths have been among residents between the ages of 19 and 64; four among residents over the age of 65.

“Due to the H1N1 flu, Wyoming continues to experience widespread flu activity at levels higher than we’ve seen over at least the last 10 typical winter flu seasons,” said Dr. Tracy Murphy, state epidemiologist with the Wyoming Department of Health. “However, the reports from the last two weeks have indicated the growth in activity has started to slow.”

Since late May, 663 swine or H1N1 flu cases have been confirmed by the department. Of those:

*56 were among residents younger than 5
*349 were among residents between the ages of 5 and 18
*253 were among residents between the ages of 19 and 64
*5 were among residents older than 65

Over the same timeframe 3,672 cases of flu have been reported to the department overall, as well as 102 influenza-related hospitalizations. The department expects the number of actual flu infections around the state to be much higher, because most ill persons do not seek medical care or are not tested specifically for the H1N1 flu strain.

Influenza symptoms include fever, cough, sore throat, body aches, headaches and fatigue. Some patients also report diarrhea and vomiting. Actions recommended to slow the spread of illness include:

· When available, get immunized with both an H1N1 flu and a seasonal flu vaccine.
· In general, people who develop influenza-like illness should stay home from work, school or travel until at least 24 hours after they are free of fever. Those who are severely ill (such as having trouble breathing) should seek medical care.
· Avoid contact with ill persons.
· Covering noses and mouths with a tissue or sleeve when coughing or sneezing, and throwing used tissues in a trash can.
· Frequent hand washing with soap and water or the use of an alcohol-based hand gel.

More information about flu in Wyoming is available online at www.health.wyo.gov

 

 

1106 Le ministre Bolduc annonce le mise en place d'un systeme de gestion de l'acces a la vax contre la H1N1 [Quebec]--«Nous avons décidé de mettre en place un système de gestion de l'accès à la vaccination contre la grippe A(H1N1) afin de faciliter le déroulement de cette opération. Cette méthode sera implantée
dans les centres de vaccination qui font face à un fort achalandage et
permettra à chacun de se prévaloir du vaccin dans un délai raisonnable et dans
des conditions acceptables.».

 

C'est ce qu'a déclaré aujourd'hui le ministre de la Santé et des Services sociaux, le docteur Yves Bolduc, lors d'un point de presse sur la campagne de vaccination. De plus, à compter d'aujourd'hui, des conférences de presse seront tenues de deux à trois fois par semaine par souci d'informer les citoyennes et les citoyens du Québec.
 

Depuis qu'elle a été lancée à la fin du mois d'octobre, la campagne québécoise de vaccination contre le virus de la grippe A(H1N1) connaît un vaste succès qui se traduit dans certains endroits par des files d'attente parfois très longues.

 

«Le gouvernement est très attentif à la façon dont se déroule la vaccination contre la grippe A(H1N1) et aux situations nouvelles qui peuvent commander des ajustements de notre part. Nous sommes constamment en train d'évaluer des moyens pour rendre l'exercice moins lourd pour tout le monde et favoriser l'accès au vaccin dans les meilleurs délais possibles. C'est pourquoi nous avons décidé de mettre en place un processus qui permettra de faciliter les choses à la population», a fait valoir le ministre.

Un système simple et efficace

La méthode préconisée par le ministre repose sur la distribution de coupons aux gens qui se présentent dans les centres de vaccination, afin de leur éviter des attentes exagérées. L'attribution des coupons se fera après la vérification habituelle de l'adresse et de l'appartenance à un des groupes aptes à recevoir le vaccin en vertu de la séquence de vaccination. «A chaque coupon correspondra une plage horaire à laquelle les gens pourront se présenter pour recevoir le vaccin. Cette façon de faire aura pour effet de limiter l'attente», a expliqué le docteur Bolduc.


«Cette méthode simple et efficace a été expérimentée avec succès en différents endroits, notamment à Gatineau, et nous croyons qu'elle pourra être utile dans tous les centres de vaccination qui font face à un fort achalandage. Partout où ce système sera implanté, des préposés pourront distribuer les coupons en matinée, indépendamment de l'heure d'ouverture des centres de vaccination. En procédant ainsi, personne n'aura à attendre inutilement, puisque le nombre total de coupons correspondra au nombre total de doses de vaccin disponibles pour la journée. Évidemment, cette mesure n'éliminera pas complètement l'attente, mais elle aura au moins l'avantage de la réduire pour qu'elle soit plus acceptable pour tout le monde», a affirmé le docteur Bolduc.


Le ministre a profité de l'occasion pour remercier la population pour avoir si bien répondu à l'appel au calme qu'il avait lancé samedi dernier, face à l'engouement suscité par le vaccin : «La collaboration de chacun est précieuse et contribue au succès de cette campagne de vaccination qui est la plus vaste que le Québec ait connue à ce jour. On constate déjà des améliorations dans les centres de vaccination, comme quoi la séquence de vaccination est maintenant appliquée par le plus grand nombre. Cette façon de faire nous permet d'offrir en priorité le vaccin aux personnes les plus à risque de complications», a-t-il rappelé, tout en assurant la population que tous ceux qui souhaitent être immunisés pourront recevoir le vaccin d'ici Noel, «toujours selon la séquence de vaccination prévue par les autorités de la santé publique».

Les précisions concernant la séquence de vaccination pour chaque région sont accessibles sur le site www.pandemiequebec.gouv.qc.ca. De plus, il sera possible d'obtenir tous les renseignements nécessaires en communiquant avec Services Québec, au numéro unique 644-4545, accessible par les indicatifs régionaux 418 et 514 ou, sans frais, par le 1 877.
 

 

1106 Assembly of First Nations and Health Canada to co-host a virtual summit on H1N1 preparedness on Nov 10 [Ottawa ON]--On November 10, 2009 at 12:00 noon EST Health Minister Leona Aglukkaq and National Chief of the Assembly of First Nations (AFN) Shawn Atleo will co-host a Virtual Summit on H1N1 preparedness for First Nations communities.

"The Government of Canada has been working closely with First Nations to help them prepare for the H1N1 Flu Virus. Vaccinations are well underway in several communities across the country", said Minister Aglukkaq. This unique outreach activity is yet another way we are reaching out and communicating with Canada's indigenous peoples.

This live nation-wide webcast will be accessible to all who wish to participate and will feature presentations by key officials, and question and answer sessions on issues related to H1N1 in on-reserve First Nations, including remote and isolated communities. The Virtual Summit will include discussions on the preparations and active implementation of measures being used to deal with the second wave of H1N1, including the distribution of vaccines and antiviral drugs for First Nations communities. There will also be video profiles of planning and preparedness efforts in two First Nations communities and an expert panel Question and Answer session.

"When I took office and the H1N1 issue arose, it became quickly apparent that there were differing levels of information and understanding between jurisdictions. This was not helpful for First Nations, for individuals or for emergency planning. The Virtual Summit is an important tool that will ensure we're working from shared knowledge of the level of preparedness in First Nations communities and that First Nations have an opportunity to ensure their concerns, issues and ideas are addressed in planning and preparedness efforts," said National Chief Shawn Atleo.

The Virtual Summit stems from the Communications Protocol signed by the Assembly of First Nations, Health Canada, and Indian and Northern Affairs Canada on September 19th which commits all partners to work together to plan for and respond quickly and effectively to an H1N1 flu-virus pandemic in First Nation communities.

Specific areas of communication are being addressed through the development of a variety of communications tools, such as public health notices for print and radio media and posters on promotion and prevention, to meet the needs of First Nations.

To date, 96% of First Nations communities have a community-level pandemic influenza pandemic plan in place.

To watch the Virtual Summit on November 10, 2009, go to: www.fnh1n1summit.ca

 

1106 Currently 14 individuals in ICUs with severe respiratory illness [Manitoba]--H1N1 Vaccine Supply Manitoba has received 17,500 doses of vaccine with adjuvant this week. In addition, Manitoba has received 9,200 doses of vaccine without an adjuvant that is being targeted initially to pregnant women in the province. Both vaccines have been distributed to the regional health authorities (RHAs).

There has been no indication of how much vaccine will be received in the coming weeks. Manitoba does not expect another shipment until next Wednesday. As of Nov. 4, Manitoba had received a total of 232,700 doses of vaccine. At the end of the day yesterday, nearly 160,000 shots had been given to Manitobans. All vaccine has been sent to RHAs to administer through clinics and by appointment. At peak, Manitoba can give nearly 31,000 shots a day.

H1N1 Flu Shots


RHAs are adapting their clinics based on the supply and demand for vaccine, reaching the priority groups, and other geographic and population realities of each RHA. Some RHAs expect to run out of vaccine with adjuvant by the end of this week or early next week and may continue to postpone clinics. Other RHAs expect to return to focusing on the original priority group.

Many clinics are now administering the vaccine without an adjuvant to pregnant women. The Public Health Agency of Canada has recommended that pregnant women at any stage of their pregnancy should receive the H1N1 flu shot without adjuvant. Data shows that pregnant women who do get the H1N1 virus are more likely to suffer complications.

H1N1 Flu


The number of people with flu-like illnesses in Manitoba increased in the last week confirming the second wave of the H1N1 flu is well underway.

There are currently 14 individuals hospitalized in intensive care with severe respiratory illnesses, 10 are on ventilators, but only one has been confirmed to have H1N1 flu. Since early October, there have been 20 people who have required intensive care for severe respiratory illness.

To date, the individuals who are in intensive care reflect the same risk factors that caused severe illness in the spring during the first wave of the pandemic flu. The individuals are in the first priority group for vaccine and are those Manitobans who would benefit the most from getting the H1N1 shot now:
· children aged six months to under five years old;
· anyone of Aboriginal ancestry (First Nations, Métis or Inuit);
· disadvantaged individuals (for example, the homeless);
· people living in remote or isolated areas;
· people under 65 with a chronic medical condition or other risk including severe obesity, substance abuse or alcoholism;
· anyone with a weakened immune system or those who live with or care for them;
· those who live with or care for infants under six months old;
· single parents or anyone solely responsible for a dependent;
· health-care workers and medical first responders; and
· pregnant women who should consult with their doctor about the right vaccine to receive.

As of Nov. 2, Manitoba Health is reporting 24 additional lab-confirmed cases of H1N1 bringing to 66 the total number of known cases confirmed since Oct. 6 when the second wave of H1N1 flu began. Lab-confirmed cases do not reflect the actual number of people with the illness. Individuals with milder illness are not being tested, nor do the numbers indicate the seriousness of disease any individual may experience.

Additional measures to help prevent flu infections:
· Cover your cough by coughing into your elbow or sleeve or use a tissue to cover your nose and mouth when coughing or sneezing. Place the tissue in the garbage.
· Wash your hands often with soap and water, especially after coughing or sneezing. Hand sanitizers may also be effective.
· Reduce the spread of germs. Limit touching your eyes, nose or mouth.
· Maintain your health by making healthy food choices, being physically active and getting enough sleep.

Manitobans are reminded to watch for signs of severe illness. If your or a family member has any of the following symptoms, go directly to an emergency room, nursing station or health-care provider or call 911:
· shortness of breath or difficulty breathing;
· severe or worsening symptoms (increased thirst, reduced strength or a decrease in urination frequency);
· dehydration or no urination for 12 hours;
· drowsiness or confusion;
· fever in an infant under three months old; and
· any serious symptoms or signs of serious illness in a child under five years of age.

More information on H1N1 flu is available at www.manitoba.ca/flu or Health Links-Info Santé at 788-8200 or 1-888-315-9257 (toll-free).

 

 

1106 For the week ending Nov 3 there were 183 new severe cases of H1N1 [British Columbia]--British Columbia continues to monitor and respond to the spread of the pandemic H1N1 flu virus. For the week ending Nov. 3, there have been 183 new severe cases of H1N1 identified in B.C. – 79 in Fraser Health, 50 in Vancouver Coastal Health, 38 in Interior Health, eight on Vancouver Island and eight in Northern Health – with three new deaths, two in Fraser Health and one in Vancouver Coastal Health.

 

In total, there have 399 confirmed severe H1N1 cases since April 2009. Of these 399 lab-confirmed cases admitted to hospital, 63 have been admitted to the ICU. Twelve new cases have been admitted to the ICU in the last week.

To date, 15 laboratory-confirmed H1N1 cases in B.C. are reported to have died. In 14 of those cases, there were underlying medical conditions.

 

The majority of lab-confirmed cases in B.C. have been mild or moderate in severity, with the patients either having already recovered or currently recovering.
 

 

1106 DNA analysis confirms positive identification on seventh foot [Burnaby BC]--Through DNA analysis, the BC Coroners Service has confirmed the remains of a right foot, found Oct. 27, 2009, is that of a deceased male from the Lower Mainland. The foot was found on the beach at No. 6 Rd. and Triangle Rd. in Richmond.

In January 2008, a 25-year-old male was reported missing to RCMP by his family. Based on the investigation into the circumstances of his disappearance and personal history, investigators do not believe foul play was involved. The man's identity is being withheld at the request of his family.

The RCMP, Delta Police Department and Coroners Service continue their investigations to determine the identities associated with other found feet. These include a female pair found in Richmond, which was matched in December 2008; a male pair found on Valdez Island and Westham Island, matched in July 2008; and a male right foot found on Gabriola Island in August 2007.

In all cases, these remains appear to have naturally separated (disarticulated) from the body. There is no forensic evidence at this time to support anything other than disarticulation.

The Coroners Service and police use information on physical characteristics from exams by forensic pathologists and anthropologists, along with DNA analysis of the feet, in order to build the most enhanced profile possible for each. Found remains profiles are maintained in a provincial database for future comparisons until identifications are determined.

No further information is available from the Coroners Service at this time.

 

 

1106 AHS investigation into inappropriate use of H1N1 vaccine [Calgary AB]--Alberta Health Services leaders learned Monday, November 2, 2009, that H1N1 vaccinations were provided last week to players and families of the Calgary Flames. Disciplinary action has been taken, resulting in the dismissal today of the most senior staff member involved. An investigation is continuing and may result in further disciplinary action. A report will be released at that time. Alberta Health Services (AHS) has determined that Flames management made a decision based on information and a process that they believed was approved by AHS.

"Like most Albertans, I am deeply offended that this circumstance has occurred. AHS Board and management have a fundamental commitment to serve all Albertans according to their needs, in medical priority. This circumstance was a clear departure from that principle. We set the expectation that this should not have happened and should not happen again," said Board Chair Ken Hughes.

"The decision to allow preferential access to the Flames and their families was a serious error in judgment on the part of the staff involved," said AHS President and Chief Executive Officer Dr. Stephen Duckett. "Our policies on vaccine distribution are designed to ensure an equitable distribution of the vaccine to all Albertans. The special treatment for the Flames and their families is unacceptable to us and contrary to all of our existing protocols and processes. I apologize for this breach of our duty to Albertans."

Mr. Ken Hughes, Chair, Alberta Health Services Board
Dr. Stephen Duckett, President and Chief Executive Officer

 

The investigation concluded the following:

* A Calgary Flames medical representative approached Alberta Health Services (AHS) on Tuesday, October 27th through a staff member to see if a H1N1 immunization clinic could be made available to the Flames and their families.
* The request was forwarded to a more senior AHS staff member, who in turn took it to a supervisor and the request was approved.
* A clinic was held Friday, October 30th at Father David Bauer arena.
* Approximately 150 vaccinations were provided to the Calgary Flames, family members and other Flames personnel.
* There is no written record of approval to proceed and there is no process for authorization of the use of the H1N1 vaccine for this purpose, as it contradicts existing protocols and processes.
* Use of the vaccine was not discussed or authorized above the level of the individual who authorized its use.
* AHS has determined that Flames management made a decision based on information provided by AHS, and that the team followed a process that they believed had been approved by AHS.
* The investigation, conducted by senior management, protective services (which provided investigative expertise) and human resources staff, has been concluded.

The following steps have been taken:

* Disciplinary action resulted in the dismissal November 4th of the most senior staff member involved. A second staff member involved in the decision has also been dismissed. No further disciplinary action is being considered at this time.
* For legal and privacy reasons, no further information will be provided with respect to the staff members involved.
* An advisory has been sent reminding all AHS clinical personnel involved in the H1N1 vaccination campaign to ensure that it is understood that no exceptions will be made to existing protocols and processes.
* A statement, attached, was issued by Alberta Health Services November 4th.
 

 

1106 More risk groups added to H1N1 vax campaign [Saskatchewan]--With an anticipated amount of up to 60,000 new doses to be received in Saskatchewan next week, the H1N1 flu vaccination campaign will be expanded to other risk groups.

"We will next vaccinate people at risk under the age of 35 with underlying health problems and put a special focus on immune-compromised individuals of all ages," Saskatchewan's Chief Medical Health Officer Dr. Moira McKinnon said. "A more explicit definition of underlying health problems and immune-compromised will be communicated in the coming days."

The vaccine is expected to arrive Wednesday, November 11, and the expansion will take place late next week or early the week after.

"Until then, we will continue to vaccinate pregnant and immediate post-partum women, people in remote and isolated communities, children from six months to Grade Six and health care workers who have not yet been vaccinated," McKinnon said.

To date, 194,600 doses of H1N1 vaccine have been received. When the additional 60,000 doses are received and sent to regions, there will be enough to vaccinate 28 per cent of Saskatchewan's population.

Regional health authorities will decide based on the traffic in their clinics exactly how it will roll out in each region. For information on flu clinics in your area, please log onto www.healthlineonline.ca, or call Healthline at 1-877-800-0002.

 

1106 Targeted H1N1 immunization of priority groups expands [Edmonton AB]--On November 10, Alberta Health Services will begin offering H1N1 vaccine to two new groups of individuals at high risk of developing severe illness related to influenza. As this process continues, no high risk groups will be removed from eligibility - only new groups added.

On November 10, and ongoing, those eligible will be:

  • (New) both parents or one parent and one caregiver of infants under six months of age;
  • (New) children under 10 as of November 1 with chronic health conditions (e.g. diabetes);
  • children over six months and under five years as of November 1; and
  • pregnant women.
Infants under the age of six months are at high risk for severe illness and cannot be immunized. In order to reduce their risk of exposure to the virus, vaccine will be provided to both parents, or to one parent and one caregiver. Proof of the infant’s age (Health Care card, birth certificate or other valid documentation) must be provided by each caregiver.

Parents and caregivers need not bring their infants with them, but caregivers attending clinics alone will need photo ID and a letter from the parent or guardian confirming their role.

The vaccine will also be provided to children under the age of 10 years as of November 1 with underlying medical conditions that put them at greater risk of severe illness related to influenza. Proof of age and a prescription or other record of the child’s medical condition will be required.

At this time, the vaccine will not be available to other Albertans. When more vaccine becomes available from the manufacturer, the targeted immunization program will be expanded to include other high risk groups. Further announcements will be made as more information becomes available on the national vaccine supply.

Alberta Health Services and Alberta Health and Wellness are working to balance the aim of providing the vaccine to as many high risk groups as possible given the limited supply of vaccine on hand.

All Albertans who want to be immunized will have that opportunity when increased supply of the vaccine arrives from the manufacturer. To ensure the vaccine can be provided to high risk groups at this time, no exceptions can be allowed. 

For the most current information on the targeted vaccination campaign, including dates, clinic locations and groups being vaccinated, go to: www.albertahealthservices.ca

 

1106 HHS orders intravenous antiviral flu meds to help patients hospitalized with H1N1 [United States]--The U.S. Department of Health and Human Services (HHS) today announced contract awards for up to 120,000 treatment courses of intravenous (IV) antiviral drugs to help treat hospitalized 2009 H1N1 influenza patients.

Patients hospitalized with 2009 H1N1 influenza are evaluated to determine if antiviral drugs will be useful; some patients are not able to take the drugs that are currently available as pills or liquid and may benefit from intravenous antiviral medications.

To help meet the potential need for IV medications to combat the H1N1 virus, HHS ordered 10,000 treatment courses each from BioCryst, Roche and GlaxoSmithKline, totaling $31.5 million. The contracts allow HHS to place additional orders of up to 30,000 treatment courses with each manufacturer over two years. Roche manufactures Tamiflu; GlaxoSmithKline, Relenza, and BioCryst manufactures Peramivir.

Because there are no Food and Drug Administration (FDA)-approved antiviral medications that can be administered intravenously to treat influenza, the FDA issued an emergency use authorization on Oct. 23 to allow use of intravenous Peramivir, an investigational antiviral drug in the class of drugs known as neuraminidase inhibitors.

The HHS orders for intravenous oseltamivir (Tamiflu) and intravenous zanamivir (Relenza), also neuraminidase inhibitors, are predicated on FDA emergency use authorization for these medications.

FDA has not issued emergency use authorization authorizing the use of intravenous Tamiflu or Relenza. Orders for Tamiflu and Relenza are based on anticipated need of emergency use authorizations for additional IV drugs in the future. Tamiflu and Relenza are FDA-approved in the form of pills or liquid, and studies are ongoing into the use of these two drugs intravenously for hospitalized H1N1 flu patients.

The emergency use authorization for IV Peramivir allowed doctors to prescribe the drug to treat certain adults and children hospitalized with confirmed or suspected 2009 H1N1 infections. Specifically, IV Peramivir is authorized only for hospitalized adult and pediatric patients for whom therapy with an IV drug is clinically appropriate.

To authorize emergency use of any product, the FDA commissioner must determine that in an emergency, based on the totality of scientific evidence available, it is reasonable to believe that the product may be effective in diagnosing, treating, or preventing the serious or life threatening disease or condition; that the known and potential benefits of the product outweigh the known and potential risks of the product in the emergency situation, and that there is no adequate, approved, and available alternative to the product for diagnosing, preventing, or treating such serious or life threatening disease or condition.

The Biomedical Advanced Research and Development Authority (BARDA) within the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) will manage the contracts. BARDA supported the advanced development of IV Peramivir beginning in 2007 as part of a larger HHS initiative to develop promising new influenza medications and vaccines.

For more information on the emergency use of IV Peramivir authorized by FDA, including information for health care providers on patient eligibility, see http://www.cdc.gov/h1n1flu/eua/.

Healthcare providers can also call 1-800-CDC-INFO (1-800-232-4636).  Additional information about BARDA contracts is available at https://www.medicalcountermeasures.gov/announcements.aspx

 

1106 King County pharmacies to offer H1N1 vax for at-risk people [Washington]--To provide another option for people prioritized to receive H1N1 vaccine, selected King County pharmacies are receiving limited supplies to begin vaccinating. A total of 15,000 doses of vaccine have been allocated to pharmacies, with more available in future weeks.

Many of the 44 participating pharmacies are taking appointments by phone starting today; some will be holding walk-up clinics without appointment starting next week. The full list of participating pharmacies, including hours, types of vaccine available, vaccination age ranges and administrative fee, is posted online.

 

This site will be updated Monday through Friday by noon; people should contact pharmacies directly for the most up-to-date information.
 

 

1106 Letter to state/local officials from CDC director re H1N1 vax [Atlanta GA]--Dear State/Local Health Officer: Today we have 35.6 million doses of 2009 H1N1 vaccine allocated for ordering, with more coming every day. As you know all too well, at present, demand for the vaccine in your communities still exceeds the supply we have received from manufacturers. That means it is more important than ever to focus on ensuring equitable access to the vaccine for the priority groups identified by the Advisory Committee on Immunization Practices: pregnant women, caretakers of infants less than 6 months of age, health care workers, children and adults with health conditions such as asthma or diabetes, and people under the age of 25. These are the people who are most vulnerable to 2009 H1N1 influenza, and it’s our job to do everything we can to keep them safe this flu season.


I know you have been working hard to distribute vaccine to the people who need it most. You are on the front lines of the fight, and no one knows better than you how to reach people in your communities. I especially appreciate the many innovative ways you’ve found to reach them, including school-located vaccine clinics, special clinics for pregnant women, outreach to children with special needs, and making vaccine available to community- and faith-based organizations serving these high-risk populations.
 

The goal of the H1N1 vaccination program is to protect our population – focusing first on these high-risk groups and ensuring equitable access to the vaccine. While vaccine supplies are still limited, any vaccine distribution decisions that appear to direct vaccine to people outside the identified priority groups have the potential to undermine the credibility of the program.
 

It is important to make it clear to the public that we are all committed to the science-based vaccination recommendations established by the Advisory Committee on Immunization Practices. This may include making clear to the public as well as health care providers how the vaccine available to you is being targeted, and the basis for targeting. CDC expects all grantees to ensure that all vaccinators chosen by state and local health departments adhere to those recommendations. Toward that end, and in light of changing projections of vaccine availability, I ask each of you to review your plans immediately and work to ensure that the maximum number of doses is delivered to those at greatest risk as rapidly as possible.

 

I know how difficult your jobs are; we are ready and willing to help you any way we can.


Sincerely,
Thomas R. Frieden, M.D., M.P.H.
Director, Centers for Disease Control and
Prevention, and
Administrator, Agency for Toxic Substances
and Disease Registry

 

 

1106 Atlantic County begins to distribute H1N1 vax [New Jersey]--The Atlantic County Division of Public Health recently received its first delivery of the H1N1 vaccine and is currently working with Executive Atlantic County Superintendent of Schools Thomas Dowd to provide vaccine to students throughout area high schools. Individuals from 6 months through 24 years are among the populations targeted by the federal Centers for Disease Control to receive the H1N1 vaccine.

“We are starting with our high school students and plan to offer vaccinations to other youth within the target populations as more vaccine becomes available,” stated County Health Officer Patricia Diamond.

Additional target populations include: pregnant women, healthcare and emergency medical personnel, people who live with or care for infants younger than 6 months of age, and individuals 25 through 64 years old who have certain chronic medical conditions or a weakened immune system. Although the vaccine is currently arriving in limited quantities, the CDC is assuring the public that everyone who wants it will eventually be able to receive it.

“Children and young adults have been more seriously affected by the H1N1 flu strain,” noted Diamond. “It appears to be disproportionately impacting these populations, as compared to seasonal flu that typically hits our seniors the hardest.

According to Diamond, letters will be going home to parents and guardians of high school students to advise them of opportunities to receive the H1N1 vaccination in their respective schools during school hours. The letters remind parents/guardians that the vaccine is voluntary and is also available from many local pediatricians, physicians and pharmacies.

Parents and guardians are also reminded that children 6 months through 9 years of age must receive two doses of the vaccine, approximately 30 days apart. Individuals 10 years and older need only receive one dose of vaccine for full protection.

Approximately 250 emergency medical services personnel were innoculated with the H1N1 vaccine on October 30 by nurses on staff with the Division of Public Health.

“First responders will be called upon to help transport those who may contract H1N1 and require hospitalization. They are included in the populations targeted by the CDC to receive H1N1 vaccinations. We recognize the importance of protecting those who so often provide our first line of defense,” Diamond said.

The Division of Public Health also plans to provide several public H1N1 vaccination clinics once it receives additional vaccine shipments.

In the meantime, residents are encouraged to continue to engage in protective hygiene practices and to stay informed by visiting the county Web site at www.aclink.org and by calling the county flu hotline at 677-5720 for updates.

 

 

1106 H1N1 continues to spread and worsen in state [Maine]--This health advisory serves to update health care providers and others on the H1N1 situation in Maine as well as access to vaccine and antiviral medications.


H1N1 CONTINUES TO SPREAD AND WORSEN IN MAINE
 

As anticipated, H1N1 continues to expand and worsen. Outpatient visits for influenza, the numbers of schools reporting high absenteeism, and hospitalizations have all increased substantially this past week. Maine has also recorded its second death due to H1N1 this week – a young adult with serious underlying conditions from Penobscot County. 25 schools have reported high (>15%) absentee rates this week, and they range from Aroostook to York County and from Washington to Oxford County. 10 people were hospitalized this past week due to H1N1. Four of them were previously healthy children, including one child admitted to an ICU. Every county has had confirmed cases of H1N1.


Maine CDC recommends that hospitals and other health care providers be ready to
implement their surge and alternate care site plans, and do so as the need arises. Pediatric providers such as children’s hospitals and health care providers who care for a number of children in southern New England have had to implement.


VACCINE EFFORTS CONTINUE
 

Vaccine Supply: A cumulative total of 138,600 doses of H1N1 vaccine have arrived in Maine at over 200 health care provider sites by the end of this week. This represents 1 dose for every 5 in the high priority groups and 1 dose for every 10 people in Maine.


Vaccine Administration: An estimated 15,000 children were vaccinated last week in 100 school-related vaccine clinics. Over 200 schools have scheduled clinics this week and next.


• There are 9 formulations of the H1N1 vaccine, each with different age group and
parameters they are licensed for. Besides formulations appropriate for school children we have increasingly received formulations appropriate for pregnant women
and pre-school aged children this past two weeks. We have now been able to distribute vaccine for pregnant women to every delivering hospital and obstetrical
health care provider who has ordered vaccine from us. We are also increasingly distributing vaccine to pediatric health care providers for pre-school aged children and very high-risk or other older children who are not being reached by school clinics. Some vaccine has also been distributed to specialty practices that care for very high-risk adults, such as pulmonary, cardiac, and oncology specialists and dialysis centers.


• The U.S. CDC continues to reiterate the importance that all vaccine only be given to those at highest risk. The overall high priority groups for H1N1 Vaccine:
o pregnant women,
o persons who live with or provide care for infants aged <6 months (e.g.,
parents, siblings, and daycare providers),
o children and young adults aged 6 months--24 years, and

o persons aged 25--64 years who have medical conditions that put them at
higher risk for influenza-related complications, and
o health care personnel.


Medical conditions that confer a higher risk for influenza-related complications include chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, cognitive, neurologic/neuromuscular, hematologic, or metabolic disorders (including diabetes mellitus) and immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus).


Because of such limited vaccine supplies at this point in time, we ask that vaccine be limited to those at the highest risk for complications, such as pregnant women, children, caregivers/household contacts of infants <6 months (to protect the young infants for whom there is no vaccine), and adults <65 years of age who have severe underlying medical conditions as listed above.


H1N1 Vaccine Information and Recommendations:
http://www.cdc.gov/h1n1flu/vaccination/professional.htm


CRITICAL IMPORTANCE OF ANTIVIRAL MEDICINES
 

Although use of influenza antiviral drugs in the United States has increased during the 2009-2010 flu season, not all people recommended for antiviral treatment are getting treated.


Clinical Indications: It is very important that health care providers and those in high
risk groups are aware of the importance of the antiviral medications oseltamivir (Tamiflu) or zanamivir (Relenza). People in high risk groups for complications who have symptoms of H1N1 or whose household members have symptoms should be strongly considered for prescriptions for these medicines. Antiviral medications can reduce the severity as well as the duration of illness. All hospitalized patients with suspected or confirmed H1N1 should receive antiviral treatment with a neuraminidase inhibitor as early as possible.


Those in these high-risk groups include anyone <2 years of age, >64 years of age, pregnant women (including 2 weeks post partum), anyone with an underlying high-risk medical condition; and anyone with lower respiratory or severe illness.


• Underlying high-risk medical conditions include:
o Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), or metabolic disorders (including diabetes mellitus);
o Disorders that that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders)
o Immunosuppression, including that caused by medications or by HIV; Full CDC recommendations for antiviral medicines can be found at: http://www.cdc.gov/h1n1flu/recommendations.htm


It is critical to remember that it is not too late to treat, even if symptoms began more than 48 hours ago. Outpatients, particularly those with risk factors for severe
illness who are not improving, might also benefit from treatment initiated more than 48 hours after illness onset.


Some people without risk factors may also benefit from antivirals. To date, 40% of children and 20% of adults hospitalized with complications of 2009 H1N1 did not have risk factors. Clinical judgment is always an essential part of treatment decisions.


When treatment of persons with suspected 2009 H1N1 influenza is indicated, it should be started empirically. If a decision is made to test for influenza, treatment should not be delayed while waiting for laboratory confirmation. Rapid influenza tests often can give false negative results. If you suspect flu and feel antiviral treatment is warranted, treat even if the results of a rapid test are negative.

 

Obtaining more accurate testing results can take more than one day, so treatment should not be delayed while waiting for these test results. For more information on influenza testing, please see: http://www.cdc.gov/h1n1flu/guidance/diagnostic_tests.htm.


Although commercially produced pediatric oseltamivir suspension is in short supply, there are ample supplies of children's oseltamivir capsules, which can be mixed with syrup at home. In addition, pharmacies can compound adult oseltamivir capsules into a suspension for treatment of ill infants and children. Additional information on compounding can be found at: http://www.cdc.gov/H1N1flu/pharmacist/.


Accessing Maine’s Antiviral Stockpile: A significant portion of Maine’s state and
federal stockpiles of antiviral medications have been distributed to federally-qualified health centers, Hannaford’s pharmacies, and other willing pharmacies. They are available for anyone in these groups with symptoms or close exposure (such as to a household member) and who do not have adequate insurance coverage (no insurance, high co-pays or high deductibles). The instructions for accessing these can be found at:
http://www.maine.gov/dhhs/boh/maineflu/h1n1/anti-viral.shtml.

 

All of Maine’s stockpile of pediatric suspension has been deployed to hospitals, health centers, and the participating pharmacies.


More Information on Antiviral Medicines:
 

Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season:
http://www.cdc.gov/H1N1flu/recommendations.htm
 

 

1106 HEALTH dept issues statement regarding confusion between Tamiflu and Theraflu [Rhode Island]--HEALTH alerts consumers that there is a difference between Tamiflu, a prescription medicine to lessen the severity and duration of flu, and Theraflu, an over-the-counter medication which may reduce fever or ease body aches and stuffiness.

 

Theraflu does nothing to lessen the severity or shorten the duration of flu related illness. In addition, some preparations of Theraflu have high doses of acetaminophen and are unsafe for children.

 

Tamiflu can only be prescribed by a physician, physician assistant, or nurse practitioner and is most effective if given within the first 24-48 hours of the onset of symptoms.

 

Tamiflu is most often prescribed for those who have underlying medical conditions or severe illness which put them at a higher risk for complications from the flu. We understand that parents are trying to care for their sick children as best they can, and we would like to clarify the differences between these two drugs so that parents can more safely care for their children at home.

 

Tamiflu · Prescription medication · Lessens severity and duration of flu · Most effective when given within 24-48 hours of the onset of flu symptoms

 

Theraflu: · Over-the-counter medication · May reduce fever or ease body aches and nasal congestion · Does NOT lessen severity and duration of flu

 

PLEASE consult your pediatrician before giving your child Theraflu as many preparations of Theraflu have high doses of acetaminophen and are not safe for children.

 

For more information, call the HEALTH Information Line at 222-8022.

 

 

1106 State receives more Tamiflu for children [Connecticut]--Governor M. Jodi Rell announced today that the state has received 3,000 bottles of pediatric Tamiflu from the federal government to help medical personnel at hospitals and clinics treat the growing cases of H1N1 influenza among children.

 

“We continue to see a marked increase in the number of confirmed cases of the H1N1 virus in both children and adults,” Governor Rell said. “But any parent who has ever stayed up all night with a sick child knows how difficult and heartbreaking it can be. It is important to treat the symptoms as soon as possible and so we must ensure that the medication is available.”

 

The Governor said Connecticut’s allocation of the pediatric Tamiflu is part of the Centers for Disease Control and Prevention’s (CDC) nationwide release of 234,000 courses of pediatric Tamiflu from the Strategic National Stockpile (SNS).

 

Department of Public Health officials say the pediatric Tamiflu will be distributed on Monday to 17 acute care hospitals that have pediatric treatment programs and 12 community health clinics, which treat underserved populations in the state.

 

The Governor last week requested more of the state’s allocation of Tamiflu and Relenza, another antiviral, from the stockpile. The state is awaiting word on whether the CDC will release more of the antivirals for adult patients as well. The CDC has raised Connecticut’s flu activity to “widespread,” the highest level of activity.

 

In April, the Centers for Disease Control (CDC) provided Connecticut with more than 130,000 treatment courses of antiviral medication, or 25 percent of the state’s SNS allocation for distribution to acute care hospitals and community health centers. Tamiflu and Relenza are administered in the early stages of the illness and lessen its severity and duration.

 

The drugs interfere with the ability of the virus to make copies of itself, which in turn helps the body fight the infection. Each treatment course is a 10-day supply of either Tamiflu or Relenza.

 

For more information on H1N1 resources in Connecticut call the H1N1 hot line at: 800-830-9426, or visit the www.ct.gov/ctfluwatch

 

 

1106 Gov Patterson urges New Yorkers to take preventive measures to reduce spread of H1N1 flu [Albany NY]--As cases of H1N1 flu increase in New York State, Governor David A. Paterson today urged New Yorkers to stay home if sick, avoid going to a hospital emergency room unless flu symptoms are severe and follow additional preventive measures to limit the spread of H1N1 influenza to others.

“H1N1 flu activity is widespread across the State and, not surprisingly, the number of positive flu tests has tripled within a week’s time,” Governor Paterson said. “It’s critical that New Yorkers take preventive measures to reduce the risk of contracting H1N1 flu and spreading it to others. As we wait for larger vaccine shipments to arrive in New York, I urge New Yorkers to use good judgment and stay home if they are sick and only go to a hospital emergency department if they or a family member experiences severe flu symptoms.”

State Health Commissioner Richard F. Daines, M.D., said: “The majority of people with H1N1 flu will experience mild to moderate symptoms and will recover at home without medical treatment. We must reserve emergency department visits for those who experience severe symptoms or develop complications from the flu and need immediate medical care.”

The State Department of Health (DOH) reports that the dominant Type Flu A strain currently circulating in the State is H1N1 flu. DOH reported more than 500 positive laboratory reports for Flu Type A statewide during the week of October 10 through 17, but that number jumped to nearly 2,000 the following week – a 300 percent increase in one week. To date, the greatest activity of H1N1 flu is being reported in the Northeastern, Western and Capital District areas of the State.

Dr. Daines added: “While flu test reports are up, the number of patients hospitalized remains low when compared to previous influenza seasons. This means that while more testing is occurring, and there are many people currently ill with flu, most cases continue to be mild.”

Although federal and state health officials expect an increase in H1N1 cases as the influenza season progresses, this increase comes at a time when New York’s statewide vaccination campaign has slowed due to a national shortage of H1N1 vaccine caused by manufacturing delays. Governor Paterson stressed that as New York waits for larger H1N1 vaccine shipments, practicing preventive measures is crucial to reducing the spread of the H1N1 virus. These preventive measures include:

    • Coughing or sneezing into a tissue or the crook of your elbow, not your hands. Throwing the tissue in the trash after you use it.
    • Washing your hands often with soap and water. Using an alcohol-based hand sanitizer if you aren’t near a sink.
    • Keeping your hands away from your eyes, nose and mouth. Flu spreads that way.
    • Avoiding close contact with sick people.
    • Staying home when you are sick and not returning to school or work until you have been fever-free without medication for at least 24 hours.

“I ask New Yorkers to be patient as we work to implement our statewide vaccination campaign,” Governor Paterson said. “The State Health Department is doing everything it can to get H1N1 vaccine out to health care providers as soon as it arrives in the State. We are hopeful that in the near future vaccine production will pick up and New York, along with other states across the country, will start to receive larger shipments of the vaccine. Until then, we must be patient and do our best to prevent the spread of the virus within our communities.”

To date, DOH has ordered approximately 1 million doses of H1N1 vaccine – the maximum made available by the Centers for Disease Control and Prevention (CDC) for areas outside of New York City. Most of these doses have been distributed by CDC to health care providers that registered with DOH and placed orders for the vaccine. DOH has cumulatively received over 6 million vaccine orders from registered providers. However, CDC’s current maximum vaccine allotment for New York State allows only one vaccine dose to be shipped for every six vaccine orders placed. As of November 3, about 5,000 health care providers outside of New York City have registered with DOH and more providers are registering daily.

Commissioner Daines said: “New Yorkers should check with their local health care provider or county health department to see when H1N1 vaccine will become available to them. As we move further into November and as more vaccine becomes available, they will schedule vaccination appointments and clinics accordingly.”

Last week, Governor Paterson issued Executive Order 29 declaring a State Disaster Emergency to help local governments prepare to operate vaccination clinics statewide when larger quantities of the H1N1 vaccine arrive in New York. This Executive Order provides additional personnel and flexibility to local governments. It permits physician and special assistants, pharmacists, dentists, certain dental hygienists, midwives and emergency personnel to administer vaccinations after they receive training.

In addition, Governor Paterson’s Executive Order authorizes school-based health centers to vaccinate adults and children, and allows hospitals to operate part-time immunization clinics on school campuses.

More information about seasonal and H1N1 flu, including educational resources and direct links to CDC’s website, is available on DOH’s website at
www.nyhealth.gov.

 

1106 Young adult is state's second H1N1 flu-related death [Maine]--A Penobscot County young adult is the second death linked to H1N1 influenza in Maine, and the first since August, the Maine CDC in the Department of Health and Human Services said today.

"It is with great sadness that we have learned of a Penobscot County young adult (age 18 – 25) who died recently of H1N1 influenza. The young person had serious underlying medical conditions," said Dr. Dora Anne Mills, Director of the Maine CDC.

 

"We extend our deepest sympathy to this man’s family and friends. While most people with H1N1 in Maine and the nation have had a relatively mild infection, this news demonstrates how severe influenza can be, especially in those with underlying conditions, pregnant women and children."

The young man died earlier this week at home and was not attending a local college or university. His name and the date of his death are not being released to help protect the privacy of the family. Upon learning of the death and of the possibility that the man had influenza symptoms, the Maine CDC called the Medical Examiner. An autopsy was performed and tests conducted by the Maine CDC’s Health and Environmental Testing Laboratory confirmed the diagnosis of the pandemic strain of H1N1 influenza.

Since first being recognized in April 2009, novel influenza A (H1N1) has spread across the globe. In June, a pandemic was declared by the World Health Organization. Children and young adults are disproportionately affected by H1N1, accounting for the majority of confirmed cases, hospitalizations, and deaths. In August, a York County man in his 50s was the first Maine resident to die of the pandemic strain of H1N1. Over the past two weeks, H1N1 has become widespread in Maine. This past week, 25 schools have experienced high absentee rates, 10 people have been hospitalized, including four children.

 

 

1106 H1N1 vax efforts expand as school absenteeism grows [Maine]--H1N1 influenza is causing widespread school absentee rates, though no schools have had to close this past week, said Dr. Dora Anne Mills, Director of the Maine Center for Disease Control and Prevention (MeCDC) in her weekly press update Thursday.

 

Twenty-five schools statewide have reported high absentee rates and include schools from York to Aroostook County, from Washington to Oxford County, Mills said.

“The good news is that about 100 schools have held vaccine clinics and more than 200 have scheduled clinics this week and next,’’ said Mills. “We anticipated that H1N1 would continue to spread. It has now been confirmed in every county, with Franklin County having its first confirmed case this week.”

Mills said that 10 people were hospitalized this past week, including four children, one young adult, and five middle-aged adults. All the children were otherwise healthy with no underlying chronic conditions.

Three of the people hospitalized spent time in intensive care units, Mills said and eight of the 10 patients have been discharged from the hospital and are recovering at home.

“Although the vaccine supply is trickling in at a much slower rate than we would like, the H1N1 vaccine efforts in Maine are unprecedented,” said Dr. Mills. “This week, about 40,000 doses arrived, for a cumulative total of 138,600 doses. “This is still about one dose of vaccine for every five who are in one of the high priority groups for vaccine, so it is still very hard to find. However, we estimate that 15,000 school children were vaccinated.”

A significant portion of the state’s stockpile of antiviral medicines has been distributed for those who do not have adequate insurance coverage, who are at risk for complications, who are ill with symptoms of H1N1 or have been exposed to a household member with influenza, Mills said.

Some doses of vaccine have also been distributed to health care providers for pregnant women, pre-school aged children, and some older children and adults with very high risk conditions.

“With nine different formulations of the H1N1 vaccine, distribution has been challenging, since each formulation has different age groups and other parameters of who can receive it. However, with new formulations available this past week, we have been able to expand the groups of people to whom we can distribute vaccine,” said Mills.

With H1N1 influenza being so widespread, it is also important that people know what to do if they become sick or are at high risk for complications. Mills stressed that those who at high risk for complications speak to their healthcare providers about the availability of prescription antiviral medicines. Nearly 41,000 courses have been delivered and can help reduce the duration and severity of illness.

To continue to prevent the spread of H1N1 and minimize its impact, the Maine CDC recommends:

  • Everyone be extra vigilant with respiratory hygiene:
    • Cover your coughs and sneezes;
    • Wash your hands frequently; and
    • Stay home if you’re sick with a fever.
  • If you are at very high risk for complications, you may want to avoid large crowds. There is generally no reason for large gatherings to be cancelled, but people who are at high risk for complications should consider avoiding them.
  • If you or your household member is sick with the symptoms, which are a fever plus a sore throat and/or a cough, there are several things you should be aware of.
    • Know that most people can stay home without a seeing a health care provider;
    • People with influenza should drink fluids and get plenty of rest;
    • Call your health care provider if you are at high risk for complications and you or a household member has symptoms of H1N1. You should be considered for prescription medicines that treat influenza, called antivirals (known as Tamiflu and Relenza).
  • Those at risk for complications include:
    • Children younger than 2 years old
    • Adults 65 years and older
    • Pregnant women
    • Anyone with certain underlying medical conditions
  • Anyone with influenza symptoms should seek medical attention for:
    • Dehydration
    • Trouble breathing
    • Getting better then suddenly getting a lot worse
    • Any major change in one’s condition

For more information and for a list of school clinics for the upcoming two weeks, go to http://www.maineflu.gov .

 

1106 More than 3,000 people received H1N1 vax yesterday [Marion County IN]--The Marion. County Health Department vaccinated 3,030 individuals during today's H1N1 public clinic at Lafayette Square Mall.

More than 1,000 individuals were in line when the clinic opened just before 10 this morning. More than 2,000 individuals received vaccine within the first 90 minutes.

The first individuals arrived before 6 this morning and the last individual was vaccinated at 2:35 p.m.

Local health officials are pleased with the results of the three clinics held at Lafayette Square.

"We have been able to protect more than 9,300 individuals through these first three public clinics. We continue to encourage those in the at-risk group to get vaccinated when they can," said Virginia A. Caine, M.D., director, Marion County Health Department.

An additional 3,000 individuals were vaccinated last month at H1N1 clinics coordinated by HealthNet.

The next Marion County Health Department public H1N1 Vaccination Clinic will be Saturday, November 7 at Warren Central High School from 11 a.m. to 3 p.m. The clinic is for those in the at-risk group only. Long lines are expected and individuals should plan accordingly.

Those coming to the Saturday clinic should enter the Warren Central High School campus from the East 21st Street entrance and follow security officer direction to parking and main entrance of the school.

Individuals with flu-related questions can call the 221-3366 Marion County Health Department Flu Helpline. The bi-lingual helpline is available Monday-Friday from 8 a.m. to 5 p.m.

 

 

1106 Three more H1N1 flu-related deaths confirmed [Iowa]--The Iowa Department of Public Health (IDPH) today reported three additional 2009 H1N1 influenza-related deaths in Iowa. The victims are identified as two adults in Polk County and one adult in Woodbury County; two of the three had known risk factors for complications.

“Surveillance continues to show an increase in adult illness,” said IDPH Medical Director, Dr. Patricia Quinlisk. “With H1N1 vaccine continuing to be allocated to states on a staggered basis, many adults are not yet in the priority group targeted for vaccination. However, in the coming weeks we expect more vaccine to become available in Iowa. Thus, the groups being vaccinated will continue to expand to include adults with medical conditions that put them at high risk for complications and death. Meanwhile, it’s important for all Iowans to continue to take personal action to prevent the spread of illness.”

These steps include cleaning your hands frequently; covering your coughs and sneezes with a tissue or your sleeve; and containing germs by staying home when ill.

Symptoms of H1N1 influenza are similar to seasonal influenza and include a fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people with H1N1 flu also have diarrhea and vomiting.

To date, Iowa has reported 14 confirmed H1N1 deaths in Iowa, including 13 adults and one child. For more information about H1N1 influenza, visit www.idph.state.ia.us/h1n1. Iowans with questions about H1N1 may also call the toll-free Influenza Hotline at 1-800-447-1985.

 

1106 State expands eligibility for H1N1 vaccine [South Dakota]--The state Department of Health announced today that effective November 9, the H1N1 vaccine will be available to more high risk groups – all kids from 5 to 18 years, young adults from 19 to 24, and adults from 25 to 64 with chronic health conditions.

“Since we received our first vaccine in early October, supplies have been limited so we’ve targeted those doses at people for highest risk of H1N1 complications, such as pregnant women and young children,” said Doneen Hollingsworth, Secretary of Health.

“The vaccine supply is slowly but steadily increasing and we’ve now distributed more than 76,000 total doses to over 400 locations in South Dakota. We know that there are still many people in the first tier who have not had a chance to get vaccinated but more public clinics are being scheduled every week and we think it’s time to start reaching out to the next group of individuals at high risk.”

Hollingsworth said that from now on, scheduled public clinics will be open to both tiers of high risk individuals and private providers will be encouraged to offer the vaccine to their patients in both groups as well. In the next week, vaccine clinics will be held at limited schools and college campuses and more will be scheduled as vaccine supplies increase. Check http://h1n1.sd.gov for an updated listing of scheduled clinics.
H1N1 vaccination is completely voluntary. The vaccine is free but some providers may charge an administration fee.
As supplies increase, the vaccine will eventually be made available to the general population. Those 65 and over are not on the initial priority list because younger age groups appear to be at higher risk for H1N1 and its complications, unlike seasonal flu which impacts older adults more.
In addition to H1N1 and seasonal flu vaccination, people can help prevent the flu by frequent hand washing, covering coughs and sneezes, and staying home when sick.

 

1106 State health officials confirm H1N1 flu-related death in Ozaukee County [Wisconsin]--The State Department of Health Services (DHS) announced today that a confirmed H1N1 influenza death has been reported in Ozaukee County. The death occurred in an individual with underlying health conditions and is the first H1N1 related death in Ozaukee County.

Out of respect for the family and patient confidentiality laws, neither DHS or the Ozaukee County Health Department will be releasing the individual’s sex, age, race or location of residence.

“For most people, the 2009 H1N1 flu is not severe. However, we know that the virus can be especially dangerous for children, individuals with compromised immune systems and those with chronic health illnesses,” said State Health Officer Dr. Seth Foldy. “We recommend that those individuals who are at high risk for severe disease from H1N1 influenza get vaccinated to protect themselves against H1N1 when vaccine becomes available. Over the past two weeks H1N1 vaccine shipments have increased significantly.”

Health officials expect that eventually there will be enough H1N1 vaccine – and seasonal vaccine – available for anyone who wants to be vaccinated.

While vaccination will be the best protection against influenza, until more people are vaccinated it is important for everyone to continue the basic protection and prevention measures: stay home if you are ill; cover your coughs and sneezes with a tissue or with your sleeve, not with your hands; wash your hands thoroughly and frequently; and stay healthy by getting plenty of rest, eating healthy food and exercising.

People who develop significant flu symptoms or those with flu symptoms who are at risk for severe flu or flu complications are advised to consult their health care provider promptly.

This is the 19th confirmed H1N1 death in Wisconsin since the spring.

For more information about H1N1 influenza, please visit www.pandemic.wisconsin.gov, or Ozaukee County Public Health’s Web Site at: http://www.co.ozaukee.wi.us/PublicHealth/index.html or call 2-1-1, or contact your health care provider.

 

1106 H1N1 (swine flu) information: easy access for residents [Washington]--H1N1 vaccine remains in short supply in most Washington communities, however, the amount available is growing. The state Department of Health is making it easier for people to find the latest information with a variety of easy access resources.

“We know there’s a lot of concern about flu this season, and we want Washington residents to have current, easy-to-find information that will help them protect themselves and their families,” said Secretary of Health Mary Selecky. “We’ve got useful guidance on how to avoid getting sick, and what to do if you get sick. Putting it all online and using social media makes it easy for most people to find quick answers.”

The Department of Health H1N1 Web site is updated regularly. It features flu prevention information, including guides for businesses and schools, tip for parents and caregivers, and downloadable outreach materials. A telephone information line (1-888-703-4364) offers helpful recorded tips on topics such as the symptoms of H1N1, what to do if you’re sick, and steps to take to stay well. Department of Health Twitter followers (http://twitter.com/WA_DeptofHealth) get frequent updates to help stay current on fast-changing influenza topics. People can send their questions to prepare@doh.wa.gov.

One of the most common questions is about the availability of H1N1 vaccine. The agency Web site includes a “vaccine locator” map, an interactive county-by-county diagram connecting visitors to vaccine distribution information in their communities. The map is updated with the latest information as the vaccine supply increases.

“We want people to take flu seriously,” Selecky said, “and remember that it can be prevented and managed with basic good health manners. Washing your hands, covering your cough and sneeze, and staying home when you’re sick are key prevention tactics. And get vaccinated when you can. Vaccination is the best protection against influenza.”

Vaccine delivery around the country has been slower than expected and supply remains limited. But H1N1 vaccine is here, and more is being shipped every day. More than 500,000 doses have now come to the state, and federal health leaders say in the weeks ahead everyone who would like to get the vaccine will be able to do so. Priority groups to receive early supplies of the vaccine include pregnant women, parents and caregivers of children under six months, healthcare and emergency service workers, people from six months to 24 years, and adults 25-64 with health conditions that put them at higher risk of flu-related complications.

A public education campaign will be launched by the Department of Health in the coming weeks to inform the public about prevention measures and the information resources available. The campaign will include TV and radio advertisements and direct outreach. It will focus on things people can do to help stop the spread of this new flu, including getting vaccinated, washing their hands more often, covering their cough and sneezes, and staying home when sick.

 

1106 Two additional H1N1-related deaths announced [Kansas]--The Kansas Department of Health and Environment (KDHE) today announced the deaths of two people who were infected with the pandemic H1N1 influenza virus.  Sixteen people in Kansas have now reportedly died after being infected with H1N1.

The deaths occurred in the following individuals:

  • A 34 year-old man from the Topeka metropolitan area was confirmed to have pandemic H1N1 on November 4. His death was reported to KDHE on November 2. The man had no underlying health conditions that placed him at greater risk for severe complications of influenza
  • 58 year-old female from southwest Kansas* was confirmed to have pandemic H1N1 on October 1. Her death was reported to KDHE on November 4. This woman had underlying health conditions that placed her at greater risk for severe complications of influenza.

KDHE Secretary Roderick Bremby and Dr. Jason Eberhart-Phillips, Kansas State Health Officer, expressed sympathy and offered their deepest condolences to the families involved.

“These deaths remind us that this virus has the potential to be quite severe and life threatening, sometimes even in people who would not be considered at great risk from a seasonal flu virus,” said Dr. Eberhart-Phillips. “The 2009 H1N1 flu is mild in most cases, but it is not possible to predict the severity of an individual case.”

The symptoms of infection with the pandemic H1N1 virus are similar to the symptoms of seasonal flu and include fever of 100 degrees or greater, body aches, coughing, sore throat, respiratory congestion, and in some cases, diarrhea and vomiting.  Most people who have been ill with pandemic H1N1 influenza have recovered without medical treatment.

However, some people develop serious complications that require hospitalization or may lead to death.  Although serious complications are more likely among persons with certain underlying chronic health conditions, this pandemic influenza virus has caused serious complications and deaths among persons without such factors.  Unlike typical seasonal influenza, the 2009 H1N1 virus is causing a greater disease burden among adolescents and young adults.  Severe illness from H1N1 virus infection can even occur among relatively young, healthy persons.

The H1N1 vaccine has started to arrive in Kansas, but at this time in very limited quantities. Certain individuals are recommended to receive the vaccine earlier.  For more information on vaccine prioritization, please visit www.kdheks.gov/H1N1/H1N1_Vaccine.htm.

Up-to-date information on H1N1 vaccination clinics being held across the state can be found by going to www.kdheks.gov and clicking on “Where can I receive the H1N1vaccine?”

KDHE is no longer accepting specimens from everyone who sees a doctor with symptoms.  In non-hospitalized cases, confirmatory testing does not affect treatment and advice given to patients by health care providers. 

Most children and adults with the flu who are generally in good health will recover without needing to visit a health care provider.  Some people may want to call their health care provider for advice on how to care for the flu at home.

Individuals who experience severe illness or who are at high risk of complications from H1N1 influenza infection, including children less than 5 years of age, adults 65 years of age and older, pregnant women, and persons with chronic medical conditions (including asthma, diabetes, heart disease, and other conditions), should contact their health care provider.

Until people are able to be vaccinated against the virus, individuals are encouraged to take the following steps to reduce its spread:

  • Wash your hands thoroughly with soap and warm water or use an alcohol-based hand sanitizer to get rid of most germs and avoid touching your eyes, nose and mouth.
  • If you become sick, stay home until at least 24 hours after fever or signs of fever without the use of fever-reducing medications, in order to avoid spreading illness to co-workers and friends.
  • Cough or sneeze into a tissue and properly dispose of used tissues.  If you do not have a tissue, cover your cough or sneeze with your elbow and not your hands.  
  • Stay healthy by eating a balanced diet, drinking plenty of water and getting adequate rest and exercise.

KDHE has established a phone number for concerned Kansans to call with questions about the 2009 H1N1 influenza A virus.  The toll-free number is 1-877-427-7317.  Operators will be available to answer questions from 8 a.m. – 5 p.m. Monday through Friday.  Persons calling will be directed to press “1” on their touch-tone phone to be directed to an operator who can answer questions.

Kansans with questions about the virus can email H1N1fluinfo@kdheks.gov.  Information is also available from KDHE at www.kdheks.gov.

The geographic areas stated are defined as follows:

  • Topeka metropolitan area:  Jackson, Jefferson, Osage, Shawnee and Wabaunsee counties
     
  • Southwest Kansas:  Greely, Wichita, Scott, Lane, Hamilton, Kearny, Finney, Hodgeman, Stanton, Grant, Haskell, Gray, Ford, Morton, Stevens, Seward, Meade and Clark counties

In order to balance KDHE’s statutory requirements to not personally identify an individual and the need to share important public health information, KDHE is releasing the region or major metropolitan area of residence, the individual’s age, sex, and the presence of any underlying health conditions for pandemic influenza-related deaths.  This new policy is currently under review and may be changed if necessary.

 

1106 Flu PSA advises students, workers to stay home when sick [Denver CO]--“Stay home when you’re sick instead of going to school or work and exposing others to influenza,” is the message state health officials hope the public hears when they watch a just-released television public service announcement (PSA) by the Colorado Department of Public Health and Environment.

 

A link to the PSA entitled, “Television PSA Urges People to Stay Home When Sick,” can be viewed at http://www.colorado.gov/nofluforyou

“While the PSA is about a student who makes countless others sick by coming to school when he’s sick, we hope everyone will relate to this message, which applies to everyone.  If you're sick, you really need to stay home from school, work or any other activity where you will be around others,” said the state’s Chief Medical Officer Ned Calonge.

The spot turns the idea of a perfect attendance award ceremony on its head to shed some light on how not staying home when you’re sick can have a real impact on others.

“We use humor in the PSA to draw attention to this issue, but, as anyone who has had 2009 H1N1 influenza can tell you, there’s nothing funny about getting sick with this illness,” Calonge said. “While most people can weather 2009 H1N1 fairly well, we need to remember the disease has proven to be very serious, even deadly, for some who are infected with the virus.”

Calonge said he appreciates the support of students, parents, school officials, employees and employers as public health workers do what they can to limit the spread of 2009 H1N1. Calonge cautioned those infected with 2009 H1N1 to stay home and rest their bodies to fully recover.

Through Oct. 31, a total of 1,553 flu hospitalizations from 48 counties in Colorado have been reported. Thirty-four deaths, with most deaths occurring in the 25- to 49-year-old range, have been reported. State laboratory surveillance continues to show that more than 99 percent of influenza viruses currently circulating in Colorado are the 2009 H1N1 virus.

Individuals with questions about H1N1 are encouraged to call CO HELP at 1-877-462-2911. The hotline has been established to respond to questions about H1N1 and seasonal influenza.

A “Home Care Guide” on caring for sick family members at home also is available for free. Download it at http://www.cdphe.state.co.us/epr/Public/H1N1/HomeHealthcare/CDPHE_HomeCareGuide.pdf .

 

1106 Two Little Diomede residents medevac'd to Nome with possible H1N1 [Anchorage AK]--Two Little Diomede residents with severe H1N1 symptoms were medevaced to Nome through a coordinated effort by the Alaska Department of Health and Social Services (DHSS), Alaska Army National Guard, Division of Homeland Security & Emergency Management, and the Norton Sound Health Corporation.

 

The remote island community is being provided medical support to help prevent and treat additional people with suspected H1N1 infection and to help prevent further transmission.


On Wednesday, Nov. 4, 2009, the Alaska Army National Guard flew both individuals from Little Diomede to Norton Sound Regional Hospital in Nome. One patient tested positive for H1N1 during an initial rapid test.


Diomede Mayor Andrew Miligrock requested that a medical team and medication be sent to the island to treat an increasing number of people with flu-like symptoms.
In response, a civilian medical team consisting of one doctor, one public health nurse, and two medics are being transported to Little Diomede on Thursday, Nov. 5, with transportation support from the Alaska Army National Guard.


“One of the most remote communities in Alaska, the village of Diomede does not have village-wide water or sewer systems,” said state epidemiologist Dr. Joe McLaughlin. “Due to frequent adverse weather conditions, it is not uncommon for this community to be inaccessible by air for long periods of time, which further limits emergency health care opportunities for villagers. For these reasons, the DHSS Section of Epidemiology fully supports this medical mission to interrupt the spread of influenza in this hard-hit and geographically remote Alaska village.”


DHSS has arranged for 130 doses of inactivated H1N1 vaccine, dedicated to Nome, to be redirected to Diomede, along with antivirals used in the treatment of H1N1. Nome supplies are being immediately restocked.


The traditional commercial means of air evacuations from Little Diomede to Nome is not available at this time. In the interim, Alaska Army National Guard stands by to respond to true emergencies.

 

 

1106 Final state WNv numbers reported for 2009 [Wyoming]--The final count of laboratory-confirmed West Nile virus infections reported in Wyoming residents was 12 this year, according to the Wyoming Department of Health.

Four of the reported case patients were from Fremont County, three from Goshen County, two from Platte County, and one each from Converse, Campbell and Washakie counties.

There was one West Nile virus-related death this year in a Washakie County resident. Four cases involved the more serious West Nile neuroinvasive disease (meningitis or encephalitis). Of the 12 cases statewide, three patients required hospitalization.

The reported dates for the onset of symptoms began May 15 and ended September 7. The cases were evenly distributed among both genders. Ages of those infected ranged from 30 to 71.

In 2008, 10 cases and no deaths were reported in Wyoming. There were 184 human cases and one death were reported in 2007; 65 human cases with two deaths in 2006; 12 human cases with two deaths in 2005; 10 human cases with no deaths in 2004; and 393 human cases with nine deaths in 2003.

More information on West Nile virus is available on the web at www.badskeeter.org.

 

1106 Web site provides one-stop shopping for sandbag distribution sites in King County [King County WA]--With the simple click of a mouse, floodplain residents across King County can now learn where and when they can find sandbags to help them protect their home and property from serious flooding.

Learn where the county is providing sandbag materials or partnering with local cities to provide sandbags to the public free of charge before and during flood events by visiting www.kingcounty.gov/floodplans and clicking on “Sandbag distribution locations” on the right side menu. The site also provides information on operating hours.

King County determined an efficient way to provide sandbags to the public before and during a flood event is to partner with local cities that already offer sandbags to their residents. Per the terms of the partnership, participating cities must make supplies available to the residents of unincorporated King County in addition to the citizens residing within their jurisdictional boundaries. Local jurisdictions or community groups oversee sandbag distribution, and the King County Water and Land Resources Division (WLR) coordinates the delivery of materials.

When significant floods are expected, staff with King County’s Water and Land Resources Division will contact all partner cities or entities distributing sandbags to ensure sufficient sandbagging supplies are on hand. When a flood warning is issued and throughout the duration of a flood event, staff at the King County Flood Warning Center will confirm what sites are open and the operating hours of the sites, as well as determine whether any additional supplies are needed.

The Flood Warning Center will provide detailed information to the public regarding sandbag availability. The information will be disseminated through methods including calls to the Flood Warning Center, the flood warning voice messaging system, Web site postings, and press releases.

Sandbags, when used properly, can reduce damages from flooding. After a flood, property owners are responsible for removing sandbag installations in compliance with their local jurisdiction’s regulations. Please note that improper disposal of sandbags following a flood event can create environmental, safety and infrastructure concerns.

On March 9, 2009, the King County Council passed Ordinance 16379, which directed WLR to identify locations for the stockpiling and distribution of sand and sandbags. Funding for the sandbag program is provided by the King County Flood Control District with support from the U.S. Army Corps of Engineers.

For more information about King County’s sandbag distribution program, please contact Jason Wilkinson at 206-263-0488.

 

1106 County offering free sandbags to residents on Green River’s flood-threatened middle stretch [King County WA]--In preparation for potential high water because of reduced flood-storage capacity at an upstream dam, farmers and other residents of the middle Green River Valley are invited to make and take home free sandbags – and free advice on how to use them – on Wednesday, Nov. 11 at Flaming Geyser State Park near Auburn.

The sandbags will be available from 9:30 a.m. to 3 p.m. on Nov. 11 near the park lodge, at 23700 SE Flaming Geyser Rd. For more information, contact Karen Kinney, King County Agriculture Program, at 206263-6429; or karen.kinney@kingcounty.gov.

The sandbags and tips on their use are being provided by the King County Flood Control District, the King County Agriculture Program and the King County Agriculture Commission. Representatives from the U.S. Army Corps of Engineers will be on hand to provide advice and tips for using sandbags.

Those who are unable to attend this event can learn of additional opportunities for getting sandbags from the cities of Auburn or Kent at http://www.kingcounty.gov/environment/waterandland/flooding/sandbag-distribution.aspx.

The right abutment to the U.S. Army Corps of Engineers’ Howard Hanson Dam was damaged this past January, when the dam was holding back a record amount of floodwaters from downstream portions of the watershed, including the middle and lower Green River Valley areas.

 

As a result of the damage, the dam can store significantly less floodwater this year than in past years, increasing the likelihood that the flood-control facility will have to release more water than the river channel can accommodate, and lead to flooding.

 

King County, federal agencies, local cities and other government organizations have taken numerous steps in response to the heightened threat of flooding, including strengthening flood-protection structures, holding several informational public meetings and contacting Green River Valley residents with information ranging from how to purchase flood insurance, to how pet and livestock owners can help protect their families and animals.

 

Additionally, local search-and-rescue personnel have gone door-to-door in the middle Green River Valley to provide area residents with updated flood information.

 

King County has created a Web site with additional information about potential Green River Valley flooding, at http://www.kingcounty.gov/safety/FloodPlan/GreenRiverValley.aspx.

 

 

1106 County heads into winter with new snow plans [King County WA]--On the heels of one of the worst winters in memory, King County is introducing some big changes to help keep people moving this season – whether they’re on a Metro bus or on a county road.

“We all know what a small amount of snow can do to our daily commute. Add a mix of snow and ice spanning several days and travel can become a nightmare,” King County Executive Kurt Triplett said. “So this year, both Metro Transit and the county’s Road Services Division will be trying some new approaches to combat snow while keeping residents better informed of impacts to bus service and road conditions.”

New tools to keep Metro riders informed
One of the biggest challenges Metro faced last year was keeping riders informed of service disruptions. The ability to provide real-time bus information won’t be available this winter, but Metro is introducing some new tools designed to speed the flow of customer information.

This season, customers will be able use the Internet to quickly see which buses in the Metro system are on snow route based on “geographic area.” Just as congestion is measured by color on congestion flow maps, the use of green, yellow or red on Metro’s new online snow map will give riders a snapshot of bus operations in each of seven geographic areas of the county. Green will indicate buses are operating on normal routes, yellow will signify minor reroutes (primarily in higher elevation areas), and red will alert customers that buses in the entire geographic area are on snow route or are being significantly impacted by snow.

If a major snowstorm spanning several days strikes, Metro will activate a newly designed Emergency Service Network for its fleet. When the network is activated, Metro’s regular routes will be replaced with 70 pre-identified “priority” snow routes across the county designed to be reliable in severe weather conditions. Metro will make every attempt to keep service operating on these routes as long as transportation service providers are able to keep roads passable.

Also new this season is an improved Metro Online website with better design and easier navigation to keep riders connected to transit information. Customers are also being encouraged to sign up online for enhanced Metro Transit Alerts being launched today that will deliver email or text messages about widespread service disruptions or weather events impacting their individual bus route.
 
Metro is also producing a booklet highlighting snow route maps and details about its new Emergency Service Network. The booklet will be available on buses and at Metro kiosks in early December.

Improved operations and coordination

Based on lessons learned last winter, Metro has revised and simplified snow routes and has closely coordinated with other public works and transportation agencies to make sure bus routes are identified as priorities for plowing and sanding. Agency leaders also negotiated a separate agreement with the city of Seattle to exchange staff during weather emergencies for improved coordination and to help the city plow streets, if necessary, in an effort to keep buses moving.

In addition to the technology and operational changes, Metro is experimenting with a new type of mud and snow tire on 65 of its standard 40-foot coaches. Based on testing, Metro believes the new tires will significantly increase performance on slick pavement.

Keeping county roads clear

The county’s Road Services Division has also been busy preparing for snow and ice removal on roads in unincorporated King County. Over the past several months, staff has been coordinating with other jurisdictions and transportation agencies to identify priority snow routes for plowing and sanding, which will benefit Metro as well as motorists.

The Road Division has worked with the state and several local cities to develop a snow route map that prioritizes snow and ice removal on major arterials, public and school bus routes, emergency corridors leading to hospitals, and access to highways.

Road Division staff has also enhanced the online Road Alert website to reflect both King County and Washington State Department of Transportation (WSDOT) road closures. During times of adverse weather, the online map and email alerts are a valuable tool for motorists.

The Road Division also has more specialized equipment this season. The division will have four additional anti-ice applicators, four new devices that pre-treat the sand before it is applied to roads for extra traction, and five dump trucks upgraded to carry both snow plows and sanders. That gives the county a total of 45 vehicles dedicated to keeping roadways passable during winter weather.

The division has also doubled its supply of anti-icing material and purchased additional storage tanks to have more on hand in more locations. The additional tanks will allow crews to refill the trucks more quickly and get the anti-icer out on the roads faster. And, it has increased its stockpile of bulk salt through a cooperative purchase with WSDOT. Not only did that get the county a better price on the salt, but the bulk quantities will also speed up operations when crews are mixing sand and salt together.

Also new this year, the division will be testing a GPS tracking application on some of its snow plows aimed at more quickly deploying crews where they are most needed. This pilot project will also help the division track and measure the effectiveness of its storm response.

These road and transit weather products are on Metro Online, and at the Road Services Division website.

Metro Transit riders without Internet access can also pick up a newly produced Metro & Snow brochure available on buses and at Metro kiosks throughout King County.

 

1104 Strong demand for seasonal flu vax strains supplies [New York City]--

With H1N1 influenza dominating the headlines, New Yorkers have turned out in record numbers for seasonal flu shots this fall – depleting vaccine supplies and prompting the Health Department to issue new recommendations for vaccination. The agency continues to recommend seasonal vaccine for all children between 6 months and 18 years of age, for all adults 65 and older, and for people with underlying health conditions that increase the risk of complications from influenza. But until vaccine supplies increase, health officials are suspending the recommendation to vaccinate healthy, non-elderly adults. The modified priority list of persons to receive seasonal influenza vaccine is as follows:

  • Children between 6 months and 18 years of age
  • Adults 65 or older
  • People 19 through 64 years of age who have underlying health conditions that increase the risk of complications from influenza*
  • Pregnant women
  • Health care workers who have direct contact with patients in the categories above
  • Caregivers of children less than 6 months old

*Conditions that increase the risk of complications from influenza include diabetes, lung disease, asthma, heart disease, kidney disease, sickle cell anemia, weakened immune system, seizure, neuromuscular, and other disorders that may cause breathing problems.

Seasonal influenza is caused by different viruses than H1N1 and requires a different vaccine. It has not begun to circulate in New York City this fall, but public concern about H1N1 influenza has heightened demand for both types of vaccine. After several weeks of brisk business – some of it driven by new regulations governing the vaccination of health care workers – many pharmacies, clinics and private providers now face diminished supplies.

Data are not available on adult vaccination rates for this season, but new Health Department figures show that children are being vaccinated in record numbers against seasonal influenza. More than 110,000 doses have already been administered to children under 5 years old, and approximately 148,000 doses have gone to children between 5 and 18 years old. These totals represent more than twice the number of immunizations given to New York City children during the same period last year. Similarly, public clinics in New York City have already vaccinated 20% more persons with seasonal influenza vaccine than they did during the entire previous year.

“Some additional supplies of vaccine are expected during November,” said Dr. Thomas Farley, New York City Health Commissioner. “But the demand may continue to exceed the supply.  The Health Department is taking steps to ensure that the available vaccine is administered to people at high risk for developing severe illness or complications from influenza. These people are either vulnerable to complications from influenza, or likely to infect vulnerable people if they contract influenza themselves. We ask healthy, non-elderly adults who are not health care workers to allow others who are at higher risk to receive vaccine until the vaccine supply increases.”

While it is still too early to predict the severity of this year’s influenza season, the Health Department is closely monitoring cases of influenza and the agency will continue to provide guidance to healthcare providers throughout the season. “The best weapon against influenza is vaccination,” Commissioner Farley said. “Because certain people are at increased risk of complications from influenza, vaccination is especially important for them.”

Influenza is a seasonal respiratory infection that causes fever with cough or sore throat and that can cause severe disease. In addition to vaccination, the Heath Department urges people to help prevent the spread of disease by following these simple guidelines:

  • Cover your mouth and nose when you cough or sneeze. Use a tissue or the inside of your elbow – not your hand.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Or use an alcohol-based hand cleaner.
  • Don’t get too close to people who are sick. Maintain a distance of 3 feet. If you get sick yourself, avoid close contact with other people.

If you feel sick (i.e., if you have a fever of 100 degrees or higher plus a cough or sore throat) stay at home until you feel better. Most people with flu-like symptoms get better on their own, without medical treatment.

For more information on influenza and sites where people in the priority groups can receive seasonal influenza vaccine, New Yorkers can visit nyc.gov/flu or call 311.

 

1104 Healthcare workers encouraged to receive H1N1 vax [Pennsylvania]--

Saying healthcare workers are “on the front lines” of battling the H1N1 flu pandemic, the Department of Health today urged healthcare professionals across Pennsylvania to be vaccinated against the H1N1 flu.
 
“With high levels of H1N1 flu being reported statewide, it is critical for healthcare workers to stay healthy and be available to care for their patients,” said Secretary of Health Everette James. “By getting vaccinated, healthcare professionals protect themselves and also their patients.”
 
James spoke at an employee immunization clinic conducted by Pinnacle Health System at Harrisburg Hospital. The hospital plans to hold additional immunization clinics for employees to encourage as many as possible to be vaccinated.
 
James also announced that a statewide H1N1 vaccination campaign targeted to healthcare workers will launch in the near future. The campaign, developed with the input of healthcare professionals, offers materials for employers to use to help increase awareness of the need for healthcare workers to be vaccinated.
 
“We’re working to inform every healthcare worker of how many lives they can protect by their decision to get vaccinated,” James added. “They not only will protect themselves, but also their families, their patients and their coworkers.”
 
All regions of the state are currently experiencing widespread influenza activity with the majority of cases reported in people between the ages of 6 months to 24 years. This age group is a priority to receive the vaccine. Other priority groups include healthcare workers, pregnant women, household contacts and childcare providers for those under six months, and those under 65 with underlying health conditions.
 
Members of the priority groups should contact their healthcare provider to learn if the H1N1 vaccine is available. If their provider does not plan to administer the vaccine or if an individual does not have a healthcare provider, please call 1-877-PA HEALTH or visit
www.H1N1inPA.com for more information.
 
Once sufficient vaccine is available, public vaccination clinics will be provided.
 
Regardless of whether individuals have been vaccinated, there are simple actions that everyone should take to slow the spread of H1N1. Those actions include:
  • Cover your mouth and nose with a tissue when you cough or sneeze, and put the used tissue in the waste basket. If you don’t have a tissue, sneeze or cough into your sleeve, but never into your hands or onto bare skin.
  • Keep your hands away from your face and don’t touch your mouth, nose and eyes.
  • Wash your hands frequently with soap and water, or use an alcohol-based hand sanitizer.
  • Keep clean frequently used surfaces such as knobs, countertops and desks.
  • Adults and children should stay home from work or school whenever they are sick, and remain home until they are fully recovered.
A wide range of H1N1 information is available online at www.H1N1inPA.com.

 

1104 Dept of Health confirms state's first pediatric death associated with H1N1 flu [Pennsylvania]--The Department of Health today confirmed that a five-year old Adams County boy died on Oct. 31 as a result of complications from H1N1 flu. This is Pennsylvania’s first pediatric death associated with H1N1.

 
To protect the family’s privacy, the department will not release additional details about the case. To date, pandemic H1N1 infection has been confirmed in 20 fatal cases of influenza in Pennsylvania.
 
“The death of this child is a very unfortunate reminder of how serious influenza can be. We extend our sympathies to his family,” said Secretary of Health Everette James. “This serves as a reminder of why we strongly urge vaccination of all children and young adults ages 6 months to 24 years against pandemic H1N1 influenza.”
 
Pennsylvania is currently seeing widespread influenza activity in all regions of the state, with the majority of the cases occurring in the younger age groups. All persons 6 months to 24 years of age are recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, or ACIP, to receive the H1N1 vaccine as soon as it becomes available.
 
Because of vaccine manufacturing delays, children may be exposed to the H1N1 virus before they are able to be vaccinated and protected. Many children who get H1N1 influenza have mild to moderate illness similar to regular seasonal influenza. Symptoms may include fever, coughing and/or sore throat, runny or stuffy nose, headaches and/or body aches, chills, fatigue and possibly vomiting and diarrhea.
 
Warning signs that indicate a child needs urgent medical attention include: rapid or difficult breathing, bluish or gray skin color, not drinking enough fluids, low urine output or no tears when crying, severe or persistent vomiting, not waking up or not interacting, being so irritable that the child does not want to be held, pain or pressure in the chest or abdomen, sudden dizziness, confusion, or flu-like symptoms that improve but later return with fever and a worsened cough.
 
Parents should contact their healthcare provider if their children have flu symptoms and also have asthma, heart, or certain other chronic underlying health conditions. Antiviral medications can be prescribed for some children to help prevent serious flu complications. These medicines work best if taken within two days of getting sick.
 
Children and adults should practice good hygiene to prevent spreading the flu. Use a tissue or sleeve to cover coughs and sneezes; keep hands away from your face and don’t touch your mouth, nose or eyes; wash your hands with soap often (washing for as long as it takes to sing “Happy Birthday” three times) or use an alcohol-based hand sanitizer; keep frequently used surfaces clean; and stay home when sick.
 
Other priority groups targeted for vaccination include healthcare workers, pregnant women, household contacts and childcare providers for those under six months, and those under 65 with underlying health conditions. 
 
The federal government has allocated more than a million doses of vaccine which the department has distributed to certified providers statewide. Members of the priority groups should contact their healthcare provider to learn if the H1N1 vaccine is available. If their provider does not plan to administer the vaccine or if an individual does not have a healthcare provider, please call 1-877-PA HEALTH or visit www.H1N1inPA.com for more information. 
 
As vaccine supplies improve, the Department of Health will begin to offer public vaccination clinics.

 

1104 Four additional H1N1-related deaths reported [Iowa]--The Iowa Department of Public Health (IDPH) today reported four additional 2009 H1N1influenza-related deaths in Iowa. The victims are identified as an adult in Dubuque County, an adult in Polk County, an adult in Mills County, and an adult in Monona County. All but one individual had medical conditions that increased the risk of complications.

“While school-age children have been most affected by the H1N1 virus over the past several weeks, surveillance is starting to show an increase in adult illness,” said IDPH Medical Director, Dr. Patricia Quinlisk. “With H1N1 vaccine continuing to be allocated to states on a staggered basis, many adults are not yet in the priority group targeted for vaccination. Until more vaccine becomes available, it’s important for all Iowans to continue to take personal action to prevent the spread of illness.

These steps include cleaning your hands frequently; covering your coughs and sneezes with a tissue or your sleeve; and containing germs by staying home when ill.

Symptoms of H1N1 influenza are similar to seasonal influenza and include a fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people with H1N1 flu also have diarrhea and vomit.

To date, Iowa has reported 11 confirmed H1N1 deaths in Iowa, including ten adults and one child. For more information about H1N1 influenza, visit www.idph.state.ia.us/h1n1. Iowans with questions about H1N1 may also call the toll-free Influenza Hotline at 1-800-447-1985.

 

1104 Protecting pets from illness [Iowa]--The Iowa Department of Public Health (IDPH) and the Iowa Department of Agriculture and Land Stewardship (IDALS) remind Iowans that in addition to protecting their families, friends and neighbors from the spread of the 2009 H1N1 influenza virus, it’s important to remember to protect family pets from the illness, as well. People who are sick with H1N1 can spread the virus not only to humans, but to some animals.

The Departments are sharing this message following the confirmation of a case of H1N1 in an Iowa cat.

The 13-year-old indoor cat in Iowa was brought to the Lloyd Veterinary Medical Center at Iowa State University’s College of Veterinary Medicine, where it tested positive for the H1N1 virus. The diagnosis is the culmination of collaborative efforts between IDPH, Iowa State University College of Veterinary Medicine, Center for Advanced Host Defenses, Immunobiotics and Translational Comparative Medicine, USDA, and IDALS Animal Industry Bureau.

“Two of the three members of the family that owns the pet had suffered from influenza-like illness before the cat became ill,” said IDPH Public Health Veterinarian, Dr. Ann Garvey. “This is not completely unexpected, as other strains of influenza have been found in cats in the past.” Both the cat and its owners have recovered from their illnesses.

People can keep their pets healthy by washing hands, covering coughs and sneezes, and minimizing contact with their pets while ill with influenza-like symptoms. If your pet exhibits signs of a respiratory illness, contact your veterinarian.

“Indoor pets that live in close proximity to someone who has been sick are at risk and it is wise to monitor their health to ensure they aren’t showing signs of illness,” said Dr. David Schmitt, State Veterinarian for Iowa.

For more information about H1N1, visit www.idph.state.ia.us/h1n1/ or call the Iowa Influenza Hotline at 1-800-447-1985.

 

 

1104 State now asking for reports of patients hospitalized with pneumonia and influenza syndrome [Alaska]--The Alaska Department of Health and Social Services is revising how it tracks hospitalized patients with influenza.

Beginning Nov. 1, 2009, the state of Alaska is asking hospitals to report the number of patients hospitalized with signs and symptoms (syndrome) of pneumonia and influenza, in addition to the number of people hospitalized with laboratory-confirmed influenza infection. Previously, only patients with lab-confirmed influenza, either seasonal or H1N1, were counted in the report.

Alaska reports hospitalizations and deaths to the federal Centers for Disease Control and Prevention (CDC) every Tuesday and publishes the results on the state Epidemiology Web site on Wednesdays.

"After discussing this choice with hospital infection control practitioners across the state, it was determined that only counting hospitalized patients with positive laboratory tests for influenza was resulting in a substantial underrepresentation of the true burden of flu-related hospitalizations in Alaska," state epidemiologist Dr. Joe McLaughlin said. "Because this new ‘syndromic’ reporting system is less restrictive, it will result in a substantial rise in the number of Alaska cases reported to CDC each week."

Seventeen other states are already reporting hospitalizations based on clinical diagnosis of pneumonia and influenza syndrome. The CDC is expecting more states to follow suit.

In order to better evaluate flu-related mortality this flu season, the state is also opening up flu-related death reporting to any person who died with lab-confirmed influenza infection, rather than just lab-confirmed flu deaths among hospitalized patients.

As of Oct. 24, 137 hospitalizations and three deaths have been attributed to any strain of influenza since Sept. 1.

For more information, go to: www.pandemicflu.alaska.gov or call the Pan Flu Hotline at 1-888-9PANFLU.

 

1103 Marion County elementary students to begin receiving H1N1 vax Nov 9 [Indianapolis IN]--The Marion County Health Department has announced that parents of Marion County elementary-aged school students in Indianapolis Public Schools (IPS) and seven other county school systems will be receiving information and consent forms for their students to get the H1N1 flu vaccine beginning Monday, November 9.

Participation in the vaccination clinics is voluntary, the clinics are for the school children only and will be given at no charge.

The school-based clinic plan is based on projected shipments of vaccine. Delays or decreases in those shipments could cause clinics to be delayed.

Along with IPS, elementary schools in Decatur, Pike, Perry, Wayne, Washington and Warren Townships, and Speedway Schools will be involved in the first of a series of clinics for school-aged children. IPS and the seven other school systems are involved because they agreed to host clinics during school hours.

Students in Lawrence and Franklin Townships and Beech Grove schools will receive the vaccine, but not during school hours. Those clinic details have not been finalized. Private, parochial, charter and other schools are part of the plan and details on clinics for those children are being finalized.

"It is critical those parents and guardians wanting their children vaccinated sign and immediately return the consent form. We must have the signed form in order to give the vaccine. The consent forms are also important because they will determine how much vaccine will be needed at each clinic site," said Virginia A. Caine, M.D., director, Marion County Health Department.

Based on participation at each school, health officials will announce later in the month when those students ages 9 and under can receive the second of the required two H1N1 vaccinations. The Centers for Disease Control and Prevention have recommended that two doses of the H1N1 vaccine are needed for those ages 6 months old to 9 years old to provide maximum protection against the virus.

Nurses will work at one township and one IPS elementary school each day. The goal is to complete these elementary schools by November 20.

During the week of November 30, middle and high school students in the four townships and IPS will be vaccinated.

The Marion County Health Department would like to have the school-aged children vaccinated before the traditional Christmas break.

 

 

1103 Almost 175,000 doses of seasonal flu and H1N1 vax given at mass flu clinics [Little Rock AR]--In one of the largest mass vaccination efforts in the state’s history, the Arkansas Department of Health (ADH) is reporting that to date a total of 172,873 doses of seasonal flu vaccine and H1N1 vaccine were given at Mass Flu Clinics across the state.

At the statewide Mass Flu Clinics, 148,961 doses of seasonal flu vaccine and 23,912 doses of H1N1 vaccine were given to Arkansans.

Dr. Paul Halverson, State Health Officer and Director, Arkansas Department of Health, said, “I am overwhelmed by the numbers of people who have received vaccinations. This will go a long way toward developing immunity in our most vulnerable populations. We will have enough seasonal and H1N1 vaccine in the coming months to give it to anyone in Arkansas that wants to be vaccinated.”

He continued, “In a few locations, the combination of bad weather, heavy demand and a limited supply of H1N1 vaccine created a rocky start. We wish that we would have had sunny skies so that families and children wouldn’t have to have been in damp, cold conditions. We appreciate the public’s patience and understanding. On behalf of the agency, I want to thank the thousands of volunteers who worked with our local health units. This was a community effort and we truly appreciate the support.”

Randy Lee, Director, ADH Center for Local Public Health, said, “I am always proud of what our local public health folks and their communities do.  But I have never been prouder knowing what they accomplished under such trying circumstances with horrible weather, huge crowds and vaccine shortages. It’s not an exaggeration to say that what they have done is both historic and heroic.”

Halverson said, “Because of the extreme shortage of H1N1 vaccine available, the ADH had to limit H1N1 vaccine availability at the Mass Flu Clinics to include children ages 6 months through 4 years, any child 5 to18 with underlying medical conditions and pregnant women. “

As Arkansas gets more H1N1 vaccine, those doses will continue to be given to priority groups first. Priority groups include pregnant women, children ages 6 months through 24 years, health care workers and emergency medical responders, people caring for infants under 6 months of age, and people ages 25-64 years with underlying health conditions. Eventually, there will be enough vaccine for any Arkansan who wants it.

It is important that every Arkansan get both the seasonal and H1N1 flu vaccine during this flu season. Additional Mass Flu Clinics will be scheduled at later dates.

For more information on novel H1N1 influenza A (Swine Flu) and seasonal flu, click on www.healthyarkansas.com or www.cdc.gov.

 

1103 First child H1N1 death reported [Iowa]--The Iowa Department of Public Health (IDPH) is reporting the first death of a child associated with the 2009 H1N1 virus in Iowa. The victim, a child in eastern Iowa who died in October, had factors that increased the risk of complications from H1N1.

 

“Surveillance is showing a steady increase in pediatric illness and hospitalizations,” said IDPH Medical Director, Dr. Patricia Quinlisk. “This death is a somber reminder of the importance of protecting Iowa’s children from this flu.”

According to the CDC, all children, especially those ages 5 years or younger, and those with chronic medical conditions, are at increased risk for complications and death from influenza. Even children who are otherwise healthy can have complications and severe or fatal outcomes after influenza infection.

Symptoms of H1N1 are similar to seasonal influenza and include: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. A significant number of people with H1N1 have also reported diarrhea and vomiting.

If your child is ill, it is important to remember they drink plenty of fluids and rest. Remember, children under the age of 18 should not take aspirin when they have the flu.

In children, urgent warning signs indicating the need for urgent medical attention include:

  • Fast breathing or trouble breathing
  • Bluish or gray skin color
  • Not drinking enough fluids
  • Severe or persistent vomiting
  • Not waking up or not interacting with people and things around them
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve, but then return with fever and worse cough

All children greater than 6 months of age; and the caregivers and those living with children less than six months of age, should receive seasonal influenza vaccine and be among the priority target group for the 2009 H1N1 vaccine.

For more information about H1N1 influenza, visit www.idph.state.ia.us/h1n1. Iowans with questions about H1N1 may also call the toll-free Influenza Hotline at 1-800-447-1985.

 

1103 Two additional H1N1 flu-related deaths announced [Kansas]--The Kansas Department of Health and Environment (KDHE) today confirmed the deaths of two people who were infected with the pandemic H1N1 influenza virus.  Fourteen people in Kansas have now reportedly died after being infected with H1N1.

The deaths occurred in the following individuals:

  • A 72 year-old man from northeast Kansas* was confirmed to have pandemic H1N1 on October 29.  His death was reported to KDHE on October 30.  The man had an underlying health condition which placed him at greater risk of severe complications of influenza.
  • A 53 year-old woman from the Wichita metropolitan area* was confirmed to have pandemic H1N1 on October 27, and her death was reported to KDHE on November 2.  This woman had an underlying health condition which placed her at greater risk of severe complications of influenza.

KDHE Secretary Roderick Bremby and Dr. Jason Eberhart-Phillips, Kansas State Health Officer, expressed sympathy and offered their deepest condolences to the families involved.

“People with specific underlying health conditions are at especially high risk of serious health problems if they get H1N1 flu,” said Dr. Eberhart Phillips. “While we wait for enough vaccine to become available to protect everyone against this infection, there are still many steps we all can take to reduce its spread.”
Those precautions include:

  • Wash your hands thoroughly with soap and warm water or use an alcohol-based hand sanitizer to get rid of most germs and avoid touching your eyes, nose and mouth.
  • If you become sick, stay home until at least 24 hours after fever or signs of fever without the use of fever-reducing medications, in order to avoid spreading illness to co-workers and friends.
  • Cough or sneeze into a tissue and properly dispose of used tissues.  If you do not have a tissue, cover your cough or sneeze with your elbow and not your hands.  
  • Stay healthy by eating a balanced diet, drinking plenty of water and getting adequate rest and exercise.

The H1N1 vaccine has started to arrive in Kansas, but at this time in very limited quantities. Certain individuals are recommended to receive the vaccine earlier.  For more information on vaccine prioritization, please visit www.kdheks.gov/H1N1/H1N1_Vaccine.htm.

Up-to-date information on H1N1 vaccination clinics being held across the state can be found by going to www.kdheks.gov and clicking on “Where can I receive the H1N1vaccine?”

The symptoms of infection with the pandemic H1N1 virus are similar to the symptoms of seasonal flu and include fever of 100 degrees or greater, body aches, coughing, sore throat, respiratory congestion, and in some cases, diarrhea and vomiting.  Most people who have been ill with pandemic H1N1 influenza have recovered without medical treatment.

However, some people develop serious complications that require hospitalization or may lead to death.  Although serious complications are more likely among persons with certain underlying chronic health conditions, this pandemic influenza virus has caused serious complications and deaths among persons without such factors.  Unlike typical seasonal influenza, the 2009 H1N1 virus is causing a greater disease burden among adolescents and young adults.  Severe illness from H1N1 virus infection can even occur among relatively young, healthy persons.

KDHE is no longer accepting specimens from everyone who sees a doctor with symptoms.  In non-hospitalized cases, confirmatory testing does not affect treatment and advice given to patients by health care providers. 

Most children and adults with the flu who are generally in good health will recover without needing to visit a health care provider.  Some people may want to call their health care provider for advice on how to care for the flu at home.

Individuals who experience severe illness or who are at high risk of complications from H1N1 influenza infection, including children less than 5 years of age, adults 65 years of age and older, pregnant women, and persons with chronic medical conditions (including asthma, diabetes, heart disease, and other conditions), should contact their health care provider.

KDHE has established a phone number for concerned Kansans to call with questions about the 2009 H1N1 influenza A virus.  The toll-free number is 1-877-427-7317.  Operators will be available to answer questions from 8 a.m. – 5 p.m. Monday through Friday.  Persons calling will be directed to press “1” on their touch-tone phone to be directed to an operator who can answer questions.

Kansans with questions about the virus can email H1N1fluinfo@kdheks.gov.  Information is also available from KDHE at www.kdheks.gov

 

1103 State health dept asks for citizens' cooperation as H1N1 vax efforts continue [Denver CO]--Increasing supplies of 2009 H1N1 influenza vaccine in Colorado are allowing several county health departments and other vaccination providers to continue their vaccinations of people at higher risk for flu complications, according to the Colorado Department of Public Health and Environment. To date, the state has received approximately 250,000 H1N1 doses. It’s estimated a total of 2 million doses are needed in Colorado for all individuals in the priority groups to receive their vaccination.

“We are pleased that the supply of the 2009 H1N1 influenza vaccine continues to increase,” said the state’s Chief Medical Officer Ned Calonge. “We are asking citizens to listen carefully to the messages they get from their county health departments regarding vaccine availability. All of these agencies are doing their best to deliver vaccine to the highest-risk individuals first, but they can only do this with the cooperation of citizens.”

For a list of county health department Web sites or flu clinic locations, go to http://www.colorado.gov/nofluforyou. Because the county health departments are fielding many calls regarding flu vaccinations, the public is urged to first go to local health departments’ Web sites when seeking information. Individuals with questions about H1N1 also may call CO HELP, Colorado’s flu hotline, at 1-877-462-2911. The hotline has been established to respond to questions about H1N1 and seasonal influenza. Operators can provide callers with flu clinic locations as well.

While some Colorado counties are finished vaccinating their health-care workers who have direct patient contact and are ready to move on to the other high-priority groups, other counties still have to concentrate only on the health-care worker population, according to Calonge.

The following list of individuals is CDC’s official priority group list. After health-care workers with direct patient contact receive vaccinations, other individuals in the priority 2009 H1N1 groups include

  • pregnant women;

  • household contacts and caretakers of children under 6 months of age;

  • all children between 6 months and 24 years of age;

  • all health-care workers;

  • adults 25 years to 64 years of age with underlying risk conditions.

As an example of areas of the state that are making progress in terms of vaccine distribution, Calonge said the Grand Junction area has been able to vaccinate some health-care workers with direct patient contact and will gradually include other priority groups as vaccine allows. On the other end of the equation, several health departments in the Denver metropolitan area and other parts of the state need additional vaccine doses before they can move beyond vaccinating health-care workers with direct patient contact. “The state health department supports local health officials’ decisions in vaccinating priority groups in the way that is most appropriate for their community based on vaccine type and quantity,” Calonge said.

Calonge thanked Colorado citizens for their patience, stating, “We know this is a challenging and frustrating time for everyone involved. However, we’ve been very impressed with the understanding we’ve seen from people who are anxiously awaiting their H1N1 vaccination.”

As director Rick Ritter of Otero County Health Department shared, “I recently addressed a waiting crowd at our flu clinic in Ordway to explain why high risk individuals needed the vaccine sooner. Afterward, a man who was in front of the line said, ‘I understand. They need it more than I do. I can wait.’ This sentiment characterized most people that could not get their vaccination that day. I truly appreciate their patient and understanding attitude.”

Calonge urged individuals to do what they can to stop the spread of this disease while they continue to wait. This includes staying home when they’re sick, coughing into their sleeve or a tissue and washing their hands frequently.”

 

1103 State health dept addresses confusion over nasal flu vax [Denver CO]--Due to repeated reports on concerns about the nasal flu vaccine called FluMist and an expectation that significant quantities of FluMist and injectable vaccine will be arriving in Colorado soon, the Colorado Department of Public Health and Environment Tuesday alerted the public to the benefits of receiving FluMist, to dispel any myths and confusion associated with the medication.

“FluMist is a very valuable tool in our fight against flu, so we’re concerned about the misinformation that is circulating regarding this vaccine,” said Chief Medical Officer Ned Calonge. “This is a critical time in our flu-fighting efforts because we anticipate several additional categories of people soon will be able to get the flu vaccinations for both seasonal and H1N1 influenza.”

FluMist is a live, attenuated, influenza vaccine (LAIV). Because the LAIV uses a weakened live flu virus, it differs slightly from the injectable vaccine, which uses a killed virus. Both vaccines have a small amount of flu virus in them to cause vaccinated people’s bodies to create antibodies that protect them from infection from the flu.

“The live virus in the FluMist vaccine is a very weakened virus, so it allows the body to respond to the virus’ presence without getting the vaccinated person sick,” Calonge explained.

People, including health-care workers, between the ages of 2 and 49 can receive FluMist vaccine. A very small group of health-care workers are recommended not to receive the vaccine. “LAIV is a very good option for most health-care providers who are healthy, younger than 50 years old and not pregnant,” according to a statement from the U.S. Centers for Disease Control and Prevention.

“However, health-care providers should not get LAIV if they are providing medical care for patients who require special environments in the hospital because they are profoundly immunocompromised (e.g., those who work in bone marrow transplant units).”

Although no immunocompromised patient has been shown to be harmed by use of LAIV among attending health-care workers, the recommendation against the use of LAIV in health-care workers with this type of patient contact is intended as an extra precaution for fragile immunocompromised patients, according to CDC.

“We believe the recommendation against a small group of health-care providers not getting the LAIV has caused some members of the public to misunderstand the underlying safety of the vaccine, and to opt against using this important flu-fighting medication,” Calonge said.

Throughout the fall, Calonge, along with CDC officials, has stressed the safety of both the LAIV and injectable flu vaccines. “These are safe vaccines that are made in the same way as flu vaccines are made each year,” he noted.

Coloradans looking for flu vaccination clinics may go to http://www.immunizecolorado.com and click the link for “Find a flu clinic.” They can search by city, town or zip code to find locations where vaccines are available. People also can receive this information by calling the CO HELP hotline at 1-877-462-2911.

 

1103 H1N1 vax continues to arrive; cases peaked week of Oct 10 [Denver CO]--While officials at the Colorado Department of Public Health and Environment expect the total number of H1N1 hospitalized cases and deaths to increase, there are indications that influenza activity has peaked in the Denver-Boulder metropolitan area.

Data from several surveillance activities indicate the peak of hospitalizations and influenza-like illnesses occurred during the week ending Oct. 10. Officials noted that this is only the beginning of a decline and Colorado still is in the middle of a historic influenza season.

“Our surveillance of flu activity in the Denver area the past three weeks has shown a leveling off and decline in the number of hospitalized cases being reported. However, it still is vitally important for Coloradans in the vaccine priority groups to get the H1N1 vaccine when it becomes available,” said the state’s Chief Medical Officer Ned Calonge. “To date the state has received approximately 270,000 doses of vaccine.”

“We continue to work closely with local public health agencies and hospitals in the state on H1N1 activity,” said Calonge. “In most cases local public health agencies are directing the vaccines to health care providers and hospitals to administer to priority populations first. As some communities complete H1N1 vaccinations to health care workers, we are seeing some communities expand the availability of the vaccine to other priority populations.”

The following individuals who are in the high-risk group for experiencing complications from H1N1 are advised to be the first in line to receive an H1N1 vaccine:

  • Health care workers with direct patient contact

  • Preschool children ages 6 months to 4 years

  • School-age children and young adults ages 5 to 18 with chronic health conditions

  • Pregnant women

  • Parents/caretakers for children younger than 6 months

While the initial vaccine deliveries to Colorado have amounted to less that anticipated, U.S. Health and Human Services Secretary Kathleen Sebelius said Monday that eventually there will be enough supplies for everyone who wants to get vaccinated.

“We are receiving more H1N1 vaccines each week and they are being distributed through the state’s network of public health agencies,” said Calonge. “As the vaccination needs of health care workers in various communities are met, vaccine distribution will extend to other priority populations.”

Through Oct. 24, a total of 1,306 hospitalizations from 46 counties in Colorado have been reported. Twenty-five deaths (seven pediatric and 18 adult) have been reported. State laboratory surveillance continues to show that more than 99 percent of influenza viruses currently circulating in Colorado are the 2009 H1N1 virus.

The department has added an online link to a free and secure interactive Web site that walks patients through a series of questions to determine the severity of their flu symptoms based on the latest Centers for Disease Control and Prevention guidelines. The link can be found at https://www.amafluhelp.org/Public/Consumer/Home.aspx .

Using this site can help patients assess their own flu symptoms, or those of a child or loved one, and the site offers guidance on whether they should seek care. There also is an opportunity for pregnant women to evaluate their need for a flu vaccine. The site also can generate a doctor’s note when it is safe to return to work or school. Personal information entered into the system is treated as private and secure.

“We are hopeful that this new American Medical Association tool will help reduce demands on our health care system,” said Chris Lindley, director of the Emergency Preparedness and Response Division of the Colorado Department of Public Health and Environment.

While AMAfluhelp.org is a useful tool for those who aren’t sure whether they have a cold or the flu, it does not take the place of a visit to the doctor’s office if symptoms are severe. Anyone who exhibits severe symptoms, such as a very high fever or difficulty breathing should contact his or her physician immediately or seek urgent care.

Individuals with questions about H1N1 are encouraged to call CO HELP at 1-877-462-2911. The hotline has been established to respond to questions about H1N1 and seasonal influenza.

 

1103 More than 24,000 vax'd during first week of H1N1 program [Prince Edward Island]--The Department of Health is pleased with the cooperation of the public during the first week of the H1N1 vaccination program on PEI. Over 24,000 people in Prince Edward Island were vaccinated this week during the first week of the province’s vaccination program.

“We would like to thank Islanders for their patience as we roll out the largest vaccination program in the history of our province,” said Health Minister Doug Currie. “We are pleased at the amount of people we were able to vaccinate during our first week and we will continue to target those who are most at risk.”

“This past week, we received a lower-than-expected supply of H1N1 influenza vaccine,” said Dr. Heather Morrison, Chief Health Office for the Department of Health. “We are pleased with our decision to focus first on those at highest risk for complications from the H1N1 Flu Virus, as identified nationally by the Public Health Agency of Canada because this reinforces the fact that our decision to target those at highest risk is appropriate.”

Provinces receive their vaccine supply through the Public Health Agency of Canada and the vaccine is delivered to provinces on a week-to-week basis per capita. Based on the reduction of vaccine arriving in the province this week, the province has adjusted their vaccination schedule to make the most effective use of the vaccine currently available. “At this point, our vaccination schedule relies heavily on how much vaccine we receive from the national supplier,” said Dr. Morrison.

Half of the expected vaccine doses allotted from the national supply for the coming week, arrived in the province on Thursday and was distributed to sites across the province to continue to vaccinate those at highest risk. With remaining doses, the focus will be to continue to target those in high risk groups.

This week, the province plans to continue to hold clinics for high risk groups, such as children aged six months to school entry and household contacts of infants under six months of age and those with chronic health conditions under the age of 65. All remaining health care workers, pregnant women and aboriginal population are being targeted this week as well.

The province is also expecting to receive their first shipment of unadjuvanted vaccine on Monday and will begin holding additional clinics for pregnant women this week. As well, in keeping with the original vaccine rollout schedule, the province will move into elementary schools later this week to start vaccinating children in elementary schools, starting with students up to and including Grade 3.

Other high risk groups, such as those with egg allergies who have underlying health conditions will also be targeted this week. Those who have egg allergies are encouraged to call the province’s toll-free line (1-888-748-5454) to have their name added to a list, if they have not done so already.

For further information on upcoming clinics, the public should watch for advertisements, visit www.gov.pe.ca/flu or call 1-888-748-5454 for the most up-to-date information on immunization clinics.

 

1103 Pediatric H1N1 flu-related death confirmed [Yukon]--Yukon’s Medical Officer of Health Dr. Brendan Hanley confirmed today that Yukon has had its first death linked with the H1N1 Influenza. “This is a very sad event and I send my deepest condolences to the family,” Hanley said.


The Public Health Agency of Canada’s last published statistics says there have been 95 deaths in Canada attributed to H1N1, and 80 per cent of victims had underlying medical conditions.


The young girl did have a chronic medical condition. She was admitted to hospital last week before being transferred to pediatric ICU in Vancouver last Monday. She died Sunday evening. Testing has confirmed she did have the H1N1 flu virus.


“This is a strong reminder that influenza is not something to be taken lightly,” Hanley said. “Every year in Canada, there are between 3,000 and 5,000 deaths. As a whole, we are seeing smaller numbers of deaths with this virus than from regular influenza; however we are seeing younger people affected. It is more important than ever for Yukoners to take proper precautions to protect themselves and others, including getting vaccinated.”


Dr. Hanley said that H1N1 has been circulating widely in Yukon since mid-October.
 

“The people who have been ill, for the most part, have only been mildly ill. Five patients with H1N1 to date have been admitted to hospital in Yukon. One was treated and released and the other three are recovering,” Hanley said.

 

 

1103 MOH confirms H1N1 outbreak at Whitehorse Correctional Centre [Yukon]--Yukon’s Medical Officer of Health, Dr. Brendan Hanley, confirmed today the first outbreak of H1N1 at the Whitehorse Correctional Centre (WCC).

“At WCC, we are dealing with a small number of inmates who are ill,” Hanley said.

Affected inmates have been isolated and are receiving treatment from the jail health staff. Vaccinations at the centre for inmates and staff began Thursday, and Yukon Communicable Disease Control (YCDC) has been working with WCC to coordinate the outbreak response.

“We are fortunate that we have not seen an outbreak before now in any of our residential facilities,” Hanley added. “However, we do have plans in place to address the outbreak.”

 

 

1103 New flu assessment clinic to lighten load [Yukon]--Beginning tomorrow, Whitehorse residents who think they may need medical treatment for influenza will have another option to calling 811, visiting their physician or going to the hospital.

Health and Social Services Minister Glenn Hart announced today that the government is establishing a flu-assessment clinic at Taiga Clinic.

“Influenza activity in Yukon is on the rise,” Hart said. “Medical clinics and the emergency room at the hospital are seeing more and more patients. A dedicated flu-assessment clinic will relieve the pressure on the clinics and hospital and make it easier for people to be assessed by a doctor.”

The Taiga Clinic, located at 210 Elliot Street, will be open to flu patients from 2 p.m. to 8 p.m., seven days a week. The clinic will be staffed by physicians and support workers from other clinics. If there is sufficient demand, clinic hours can be extended with 24 hours notice.

“One of our public health messages is that if you are sick, stay home and stay away from others to keep from passing on the virus,” Medical Officer of Health Dr. Brendan Hanley said. “But we do want to ensure that people have access to a doctor when they need one. We also want to protect patients from unnecessary exposure to the H1N1 influenza virus while seeing their family doctors for other medical reasons.”

However, patients will have the option to see their own doctors, according to their availability and advice.

“The department and physicians are working together to increase our capacity to provide medical services during the pandemic,” Hart added.

The flu assessment clinic will be drop-in. No appointments will be required.

 

 

1103 H1N1 unadjuvanted vax available by appointment this week for pregnant women up to 20 wks [Newfoundland and Labrador]--The Honourable Jerome Kennedy, Minister of Health and Community Services, announced today that a supply of H1N1 unadjuvanted vaccine will be available later this week for women in the first half of pregnancy (up to 20 weeks).

"We will be receiving 2,900 doses of the unadjuvanted vaccine tomorrow and will be able to offer it to pregnant women the first half of their pregnancy on an appointment basis," said Minister Kennedy. "Pregnant women are asked to contact their regional health authority to make an appointment to receive the vaccine later this week."

Starting today, women are asked to call the toll free lines established by regional health authorities to make an appointment to receive the vaccine. Appointments will start on Wednesday, November 4 and will be separate from the regular immunization clinics. The toll free lines are as follows:

Eastern Health 1-877-752-4358
Central Health 1-877-311-2613
Western Health 1-877-632-H1N1(4161)
Labrador-Grenfell Health 1-877-896-0422

H1N1 vaccination clinics continued today for the high risk categories put in place this past weekend which include:

  • Children six months up to 59 months (up to fifth birthday)
  • People five years of age up to and including 24 years of age with chronic conditions
  • Pregnant women in the second half of their pregnancy (20 to 40 weeks)
  • Parents or other primary care providers (up to two per child) of children under the age of six months; and of immunocompromised children and young adults (up to and including 24 years of age) who cannot themselves be vaccinated.
  • Minister Kennedy added that he will provide further details about our plans for the small supply of adjuvanted vaccine that the province will receive on November 4.

    "I assure everyone that we will eventually receive enough vaccine for anyone who wants it and I ask for patience as we attempt to deal with this national vaccine shortage," said Minister Kennedy.

     

    1103 H1N1 priority groups further restricted [New Brunswick]--The chief medical officer of health for New Brunswick advised on Friday afternoon, Oct. 30, that the priority groups for H1N1 vaccination clinics are now restricted to the following:

    • front-line health-care workers;
    • children aged six months to18 years;
    • parents of children under six months old;
    • pregnant women - 20 weeks or more;
    • pregnant women - fewer than 20 weeks, and with underlying medical conditions; and
    • First Nations individuals (on reserve, only).

    This restriction is in place to ensure that the highest priority groups are vaccinated soonest.

    Those with chronic diseases should not go to the clinics that are currently advertised. There will be targeted approaches in the coming weeks to reach those with chronic medical conditions. The Department of Health is working with provincial chronic-disease specialists to develop opportunities for these groups.

    Individuals who are not members of a priority group should wait until clinics for other priority groups and the general public open later in November. Clinics being held in health-care facilities are for front-line health-care workers, front-line health-care volunteers, and front-line health-care students only, and not for the general public. It is very important that everyone work together to protect those most vulnerable.

    Complete clinic listings may be found at www.gnb.ca/flu, or by calling 1-800-580-0038. Clinic listings are being updated continually. Wait times on the 1-800 line are being improved. More clinics will be added as more vaccine is received from the federal supplier. Clinics will run from now until Christmas. If those wishing to receive the vaccine do not see a clinic listing at a convenient date, time or location for their priority group, they should check again in a few days.

     

    1103 Initial results show pregnant women mount strong immune response to one dose of H1N1 flu vax [United States]--Healthy pregnant women mount a robust immune response following just one dose of 2009 H1N1 influenza vaccine, according to initial results from an ongoing clinical trial sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health.

    "For pregnant women, who are among the most vulnerable to serious health problems from 2009 H1N1 infection, these initial results are very reassuring," says NIAID Director Anthony S. Fauci, M.D. "The immune responses seen in these healthy pregnant women are comparable to those seen in healthy adults at the same time point after a single vaccination, and the vaccine has been well tolerated."

    According to the Centers for Disease Control and Prevention, since the outbreak began last spring, at least 100 pregnant women have been hospitalized in intensive care units in the United States and at the last official count, 28 pregnant women have died.

    A preliminary analysis of blood samples taken 21 days post-vaccination from a subgroup of 50 pregnant women participating in the trial shows the following:

    * In 25 women who received a single 15-microgram dose of the vaccine, the H1N1 flu vaccine elicited an immune response likely to be protective in 92 percent, or 23 of 25, of these women.
    * In 25 women who received a single 30-microgram dose of the vaccine, the H1N1 flu vaccine elicited an immune response likely to be protective in 96 percent, or 24 of 25, of these women.

    The trial began on Sept. 9 and reached its target enrollment of 120 volunteers in mid-October. All participants are between 18 to 39 years old and began the study in their second or third trimester (14 to 34 weeks) of pregnancy. At entry into the study, the participants were divided at random into two groups: half are receiving two doses of a 15-microgram vaccine and the other half are receiving two doses of a 30-microgram vaccine. The two injections of vaccine are spaced three weeks apart.

    Safety is being monitored closely in the trial, by the study investigators and by an independent panel of experts known as a safety monitoring committee. To date, the vaccine appears to be well-tolerated, and no safety concerns related to the vaccine have arisen.

    The vaccine used in this clinical trial was manufactured by Sanofi Pasteur in its plant in Swiftwater, Pa., in the same manner as the company’s injectable seasonal influenza vaccine. Like the seasonal flu vaccine, the 2009 H1N1 flu vaccine contains a purified portion of the killed virus and therefore cannot cause infection. The vaccine does not contain the preservative thimerosal or an immune boosting substance known as an adjuvant.

    NIAID is conducting this trial through five clinical sites affiliated with its longstanding clinical trials network known as the Vaccine and Treatment Evaluation Units.
     

     

    1103 Survey: Awareness of COPD is rising but understanding is still low [United States]--Awareness of COPD — chronic obstructive pulmonary disease — continues to grow in the United States, according to national survey results released today by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.

    Sixty-eight percent of adults are now aware of COPD, a disease that affects 1 in 5 people over age 45, compared with 64 percent last year, and 49 percent in a 2004 survey. Among a high risk group, those who are currently smoking, awareness rose to 74 percent compared to 69 percent a year ago.

    Less than half of all adults, 44 percent, understand that the disease can be treated. November is National COPD Awareness Month.

    "Awareness is an important first step," said James P. Kiley, Ph.D., director, NHLBI Division of Lung Diseases. "However, awareness alone is not enough. People at risk of developing the disease need to know what the disease looks and feels like, and most importantly, to understand that it can be treated. The key is to get tested and start treatment as soon as possible."

    COPD, which is sometimes referred to as chronic bronchitis or emphysema, is a serious lung disease affecting 24 million men and women in the United States. However, half of them remain undiagnosed despite recognizable symptoms such as shortness of breath while doing activities that used to be easy, wheezing, or chronic cough (sometimes called a "smoker’s cough") Eight out of 10 cases of COPD are due to smoking, typically affecting those over 40. The remaining cases are due to genetics or other environmental exposures.

    The survey showed that physicians maintain an optimistic view about COPD treatability. Approximately 9 out of 10 primary care physicians agree that available treatments can optimize quality of life for their patients with COPD. However, the survey also showed that this message may not be familiar to their patients.

    Symptoms of COPD were approximately two times more common among current smokers than former smokers, but current smokers are only half as likely to talk to their doctors about these symptoms. Survey results also showed that 41 percent of current smokers do not talk to their doctors about these symptoms because they do not want to hear another quit smoking message.

    COPD is diagnosed with a simple noninvasive breathing test called spirometry, which can be conducted in a doctor's office. Taking the test involves breathing hard and fast into a tube connected to a machine which measures the total amount of air exhaled, called the forced vital capacity or FVC, and how much air is exhaled in the first second, called the forced expiratory volume in one second or FEV1.

    "We know that for many people, taking the step to talk to a doctor about their smoking and symptoms is difficult," said Kiley. "But these actions, including testing of lung function, should be seen as proactive for better health."

    The NHLBI analyzed the results of the annual HealthStyles and DocStyles surveys of the public health attitudes, knowledge, practices, and lifestyle habits of consumers and health care professionals, conducted each year by Porter Novelli, communications contractor for NHLBI's COPD Learn More Breathe Better campaign. The results represent a sample of 4,172 consumers through a mailed survey with a margin of error of plus or minus 1.5 percentage points and 1,000 physicians through a Web-based survey with a margin of error of plus or minus 3.1 percentage points. Both surveys were conducted in summer 2009.

    The NHLBI initiated the first national awareness campaign on COPD, called the COPD Learn More Breathe Better campaign, in 2007 to improve knowledge about COPD among those already diagnosed and at risk for COPD, as well as health care providers — particularly those in a primary care setting. The program's new effort, Country Conquers COPD, aims to reach and raise knowledge of COPD among people at-risk at country-themed fairs and festivals across the country.

     

     

    1103 H1N1 vax distributed to more than 900 providers [Pennsylvania]--“While delays in vaccine production have occurred, the department continues placing orders as soon as vaccine is allocated to ensure it reaches Pennsylvania residents as quickly as possible,” said Secretary of Health Everette James. 

     
    The vaccine has been distributed to 927 certified providers, including pediatricians, family health practitioners, obstetricians, hospitals, schools, colleges and universities that agreed to target the groups of people considered most vulnerable to complications from the H1N1 virus.
     
    Priority groups for receiving the H1N1 vaccination include pregnant women; persons six months to 24 years old; healthcare providers and emergency medical services personnel; parents, household members or caregivers of children under six months; and those under 65 with certain underlying medical conditions.
     
    Members of priority groups should contact their healthcare provider to find an H1N1 vaccination site. If their provider does not plan to administer the vaccine or if an individual does not have a healthcare provider, please call 1-877-PA HEALTH or visit www.H1N1inPA.com. Public vaccination clinics will be held across the state once sufficient vaccine becomes available.

     

    1103 H1N1-related death reported [Nebraska]--Douglas County reported a H1N1 death to the Nebraska Department of Health and Human Services. The man was in his 50s and had a health condition. He tested positive for H1N1 early last week.

    Because of state statutes, the name and other details about the person can’t be released.

    “As always, I am deeply saddened by the loss of another Nebraskan and my thoughts go out to his family,” said Dr. Joann Schaefer, Chief Medical Officer for the Nebraska Department of Health and Human Services. “H1N1 activity is widespread across the state and unfortunately, we will see more illness.”

    So far, there have been a total of eight H1N1 flu deaths reported in Nebraska. DHHS will continue to track deaths from H1N1.

     

     

    1103 First H1N1-related death announced [North Dakota]--The North Dakota Department of Health announced today the state’s first H1N1 influenza-related death, according to State Health Officer Terry Dwelle, M.D.


    The individual was a resident of northwestern North Dakota. According to Dwelle, the man was older than 60 and had underlying medical conditions.


    “We extend our sympathy to the family and loved ones of the gentleman who died,” Dwelle said. “This loss should remind all of us that influenza, whether seasonal or H1N1, can be a serious illness for some people.”


    As of Wednesday, Oct. 21, 2009, a total of 1,216 cases of influenza had been reported to the Department of Health. It is estimated that about 92 percent of the influenza circulating in North Dakota is H1N1.


    “It’s so very important that we all do our part to help stop the spread of influenza,” Dwelle said. “That’s why we keep urging people to wash their hands often throughout the day, cover their coughs and sneezes, and stay home when they are sick. These simple steps can make a huge difference in stopping the spread of flu.”


    Late this week, 21,000 doses of H1N1 influenza vaccine will be allocated to the state. This allocation will consist of both the nasal spray FluMist and the injectable flu shot. The allocated doses will be shipped to various providers throughout North Dakota next week.

     

    The North Dakota Department of Health has activated a toll-free public health hotline for people to call if they have questions about influenza. (The hotline cannot provide medical advice to callers. For that information, people should call their physicians.) The number to call is 866.207.2880. The hotline is available Monday through Friday from 8 a.m. to 5 p.m. Central Standard Time. Information about influenza also is available on the Department of Health’s influenza website at www.ndflu.com.

     

     

    1103 Families asked to be patient while waiting for H1N1 vax [Louisiana]--The Louisiana Department of Health and Hospitals updated the status of the state’s Fight the Flu campaign today. As the H1N1 vaccination campaign moves forward, it is important for Louisiana families to be patient if their provider has not yet received the H1N1 vaccine, as more vaccine is arriving every week. Residents should stay in contact with their provider as to the vaccine’s availability and to make an appointment when the time comes.

    State Health Officer Jimmy Guidry, M.D., also announced that the Governor has proclaimed this week Pneumonia Awareness Week in Louisiana. Approximately 50,000 Louisianians contract pneumonia annually. In 2006, the latest year for which numbers are available, 1.2 million people in the U.S. were hospitalized with pneumonia and 55,477 people died from the disease. These numbers are despite the fact that a vaccine is available to combat many forms of bacterial pneumonia, and the vaccine is widely available throughout the country.

    "Pneumonia is one of the most common causes of death in America from a vaccine-preventable disease, and is a common complication associated with severe cases of both seasonal and H1N1 flu," said Dr. Guidry. "According to the CDC, about 20 percent of fatalities nationwide from H1N1 have been influenza leading to a bacterial pneumonia. This underscores the importance for those in pneumonia target groups to receive the pneumonia vaccine. It can save lives."

    The pneumococcal conjugate vaccine, PCV7, can be used in children under the age of 2 years. This age group is also a high-risk group for H1N1. This is especially important when considering that children under six months cannot receive any sort of flu vaccine, but those between two and six months can get the PCV7 vaccination.

    The pneumococcal polysaccharide vaccine (PPSV) is currently recommended for use in all adults who are older than 65 years of age and for people who are two years and older and at high risk for disease. The CDC also recommends it for any adult 19 through 64 years of age who is a smoker or has asthma. People over two years old with pre-existing conditions are also one of the high-risk groups for H1N1.

    Louisianians are encouraged to contact their health care provider as to whether or not they should receive the pneumonia vaccine. According to the National Foundation for Infectious Diseases, the pneumococcal vaccine has been available for more than 20 years in the United States, yet more than one-third of people 65 years of age and older reported that they have not received the pneumococcal vaccine, and fewer than 20 percent of adults in other high-risk groups who should get the pneumococcal vaccine have received it.

    This Week’s H1N1 Vaccination Campaign Highlights

    • Of the 332,700 doses of H1N1 vaccine the state has ordered, the CDC reports that approximately 253,800 doses of H1N1 vaccine have been shipped to Louisiana as of Wednesday, October 28.
    • 544 providers in Louisiana have administered 31,094 doses of H1N1 vaccine.
    • It is important to remember that even though a provider has received H1N1 vaccine, it will take time to schedule appointments and vaccinate his or her target population.
    • The CDC reports on the national level that as of Friday, October 30, 26.6 million doses of vaccine were available nationwide, a 65 percent jump from the 16.1 million available October 23.

    H1N1 Vaccination Campaign Summary

    • LAIV nasal spray vaccine continues to be available through registered providers, including pediatric providers.  Most of these doses have been slated for use in children.
    • Additional shipments of H1N1 vaccine are expected every 5 to 10 days for the next 2 to 3 months, with pregnant women, front line health care workers, parents and other caregivers of children less than 6 months of age, and adults with pre-existing medical conditions as the next target groups for vaccination.
    • Every Louisianian who wants the vaccine should have access by the end of January.
    • Residents should check with their providers regarding the availability of H1N1 vaccine.
    • DHH will soon post a flu shot locator on www.FightTheFluLA.com, showing locations where vaccine will be available to the public in the target groups across the state.
    • DHH has launched a Twitter feed (FightTheFluLA) and a Facebook page to help ensure teenagers and young adults, both of which fall into high-risk groups for H1N1, have easy access to up to date information regarding the H1N1 virus and vaccine.

    Overall Influenza Activity

    • There are now 1,706 lab confirmed cases of the H1N1 flu in the state of Louisiana.
    • Estimates derived by DHH in conjunction with CDC data indicate approximately 121,000 Louisianians currently have or have had the H1N1 flu.
    • DHH has confirmed six additional H1N1-related deaths in the past week, bringing Louisiana’s total to 30:
      • Two male children and two adult females from Region IV, the seven-parish area including Lafayette
      • A male child from Region V, the five-parish area including Lake Charles
      • An adult female from Region IX, which includes Livingston, St. Helena, St. Tammany, Tangipahoa, and Washington parishes.

     

    1103 Pregnant women targeted for H1N1 vax [Iowa]--Three weeks after the 2009 H1N1 influenza vaccine began arriving in Iowa, the supply continues to be allocated to counties on a staggered basis. Until the vaccine is widely available, vaccination priority groups have been established to target those individuals known to be at highest risk for complications from H1N1.

    Pregnant women are an important part of this targeted population. All influenza can be dangerous to pregnant women and their babies. The Iowa Department of Public Health (IDPH) and the Centers for Disease Control and Prevention (CDC) recommend seasonal and 2009 H1N1 vaccines for pregnant women.

    “Compared with people in general who get H1N1, pregnant women with H1N1 flu are more likely to be admitted to hospitals, more likely to have serious illness, and more likely to die from H1N1,” said IDPH Medical Director, Dr. Patricia Quinlisk.

    Pregnant women should get both the 2009 H1N1 flu shot and the seasonal flu shot. Both these injected vaccines are ‘killed’ vaccines, so you cannot catch the flu from getting these shots. (The other type of flu vaccine - a nasal spray - is not recommended for pregnant women.) Women can receive flu shots at any stage of pregnancy.

    If you are pregnant and have flu symptoms, including fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, or fatigue, call your health care provider right away. If H1N1 is suspected, your health care provider may prescribe antiviral medicine that treats the flu. Being pregnant should not stop women from using antiviral medicines if their doctor decides that they are needed.

    Women who are breastfeeding and are sick with the flu should continue to breast feed. Babies who are breast fed get sick from infections like the flu less often and less severely than babies who are not breast fed. Postpartum women should also contact their health care provider immediately if they have symptoms of the flu.

    For more information on pregnancy and H1N1, visit www.cdc.gov/Features/PregnantH1N1Flu.

    Additional information about H1N1 influenza can be found at www.idph.state.ia.us/h1n1/default.asp.

     

    1103 Statewide H1N1 vax blitz planned [Oklahoma]--State Health officials are planning a statewide H1N1 influenza vaccination effort Saturday November 7th for Oklahomans who fall into one of the priority groups targeted to receive this vaccine.

     “We recognize that many Oklahomans are trying to obtain the H1N1 vaccine to protect their children or themselves from this new strain of flu.  Although the amount of vaccine that our state has received so far is not enough to meet the demand, our goal is to deliver as many vaccinations as possible November 7th,” said State Epidemiologist Dr. Kristy Bradley.  “The H1N1flu virus continues to strike children and pregnant women particularly hard.  We encourage people included in the priority groups to continue to seek a vaccination.” 

    Priority groups for the H1N1 vaccine now include all children ages six months to 18 years, pregnant women, custodial parents of infants less than six months of age, front-line health care workers who have direct patient contact with acutely ill persons, and adults 19 – 64 years of age with chronic disease.

    Clinics will be held at multiple locations statewide Saturday, November 7, 2009 for the vaccine priority groups.  The time and location of these clinics will be announced later in the week. People seeking vaccinations will be screened to ensure that they meet the priority group definition for H1N1 vaccine.

    An additional 93,100 doses of the novel H1N1 influenza vaccine is arriving in the state. The doses include both nasal spray and injectable vaccines. The Oklahoma State Department of Health is projected to receive H1N1 vaccine in weekly shipments through early January 2010.

    In addition to providing vaccine through regularly scheduled clinics, county health departments will begin to distribute vaccine to certain private providers with an emphasis on practices that serve children.

    For more information about the availability of H1N1 influenza vaccine in your area, call your local county health department or visit www.health.ok.gov, or call the Oklahoma State Department of Health toll-free H1N1 hotline at: 1-866-278-7134. Phones are answered Monday through Friday from 8 am to 5 pm.

     

    1103 If the Green River floods, follow the signs [King County, Washington]--If the Green River Valley is threatened with major flooding this season, will you know the quickest way to higher ground? 
     
    In an effort to speed evacuation when floodwaters rise, King County began installing evacuation signs on key roads in unincorporated areas Monday.
     
    Many homes and businesses in the Green River Valley that don’t typically see floodwater - including parts of Auburn, Kent, Renton, Tukwila and unincorporated King County - should be prepared to evacuate this winter. Seepage from an earthen bank next to the Howard Hanson Dam has reduced capacity to hold back water during periods of prolonged heavy rain - and that has increased the risk of serious flooding.
     
    If evacuations do become necessary, residents should know the quickest and safest passage away from areas considered vulnerable to flooding. In the coming days, 
    King County Road Services Division crews will install 27 blue and white signs with directional arrows along 11 roads in unincorporated areas.
     
    King County and other government service providers in the valley have been working together for several months to identify the least flood-prone routes providing the quickest routes to higher ground. The coordinated effort will also ensure that there is a common understanding among agencies of roads considered priorities before and after the flood.
     
    A map of roads that have been identified as evacuation routes in the Green River Valley will be posted
    online beginning Monday, Nov. 2.
     
    Once the evacuation signs are in place, residents should take the time to familiarize themselves with posted routes near their home that will safely take them out of harm’s way. The idea is to have more than one way out when flooding begins to occur.
     
    Of course, no road is safe when it is overtaken by floodwater. Motorists should never drive around barricades or road closure signs – this is the leading cause of drowning during floods. Roads and bridges are closed when crews determine they are no longer safe for travel.
     
    In addition to identifying evacuation routes, contingency planning has also been underway to identify impacts from flooding to Metro Transit service in the Green River Valley.
     
    Metro has identified a revised bus service plan for about 30 regular routes when service can no longer be operated due to flooding. However, service on some existing routes may be suspended until roadways can be reopened. That’s why transit customers are being encouraged to identify backup travel plans as part of their pre-flood planning. They can learn more about these transit service alternatives by visiting
    Metro Online.

     

     

    1103 Pediatric H1N1-related death in Bernalillo County [New Mexico]--The New Mexico Department of Health announced today that an 11-year-old male with H1N1 influenza from Bernalillo County died Nov. 1st. The boy had a chronic medical condition that put him at higher risk for serious complications and was hospitalized at the University of New Mexico Hospital in Albuquerque since Oct. 11.

    "We express our deepest sympathies to the family who is dealing with the heartbreaking loss of their child," said Health Secretary Alfredo Vigil, MD. "This tragedy should remind every New Mexican that influenza can cause serious complications and even death, so it is important for everyone to follow the prevention guidelines to minimize the spread of the disease."

    So far in 2009, there have been 22 deaths related to H1N1 influenza in New Mexico. A complete listing of all H1N1-related deaths can be found on the Department of Health’s H1N1 website at www.nmhealth.org/H1N1.

    The Department of Health recommends people who are at higher risk for complications and are experiencing typical, mild flu symptoms that include fever, sore throat and cough to call their healthcare provider or a local community health center for consideration for treatment with antiviral medications. If people do not have a healthcare provider, they can call the Department of Health’s Health Alert Hotline at 1-866-850-5893.

    The Department of Health is also recommending the following people either stay home or seek medical care if they are experiencing flu-like symptoms: People who are experiencing typical, mild symptoms of influenza and are not at higher risk for flu complications should stay home and avoid public places until they are well. People who develop severe symptoms of influenza should seek care immediately from the emergency room. Severe symptoms include shortness of breath, rapid breathing, dehydration, or decreased responsiveness.

    People at higher risk for serious complications include pregnant women, household members/caretakers of infants less than 6 months old, children 6 to 59 months of age, children 5 to 18 years with certain chronic health conditions that increase their risk of complications from flu, and healthcare workers and emergency medical service personnel with direct patient care.

    The Department of Health is encouraging people who are at a higher risk for developing serious complications from H1N1 to get vaccinated as soon as possible. The Department of Health is encouraging people in priority groups to call their primary healthcare providers to ask if they are providing the H1N1 vaccine. People in the target groups without insurance or a healthcare provider, or whose provider will not offer the H1N1 vaccine, can get the vaccine from a local public health office. Call your local public health office first to check the availability of H1N1 vaccine. Public health offices are listed in the phonebook’s blue pages under state government or online at www.nmhealth.org

    The Department of Health has ordered 124,310 doses of nasal and injectable H1N1 vaccine so far and expects to receive 1.2 million doses by the end of January 2010. Vaccine is arriving in small amounts and is being distributed to providers and public health offices statewide.

    For information about scheduled flu shot clinics, call toll-free at 866-681-5872 or go online to www.nmivc.org/cliniclist.php

     

    1030 NSTU wants H1N1 vaccine clinics in schools [Nova Scotia]--The Nova Scotia Teachers Union is urging the Nova Scotia Department of Health Promotion and Protection to administer the H1N1 vaccine to students and teachers while they are at school.

    "Students and teachers are on the front line of this pandemic, and yet schools seem to have been left out of the H1N1 vaccination planning," says Alexis Allen, NSTU President. "Schools are an ideal venue for vaccinating our children and their teachers, instead of having them line up for hours before and after school at public arenas and community centres."

    Many schools across the province are already seeing increased rates of absenteeism since the second wave of the H1N1 virus hit Nova Scotia this fall. With the first public vaccination sites already swamped and turning people away, Allen says vaccinating children and teachers at school is the logical next step.

    "One of our main roles as teachers is to advocate on behalf of our students, and right now the best way to do that is to ensure they receive the H1N1 vaccine," says Allen. "Giving them the vaccine at school would not only ensure that they receive it; it would also cut down on lineups at the public vaccination sites and eliminate the need for parents to take their children out of school to get the vaccine."

     

     

    1030 Province evaluating vax plans as supplies significantly less than expected [Saskatchewan]--Saskatchewan's H1N1 immunization roll-out will continue as planned next week, but future plans are being re-evaluated in light of news that all provinces will receive significantly fewer doses than expected of H1N1 vaccine.

    "While this is disappointing and frustrating news, we do have enough vaccine to immunize young children and pregnant and post-partum women as planned next week," Chief Medical Health Officer Dr. Moira McKinnon said. "We will continue to open up vaccine clinics to other high-risk groups based on available vaccine and the most current information we have about H1N1's tendencies and patterns."

    Due to the manufacturer's difficulties in producing enough vaccine to meet demand, Saskatchewan will be receiving 13,000 doses in its next shipment, rather than the 60,000 expected. As a result, the province's supply will need to be carefully managed until more vaccines arrive.

    Other provinces are now moving away from open clinics and are instead having to re-evaluate how to target those higher risk groups like Saskatchewan's roll-out plan.

    As H1N1's second wave continues throughout the province, Saskatchewan's toll-free health information line is hiring additional registered nurses and opening more phone lines to field inquiries about the virus and vaccination program.

    HealthLine, which is available 24 hours a day, seven days a week at 1-877-800-0002, provides guidance on such topics as how to address flu symptoms, when to call their physician or visit an emergency room, and the locations and times for local H1N1 vaccination clinics.

    To date, most people in Saskatchewan who have contracted H1N1 have experienced only mild illness.

    Healthy individuals experiencing milder symptoms such as cough, fever, or muscle aches, are advised to rest and care for themselves at home.

    For individuals experiencing more severe illness, antiviral medications are available to ease symptoms.

    "We're suggesting that people with underlying medical conditions who are experiencing flu-like symptoms should call their doctors right away," McKinnon said. "At the physician's discretion, the patient can be prescribed medication to address the symptoms."

    In the meantime, all Saskatchewan residents are urged to continue with infection prevention measures such as frequent washing of hands and staying home if unwell.

    Up-to-date vaccine clinic information will continue to be posted at www.health.gov.sk.ca

     

     

    1030 Province extends palliative home care drug pilot project [Prince Edward Island]--The Province is extending the Palliative Home Care Drug Pilot Project, which provides drug coverage for pain and symptom management to those who wish to spend their last days in the location of their choice, including at home, says Premier Robert Ghiz.

    “This project gives individuals the resources and medications they need to receive end-of-life care where they are most comfortable,” said Premier Ghiz. “That is why I am pleased to announce that my government is extending this project. We will continue to cover the cost of medications that qualified patients need to keep them comfortable and symptom free, in the place of their choice, during the last days of their lives.”

    The Palliative Home Care Drug Pilot Project is an extension of the Integrated Palliative Care Program, which aims to enhance client and family options for palliative care through access to trained, qualified health care teams in the most appropriate setting.

    “This project is designed to give people choices and to compassionately provide respect and dignity to individuals in the final stages of life,” said Health Minister Doug Currie. “Giving individuals the option to remain at home helps strengthen communities and reduces the emotional and financial burden on families. This project is a solid example of how improvements to services for Islanders are being achieved through integrated health system change.”

    The province is investing an additional $750,000 to continue covering the cost and delivery of the project.

    Eligibility for the project is based on a number of criteria that define the patient’s need for end-of-life care. Staff who are trained in palliative care work closely with family and caregivers to ensure the patient is a good fit. Once it is determined that a patient qualifies, and is registered with Pharmacy Services, clients are able to obtain palliative specific medications from their own local pharmacist.

     

    QUESTION & ANSWERS

    Palliative Home Care Drug Pilot Project Extended

    What is the Palliative Home Care Drug Pilot Project?

    The Palliative Home Care Drug Pilot Project is an extension of the existing Integrated Palliative Care Program. It provides coverage for end-of-life medications for patients who prefer to receive palliative treatment at home.

    For the purposes of this project, home is defined as wherever the person is living, whether in their own home, living with family or friends, or living in a supportive living residence. It does not include a hospital setting, a palliative care unit, or a provincially operated long term care facility.

    How long has the project been operating?

    It officially began operating October 2008 as a 12 month pilot.

    How long is the project being extended?

    The provincial government is investing an additional $750,000 to continue covering the cost and delivery of the project for another 18 months. The province previously invested $547,500.

    What is required to make this project a provincial program?

    The program needs to be developed in phases based on recommendations that will be determined by the upcoming results of an on going evaluation process. This process is being carried out by the pilot project manager and staff of the current Integrated Palliative Care Program.

    Additional resources will also be required.

    What information is available on the project based on the ongoing evaluation process?

    Since the implementation of the project:

    • 81 patients have been registered, ranging in age from 18 months to 96 years

    • average number of days per patient in program is 61 days

    • total number of program days is 5789 - out of this, total number of days patients have been able to remain at home is 4626 (79 percent) - average number prior to project was 55 percent

    • total number of days in hospital is 378

    • total number of days in designated palliative care bed is 785

    • total number of hospital days reduced by this project is 1110

    • patients have spent 24 percent more time at home during illness than prior to project

    • additionally, this has resulted in estimated savings to the health care system of more than $1 million (estimated hospital/institutional care rate is $1000 per patient, per day)

    • 41 patients have died, of those, 12 died at home - 18 died in designated palliative care beds, 11 died in hospital

    Who is eligible for the project?

    A patient must first be eligible for the Integrated Palliative Care Program. A patient who is diagnosed with a life threatening disease can be referred to the Integrated Palliative Care Program for assessment. Following assessment, a home care nurse, trained in palliative care, and other resources are assigned as needed. Then a Palliative Performance Scale (PPS) assessment is performed. This scale measures the functional status of an individual. In order for a patient to qualify for the project, the family, care givers, and patient must agree that the treatment protocol is of a palliative nature.

    How does a patient apply?

    A patient who has been diagnosed with a life threatening disease can be referred to the Integrated Palliative Care Program for assessment. Home care palliative care nurses will assess the needs of the patient to determine the level of care and medication requirements.

    If a patient is eligible, the palliative care nurse registers the patient with Pharmacy Servies. Once registration is complete the patient can obtain palliative medications through their local pharmacy. The patient will be required to pay a small co-payment of two dollars per prescription.

    Is there a time limit for coverage?

    No, there is no time limit of coverage for end-of-life medications in the Palliative Home Care Drug Pilot Project.

    Will a patient need to reapply if hospitalization is required?

    No, if the client is hospitalized, coverage through the project is suspended. Once the client returns home, coverage resumes. Coverage continues while the client is receiving home based palliative care.

    What does the project cover?

    It covers most end-of-life medications. These are medications that are used for pain and symptom management, ranging from anti-depressants and laxatives to pain relieving medications, such as morphine.

    This project supplements the care that is already provided by the Integrated Palliative Care Program, which may include a Nurse, Occupational Therapist, Home Support Worker, Social Worker, Physiotherapist, Dietician, Community Support Worker, Pharmacist, and Hospice volunteers.

    What is not covered by the project?

    Medications that are considered active life-prolonging drugs, such as chemotherapy drugs, Total Parenteral Nutrition (TPN), and nutritional supplements, are not covered. This is a drug pilot project, therefore, most palliative equipment is not covered. There is a minimal amount of palliative care equipment provided by the Integrated Palliative Care Program that will still be provided to patients depending on availability.

     

     

    1030 Temporary changes to visitor guidelines at QE and Prince County Hospitals [Prince Edward Island]--Staff and administration at the Queen Elizabeth Hospital (QEH) and Prince County Hospital (PCH) would like to advise the public of changes to visitor guidelines that come into effect tomorrow – Saturday, October 31 – at both facilities.

    “Our patients are our top priority and these temporary changes to visitor guidelines are reflective of the impacts of the H1N1 influenza in the community,” said Rick Adams, Executive Director of the Queen Elizabeth Hospital. “We need to ensure that we take the appropriate precautionary steps to protect our patients, staff, physicians and volunteers from the H1N1 virus while they are at the hospital.”

    Temporary changes to visitor guidelines include:

    • No visitors under the age of 18 years.

    • No more than 2 designated visitors per patient may visit during that patient’s stay in hospital.

    Patients will be asked to identify two persons to designate as visitors during their stay in hospital. Reducing hospital visits will reduce the risk of influenza-like illness coming into the facilities. Designated visitors who are experiencing influenza-like illness – cough with or without fever, accompanied by either a sore throat, sore muscles, achy joints or extreme fatigue – are asked to refrain from visiting patients at the hospital until they are symptom-free.

    Compassionate exceptions will be made to the temporary visitor guidelines on an individual patient basis and will be done in consultation with the patient and their health care team.

    “The incidents of individuals under the age of 18 infected with influenza-like illness in our communities is increasing across the province,” said Prince County Hospital Executive Director, Arlene Gallant-Bernard. “A collaborative effort is needed to ensure that these temporary guidelines are followed as a measure to protect the health and safety of patients and visitors, as well as to prevent the spread of influenza.”

    In addition to the temporary changes to visitor guidelines, the Queen Elizabeth and Prince County Hospitals are asking individuals who are experiencing influenza-like illness and have scheduled appointments at either hospital to please contact the facility in advance of their appointment to advise them of their symptoms. In an ongoing effort to reduce the spread of influenza, staff will then make the appropriate arrangements with the individual to either reschedule their appointment to a later date or make alternative arrangements for care delivery. Individuals with scheduled hospital appointments are also reminded that, where possible, they may only bring one other person with them to the appointment. The accompanying individual must be 18 years or older as per the new temporary guidelines.

    In order to relieve pressures at emergency rooms, the public is reminded that influenza assessment sites have been set up across the province to provide health services to Islanders with influenza-like illness. Persons with influenza-like illness that are also experiencing chest pains and shortness of breath should continue to seek medical attention at an emergency department. Islanders should also continue to seek immediate medical attention at an emergency department for a child if he/she has very fast breathing or trouble breathing, bluish skin colour, is not drinking enough fluids, not waking up or not interacting; or has increased irritability, fever with a rash, or flu-like symptoms that improve and then return with fever and worse cough.

    It is extremely important that anyone visiting the hospitals clean their hands before and after visiting a patient’s room, unit, and upon entering and leaving the facilities. Alcohol hand rinse stations are available throughout the hospitals for this purpose.

     

     

    1030 Limited vax requires important changes to H1N1 vax criteria for coming week [Newfoundland and Labrador]--The Department of Health and Community Services is advising the public that due to a reduced amount of vaccine available to the province by the Federal Government in the coming week, H1N1 vaccinations will be limited to the following high-risk groups:

    • Children six months up to 59 months (up to fifth birthday)

    • People five years of age up to and including 24 years of age with chronic conditions

    • Pregnant women in the second half of their pregnancy (20 to 40 weeks)

    “We received information late today from the Federal Government advising that our vaccine allocation for the coming week would be much less than anticipated,” said the Honourable Jerome Kennedy, Minister of Health and Community Services. “Based on this, we have had to reduce the high-risk groups targeted for clinics for the coming week to ensure that the limited amount of vaccine we have available to the province is offered to those who need it most. Ethically, this is the right thing for us to do.”

    The restricted criteria apply to clinics in all regions of the province and will be strictly enforced.

     

     

    1030 Significant increase in H1N1 flu activity [New Brunswick]--The following update on the H1N1 flu virus was issued by the Office of the Chief Medical Officer of Health for New Brunswick on Friday, Oct. 30.

    Canada is experiencing a second wave of pandemic influenza activity. During the past week, New Brunswick has seen a significant increase in activity, which is now widespread across the province.

    The majority of those affected have been children. Nearly all cases have been mild. We have seen some school absenteeism, but most children are well enough to go back to school within a few days. A smaller number are having cough and fever for four-to-five days before being able to go back.

    We are not seeing much severe disease. We have had one new hospitalization due to H1N1 in the province this week. The case is a male in the 10-19 age range. There have been no H1N1 deaths reported in the province.

    We are aware that some schools in the province are closing for short periods of time due to operational considerations, not public health concerns. We encourage children and staff who are well to attend school.

    The H1N1 vaccine clinics will run throughout November and December. The government has purchased enough vaccine for every New Brunswicker who chooses to be vaccinated.

    We encourage New Brunswick residents to read clinic information and more information about the H1N1 flu virus and its symptoms by vising the flu website, www.gnb.ca/flu, or by calling toll-free, 1-800-580-0038, which is available 24/7.

    The information, including dates, times, locations, and eligible groups for H1N1 clinics, is available by region through the website or the toll-free number. The clinic listings will be updated continually over the course of the H1N1 vaccination program.

    We have had an extraordinarily positive response to the first week of our vaccine program. This is good because it will contribute to overall immunity levels in the population, and this means that there will be fewer people contracting and spreading the virus.

    We know that people have had to deal with long waits, and changed schedules. We appreciate the patience and co-operation of the people of New Brunswick as we work as fast as we can to protect our population.

    We will need to adjust our schedules according to the amount of vaccine we have to work with. Like other Canadian jurisdictions, New Brunswick is anticipating a lower-than-expected supply of H1N1 flu vaccine shipped from the federal government over the next week.

    This reduced vaccine availability is because the vaccine manufacturer had dedicated a production line to produce unadjuvanted vaccine.

    A number of previously scheduled clinics have been cancelled and will be rescheduled once details of the next federal shipment are known.

    Over the next week we will be focusing in a much more concerted way to ensure that priority groups, particularly children, are getting vaccinated.

    We are aware that heavy demand for information may occasionally cause longer wait times than usual on the toll-free line. Extensive improvements continue to be made.

    Tamiflu, one of the antivirals used to treat H1N1, is available at community pharmacies throughout New Brunswick for those who have a doctor's prescription.

    New Brunswickers should continue to protect themselves and those around them by washing hands thoroughly and often, coughing or sneezing into sleeves, staying home if sick, and keeping common surfaces clean.

    Persons at high risk of complications from influenza-like illness should seek medical attention promptly. Those at risk include pregnant women, people with underlying medical conditions such as diabetes, chronic lung conditions, or those with compromised immune systems.

    Persons with influenza-like symptoms should stay home and minimize contact with family members as much as possible. If symptoms worsen, they should visit their physician or nurse-practitioner, a walk-in clinic, or the nearest hospital emergency department.

    It is recommended that sick people limit contact with other people until they are free of symptoms and they are feeling well.

    It is important for New Brunswickers to understand that if they do not have influenza-like symptoms, they may continue to go to work and school as usual, to participate in activities, and to socialize.

    More information on the H1N1 flu virus may be found online, or by calling the 24-hour H1N1 line, 1-800-580-0038.

     

    1030 Four confirmed cases of E.coli believed to be linked to Wendy's restaurant [Fredericton NB]--The Fredericton office of Public Health Services is following four confirmed cases of E. coli believed to be linked to persons who ate at Wendy's Restaurant, 967 Prospect St., Fredericton.

    "Public Health advises those who ate at the restaurant before Tuesday, Oct. 27, seek medical attention if they experience symptoms of gastro-intestinal illness, such as severe cramps, diarrhea (may be bloody and watery), abdominal pain and vomiting," said Dr. Cristin Muecke, regional medical officer of health for the Fredericton area.

    The cases of E. coli 0157:H7 are believed to be linked to salads prepared and served at the Prospect Street restaurant location. There is no evidence to suggest a public health concern at other restaurant locations. Public Health Services is continuing its investigation into the matter.

    The restaurant has implemented control measures to help minimize any risks and has been fully inspected. The restaurant is fully co-operating with Public Health Services and, at this time, Public Health officials do not have any concerns with the restaurant remaining open.

    Muecke said anyone experiencing symptoms should follow good hygiene practices, such as washing their hands thoroughly. They should avoid contact with persons who may be particularly susceptible, including the very young, very old and those with weakened immune systems.

     

     

    1030 Due to H1N1 vax shortages mass clinics may be postponed [Manitoba]--Manitoba has been advised the province will receive 15,500 doses of vaccine next week, well below the expected 72,000 doses.

    As a result, each region will be adjusting their plans according to their population and geographic realities. Mass immunization clinics may be postponed in some regions.

    Many regions will continue to provide vaccine to people in the first priority group with a particular emphasis for people most at risk of severe illness. This includes targeting these individuals on the priority list:
    · children aged six months to under five years old;
    · anyone of Aboriginal ancestry (First Nations, Métis or Inuit);
    · people under 55 with a severe chronic medical or other risk condition; and
    · pregnant women.

    This focuses on the key populations in Manitoba’s priority list who are most at risk of severe illness or death. For more details on how to access vaccine, please contact your local regional health authority.

    The initial delivery from the federal government of 134,000 doses and a second delivery of 72,000 doses have already been distributed for use in clinics around the province. As of the end of day Oct. 29, there had been 92,901 flu shots administered in Manitoba.

    Next week, Manitoba will take delivery of vaccine that does not have an adjuvant. This vaccine is for pregnant women. Manitoba expects to receive approximately 9,200 doses of the Australia-based vaccine obtained by the federal government.

    Additional measures to help prevent flu infections include:
    · Cover your cough by coughing into your elbow or sleeve or use a tissue to cover your nose and mouth when coughing or sneezing. Place the tissue in the garbage.
    · Wash your hands often with soap and water, especially after coughing or sneezing. Hand sanitizers may also be effective.
    · Reduce the spread of germs. Limit touching your eyes, nose or mouth.
    · Maintain your health by making healthy food choices, being physically active and getting enough sleep.

    For more information on H1N1 flu, visit www.manitoba.ca/flu or call Health Links-Info Santé at 788-8200 or 1-888-315-9257.

     

     

    1030 H1N1 flu vax update - further distribution will include phased approach [British Columbia]--Despite unexpected delays in the manufacture of pandemic H1N1 influenza vaccine in Canada, all British Columbians who need or want the vaccine will be able to receive it before the end of the year as has been said previously, Minister of Healthy Living and Sport Ida Chong and Provincial Health Officer Dr. Perry Kendall reiterated today.  

     

    The federal government has advised all provinces, including B.C. that they won't be receiving as many doses of pandemic vaccine in the next few weeks as anticipated. Nevertheless, the provincial rollout will continue with a significant number of doses over the next week, and B.C. has ordered more than four million doses of the vaccine, more than enough to cover the province.

     

    “Based on the information the federal government has conveyed, every British Columbian who needs and wants the vaccine will be able to receive it before the end of this year,” said Chong. “The Province has a plan in place to first deliver the vaccine to those most at risk from serious consequences of H1N1 infection, and we will continue to implement that plan.”

     

    B.C. began the largest immunization campaign in its history earlier this week with the vaccine made available to the first groups of high-risk residents – people under 65 years of age with chronic health conditions, pregnant women and individuals, including First Nations living on reserves, who reside in remote or isolated areas.

     

    Beginning next week, eligibility to receive the vaccine will be extended to include front-line health care workers, children between six months and five years of age, and household contacts of babies less than six months old and of immunocompromised people. Not everyone in these groups will be immunized in the second week of the program.  Each region will need to gauge supply and demand, and there may be some differences in timing because of these variables.

     

    As a result of smaller than expected shipments of the vaccine, further distribution will include a phased approach. Vaccination of health care workers will be prioritized to first cover those deemed to require it most in order for critical health care services in B.C. to be maintained. Not all health care workers will be able to receive the vaccine immediately but, as supplies increase, all health care workers who want the vaccine will get it.

     

    In addition, health authorities that had been running seasonal influenza clinics for seniors may temporarily be suspending those clinics, depending on local logistics, in order to focus on delivering the H1N1 vaccine to those most at risk. Seniors’ influenza clinics will resume later in November, the time of year that they are normally held. This change isn’t expected to have any impact on the rate of seasonal influenza among seniors this winter.

     

    To date, B.C. has received nearly a half-million doses of the adjuvanted H1N1 vaccine and is expecting a shipment of another 350,000 doses for distribution next week. In addition, the province is scheduled to receive 58,000 doses of adjuvanted and 25,000 of unadjuvanted vaccine from Canada’s pandemic H1N1 vaccine manufacturer GlaxoSmithKline – the latter specifically for pregnant women – late next week.

     

    Health authorities in B.C. are receiving vaccine shipments based on their respective populations. Each health authority has implemented a vaccination plan which best suits its geographical area and population densities.

     

    “We acknowledge that there may be concern among the public that the H1N1 vaccine is not getting to B.C. and other provinces as quickly as it should,” noted Dr. Kendall, “but I am confident that the federal government and GlaxoSmithKline are doing their best to ensure that the vaccine is manufactured and distributed as quickly as possible. There have been similar challenges in the United States and other countries as well. In the meantime, our provincial health authorities will tailor their delivery plans to ensure that the vaccine we do have is used in the best possible way.”

     

    “Members of the general population who don’t fall into the high-risk categories identified in the phased implementation approach will be able to receive the H1N1 vaccine as soon as supply is sufficient but not at this time,” said Dr. Monika Naus, medical director of immunization programs at the B.C. Centre for Disease Control, an agency of the Provincial Health Services Authority. 

     

    “We ask that healthy individuals allow those who need the vaccine most at this time to get it first. In the meantime, we remind everybody that basic infection control measures remain a powerful weapon against influenza infection and spread. Wash your hands properly and often, cough or sneeze into your sleeve or a disposable tissue, and remain at home if you are sick.”

     

     

    1030 H1N1 flu public clinics set to begin Nov 3 [Vermont]--The Vermont Department of Health and the state’s home health agencies and Visiting Nurse Associations are offering H1N1 flu vaccine. A total of 37 clinics are currently scheduled for locations around the state starting Nov. 3 and continuing into January.

    These clinics are for those people who are most at risk for serious illness from the 2009 H1N1 flu and are not getting vaccinated by their health care provider or at a school clinic:

    • Pregnant women
    • Household contacts and caregivers for infants younger than 6 months
    • Anyone age 6 months to 24 years
    • Anyone age 25 through 64 who have health conditions that put them at higher risk of medical complications from the flu. This includes people with chronic lung disease, such as asthma; chronic heart, kidney or liver disease; diabetes; compromised immune system due to disease or treatment; and neuromuscular conditions

    Anyone 65 years and older is not eligible for H1N1 vaccine at the public health clinics at this time.

    To locate a vaccination clinic, got to the Health Department’s website at www.healthvermont.gov, then select H1N1 Vaccine Clinics at the top of the home page. Clinics next week are being held in Middlebury, Manchester Center and Colchester.

    Vaccinations are provided at no charge. No documentation or insurance cards are needed to be vaccinated. Vaccine will be delivered on a first-come, first-served basis. There may be some waiting in line, so clinic organizers suggest that people wear comfortable shoes and clothing.

    Extensive information, tools and resources about seasonal and pandemic flu, healthy habits and preparedness are available at the Health Department’s website: healthvermont.gov or dial 2-1-1. You can also follow us on Twitter at twitter.com/healthvermont.

     

    1030 Vax efforts unprecedented as H1N1 flu becomes widespread [Maine]--The Maine Center for Disease Control and Prevention/Maine DHHS has determined H1N1 influenza (swine flu) to be widespread in the state. However, the H1N1 vaccine is also being administered at unprecedented speed.

    “Although the vaccine supply is trickling in at a much slower rate than we would like, the H1N1 vaccine efforts in Maine are extraordinary,” said Dr. Dora Anne Mills, the Director of the Maine CDC. “An estimated 12,000 school-aged children were vaccinated this week in many communities across state. Many more school clinics are planned for next week.”

    Most of these clinics will be located in schools and will take place during regular school hours to minimize disruption for students, teachers and parents, Mills said. With so many children being vaccinated against H1N1, not only are they being protected, but their entire community is also given some protection since school children are the major transmitters of influenza, she added.

    Maine CDC received its first vaccine last week for pregnant women. Those doses have arrived in hospitals and many obstetrical practices across the state. Shipments of vaccine to pediatric health care providers for pre-school aged children have steadily increased and several school clinics have also opened their doors to them. This week, 44,000 doses of vaccine are expected to arrive, bringing the total number of doses to 99,000.

    H1N1 is now widespread in Maine, with increases in visits to health care providers and school absenteeism, especially in the southern half of the state. There have been nine outbreaks in schools and other settings. In addition, the first Piscataquis County case of H1N1 was diagnosed. Two people were hospitalized this week and both hve been discharged and are recovering at home, Mills said.

    “With enough vaccine for only one in seven people in the high priority groups, it is important that everyone know what they can do to prevent illness as well as what they should do if they become ill,” Mills said.

    The Maine CDC recommends

    • Everyone be extra vigilant with respiratory hygiene:
       
      1. Cover your coughs and sneezes;
         
      2. Wash your hands frequently; and
         
      3. Stay home if you’re sick with a fever.
         
    • If you are at very high risk for complications, you may want to avoid large crowds. There is generally no reason for large gatherings to be cancelled, but people who are at high risk for complications should consider avoiding them.
    • If you or your household member is sick with the symptoms, which are a fever plus a sore throat and/or a cough, there are several things you should be aware of.
      1. Know that most people can stay home without a seeing a health care provider;
      2. People with influenza should drink fluids and get plenty of rest;
      3. Call your health care provider if you are at high risk for complications and you or a household member has symptoms of H1N1. You should be considered for prescription medicines that treat influenza, called antivirals (known as Tamiflu and Relenza).
    • Those at risk for complications include:
      1. Children younger than 2 years old
      2. Adults 65 years and older
      3. Pregnant women
      4. Anyone with certain underlying medical conditions
    • Anyone with influenza symptoms should seek medical attention for:
      1. Dehydration
      2. Trouble breathing
      3. Getting better then suddenly getting a lot worse
      4. Any major change in one’s condition

    A list of school clinics over the next two weeks and vaccine distribution follows. Check www.maineflu.gov for up-to-date clinic information.

    Some towns that have school vaccine clinics scheduled this week:

    • Augusta
    • Bangor-Brewer area
    • Belfast/Searsport
    • Belgrade
    • Bethel
    • Benton
    • Cape Elizabeth
    • Cumberland/North Yarmouth
    • Freeport
    • Gardiner
    • Indian Township
    • Lewiston
    • Matinicus
    • Monmouth
    • Pittsfield
    • Portland
    • Pownal
    • Sanford/Springvale
    • Thorndike/Unity
    • Westbrook

    Some towns with probable school clinics next week:

    • Auburn
    • Augusta area
    • Bangor/Brewer area
    • Bath
    • Bethel
    • Brunswick
    • Durham
    • Fairfield
    • Farmington
    • Hallowell/Farmingdale
    • Hartland
    • Indian Island
    • Kittery
    • Lewiston
    • Limestone
    • Monmouth
    • Pittsfield
    • Portland
    • Strong
    • Topsham
    • Vassalboro
    • Waterville/Winslow area
    • Wells
    • Westbrook
    • York

    Many are listed on the clinic locator at http://www.maineflu.gov

    VACCINE DISTRIBUTION AS OF FRIDAY OCTOBER 30, 2009

    County: Doses % of population
    Cumberland 28,900 10%
    Kennebec 12,600 10%
    Penobscot 12,200 8%
    York 12,100 6%
    Androscoggin 8,500 8%
    Knox 4,400 11%
    Aroostook 4,200 6%
    Oxford 3,200 6%
    Hancock 2,300 4%
    Somerset 2,300 5%
    Washington 2,000 6%
    Waldo 2,100 6%
    Franklin 1,800 6%
    Lincoln 1,700 5%
    Piscataquis 500 3%
    Sagadahoc 200 1%
    Total 99,000 Average = 6%
    Many residents of one county (eg Sagadahoc) obtain their care in another county (Cumberland).

     

     

    1030 H1N1 flu shots to be offered at City colleges [Chicago IL]--After successfully vaccinating a total of more than 12,000 people across the city on Saturday and Tuesday, Chicago Department of Public Health (CDPH) officials are looking forward to protecting thousands more Chicagoans from the H1N1 flu on Thursday.

    “We continue to say that the best place to get an H1N1 flu vaccination is your own family doctor or other regular medical provider,” stated Chicago Department of Public Health Commissioner Terry Mason, M.D. “Many thousands of doses of vaccine have already been distributed to hospitals, clinics, family practitioners, pediatricians, obstetricians, and college/university health services. But for those Chicago residents who do not have a doctor or whose doctor does not plan to give H1N1 vaccinations, we are offering H1N1 flu vaccinations at six locations across the city.”

    The vaccinations are intended for people at increased risk for flu and flu complications:

    • pregnant women
    • all children and young adults ages 6 months to 24 years
    • people who live with and/or care for infants younger than 6 months of age
    • people age 25-64 with chronic health conditions (like asthma or diabetes).
    • health care workers

    The six locations are:

    • Kennedy King College, 6301 S. Halsted
    • Olive Harvey College, 10001 S. Woodlawn
    • Richard J. Daley College, 7500 S. Pulaski
    • Truman College, 1145 W. Wilson
    • Arturo Velasquez Institute, 2800 S. Western
    • Wright College, 4300 N. Narragansett

    The locations will be open to serve Chicago residents at increased risk on Tuesdays, Thursdays and Saturdays.

    Hours of operation are 3:00 to 8:00 p.m. Tuesdays and Thursdays, 9:00 a.m. to 2:00 p.m. Saturdays.

    No appointments are necessary, and all vaccinations will be delivered free of charge, on a first come/first served basis.

    People who are allergic to eggs should not receive the vaccination.

    In addition to doctors’ offices and public health vaccination sites, H1N1 vaccine is expected to be available at retail pharmacies in the weeks ahead----giving Chicagoans ample opportunities to get vaccinated.

    College students in the city are advised to check in with their campus health service to see if and when H1N1 vaccinations will be offered.

    "Vaccination is a smart, safe and effective public health intervention,” added CDPH Immunization Program Medical Director Julie Morita, M.D. “Every week, thousands of doses of H1N1 vaccine are arriving in the city and suburbs. Assuming that vaccine production continues as anticipated, it is fair to say that every Chicagoan who wants an H1N1 vaccination will be able to get one in the weeks and months to come.”

    In addition to getting a flu vaccination, CDPH officials advise all Chicagoans to:

    • make an extra effort to cover coughs and sneezes, and wash hands regularly with soap and water.
    • stay home from work and/or school if you have influenza-like symptoms (coughing, sore throat and a fever).
    • remind parents of young children to teach these good health habits to their sons and daughters---and to plan ahead and make home-care arrangements for their children on days when they are ill and should be kept home from school or day care.

    For local information on flu prevention, go online to www.cityofchicago.org/swineflu.

     

    1030 H1N1 flu vax available at County Health depts next week [Mississippi]--The Mississippi State Department of Health (MSDH) announces the limited availability of the 2009 H1N1 (swine flu) vaccine at all county health department clinics beginning Monday.  So far, 223,800 doses have been allocated to Mississippi. Of those doses, 146,000 are injectable vaccine and 77,800 are nasal mist vaccine.

    The first injectable vaccine doses at the county clinics will be available for those in the following priority groups: pregnant women; children six months through four years of age; and parents, siblings, caregivers and anyone else living in the house with an infant under six months of age. These groups are at the highest risk for complications from influenza. The vaccine is free at all county health departments.

    “Mississippians have proven to be very gracious in times of limited vaccine availability,” said MSDH State Epidemiologist Dr. Mary Currier. “We ask everyone to remain patient as those with the highest risk of complications receive their vaccinations first. We’re receiving additional doses each week, and we expect the vaccine will be available for everyone once the priority groups have been vaccinated.”

    Next week, MSDH will also begin mass vaccinations for students at various schools throughout the state. The school vaccinations of the nearly 500,000 school-aged children in Mississippians will take several weeks to complete.

    “Just like the rest of the country, Mississippi is receiving limited shipments of the vaccine based on the population of our state,” said Dr. Currier. “Decisions are being made after each shipment arrives about how to reach those who are at the highest risk for complications and need the vaccine first.”

    For those not in the high priority groups, Dr. Currier recommends getting your seasonal flu shot to protect yourself from seasonal influenza in the meantime. Also, continue using basic prevention methods including washing your hands frequently or using an alcohol-based hand sanitizer, coughing or sneezing into your sleeve, or coughing into a tissue followed by hand washing, and avoiding close contact with those who are sick. If you are ill, stay home until you are well, unless you need to see a doctor, in which case call first to prevent possible transmission in the doctor’s waiting area.

    For more information on swine flu, visit the MSDH website at www.HealthyMS.com  or call the toll-free MSDH flu hotline at 1-877-222-9FLU. The hotline hours are 8 a.m. – 5 p.m. Monday through Friday, except state holidays.To receive updates on Twitter, visit the MSDH H1N1 swine flu page to sign up as a follower.

     

    1030 Three more H1N1 flu-related deaths confirmed [Kansas]--The Kansas Department of Health and Environment (KDHE) today confirmed the deaths of three people who were infected with the pandemic H1N1 influenza virus.  None of the cases announced today had any underlying health conditions that placed them at greater risk of complications from H1N1 flu. Twelve people in Kansas have now reportedly died after being infected with H1N1.


    The deaths occurred in the following individuals:

    • A 52 year-old woman from the Wichita metropolitan area* was confirmed to have pandemic H1N1 on October 13.  Her death was reported to KDHE on October 27.
    • A 39 year-old man from the Kansas City metropolitan area* was confirmed to have pandemic H1N1 on October 15, and his death was reported to KDHE on October 28.
    • A 51 year-old woman from the Topeka metropolitan area* was confirmed with pandemic H1N1 on October 27. This woman’s death was also reported to KDHE on October 28.

    KDHE Secretary Roderick Bremby and Dr. Jason Eberhart-Phillips, Kansas State Health Officer, expressed sympathy and offered their deepest condolences to the families involved.

    “These deaths underscore the importance of doing everything that we can to protect ourselves and each other from H1N1,” Dr. Eberhart-Phillips said. “Besides vaccination and other preventive measures like frequent and thorough hand washing and properly covering coughs and sneezes, there are other steps that we can all take to significantly reduce our risk of catching and spreading flu viruses.”
    According to Dr. Eberhart-Phillips, everyone should take the following health precautions:

    • Monitor yourself and your family members every day for symptoms of influenza.  Remain home at the first sign of illness.  Try to limit the interaction between family members who are ill and those who are well.  Remember that individuals with symptoms of influenza should stay isolated and not return to school or work for at least 24 hours after the fever is gone without taking fever-reducing medicine.  
       
    • Check to see if the schools and childcare facilities where your children attend monitor for illness and immediately isolate symptomatic children until they can be picked up.  Find out if concerts or athletic events are postponed or altered when there are high levels of influenza-like-illness among students and staff.
       
    • At work, try to create space (at least 3-6 feet) between yourself and co-workers.  Learn all you can about your employer’s policies for sick leave.  Ask if there are ways that you can work remotely from home if illness is prevalent at your workplace.

    The H1N1 vaccine has started to arrive in Kansas, but at this time in very limited quantities. Certain individuals are recommended to receive the vaccine earlier.  For more information on vaccine prioritization, please visit www.kdheks.gov/H1N1/H1N1_Vaccine.htm.

    Up-to-date information on H1N1 vaccination clinics being held across the state can be found by going to www.kdheks.gov and clicking on “Where can I receive the H1N1vaccine?”

    The symptoms of infection with the pandemic H1N1 virus are similar to the symptoms of seasonal flu and include fever of 100 degrees or greater, body aches, coughing, sore throat, respiratory congestion, and in some cases, diarrhea and vomiting.  Most people who have been ill with pandemic H1N1 influenza have recovered without medical treatment.

    However, some people develop serious complications that require hospitalization or may lead to death.  Although serious complications are more likely among persons with certain underlying chronic health conditions, this pandemic influenza virus has caused serious complications and deaths among persons without such factors.  Unlike typical seasonal influenza, the 2009 H1N1 virus is causing a greater disease burden among adolescents and young adults.  Severe illness from H1N1 virus infection can even occur among relatively young, healthy persons.

    KDHE is no longer accepting specimens from everyone who sees a doctor with symptoms.  In non-hospitalized cases, confirmatory testing does not affect treatment and advice given to patients by health care providers. 

    Most children and adults with the flu who are generally in good health will recover without needing to visit a health care provider.  Some people may want to call their health care provider for advice on how to care for the flu at home.

    Individuals who experience severe illness or who are at high risk of complications from H1N1 influenza infection, including children less than 5 years of age, adults 65 years of age and older, pregnant women, and persons with chronic medical conditions (including asthma, diabetes, heart disease, and other conditions), should contact their health care provider.

    Until people are able to be vaccinated against the virus, individuals are encouraged to take the following steps to reduce its spread:

    • Wash your hands thoroughly with soap and warm water or use an alcohol-based hand sanitizer to get rid of most germs and avoid touching your eyes, nose and mouth.
    • If you become sick, stay home until at least 24 hours after fever or signs of fever without the use of fever-reducing medications, in order to avoid spreading illness to co-workers and friends.
    • Cough or sneeze into a tissue and properly dispose of used tissues.  If you do not have a tissue, cover your cough or sneeze with your elbow and not your hands.  
    • Stay healthy by eating a balanced diet, drinking plenty of water and getting adequate rest and exercise.

    KDHE has established a phone number for concerned Kansans to call with questions about the 2009 H1N1 influenza A virus.  The toll-free number is 1-877-427-7317.  Operators will be available to answer questions from 8 a.m. – 5 p.m. Monday through Friday.  Persons calling will be directed to press “1” on their touch-tone phone to be directed to an operator who can answer questions.

    Kansans with questions about the virus can email H1N1fluinfo@kdheks.gov.  Information is also available from KDHE at www.kdheks.gov.

     

    1030 Death of elderly female linked to H1N1 flu [Wyoming]--According to the Wyoming Department of Health, swine (novel H1N1) flu was linked to the death last week of an elderly female Laramie County resident with underlying health conditions associated with higher risk of severe illness.

    This is the sixth flu-related death reported to the department since the emergence of swine (novel H1N1) flu in Wyoming; four of those were confirmed as due to the H1N1 strain. Four of the reported deaths were among residents between the ages of 19 and 64; two were among residents over the age of 65.

    “Wyoming is experiencing widespread flu activity at a level higher than we’ve seen over at least the last 10 typical winter flu seasons,” said Dr. Tracy Murphy, state epidemiologist with the Wyoming Department of Health.

    Since late May, 3267 flu cases have been reported to the department. 

    Of those:

    541 were among residents younger than 5

    1742 were among residents between the ages of 5 and 18

    959 were among residents between the ages of 19 and 64

    24 were among residents older than 65

    The department expects the number of actual flu infections around the state to be much higher, because most ill persons do not seek medical care or are not tested. 

    Over the same timeframe, the department has received reports of 87 Wyoming hospitalizations in connection with influenza. Of those:

    15 were among residents younger than 5

    15 were among residents between the ages of 5 and 18

    46 were among residents between the ages of 19 and 64

    6 were among residents older than 65

    5 were among residents for whom age information was not readily available

    Influenza symptoms include fever, cough, sore throat, body aches, headaches and fatigue.  Some patients also report diarrhea and vomiting. 

    Actions recommended to slow the spread of illness include:

    When available, get immunized with both a swine flu and a seasonal flu vaccine.

    In general, people who develop influenza-like illness should stay home from work, school or travel until at least 24 hours after they are free of fever.  Those who are severely ill (such as having trouble breathing) should seek medical care.

    Avoid contact with ill persons.

    Covering noses and mouths with a tissue or sleeve when coughing or sneezing, and throwing used tissues in a trash can.

    Frequent hand washing with soap and water or the use of an alcohol-based hand gel.

     

    More information about flu in Wyoming is available online at www.health.wyo.gov

     

     

    1029 ERs at Montreal's childrens' hospitals seeing a significant increase in number of children seeking care [Quebec]--The CHU Sainte-Justine and The Montreal Children's Hospital of the McGill University Health Centre are currently seeing a significant increase in patients in their Emergency Departments.

     

    Children are arriving with mild flu-like symptoms and fever. The hospitals wish to remind parents that their Emergency Rooms are reserved for urgent care. Mild flu-like symptoms should be treated at home. Also, due to the increased demand for care, the hospitals are NOT testing children to determine if they have H1N1.

    "The Emergency is unusually busy for this time of year," says Dr. Harley Eisman, Medical Director, Emergency Department at The Montreal Children's Hospital. "The increase is attributable to children coming in with mild flu-like symptoms and fever. This increase is resulting in extra pressures on the Emergency Department, and therefore, an increase in wait times."

    Dr. Eisman reminds parents that the H1N1 influenza is a relatively mild form of the flu and is very similar in severity to the annual flu virus. The only difference is that flu season has started earlier and more people are being infected.

    Even though the second wave of the H1N1 virus has only just started, both ERs are already at 180% capacity. The Montreal Children's Hospital Emergency Room is staffed and equipped to treat approximately 180 children per day. The current daily average is 300. CHU Sainte-Justine is staffed and equipped to treat 180 per day and is currently seeing 250 children.

    "Children in need of urgent care are our number one priority. There is absolutely no wait for emergency care. However, any patient arriving with mild flu-like symptoms can expect to wait before seeing a health professional. It is important, that parents prepare for the flu season by educating themselves on ways to keep their children healthy, to manage minor illness and injury at home, to know when they should see a doctor and when they should visit the Emergency Department," says Dr. Michael Arsenault, Medical Manager of Emergency Services at the CHU Sainte-Justine.

    Dr. Arsenault points out that emergency rooms must be reserved for children who are seriously ill or injured. He says, if everyone runs to the ER when their child has a low-grade fever it will impinge on the staff's ability to treat children whose lives are in danger.

    Both physicians recommend parents refer to the Self-Care Guide distributed by the Québec Government. However, they want to point out a small error in the guide. The guide says that parents should consult a doctor as soon as possible if their child aged two or younger has a fever. This is not accurate. Parents need only consult a doctor urgently if their newborn (three months and younger) has a fever of more than 38.3 degrees C (100.9 degrees F). For all other children, a doctor should only be consulted if the child has a fever and other complications associated with the flu as described in the guide.

    They also recommend you take your child or teenager to the emergency department if your child has:

    - Difficulty breathing (for example: breathing faster than normal; and
    look paler than usual or have whitish or bluish lips; are coughing
    excessively, choking or breathing irregularly).
    - An injury where it is suspected that a bone may be broken or stitches
    required.
    - Vomiting following an injury.
    - A fever over 38 degrees C or 100.4 degrees F and are under three months
    of age.
    - A fever and is difficult to wake up or is very sleepy.
    - A rash that does not turn white when you push on it.
    - Diarrhea, vomiting and have no tears, a very dry mouth, and have not
    urinated at least two to three times over the last 24 hours.

    Both doctors ask families to visit their pediatrician or family doctor, unless they are dealing with a true emergency, as described above. If there is no community physician, or the physician is unavailable, families should go to their local CLSC or walk in clinic. You should be using the health care services available in your neighbourhood. To learn where these services are located please call Info-Santé by dialing 8-1-1.

    Not a Vaccination Centre

    A reminder: neither the CHU Sainte-Justine nor The Montreal Children's Hospital are H1N1 vaccination centres. To find the vaccination centre nearest your home call Info-Santé at 8-1-1 or go to: www.pandemiequebec.gouv.qc.ca.

     

     

    1029 Statement from Ontario Medical Association on H1N1 vax delays [Toronto ON]--"Patient concern has grown across the province about the pending wave of the H1N1 virus in Ontario. As expected, community doctors' offices have been inundated with calls from patients wishing to get themselves and their families vaccinated in order to protect themselves.

    Over the last few days there have been suggestions in the media and some in public health that Ontario doctors are not interested in participating in the H1N1 vaccination program. I want to assure the public that Ontario doctors are ready, willing and wanting to provide the vaccine to patients. The problem is that many doctors can't get the vaccine to give to our patients yet.

    Unfortunately, it appears that some local health units have made the decision to limit the distribution of the vaccine to mass vaccination centres, rather than the traditional community physician office for the time being. We understand that this decision has been made due to a limited supply of the vaccine. Some doctors who have ordered the vaccine have been told that they won't be receiving it right away. To date, we have not received confirmation as to when these current supply issues will allow for wide distribution of the vaccine to community physicians.

    We need manufacturers and government officials to expedite the distribution of the vaccine as quickly as possible.

    Doctors are frustrated by the mixed information they have been receiving. We're also frustrated by our inability to provide for the patients who have been asking to get vaccinated. However, all of us are committed to working together with our health care partners to provide whatever care we can in this challenging time for Ontario families.

    Ontario's doctors understand the concerns of parents given recent unfortunate events. We encourage families to try to be patient over the next few weeks. There is no doubt that government officials, public health units, doctors and all health care providers are all working towards the same goal - providing the best care possible to our patients - despite some of these challenges."

    Suzanne Strasberg, MD

    President, Ontario Medical Association

    Dr. Strasberg is also a family doctor who practices at a clinic in Toronto's Jane and Finch corridor.

     

     

    1029 New advice on H1N1 care [Nova Scotia]--Nova Scotians now have more detailed advice on what to do if they have flu-like symptoms, which include fever and/or cough, sore throat and extreme tiredness.

    "Up to this point in time, we have been telling people that if they are sick, they should stay home. Now, as we have learned more about the H1N1 virus, we have new guidelines that offer much better clarity and direction on what to do if you have influenza symptoms," said Dr. Ken Buchholz, senior physician advisor, Department of Health.

    People with symptoms in risk groups -- those younger than five, pregnant women and people younger than 65 with a chronic medical condition for which they receive regular medical care -- should be assessed and receive early treatment as soon as possible. They should visit family doctors, nurse practitioners or family health nurses, go to a walk-in clinic, or visit a primary assessment centre, if one is available in their area.

    People with severe flu-like symptoms, which may include shortness of breath, chest pain, dizziness, severe vomiting, high fever and confusion, should call 911, or immediately go to the local emergency room.
    "As we are starting to see an increase in cases of flu throughout the province, it is important that Nova Scotians know how to recognize flu-like symptoms, and when and where to seek medical care," said Dr. Buchholz.

    Like other provinces and territories, Nova Scotia has a stockpile of antiviral drugs. It is being distributed to district health authorities and pharmacies and supplies should be in stock everywhere by early next week. Antivirals will be available, at no cost, to Nova Scotians who are in the risk groups and have a prescription.

    People with flu-like symptoms who are otherwise healthy should stay home until they are feeling well. If their condition worsens, they should seek medical care.

    Effective today, lab tests will be done only on people admitted to hospital with flu symptoms so labs are focused on testing those who need it most.

    For information and advice on H1N1, people can contact Healthlink 811 to speak with a registered nurse. For more information on H1N1, including who is at risk, flu symptoms and primary assessment centres, visit www.gov.ns.ca/h1n1

     

     

    1029 Significantly less H1N1 vax available than had been anticipated [Manitoba]--The federal government is advising all provinces, including Manitoba, that there will be significantly less vaccine delivered than had been anticipated in the weeks ahead.
     

    The initial delivery from the federal government of 134,000 doses and a second delivery of 72,000 doses have already been distributed for use in clinics around the province. As of the end of day Oct. 28, there had been 67,078flu shots administered in Manitoba.
     

    As a result, Manitobans who are not in the first priority group are asked to wait to get their flu shots. Manitoba’s priority groups include those who are most at risk and would benefit the most from getting the shot. All Manitobans will have access the shot as soon as enough supply of the vaccine arrives. The first group of Manitobans who should get the H1N1 flu shot now include:
    - children aged six months to under five years old;
    - anyone of Aboriginal ancestry (First Nations, Métis or Inuit);
    - disadvantaged individuals (for example, the homeless);
    - people living in remote or isolated areas;
    - people under 65 with a chronic medical condition or other risk including severe obesity, substance abuse or alcoholism;
    - anyone with a weakened immune system or those who live with or care for them;
    - those who live with or care for infants under six months old;
    - single parents or anyone solely responsible for a dependent;
    - health-care workers and medical first responders; and
    - pregnant women who should consult with their doctor about the right type of vaccine to receive.
     

    Regional health authorities (RHAs) may have to adjust their clinic schedules including postponing clinic dates until there is sufficient vaccine supply. RHAs will issue updates as their plans are adapted.
     

    Next week, Manitoba will take delivery of vaccine that does not have an adjuvant. This vaccine is for pregnant women. Manitoba expects to receive approximately 8,200 doses of the Australia-based vaccine obtained by the federal government.

     

     

    1029 Flu Assessment Centre opening Oct 30 [Edmonton, Alberta]--Alberta Health Services will open an Influenza Assessment Centre (IAC) in Edmonton on Friday, October 30 at 8 a.m. 

    Located at Duggan Health Centre (5035-108 A Street), the Influenza Assessment Centre (IAC) will provide assessment and limited treatment services to Edmonton-area residents requiring care for influenza symptoms.  The IAC will be open 7 days a week, from 8 a.m. to midnight.

    Before seeking treatment, individuals suffering from symptoms of influenza are asked to:

    • visit www.albertahealthservices.ca for Self-Care information and local Influenza Assessment Centre details;
    • call Health Link Alberta for further advice on managing symptoms & accessing additional services; or
    • call their family physician

    Common symptoms of influenza include:

    • Cough
    • Fever
    • Muscle aches
    • Lethargy
    • Lack of Appetite

    For more Influenza information, visit www.albertahealthservices.ca or call Health Link Alberta toll-free at 1-866-408-5465; in the Edmonton-area at 780-408-5465; in the Calgary-area at 403-943-5465.

     

    1029 H1N1 vax rollout continues [Alberta]--In the first three days of Alberta’s pandemic H1N1 2009 influenza immunization campaign, the vaccine has been administered to well over 150,000 people provincewide. This exceeds the start of any other immunization program in Alberta history.

    Alberta Health and Wellness and Alberta Health Services are working to address the challenges of delivering a public health initiative of this scale - the largest of its kind ever seen in the province or in Canada.

    Immunization wait times continue to be a concern. Albertans who are not among those at greatest risk for severe illness related to H1N1 influenza are reminded to delay their immunization to ensure those with the greatest need are protected.

    As announced by public health officials on October 22, in order to make the best use of the vaccine supply on hand in the province, Alberta aims to protect those most at risk for severe illness due to H1N1 influenza first. The following groups are encouraged to be immunized as soon as possible:

    • pregnant women;
    • children six months to less than five years of age;
    • people under 65 with chronic health conditions;
    • people living in remote and isolated settings or communities;
    • health care workers involved in pandemic response or the delivery of essential health care services; and
    • household contacts and care providers of people at high risk but who cannot be immunized or may not respond to vaccines.

    There are constraints to how quickly the campaign can proceed, including vaccine supply. Alberta and other provinces are receiving regular shipments from the manufacturer. Alberta will have received roughly 600,000 doses of vaccine by October 30. Starting the week of November 2, deliveries of adjuvanted vaccine to provinces will slow down while the vaccine manufacturer temporarily shifts its focus to producing enough non-adjuvanted vaccine to meet Canadian demand. Non-adjuvanted vaccine is provided to accommodate personal choice for pregnant women.

    For more information on H1N1, visit www.health.alberta.ca.

     

    1029 More details about the H1N1 vax distribution program [Massachusetts]--As of today, more than 480,000 doses of H1N1 vaccine have been distributed to providers in Massachusetts –- just the tip of the iceberg of the total 3.5 million doses of vaccine that we expect to receive this flu season. This is not where we expected to be at this point based on what we were initially told by the federal government, and it creates a difficult and frustrating situation for everyone, especially those people at greatest risk of complications from the H1N1 flu.

    These initial limited supplies have been prioritized for distribution to the health care providers who serve populations at the highest risk of H1N1 flu –- children and pregnant women. It has also been prioritized for health care workers with direct patient contact in light of their vital role in ensuring a functioning health care system. DPH believes this targeted distribution approach, using health care providers who serve these high risk groups every day, is the most effective way to ensure the vaccine gets to those who need it most as quickly as possible.

    As vaccine supplies arrive in larger quantities, more and more providers will receive vaccine for their patients. Vaccine will then be targeted to young adults up to 24 years old and people 25-64 with chronic health problems. Eventually, flu clinics for the general public will begin. However, they won’t be scheduled until there are large enough quantities of vaccine available to support them. Based on current projections from the Centers for Disease Control and Prevention, these flu clinics will not likely be feasible until December. When they have been scheduled, you can find one near you at http://flu.masspro.org. It is important to note that no H1N1 vaccination clinics are listed at this time.

    This vaccine supply situation is complex and confusing. We continue to receive requests for further details on how vaccine arrives in the state, the role of DPH in that process, and how providers receive word on upcoming vaccine availability. Here’s how the system works:

    Major vaccine manufacturers are producing H1N1 vaccine in addition to the seasonal flu vaccine they produce every year. There are nine different H1N1 vaccine formulations approved for various age groups. Vaccine comes as thimerisol-free prefilled syringes, multidose vials with thimerisol, and live, attenuated virus nasal spray (Flumist). More detailed information is available on this chart.

    When a provider first registers with DPH to receive H1N1 vaccine, they include key details about their practice, including:

    * Type of practice and target patient population served
    * Capacity to vaccinate (how many people could they vaccinate in a month with sufficient vaccine supplies)
    * Whether they consent to receive live attenuated vaccine formulations (e.g., Flumist vaccine)
    * How much vaccine and which formulations they would like to order

    Several times each week, DPH receives notice about how much newly available vaccine, and in which formulations, the state can expect to receive. We use the details provided to our vaccine registration system to figure out where that vaccine can and should be shipped. For instance, pregnant women can’t take Flumist, so if a manufacturer tells us there is a new batch of Flumist coming, we cannot send that new quantity to OB/GYNs. It can however, be administered to healthy children, and would therefore be sent to pediatricians.

    DPH does not play any role in physically receiving and redistributing H1N1 vaccines, which are shipped directly to providers in the community. However DPH does play a vital role in matching up available formulations to appropriate providers as vaccine comes off the production line.

    There are more than 4,000 health care providers in Massachusetts that have signed up with DPH to receive H1N1 vaccine this year. (The actual number of vaccination sites is higher, because some of the larger providers will further distribute their allocations of vaccine to their affiliated provider locations.) Virtually all of the providers that serve the priority groups have received some amount of vaccine and will receive more in the coming weeks.

    Unfortunately, the vaccine supply is unpredictable during these early days of distribution even to the point of not having enough for the highest priority groups. Thus, it is possible that a pregnant woman with an underlying health condition may not be able to get vaccinated right away. As more vaccine becomes available in all of the various formulations, these allocations will even out, and all pregnant women who wish to be vaccinated can be.

    Understandably, given the delays in receiving large quantities of vaccine, people want to know exactly where the vaccine has been shipped. We have received requests for specific information on which providers have which quantities of which formulations at any given time. This information is difficult to accurately convey as the situation is constantly evolving. Furthermore, releasing that level of information would likely result in an overwhelming surge of calls and visits to providers, preventing them from quickly and efficiently dispensing the vaccine that they have available to their most at-risk patients. These disruptions may also discourage providers from participating in the H1N1 vaccination program, contributing to further delays in getting vaccine to individuals in the community.

    DPH is as frustrated as you are about the current situation. Regrettably, neither the states nor the federal government have the ability to speed production. What we can do is pledge to distribute the vaccine to the appropriate providers as soon as it becomes available and to continue providing the most up to date information on the situation.

     

     

    1029 National delays in H1N1 vax distribution highlight need for continued prevention efforts [Pennsylvania]--Responding to delays in the nationwide distribution H1N1 flu vaccine, Department of Health officials today urged Pennsylvanians to continue to take steps to prevent the spread of illness.

     
    “We recognize that many people are frustrated trying to find the H1N1 vaccine,” Department of Health Deputy Secretary Michael Huff said while hosting a webinar on the status of vaccine supply and distribution. “We, too, are frustrated by the production delays. We are promptly distributing all of the vaccine allocated to us by the federal Centers for Disease Control and Prevention in order to ensure it reaches those who need it the most.”
     
    The department continues to target the Advisory Committee on Immunization Practices, or ACIP, priority groups for vaccination — individuals between the ages of six months and 24 years, household contacts and caregivers for children younger than six months of age, pregnant women, healthcare providers and emergency medical services personnel, and those under 65 with underlying health conditions.
     
    To date, the Centers for Disease Control and Prevention, or CDC, has allocated approximately 820,400 doses of the pandemic H1N1 vaccine for Pennsylvania. The vaccine has come mostly in multi-dose injectable vials and as Live Attenuated Influenza Vaccine (LAIV), also known as FluMist.  LAIV is licensed for use in healthy persons between 2-49 years of age.
     
    Pennsylvania has also received a small number of preservative-free single dose injections for use in individuals four years of age and older.
     
    The vaccine allocated to Pennsylvania has been distributed to 662 certified providers, including pediatricians, family health practitioners, obstetricians, hospitals, schools, colleges and universities who agreed to target the ACIP recommended groups. The certified providers are those that have registered with the Department of Health to provide H1N1 vaccine and have completed the required vaccine user agreement.
     
    A limited amount of vaccine has also been supplied to state health centers and local, county and municipal health departments to help reach the target populations.
     
    Members of the priority groups should contact their healthcare provider to learn if the H1N1 vaccine is available in their area. If their provider does not plan to administer the vaccine or if an individual does not have a healthcare provider, please call 1-877-PA HEALTH or visit www.H1N1inPA.com for more information.
     
    The CDC indicates that eventually there will be enough vaccine for everyone who wants to receive it, but that may be several months away. Public vaccination clinics will be held across the state once sufficient vaccine becomes available.
     
    Even as the H1N1 vaccine becomes more widely available, it is important to follow these steps to prevent the spread of illness:
     
    • Cover your mouth and nose with a tissue when you cough or sneeze, and put the used tissue in the waste basket.  If don’t have a tissue, sneeze or cough into your sleeve, but never into your hands or onto bare skin.
    • Keep your hands away from your face and don’t touch your mouth, nose and eyes.
    • Wash your hands frequently with soap and water, or use an alcohol-based hand sanitizer.
    • Keep clean frequently used surfaces such as knobs, countertops and desks.
    • Stay home from work or school whenever you are sick, and remain home until you are fully recovered.
    A wide range of H1N1 information is available online at www.H1N1inPA.com.

     

    1029 While we wait for the H1N1 vax: taking charge of your health [by Jason Eberhart-Phillips MD, Kansas State Health Officer and Director of Health, KDHE]--Many Kansas families have been anxiously waiting this month to have their children and themselves vaccinated against the pandemic H1N1 flu virus. Regrettably, makers of the new H1N1 vaccine have found that production of the vaccine’s active ingredient in their laboratories is occurring much slower than anyone expected.

    As a result, the quantity of H1N1 vaccine produced so far – about 22.4 million doses – is lagging well below anticipated levels. At the same time, the level of disease due to the pandemic – including hospitalizations and deaths – has been steadily rising.

    The shortage of vaccine is both frustrating and a bit scary.

    The good news is that much larger quantities of H1N1 vaccine will become available during November and beyond. Eventually there will be enough vaccine for everyone in Kansas who wants it.

    But in the meantime there is more good news: you can take charge of the situation now and reduce the risk your family faces from H1N1 flu, all without the vaccine.

    Aside from the highly publicized importance of frequent and thorough hand washing and respiratory etiquette such as covering one’s coughs and sneezes, you have got one other powerful tool to slow the spread of the flu and keep yourself safe. It’s called social distancing.

    Social distancing is the idea that simply by reducing the frequency, proximity and duration of contact between yourself and others the chances of spreading the disease can be reduced. With a little vigilance wherever you go, such as in schools and childcare facilities, at work and in the community, you can dramatically cut your risk of catching the flu.

    • Start at home by monitoring yourself and your family members every day for symptoms of influenza.  Remain home at the first sign of illness.  Try to limit the interaction between family members who are ill and those who are well.  Remember that individuals with symptoms of influenza should stay isolated and not return to school or work for at least 24 hours after the fever is gone without taking fever-reducing medicine.   
    • Check to see if the schools and childcare facilities where your children attend monitor for illness and immediately isolate symptomatic children until they can be picked up.  Are concerts or athletic events postponed or altered when there are high levels of influenza-like-illness among students and staff?
    • At work, try to create as much space as possible between yourself and your co-workers, and always model good hand hygiene and respiratory etiquette.  Are you knowledgeable about your employer’s policies for sick leave, and do you know when you will be allowed to return to work?  If illness is prevalent, is there any way you can work remotely from home?

    No one likes to wait, and all of us – including me and my family – now find ourselves cooling our heels as we await ever-increasing amounts of vaccine to be produced and distributed.  In the meantime, we can all be active participants in the fight against this virus by implementing preventive measures of good hygiene and other proven strategies to avoid exposure to the flu and stay well.

    Until there is enough vaccine to put an end to this pandemic once and for all in Kansas, please join me in doing what we can to reduce the spread of H1N1 flu,  protecting our families and ourselves.  For more information on reducing the spread of H1N1 flu, go to http://kdheks.gov/H1N1.

     

    1029 King County Flood Warning Center opens as Snoqualmie, Tolt rivers rise on heavy rains [Washington]--Following intense rainfall across much of eastern King County, the King County Flood Warning Center opened at 8:30 a.m. Monday to monitor rising flows on the Snoqualmie and Tolt rivers.

    As of 9 a.m., the sum of the forks of the Snoqualmie River was 13,428 cubic feet per second (cfs), which is above the threshold for a Phase II flood alert level. At these flows, minor flooding could be expected in agricultural areas in the Snoqualmie Valley.

    Meanwhile, the Tolt River was flowing at 2,920 cfs at 9 a.m., which is a Phase II flood alert level. At this level, very minor flooding could be expected in low-lying areas along the Tolt River.

    The current rainfall is not expected to lead to any flooding in the Green River Valley, where the reduced flood-storage capacity at Howard Hanson Dam has led to numerous flood-preparation activities.

    A Phase II warning on any major King County river is the level of the county's four-phase warning system at which the Flood Warning Center is activated to monitor lowland flooding. The center will remain open and continue to monitor the river flooding until conditions improve.

    Flood Warning Center staff are monitoring stream gages and weather reports, and will provide updated information on river conditions as necessary.

    Flood Warning Center staff will continue to monitor stream gages and weather reports and provide updated information on river conditions as necessary. Real-time river level information is available online at
    www.kingcounty.gov/flood

    Updated information on flooding will also be posted on the King County Web site at
    www.kingcounty.gov, or via RPIN, the area's regional Web site at http://www.rpin.org. A recorded flood-information hotline is also updated each hour for citizens wanting information in flood areas. The number is 206-296-8200 or 1-800-945-9263.

    Citizens who need help interpreting flood information should call 206-296-4535 or 1-800-768-7932. Problems on county maintained roads can be reported by calling 206-296-8100 or 1-800-KC-ROADS.

     

     

    1028 The CHU Saint-Justine and the Montreal Children's Hospital reminds parents that ERs are for urgent care [Quebec]--The two pediatric ERs are being flooded with children with only mild flu-like symptoms and fever as parents ask that their child be tested for H1N1.

     

    As per the Ministry of Health and Social Services recommendations, Pediatric Emergency Staff will only do testing on patients who are sick enough to be admited or those with risk factors (e.g. cystic fibrosis, immunosuppressed state) that may put them at risk for complications.

     

    Staff will not routinely test for A(H1N1) influenza even if they present from an outside health care provider. Critically ill patients with febrile respiratory illness will be their priority.

     

     

    1028 More than 38,000 vaccinated against H1N1 this week [Manitoba]--As of Oct. 27, approximately 38,476 Manitobans had received the H1N1 flu shot. Flu clinics organized by the province’s 11 regional health authorities and Health Canada’s First Nations and Inuit Health Branch are being held across the province this week.


    · To date, Manitoba has received 134,000 doses of H1N1 vaccine from the national allocation. It is anticipated that an additional 72,000 doses of vaccine will arrive late this week and the same amount will be shipped next week. The exact amounts may change depending on manufacturing capacity and federal distribution plans.
     

    · Manitobans who should get the shot first should attend the clinics in their area now. Once these Manitobans are immunized over the next few weeks, the H1N1 flu shot will be made available to every Manitoban who needs or wants to be vaccinated or is expected to benefit from the shot.

     

    Manitobans who should get the H1N1 flu shot now include:
    - children aged six months to under five years old;
    - anyone of Aboriginal ancestry (First Nations, Métis or Inuit);
    - disadvantaged individuals (for example, the homeless);
    - people living in remote or isolated areas;
    - people under 65 with a chronic medical condition or other risk including severe obesity, substance abuse or alcoholism;
    - anyone with a weakened immune system or those who live with or care for them;
    - those who live with or care for infants under six months old;
    - single parents or anyone solely responsible for a dependent;
    - health-care workers and medical first responders; and
    - pregnant women who should consult with their doctor about the right type of vaccine to receive.

    Flu Update


    · Manitoba is now at the beginning of the second wave of the pandemic. As of Oct. 26, there were 19 new cases of laboratory-confirmed cases of H1N1 flu bringing the lab-confirmed case count since Oct. 1 to 32. The best way to protect against the flu is to get immunized.
    · In addition to getting the flu shot, there are other steps to take to prevent spreading or getting the flu and to prevent severe illness and death:
    - Cover your cough, wash your hands regularly and limit touching your eyes, nose and mouth.
    - Stay home when you are sick and don’t return to work or school until you feel well enough to do so.
    - See a doctor or nurse within 24 hours of getting even mild symptoms of the flu if you have risk conditions for severe illness (e.g. under five years of age, chronic medical condition, Aboriginal ancestry, pregnant). You need to be assessed and you could be offered antiviral medication that should be given within two days of the onset of symptoms.
    - Get emergency medical care if you develop severe symptoms or if your symptoms get worse, especially shortness of breath or severe or worsening weakness.
    · If you have mild flu symptoms, you should:
    - Stay home from school or work until you feel well enough to return and limit unnecessary contact with others.
    - Contact you nearest health-care provider or visit your nearest health-care centre if you have risks for severe illness or you are concerned that you may need care, especially if your symptoms are severe or worsening. Early treatment (within 24 to 48 hours) may be very important.
    · Go for emergency medical help or call 911 if you or a family member:
    - experience shortness of breath or have difficulty breathing;
    - experience severe or worsening symptoms such as increased thirst, or decreased urination and strength;
    - are dehydrated or have not urinated for 12 hours;
    - are drowsy or confused; or
    - have an infant under three months old with a fever.

    For more information on H1N1 flu, visit www.manitoba.ca/flu or call Health Links-Info Santé at 788-8200 or 1-888-315-9257.

     

     

    1028 Flu assessment clinic opening in Charlottetown [Prince Edward Island]--An Influenza Assessment Site, opening in Charlottetown tomorrow, will provide health services to Islanders with influenza-like illness, says Dr. Heather Morrison, Chief Health Officer for Prince Edward Island.

    “In recent days, increasing numbers of Islanders with influenza-like symptoms have been presenting at clinics throughout Charlottetown and at the emergency room at the Queen Elizabeth Hospital,” said Dr. Heather Morrison, Chief Health Officer. “At the Influenza Assessment Site, symptomatic people can be assessed and, if necessary, receive treatment. We hope this will also alleviate some of the pressure off the Queen Elizabeth Hospital Emergency Room and the doctors’ offices.”

    Dr. Morrison provided the following guidelines to help Islanders decide when to seek medical attention:

    • If you have mild symptoms (see below) of influenza-like illness, but are otherwise healthy, you should stay at home to recuperate until symptom free and able to return to regular work or school activities. However, if conditions worsen, a health care provider should be contacted.

    • If you have influenza-like illness and have underlying health conditions or if you are pregnant, you should contact your health provider or doctor or visit the Influenza Assessment Site.

    • Seek immediate medical attention if you become very ill, or have shortness of breath, difficulty breathing, chest pain, confusion, sudden dizziness, severe or persistent vomiting.

    • Seek immediate medical attention for a child if he/she has very fast breathing or trouble breathing, bluish skin colour, is not drinking enough fluids, not waking up or not interacting; or has increased irritability, fever with a rash, or flu-like symptoms that improve and then return with fever and worse cough.

    For more information on when to seek medical treatment, call 1-888-748-5454.

    Symptoms of H1N1 Flu Virus are similar to those of regular influenza and include cough with or without fever plus one of the following: sore throat, body aches and pains, fatigue, and lack of appetite. Gastrointestinal symptoms (like vomiting and diarrhea) may also be present. Fever may not be prominent in those under age five or over 65.

    The Influenza Assessment clinic will open Thursday, October 29 at the Four Neighbourhoods Family Health Centre, 152 St. Peters Road, and will continue to run daily from 10 a.m. - 8 p.m., including weekends. Additional assessment clinics may be established in other communities if required. In the meantime, individuals should continue to seek medical care as required according to the above guidelines. Vaccines will not be available at the Influenza Assessment Site.

    H1N1 Vaccine Clinics are continuing to operate throughout the province. This week vaccinations are offered to those who would benefit most from the vaccine as well as those who care for them. For a complete schedule, and list of the times and locations of clinics across the province each week, visit www.gov.pe.ca/flu or see the ads in local newspapers.

    For more information on how to look after someone who is ill at home, visit the Public Health Agency website at www.fightflu.ca.

     

    1028 First H1N1 flu-related hospitalization confirmed [Yukon]--Yukon’s medical officer of health, Dr. Brendan Hanley, today confirmed that Yukon has had its first hospitalization linked to pandemic H1N1 (pH1N1).

    “The first patient was a child, with an underlying chronic condition who was hospitalized last week, and has now been released,” Hanley said. The lab has confirmed that the patient had H1N1.

    “We are seeing more flu activity right now and it was to be expected that some of our cases would be hospitalized,” Hanley added. “We are very fortunate that until now, most cases have been mild.”

    Hanley said he will not be reporting numbers of lab confirmed cases because numbers do not truly reflect the actual situation. Physicians and community nurses are being asked to test only those individuals who have influenza-like illness with either risk factors or severe illness.

     

     

    1028 Statement from chief medical officer of health: H1N1 flu clinics update [New Brunswick]--The following statement was issued today by Dr. Eilish Cleary, chief medical officer of health:

    The Province of New Brunswick has launched its H1N1 flu immunization program. The government has ensured that sufficient H1N1 influenza vaccine will be available to protect every resident this flu season. The vaccine will be provided free to all New Brunswickers aged six months and older.

    The clinics listed on www.gnb.ca/flu, or through the toll-free flu information telephone number, are for priority groups. If you are not a member of a priority group, we ask that you wait until clinics open for the public. It is important that we all work together to protect those most vulnerable, and we appreciate your co-operation.

    The priority groups include:

    • people younger than 65 with chronic medical conditions;
    • children aged six months to younger than five years;
    • pregnant women;
    • schoolchildren;
    • people of Aboriginal ancestry;
    • health-care workers;
    • postpartum women (women who have had a baby in the last six weeks); and
    • household contacts, or those who care for either an infant under six months old or an immunocompromised person.

    The information, including dates, times, locations, and eligible groups for H1N1 clinics is available by region at www.gnb.ca/flu . This site will be updated continually to include clinics scheduled throughout the months of November and December. These clinic listings will be clearly labelled as the vaccine is extended to other groups, as well as to the general public.

    We ask for the public's co-operation and patience as we hold these clinics throughout the province. There will enough vaccine for every New Brunswicker who chooses to be vaccinated.

    Please continue to check our website or call 1-800-580-0038 for weekly H1N1 vaccine clinic listings.

     

    1028 Govt of Canada providing H1N1 travel guidance [Ottawa ON]--The Government of Canada today provided important guidance on how to reduce the spread of the H1N1 flu virus on planes, trains, ferries and inter-city buses

    "Canadians want to know how the H1N1 flu virus affects their regular travel " said Health Minister Leona Aglukkaq.  These guidelines help clarify how passengers, crews, travel agencies and operators can help reduce the spread of infection on planes, trains, ferries and buses ."

    The guidance document primarily targets travellers undertaking longer trips, particularly those traveling between cities, provinces or countries.  Canadians who are feeling healthy are encouraged to continue their regular use of public transit.

    "Everyone has a role to play in reducing the spread of the H1N1 flu virus," said Chief Public Health Officer, Dr. David Butler-Jones.  "If you are sick you should postpone your travel plans until you feel well enough to participate fully in all regular activities." 

    Guideline recommendations include:

    • passengers and crew members staying home if they are sick; 
    • travel companies, airlines, bus lines and others who operate public conveyances allowing Canadians to easily rebook their travel plans if they get sick;
    • operators posting preventive measure signs advising travellers to wash their hands frequently with soap and water or alcohol-based sanitizer, and to cough and sneeze into arms, and not their hands; 
    • travel companies ensuring that facilities for hand washing are readily available for passengers;
    • regular cleaning of common surfaces in transportation vehicles according to cleaning and disinfection procedures developed by Health Canada; and 
    • crew members avoiding using gloves, masks, facemasks, and eye protection in most situations. 

    The guidance document also provides advice on how to deal with sick passengers on board planes, trains, ferries and buses, and outlines the responsibilities of conveyance operators for notifying public health or other appropriate authorities about sick passengers (see backgrounder).  The first priority is to arrange for immediate medical attention of a passenger, if required.

    The guidance document has been distributed to all conveyance operators, and is available on the website of the Public Heath Agency of Canada.

     

    1028 First death linked to H1N1 reported as flu is widespread [Vermont]--The Vermont Department of Health is reporting a significant increase in influenza illness around the state over the past week. Cases of 2009 H1N1 have been confirmed by the Health Department Laboratory in all areas of the state, and hospitals are reporting a sharp increase in the number of visits related to respiratory or viral illness.

    The first death in Vermont linked to 2009 H1N1 influenza was also reported this week in an adult with serious medical conditions.

    “While we know that every year the regular seasonal flu causes serious illness, hospitalizations and deaths, this is a very sad marker in our experience with the new H1N1 influenza,” said Health Commissioner Wendy Davis, MD at a media briefing today. “Unfortunately, we expect – as is the case in every flu season – that there will be more hospitalizations and deaths in the coming weeks and months.”

    Most people who get the flu will be sick for a few days or a week and recover well after staying home and taking care. Most people will not need to see their health care provider, and will not need to go to the hospital.

    “Fortunately, so far and for most people, this new flu is causing mild illness,” said Dr. Davis. “But we want everyone to be alert for warning signs and to know when to call for help and get medical attention.”

    Unlike the regular season flu, the 2009 H1N1 virus is especially affecting children and young adults – as well as people with chronic medical conditions.

    The Health Department also reported today the loss of 800 doses of vaccine due a refrigeration malfunction in one of its offices this weekend. Flu vaccine must be continuously be stored at a temperature of 2 to 8 degrees Celsius (35.6 to 46.4 degrees Fahrenheit) until it is used.

    “The loss was concerning to all of us at the Health Department. Unfortunately, it is a known risk in the vaccination world and underscores the critical nature of vaccine storage and handling. We have taken immediate steps to prevent this from happening again,” Dr. Davis said.

    This is the first week that vaccine is being provided in school clinics. Fifteen clinics have been held to date, with a total of 27 scheduled for the week, and more being scheduled for the coming weeks. Despite postponements of some clinics due to limited vaccine supply, reports so far are that the clinics are running smoothly and without major problems.

    “More vaccine is coming into the state every week, and we are working hard to move it out as quickly and equitably as possible to health care providers, hospitals, health agencies, schools and colleges so we can vaccinate first the people who need it most,” said Dr. Davis.

    To date, a total of 38,100 doses of H1N1 vaccine have been received and distributed around the state.

    Extensive information, tools and resources about seasonal and pandemic flu, healthy habits and preparedness are available at the Health Department’s website: healthvermont.gov or dial 2-1-1. You can also follow us on Twitter at twitter.com/healthvermont.

     

    1028 City officials launch school-based H1N1 vax program [New York City]--

    Deputy Mayor for Health and Human Services Linda I. Gibbs, New York City Health Commissioner Dr. Thomas A. Farley and Schools Chancellor Joel I. Klein today marked the beginning of a three-phase initiative to vaccinate the city's school-age population against H1N1 influenza.

    The first phase starts today at 125 public elementary school buildings with enrollments of less than 400. Phase two starts November 4 in school buildings with enrollments of more than 600, and the third phase begins November 9 in the remaining schools.

    Vaccinations will continue at participating elementary schools for approximately eight weeks. Non-public schools that choose to participate in the city's vaccination effort will also receive vaccine during this period. Weekend vaccine sites for middle-school and high-school students will be held in each borough starting in November.

    Last week, New York City's elementary school students started taking home vaccine information packets that include consent and screening forms. By signing and returning the forms - also available in 10 languages at nyc.gov/flu – parents can have their children vaccinated free-of-charge against the H1N1 influenza virus.

    “The City is making this extra effort to vaccinate children,” said Deputy Mayor Gibbs. “Parents who want to have their children vaccinated may do so at no cost. Since immunization is the best way to prevent the spread of H1N1 in schools and throughout the community, this initiative is essential to the City's influenza-prevention plan.”

    The City has put particular emphasis on vaccinating children because they are especially susceptible to novel H1N1 and because vaccinating children also helps prevent the spread of infection from them to adults in the community. “We strongly encourage families to take advantage of this immunization effort,” Commissioner Farley said. “Besides protecting their own children from influenza, parents who take advantage of the vaccinations will help prevent the spread of the virus to others.”

    “Our schools are working closely with the Health Department to make sure all of our students receive the vaccine if their parents want them immunized," said Chancellor Klein. "The program is voluntary and we will not vaccinate children without parental consent, so we encourage families to sign the consent forms and send them back to their schools as soon as possible.”

    City officials encourage parents to have their children vaccinated by their regular health care providers if possible. Approximately 800 New York City providers who ordered H1N1 vaccine have more than 380,000 doses ready to administer. Additional orders of 220,000 doses have already been placed and New York City providers should be receiving them in the coming days. These providers include hospital clinics and community health centers as well as private pediatricians.

    Though H1N1 vaccine is now increasingly available for children and health care providers who want to be immunized, the federal government has yet to distribute enough vaccine to fully cover other populations. Federal authorities expect allocations to increase in coming weeks. The school vaccination program is intended to ensure that no school-age child goes unvaccinated for lack of access. Currently, H1N1 influenza is circulating in New York City at low levels.

    The H1N1 vaccine comes in two forms: an injection and a nasal spray. Children may receive one form or the other depending information parents provide on the consent and screening forms. Children under 10 years old will need two doses of the vaccine to get full protection.

    After school-based vaccination, parents will receive written confirmation that their children have received the vaccine. Parents are instructed to give a copy of the confirmation to the child's medical provider.

    The H1N1 vaccine is produced in exactly the same way that seasonal influenza vaccines are produced, and it has undergone the same testing. Influenza vaccines can cause mild side effects, but serious reactions are exceedingly rare.

    The H1N1 virus typically causes several days of fever, cough and sore throat. Most people recover quickly without treatment, but the infection can cause severe illness or death, especially among people with underlying health conditions. Because certain people are at increased risk of complications from H1N1 influenza, vaccination is especially important for them. The following people should receive the H1N1 vaccine:

    • People 6 months to 24 years old
    • Pregnant women
    • Health care and emergency medical workers
    • People aged 25 to 64 years with long-term health problems
    • People who live with or care for children younger than 6 months.

    More details are available at nyc.gov/flu or cdc.gov/h1n1flu/. Starting today, the flu locator— accessible from www.nyc.gov/flu— will be updated to include approximately 40 H1N1 vaccine distribution locations.

    Although students are being sent home with consent forms, parents can also download the forms from nyc.gov/flu, sign printed copies and send them back to school with their children. All materials are available in Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish and Urdu. Consent forms will also be available on site at the weekend vaccination clinics the City is holding for middle-school and high-school students during November and December. For more information about these weekend vaccination events, visit nyc.gov/flu or call 311.

    New York City Flu Fighters have also been working to promote flu awareness at school events and ensuring other parents are aware of the due date for consent forms for school-based vaccination. New Yorkers interested in becoming a Flu Fighter should visit www.nyc.gov or call 311.

     

    1028 Flu activity widespread as H1N1 vax delays continue [New Jersey]--Statement from Dept of Health and Human Services Commissioner Heather Howard: New Jersey continues to maintain open lines of communication with the public to ensure they have access to the most recent information on H1N1 influenza. There are a number of tools that New Jerseyans can use to stay informed, and simple everyday actions we can take to stay healthy.

    New Jersey opened an H1N1 Information Hotline - 1-866-321-9571 earlier this month. Because of increased interest, call center hours will be extended to weekends. This toll-free public hotline will now be accessible seven days a week from 9 a.m. to 5 p.m. Call center operators will be able to provide general information about H1N1, vaccine safety and availability information, symptoms of H1N1 and flu preventive measures. Since opening the hotline, the Department has answered more than 7,730 calls from the public.

    New Jersey’s flu activity has moved from regional to widespread. This means that H1N1 flu is present in a majority of counties throughout the state. While any type of flu is cause for concern, it is not cause for alarm. I urge all residents to stay informed and take simple preventive measures to stay healthy.

    I also want to take this opportunity to provide an update on vaccine production and availability, vaccine safety, and H1N1 target populations.

    New Jersey’s H1N1 Public Information Initiative

    In an effort to provide critical information to the public, New Jersey created a Find a Flu Shot Locator, an H1N1 Resource Center website, and a toll-free hotline. These resources will help ensure residents and health care providers have access to information and can obtain accurate responses to their questions.

    The State established an H1N1 Resource Center website that includes important information and timely updates on H1N1 flu in New Jersey. The website can be found at www.nj.gov/health. Additional information on H1N1 flu is available at the federal website, www.flu.gov.

    The Find a Flu Shot Locator can be accessed at www.nj.gov/health. Residents can find where H1N1 flu clinics are being held throughout the State. Not all clinics are included on this list because some are being offered to very specific target populations, such as school-based efforts and private doctors’ offices. Public flu clinics will be posted on this site as soon as they are scheduled. Additional public health clinics will be scheduled as more vaccine arrives.

    H1N1 Vaccine Production and Availability

    Many residents are concerned with the slower than expected arrival of H1N1 vaccine. Please understand that the H1N1 vaccine, like other vaccines, is produced by manufacturers and distributed by the federal government. We will do all that we can to ensure orders are placed in a timely manner and that the vaccine is getting to the target populations.

    As of October 28, 2009, New Jersey ordered approximately 1.3 million doses of vaccine and more than 567,000 doses have been distributed to nearly 891 providers statewide. Shipments of the H1N1 vaccine will continue to arrive throughout this month and into the winter.

    The federal government has assured us that ultimately there will be enough vaccine for everyone who wants it. However, with only limited vaccine available at this time, it is important to first target the individuals most susceptible to H1N1 flu.

    H1N1 Target Populations

    It is recommended that certain target groups be among the first to receive the H1N1 vaccine as it becomes available. These groups include:

    * Pregnant women
    * Household contacts and caregivers for children younger than 6 months of age
    * Healthcare and emergency medical services personnel
    * All people from 6 months through 24 years of age
    * Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza

    H1N1 Vaccine is Safe

    Many parents have raised concerns about the safety of the new H1N1 vaccine. All vaccines, including the H1N1 vaccine, are held to the highest standard of safety and are continually monitored. Each year, millions of Americans safely receive seasonal flu vaccines. The H1N1 vaccine is made the same way as seasonal flu vaccine by the same manufacturers that make seasonal flu vaccine. In addition, the National Institute of Health (NIH) has conducted clinical trials for the H1N1 vaccine. The vaccine has been tested and safely used in children, pregnant woman, and adults.

    What You Can Do to Stay Healthy

    * Cover your nose and mouth with a tissue when you cough or sneeze.
    * Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
    * Avoid touching your eyes, nose or mouth. Germs spread that way.
    * Stay home if you are sick.

    Symptoms of H1N1

    The symptoms of H1N1 flu include fever, cough, sore throat, body aches, headaches, chills and fatigue. Some people have reported diarrhea and vomiting. You should immediately call your physician if your child is exhibiting the above symptoms.
     

     

    1028 H1N1-related death in an 80-year-old woman [Delaware]--Delaware’s Division of Public Health (DPH) has learned of another H1N1-related death, this time in an 80-year-old Sussex County woman. She passed away Saturday, October 24, in a Delaware hospital. Because she doesn't fit the typical age profile, additional H1N1 investigation was conducted to confirm her status.

    "Our hearts go out to her loved ones," said Dr. Karyl Rattay, DPH director. "As with most H1N1-related deaths, this individual had multiple other existing medical conditions."

    While people 65 years and older are much less likely to become ill with novel H1N1 flu, when people in this age group get the infection, especially those who are immuno-compromised, their risk of poorer outcomes is increased. This is not surprising given that people 65 and older are generally considered at higher risk of serious flu-related complications, including those requiring hospitalization, from seasonal flu illness.

    Certain groups of people are at higher risk of complications from the H1N1 flu, including people with chronic underlying health conditions such as asthma, diabetes, heart disease, obesity, and those who are immuno-suppressed. For most healthy people this has been a mild infection.

    Precautions to help stop the spread of flu include:

    * Get vaccinated against both H1N1 and seasonal flu.
    * Wash your hands frequently with soap and warm water or use an alcohol-based hand sanitizer.
    * Cover your cough/sneeze with a tissue, or cough/sneeze into your inner elbow and not into your hands.
    * If you are sick, stay home for at least 24 hours after your fever goes away. This means no fever for at least 24 hours after you have stopped taking any fever-reducing medication. Employers are encouraged to be flexible with their employees on the issue of staying home when ill.
     

     

    1028 Rumor control: H1N1 vax and prisons [Texas]--Texas has not allocated any H1N1 vaccine to prisons at this time. Prisoners are not a priority group to receive the vaccine and will not be vaccinated ahead of the general public.

    Given the limited national supply, Texas is initially targeting priority groups most at risk. Pregnant women are one of those groups. There are pregnant women who are incarcerated who need the vaccine to help protect their unborn children.

    Health care providers who serve pregnant women in prisons have requested vaccine from the Texas Department of State Health Services. It is unclear when the state will be able to fill those orders given the limited national supply of the vaccine.

    Texas has been providing vaccine since the state first received allocations from the U.S. Centers for Disease Control and Prevention earlier this month. A limited supply will be going to the prison system to vaccinate those most at risk.

    Texas continues to order its full allocation of H1N1 vaccine, but the national supply still isn't adequate to meet demand. Texas plans to allocate more vaccine to other groups as it becomes more widely available.

    Texas had expected to receive 3.4 million doses of the vaccine by mid-October, according to the initial projections from the CDC. However, the state has been allocated less than 1.7 million doses so far.

     

     

    1028 Two more H1N1 deaths confirmed [Minnesota]--Two more deaths from 2009 H1N1 influenza have been confirmed by the Minnesota Department of Health, bringing the total number of H1N1 deaths to 12 since April. The additional deaths were confirmed in:

    * An adult in the 50-59 age range from south central Minnesota with no underlying health conditions.
    * An adolescent in the 10-19 age range from the Twin Cities metro area who did have underlying health conditions.

    MDH continues to investigate possible H1N1-related deaths on an ongoing basis.

     

     

    1028 H1N1 mass vax clinics update [Arkansas]---The Arkansas Department of Health (ADH) will hold mass vaccination clinics throughout the state on Thursday, Friday and Saturday, October 29-31. CHECK YOUR LOCAL AREA FOR EXACT TIMES.

    * Supplies of H1N1 vaccine are arriving in the state in very limited quantities. This is happening in states nationwide.
    * We have more seasonal vaccine available this year than in past years, but we expect the demand to be high.
    * We would like to be able to vaccinate everyone who wants to get the H1N1 vaccine during the Mass Flu Clinics scheduled for October 29-30, but there is not enough vaccine at this time.
    * Our supply of H1N1 vaccine is so small that we are currently vaccinating only priority groups at most risk for serious complications from H1N1 flu:

    1. pregnant women, because they suffer the most complications from flu infection;

    2. children 6 months through 4 years of age, and children 5 through 18 years of age with underlying medical conditions. These include: chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, cognitive, neurologic/neuromuscular, hematological or metabolic disorders (including diabetes mellitus); children that are immunosuppressed (including immunosuppression caused by medications or by human immunodeficiency virus); are receiving long-term aspirin therapy and therefore might be at risk for experiencing Reye syndrome after influenza virus infection; are residents of long-term care facilities.

    3. We will vaccinate persons in these two priority groups until our supply of H1N1 vaccine runs out.

    * We ask for the public’s patience at the mass flu clinics. Many of the staff at the clinics are community volunteers. They and ADH staff are doing the best they can to vaccinate as many people as possible given limited vaccine supplies and adverse weather conditions. Local ADH staff and volunteers did not set the priorities for who would receive vaccine. These are national recommendations based on people most at risk for serious complication from flu.
    * There are positive indications that the supplies of H1N1 will increase substantially over the next 3-4 weeks and additional mass flu clinics will be scheduled at later dates. Also, as supplies increase, we will be providing vaccine to the roughly 900 private providers that have pre-registered to distribute vaccine.
    * As we get more H1N1 vaccine, those doses will continue to be given to priority groups first. These include pregnant women, children ages 6 months through 24 years, health care workers and emergency medical responders, people living with and caring for infants under 6 months of age, and people ages 25-64 years with underlying health conditions (like asthma and diabetes).
    * All vaccines are FREE at the mass vaccination clinics, but we ask that if you have insurance, Medicare, Medicaid or ARKids First, bring your cards with you so that we can file with your insurance.
     

     

    1028 Child death linked to pertussis [Iowa]--The Iowa Department of Public Health (IDPH) has confirmed the pertussis (whooping cough)-associated death of a young child in southeast Iowa. “This tragic death serves as a reminder that vaccine-preventable diseases can cause complications and death among infants and young children who are too young to be fully vaccinated,” said IDPH Medical Director, Dr. Patricia Quinlisk.

     

    “It’s important for all adults, especially those around children less than 5 years of age, to be fully vaccinated to prevent the spread of infectious diseases like pertussis.”

    Pertussis is a disease caused by bacteria. It causes coughing spells so severe that it is difficult for infants to eat, drink or breathe. Whooping cough is spread when someone who is sick with pertussis coughs and spreads the bacteria to others. Coughing spells can last for weeks; pertussis can lead to pneumonia, seizures, brain damage and death.

    Adults may not realize they have whooping cough because the symptoms of pertussis can begin like the common cold. Young children get whooping cough from infected people around them. This is why it’s critical for everyone around infants and young children to be up-to-date on their tetanus, diphtheria, and pertussis vaccines.

    Until recently there was no pertussis vaccine for adults, but today the tetanus booster vaccine, Tdap, contains pertussis and provides the immunity needed to ensure they do not pass pertussis to vulnerable people. Even if you had a tetanus booster less than 10 years ago, you can receive the pertussis-containing vaccine.

    IDPH recommends all adults receive the Tdap booster vaccine and all children receive their recommended vaccines on time, including the pertussis vaccination.

    For more information about pertussis, visit www.idph.state.ia.us/adper/pertussis.asp.

     

     

    1028 State recommends prioritization of H1N1 vax [Wisconsin]--The Department of Health Services (DHS) is recommending that local health departments and health professionals target H1N1 vaccine for those individuals most-at-risk during the next several weeks as the vaccine supply continues to fluctuate.

     

    DHS has also requested that, beginning next week, public and private health care providers refrain from mass public vaccination clinics, unless they are targeted at those most at risk. As of today, Wisconsin has been allocated a total of 407,000 doses of H1N1 vaccine.

    “As we have seen in every state in the nation, the supply of H1N1 vaccine is unpredictable. Therefore, the safest course of action is to target the vaccine we do have for those who are most-at-risk of becoming seriously ill from this virus,” says Secretary Karen Timberlake. “While we do not anticipate this will need to be a long-term strategy, we’ve issued guidance to help our health professionals make the largest impact with the vaccine that is available.”

    DHS is now recommending that the public health and health care community focus vaccination efforts on the following subset of CDC’s target groups:

    • Pregnant women

    • Persons who live with or provide care for infants age 6 months or younger (examples: parents, siblings, daycare providers)

    • Health care and emergency medical services personnel who have direct contact with patients or infectious material

    • Children age 6 months - 4 years

    • Children and adolescents age 5-18 years who have chronic medical conditions that put them at higher risk for influenza-related complications (see attached letter for list of chronic medical conditions)

    These recommendations are consistent with the Advisory Committee on Immunization Practices guidelines when vaccine supply is limited. The Advisory Committee on Immunization Practices advises the CDC.

    “The CDC had to choose between waiting to distribute vaccine until it had large quantities ready to be shipped or distributing limited quantities of the vaccine sooner,” says Secretary Timberlake. “The CDC chose the latter knowing it would create some challenges and frustrations for health care providers and the public, but also realizing it would allow us to start protecting people against this virus as soon as possible.”

    Community vaccination clinics will resume as H1N1 vaccine becomes more readily available. People may call 2-1-1 to find out an H1N1 or seasonal influenza vaccine clinic nearest them. A “clinic finder” is also available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

     

     

    1028 Strategy for H1N1 vax response [Oklahoma]--Vaccine News: OSDH will receive considerably less vaccine next week than expected. The CDC has announced that these reductions are a result of manufacturing delays. Next week’s shipment to Oklahoma will be around 37,000 doses.


    OSDH Vaccine Response:
     

    Due to the low vaccine doses expected for next week, the vaccination strategy will be primarily focused on:
    o Pregnant women
    o School-aged children
    o Parents and custodial parents of children less than 6 months old.
    o Healthcare workers providing direct patient care to acutely ill patients.
     

    Local County Health Departments will need to review provider registrations and identify any physician offices in their counties that will receive vaccine shipments next week.
     

    OSDH has developed a strategy to increase vaccination rates amount pregnant women but the low amount of available vaccine has made it difficult to implement.
    As vaccine shipments increase, OSDH will be implementing a plan for “fast-passes” for OB-GYN physicians to give to their patients that will allow pregnant women a quick move to the front of lines at public health clinics. Pregnant women have had the highest complication rates from the flu this season.


    OSDH Operations:


    Hospital visits continue to increase statewide but medical systems are still reporting that they are capable of handling the current volume. OSDH continues to follow-up with any hospital that identifies signs of stress.


    Tamiflu suspension is available in the counties for patients who cannot afford costs of compounded Tamiflu suspension. The FDA has also posted instructions for parents who receive Tamiflu capsule prescriptions for children that have difficulty
    swallowing. This information may be found at:
    http://www.cdc.gov/H1N1flu/antivirals/mixing_tamiflu_qa.htm

     

     

    1028 Indications flu activity has peaked in Denver-Boulder metro area [Colorado]--While officials at the Colorado Department of Public Health and Environment expect the total number of H1N1 hospitalized cases and deaths to increase, there are indications that influenza activity has peaked in the Denver-Boulder metropolitan area.

    Data from several surveillance activities indicate the peak of hospitalizations and influenza-like illnesses occurred during the week ending Oct. 10. Officials noted that this is only the beginning of a decline and Colorado still is in the middle of a historic influenza season.

    “Our surveillance of flu activity in the Denver area the past three weeks has shown a leveling off and decline in the number of hospitalized cases being reported. However, it still is vitally important for Coloradans in the vaccine priority groups to get the H1N1 vaccine when it becomes available,” said the state’s Chief Medical Officer Ned Calonge. “To date the state has received approximately 270,000 doses of vaccine.”

    “We continue to work closely with local public health agencies and hospitals in the state on H1N1 activity,” said Calonge. “In most cases local public health agencies are directing the vaccines to health care providers and hospitals to administer to priority populations first. As some communities complete H1N1 vaccinations to health care workers, we are seeing some communities expand the availability of the vaccine to other priority populations.”

    The following individuals who are in the high-risk group for experiencing complications from H1N1 are advised to be the first in line to receive an H1N1 vaccine:

    • Health care workers with direct patient contact

    • Preschool children ages 6 months to 4 years

    • School-age children and young adults ages 5 to 18 with chronic health conditions

    • Pregnant women

    • Parents/caretakers for children younger than 6 months

    While the initial vaccine deliveries to Colorado have amounted to less that anticipated, U.S. Health and Human Services Secretary Kathleen Sebelius said Monday that eventually there will be enough supplies for everyone who wants to get vaccinated.

    “We are receiving more H1N1 vaccines each week and they are being distributed through the state’s network of public health agencies,” said Calonge. “As the vaccination needs of health care workers in various communities are met, vaccine distribution will extend to other priority populations.”

    Through Oct. 24, a total of 1,306 hospitalizations from 46 counties in Colorado have been reported. Twenty-five deaths (seven pediatric and 18 adult) have been reported. State laboratory surveillance continues to show that more than 99 percent of influenza viruses currently circulating in Colorado are the 2009 H1N1 virus.

    The department has added an online link to a free and secure interactive Web site that walks patients through a series of questions to determine the severity of their flu symptoms based on the latest Centers for Disease Control and Prevention guidelines. The link can be found at https://www.amafluhelp.org/Public/Consumer/Home.aspx

    Using this site can help patients assess their own flu symptoms, or those of a child or loved one, and the site offers guidance on whether they should seek care. There also is an opportunity for pregnant women to evaluate their need for a flu vaccine. The site also can generate a doctor’s note when it is safe to return to work or school. Personal information entered into the system is treated as private and secure.

    “We are hopeful that this new American Medical Association tool will help reduce demands on our health care system,” said Chris Lindley, director of the Emergency Preparedness and Response Division of the Colorado Department of Public Health and Environment.

    While AMAfluhelp.org is a useful tool for those who aren’t sure whether they have a cold or the flu, it does not take the place of a visit to the doctor’s office if symptoms are severe. Anyone who exhibits severe symptoms, such as a very high fever or difficulty breathing should contact his or her physician immediately or seek urgent care.

    Individuals with questions about H1N1 are encouraged to call CO HELP at 1-877-462-2911. The hotline has been established to respond to questions about H1N1 and seasonal influenza.

     

    1027 Fifth Calgary H1N1 vaccination clinic opens Wednesday, October 28 [Alberta]--Alberta Health Services is opening a fifth H1N1 vaccination clinic in Calgary, October 28 at 8:30 a.m.  This fifth clinic - located on the 2nd floor of the Olympic Oval at the University of Calgary - will deliver H1N1 Vaccine specifically to pregnant women, children aged six months to less than 10 years, seniors, and family members accompanying the above groups.  The clinic will be open from 8:30 a.m. to 8 p.m. Mondays to Thursdays, and 8:30 a.m. to 3:30 p.m. Fridays, Saturdays and Sundays.

    In addition to opening this fifth H1N1 vaccination clinic, Alberta Health Services has today added another 15 vaccination stations within the existing four H1N1 vaccination clinics.  As of October 28 at 8:30 a.m., a combined total of 127 vaccination stations will be open across the five Calgary H1N1 vaccination clinics, an increase of 47 stations within the first 48 hours of clinic operations.  We will continue to add further vaccination stations to Calgary's five clinics as our staff vaccination program is completed.

    To enable delivery of H1N1 vaccine to as many Calgarians as possible, as efficiently as possible, the Seasonal Influenza vaccine is no longer offered in our five mass vaccination clinics.

    In an effort to ensure all five H1N1 vaccination clinics are fully staffed, Calgary Community Health Centres will be temporarily closed, as of 5 p.m. October 27, until further notice.

    The H1N1 vaccine is available for all Albertans over six months of age; however, individuals at high risk for influenza-related complications are encouraged to get their H1N1 vaccination as soon as possible.

    "H1N1 is expected to be the most prevalent strain of the influenza virus this year," says Dr. MacDonald. "We are pleased with the public's response to the H1N1 vaccine clinics, and appreciate the patience of all Calgarians as we work to deliver vaccine efficiently, to all who wish to receive it."

    For detailed clinic information, including dates, times and locations, visit www.albertahealthservices.ca or call HEALTHLink Alberta toll-free at 1-866-408.LINK (5465), in Edmonton-area at 780-408-LINK (5465) or in Calgary-area at 403-943-LINK (5465).

     

    1027 Adjuvanted H1N1 vax now available for some pregnant women [Prince Edward Island]--The province is now recommending that pregnant women who are in the second half of their pregnancy (20 weeks and over) receive the adjuvanted vaccine at this time. In addition, those pregnant women who are under 20 weeks and have serious underlying health conditions should also receive the adjuvanted vaccine at this time. This recommendation is supported by the Public Health Agency of Canada and the National Society of Obstetricians and Gynaecologists of Canada.

    “The original plan, based on national recommendations, was to wait until the unadjuvanted vaccine was available for pregnant women unless there was an increase in influenza activity,” said Dr. Heather Morrison, Chief Health Officer. “We have started to see an increase in the amount of influenza-like illness reported in the province which has prompted PEI, and many other provinces, to recommend the adjuvanted vaccine to pregnant women in certain situations.”

    This decision is based on the fact that pregnant women in the second half of their pregnancy or those under 20 weeks that have underlying health conditions have a high risk of complications and would therefore benefit most from getting vaccinated.

    Pregnant women can start to receive the vaccine at their obstetrician’s office and, in addition, there will be clinics held this week in Charlottetown and Summerside for prenatal patients who are in their second half of their pregnancy or those who are under 20 weeks but have serious underlying health conditions.

    Clinics include:

    Polyclinic Medical Centre ~ October 30, 9 a.m.-7:30 p.m.

    Summerside Medical Centre ~ October 30, 10 a.m.-3 p.m.

    Pregnant women can also receive the vaccine at any public health clinic across the province. For a complete list of the times and locations of upcoming clinics, watch the newspaper, visit www.gov.pe.ca/flu or call 1-888-748-5454 for further information.

     

    1027 Province has 80 new cases of H1N1 flu [Nova Scotia]--Canada is experiencing the second wave of the H1N1 virus. This means that increased flu activity is being witnessed across the country, including Nova Scotia.

    Nova Scotia has seen 80 new lab-confirmed cases of H1N1, and one hospitalization, since influenza re-emerged this fall.

    There has been one H1N1-related death in Nova Scotia, in July.

    H1N1 activity has been highest in the Guysborough-Antigonish Strait Health Authority and Capital Health.

    "An increase in H1N1 activity was fully expected in our province with the start of the fall flu season," said Dr. Robert Strang, chief public health officer for the province. "That's why I strongly encourage Nova Scotians to get the vaccine as soon as it is made available in their area. Getting vaccinated is the best way to protect yourself, your family and your community.

    "H1N1 is a community virus. We can expect to see it everywhere in our communities -- schools, grocery stores, day cares, libraries and more."

    Women in the second half of their pregnancy, and women at any stage of pregnancy with chronic health conditions, are most at risk of complications from H1N1 and seasonal flu.

    Because of increased H1N1 activity in Nova Scotia, Dr. Strang recommends pregnant women, at 20 weeks gestation or less, who have pre-existing health conditions, consider receiving adjuvanted vaccine. It is also recommended that all pregnant women in the second half of their pregnancy (more than 20 weeks gestation) receive adjuvanted vaccine.

    Healthy pregnant women in the first half of their pregnancy are at less risk of complications, and can wait to receive the unadjuvanted vaccine. Unadjuvanted vaccine will start to be available in Nova Scotia next week.

    H1N1 vaccine will be available, free of charge, to all Nova Scotians who want it. H1N1 clinic dates and times from across the province are available at
    www.gov.ns.ca/H1N1 or through HealthLink 811.

    This is the largest immunization campaign in the province's history. Dr. Strang urged Nova Scotians to be patient and to get the vaccine when it becomes available at a clinic in their community.

    In addition to getting vaccinated, Dr. Strang said Nova Scotians should continue to take other precautions to avoid illness:

    -- Most importantly, stay home if sick with flu-like symptoms, which are fever and/or cough with unusual tiredness, head/muscle/joint aches or sore throat.
    -- Wash hands often with soap and water, especially after a sneeze or cough. When soap and water are not handy, alcohol-based hand sanitizers are an acceptable alternative.
    -- Cough and sneeze into elbow or sleeve.
    -- If using tissues, dispose of them appropriately and wash hands.
    -- Limit touching eyes, nose and mouth.
    -- Do not share drinking glasses, water bottles, mouth guards, cosmetics or eating utensils.
    -- If concerned that medical advice or care is needed, contact HealthLink 811. Like any illness, should symptoms worsen, visit a doctor or walk-in clinic.

     

    As of Oct. 27, Nova Scotia is experiencing increased flu activity. As a result, women in the second half of their pregnancy (more than 20 weeks gestation), and women at any stage of pregnancy with chronic health conditions, should consider receiving the adjuvanted H1N1 vaccine. These women are most at risk of complications from H1N1 and seasonal flu.

    Healthy pregnant women in the first half of their pregnancy are at less risk of complications, and can wait to receive the unadjuvanted H1N1 vaccine. Unadjuvanted vaccine will start to be available in Nova Scotia the first week in November.

     

     

    1027 Almost 90 new severe cases of H1N1 flu since Oct 20 [British Columbia]--British Columbia continues to monitor and respond to the spread of the pandemic H1N1 flu virus. Since Oct. 20, there have been 88 new severe cases of H1N1 identified in B.C. – 43 in Fraser Health, 29 in Vancouver Coastal Health, 11 in Interior Health, four on Vancouver Island and one in Northern Health – with three new deaths, two in Fraser Health and one in Interior Health.

     

    The majority of lab-confirmed cases in B.C. have been mild or moderate in severity, with the patients either having already recovered or currently recovering.

    While the Province continues to monitor all laboratory-confirmed cases, the weekly report now includes only severe confirmed H1N1 cases (hospitalizations and deaths).

     

    Since Oct. 20, there have been 88 new severe cases of H1N1 identified in B.C., with three new deaths.

    In total, BC Centre for Disease Control (BCCDC) has confirmed 199 severe H1N1 cases in British Columbia since April 2009, including:

    Eighty-seven in Fraser Health, including seven deaths.

    Thirty-one in Interior Health, including three deaths.

    Six in Northern Health.

    Sixty in Vancouver Coastal Health, including one death.

    Fifteen on Vancouver Island, including one death.

    Of these 199 lab-confirmed cases admitted to hospital, 51 have been admitted to the ICU. Twenty-one new cases have been admitted to the ICU in the last week.

    To date, twelve laboratory-confirmed H1N1 cases in B.C. are reported to have died. In eleven of those cases, there were underlying medical conditions.

     

    British Columbians can use the Flu Clinic Locator at www.immunizebc.ca to find out where to get the H1N1 vaccine. If there are no clinics posted in a particular area, people can call their public health unit or family physician to find out where and when they can get vaccinated.

    Starting the week of Oct. 26, the people who will benefit most from pandemic H1N1 immunization, and who need and want to get vaccinated, will be able to receive that vaccine should they choose to do so.

    These groups include:
    · Persons under the age of 65 with chronic conditions.
    · Pregnant women.
    · Persons – including First Nations – living in remote and isolated settings or communities.

    People who fall into these groups AND for whom the seasonal flu vaccine is normally recommended will be able to receive both shots at the same time. People who do not fall into these groups are asked to put off receiving the H1N1 vaccine for a few weeks to allow those at most risk to get their vaccine first.

    Starting the week of Nov. 2, the people eligible to receive the H1N1 vaccine will expand to include the following groups:
    · All initial groups.
    · Children 6 months to less than 5 years of age.
    · Healthcare workers (including all health-care system workers involved with the pandemic response or delivery of essential health services).
    · Household contacts and care providers of infants less than 6 months of age, and persons who are immunocompromised.

    People who fall into these groups AND for whom the seasonal flu vaccine is normally recommended will be able to receive both shots at the same time.

    Beginning in mid-November, everyone else who needs and wants the H1N1 vaccine will be recommended to receive it. Public notification will happen at this time so that everyone is aware the vaccine is available to them.

     

     

    1027 DHS proposes guidance for anthrax responders [Washington DC]--In conjunction with an interagency task force, Department of Homeland Security (DHS) Secretary Janet Napolitano today announced new proposed guidance for protecting the health of emergency responders during an anthrax attack on a major U.S. city.

    "Protecting our first responders during terrorist attacks is critical to our nation’s security," said Secretary Napolitano. "This guidance will better equip the courageous men and women across the country who would be the first to respond during a large-scale anthrax attack."

    "It is essential that all responders have the appropriate protections available to them to be able to operate while minimizing exposure to these lethal threats," said Assistant Secretary for Health Affairs and Chief Medical Officer Dr. Alexander Garza. "This proposed guidance will help keep responders healthy and safe while remaining consistent with operational realities."

    The proposed guidance recommends protective measures such as personal protective equipment and decontamination and hygiene procedures for first responders, public health and medical professionals, skilled support personnel, essential workers in critical infrastructure sectors, certain federal and private sector employees, and volunteers.

    The guidance - developed by a federal working group consisting of experts from more than a dozen agencies relating to biodefense, infectious diseases, and occupational health and safety - reflects the most current understanding of the unique environment that would exist after a wide-area anthrax attack. It comes in response to a 2008 Homeland Security Council tasking requiring the development of appropriate measures for responders in the immediate post-attack environment of an aerosolized anthrax attack.

    The guidance is also intended to support ongoing planning and preparation efforts for protecting responders engaged in environmental sampling and remediation, as well as others in responder roles.

    DHS published the Notice of Availability of the guidance in the Federal Register today and the public will have 30 days from that date to comment.

    Interested stakeholders are encouraged to comment through www.regulations.gov.

     

    1027 Clarification on H1N1 priority groups - in English and Spanish [Massachusetts]--We want to provide some clarification on how the H1N1 vaccine is being distributed amongst priority groups across the state.

    When the CDC originally outlined these groups, they also recommended that if the vaccine was initially only available in limited qualities that these groups would need to be sub-prioritized. Unfortunately, due to an unprecedented flu season involving the need to produce 2 different types of vaccines, there have been interruptions in the production and distribution of the H1N1 vaccine and we have only received a small percentage of our total allocation from the federal government.

    Based on the CDC recommendations, this limited supply is reserved for people at especially high risk for flu, which includes pregnant women, children, caregivers of infants and healthcare workers with direct patient contact. As supplies grow, this will expand to include the additional priority groups of young adults up to the age of 24, and people between the ages of 25 and 64 with underlying health conditions like asthma and diabetes.

    We expect the number of doses of H1N1 vaccine in the state to exceed 1 million by the end of November. As it arrives, we will continue to work to ensure that the vaccine that is available goes to these high priority groups. We thank you for your patience and understanding.

     

     

    Gostaríamos de esclarecer algumas coisas sobre a distribuição da vacina contra a gripe A H1N1 entre os grupos prioritários do Estado.

    Quando o CDC inicialmente determinou os grupos prioritários, eles também recomendaram que caso houvesse falta de vacina uma nova ordem de prioridade deveria ser estabelecida. Lamentavelmente, devido a uma temporada anual de gripe sem precedentes – e a necessidade de fabricar dois tipos diferentes da vacina – houve interrupções na fabricação e distribuição da vacina contra a gripe A H1N1. Somente recebemos uma pequena percentagem do número total de doses que o governo federal tinha inicialmente destinado para Massachusetts.

    Segundo recomendações do CDC, esse pequeno número de vacinas está reservado para pessoas consideradas dentro do principal grupo prioritário na vacinação. Isto é, mulheres grávidas, crianças, pessoas que cuidam de crianças pequenas e profissionais da área da saúde que têm contato direto com doentes. Na medida em que os carregamentos da vacina forem chegando, a vacinação irá abranger o resto do grupo de prioridade, que inclui jovens até a idade de 24 anos e pessoas entre os 25 e 64 anos de idade que tiverem condições de saúde debilitantes, como asma e diabete.

    Esperamos receber mais de um milhão de doses da vacina contra a gripe A H1N1 até o final de novembro. Conforme a vacina chegar, continuaremos trabalhando para que a vacina que estiver disponível chegue a todos aqueles dentro desses grupos prioritários. Agradecemos sua paciência e compreensão.
     

     

    1027 DHHS announces activation of H1N1 flu public inquiry line [New Hampshire]--The New Hampshire Department of Health and Human Services is announcing the activation of New Hampshire’s H1N1 Flu Public Inquiry Line. DHHS is urging residents with questions about the H1N1 influenza virus, the H1N1 vaccine, and any other questions related to H1N1 to contact 2-1-1 NH by dialing 2-1-1.

    “People have questions about the H1N1 virus and the status of the supply of H1N1 vaccine. We are activating the public inquiry line because we want to be sure people have access to good information are getting answers to their questions and are taking the proper steps to prevent the spread of the virus,” which is why we are activating the public inquiry line,” said Gov. John Lynch.

    “We understand that people are concerned about H1N1, particularly with the delay in vaccines being made and shipped from private manufacturers. But we want to assure the public that the vaccine will be coming,” said DHHS Public Health Director Dr. José Montero. “We want to encourage everyone, in the absence of the vaccine, to take common sense preventative measures to avoid becoming sick with H1N1 or any other illness. This includes washing your hands frequently, covering your mouth when you cough or sneeze, and staying home from work or school if you are sick.”

    DHHS has been working with 2-1-1 NH, (a program of United Ways of NH in partnership with Public Service of NH, The State of NH and Exeter Hospital) to be ready to respond as the State’s public inquiry line for all questions regarding H1N1 influenza. Initially the public inquiry line will be open for H1N1 related questions from 8 am – 5 pm Monday through Friday.

    For more information on H1N1 flu, visit www.dhhs.nh.gov or the Centers for Disease Control and Prevention (CDC) at www.cdc.gov/h1n1flu.

     

     

    1027 E.coli 0157:H7 found in beef patties after more than 20 children became ill [Massachusetts]--South Shore Meat Company in Brockton, Mass. has initiated a voluntary recall on certain ground beef and other beef products based on confirmed laboratory evidence of the presence of E. coli O157:H7 in leftover ground beef samples obtained from a nature camp in Plymouth, Mass.

     

    Suspect ground beef patties were collected and tested by the Mass. Department of Public Health (DPH) after more than 20 school children and adults from Rhode Island, who had visited Camp Bournedale in Plymouth, Mass., the week of October 13th became ill with gastrointestinal symptoms.

     

    DPH is continuing to investigate the outbreak in cooperation with the Rhode Island Health Department and the Centers for Disease Control and Prevention.

     

    There is now laboratory evidence that the ground beef collected at the camp is the same strain of E. coli O157:H7 confirmed in two of the children. No other camp attendees have reported any illnesses to date.

    DPH is continuing to work with United States Department of Agriculture to identify all affected beef products that will need to be recalled. Additional information on recalled products will be posted at www.fsis.usda.gov/FSIS_Recalls/Open_Federal_Cases/index.asp as it becomes available.

    DPH is reminding the public to consume only fully cooked ground beef. Cooking meat to an internal temperature of 160 degrees Fahrenheit kills the bacteria.

    E. coli O157:H7 is a type of bacteria that can cause bloody diarrhea, dehydration and, in the most severe cases, kidney failure. The very young, the elderly and persons with weakened immune systems are the most susceptible to foodborne illness.

    Anyone with signs or symptoms of foodborne illness should consult their health care provider, local board of health, the DPH Epidemiology Program at 617-983-6800 or the Food Protection Program at 617-983-6712.

     

    1027 DoH expands list of priority groups served at free H1N1 vax clinics [Washington DC]--The DC Department of Health (DOH) announced today that the free H1N1 vaccine clinics for District residents will expand the priority groups served. Since October 19 the Department of Health has hosted clinics for pregnant women and youth ages 6 months to 24 years. The clinics will now also serve adults with underlying health conditions such as asthma and diabetes, and caregivers of children under 6 months. The clinics will continue to be in every ward once a week for the next three weeks.

    DOH also announced that vaccine is now expected to arrive at pharmacies the week of November 2. The vaccine is also still available at pediatricians, family physicians and community health centers who have registered to distribute the vaccine. As DOH continues to receive updates from the federal government on vaccine supply and availability it will update the vaccine distribution schedule to reflect those updates.  Residents can find regular updates and additional information on H1N1 at flu.dc.gov or by calling the Mayor’s Citywide Call Center at 311.

    Select  H1N1 Vaccine Clinic Schedule for Priority Groups to see the list of clinics.

    Select H1N1 Vaccination Information Availability to see the expected vaccine availability for different priority groups.

     

    1027 High-risk individuals offered H1N1 influenza vaccine [Alabama]--County health departments will start administering a limited number of doses of H1N1 influenza vaccine to individuals in targeted high-risk groups beginning Wednesday at locations throughout the state. Statewide the health department has 55,000 doses available at this time.


    Vaccine in injectable form will be offered only to pregnant women; children 6 months though 4 years old; parents, siblings and caregivers of children less than 6 months old; children and adolescents 5 through 18 years old who have underlying medical conditions; and health care workers.


    “We must target our limited amounts of vaccine to individuals at the highest risk because of the uncertainties in supply we face,” Dr. Donald Williamson, state health officer, said. “We ask for your support and understanding at this time. As more vaccine becomes available, our department and other health care providers will begin vaccinating school children and others outside of these target groups.”


    Alabama and the nation are experiencing significant delays in the amount of H1N1 influenza vaccine received. Vaccine supply is short for both private providers and health departments. The number of vaccine doses sent to each county health department has been allocated based on population.

     

    The public can find clinic dates, times and locations at www.adph.org. Information is also available by calling the health department’s toll-free hotline at 877-377-7285 between 7 a.m. and 7 p.m. Monday through Friday.

     

     

    1027 Flu helpline surpasses 5,000 calls [Marion County, Indiana]--The Marion County Health Department Flu Helpline has received more than 5,000 calls since opening September 21.

    As of October 27, the Flu Helpline has received 5,558 calls.

    The 221-3366 helpline allows the public to ask general flu related questions.

    "We are pleased with the response. People are concerned and it's appropriate we provide this resource," said Pam Thevenow, Flu Helpline Coordinator and administrator of the health department's water quality and hazardous materials management program.

    A majority of calls are from those wanting to know where they can get the H1N1 vaccine. Other callers want information on the seasonal flu vaccine.

    "By and large callers are interested in getting the latest information. Most understand that we don't have a lot of vaccine to distribute and that those in the at-risk groups are getting the initial doses of vaccine," said Thevenow.

    The Flu Helpline was established to provide current flu information and take calls that might otherwise go to 911, 211 or the Mayor's Action Center.

    Health educators are available to take calls in English and Spanish, Monday to Friday from 8 a.m. - 5 p.m. Those calling at other times can leave a message and have their call returned.

     

     

    1027 State Public Health director urges patience as H1N1 vax supply limited [Illinois]--Dr. Damon T. Arnold, Director of the Illinois Department of Public Health, is urging Illinoisans to be patient in getting the H1N1 vaccine. Due to slower than anticipated production, there is currently a limited supply of the H1N1 vaccine nationwide. However, manufacturers continue to produce the vaccine as quickly as possible and supplies are expected to increase throughout November and December.

    “Illinois will continue to receive additional shipments of the H1N1 vaccine so there will be enough vaccine for everyone,” Dr. Arnold said. “Certain people are at higher risk of complications due to the 2009 H1N1 flu and others work with populations at risk of complications, so we ask you to consider allowing these people to receive their H1N1 flu vaccination first. Again, additional doses of the H1N1 vaccine will be delivered to providers over the coming weeks and months so there will be enough vaccine to go around. In the meantime, we ask that you be patient and take everyday preventive actions to stay healthy – follow the 3 Cs: Clean, Cover and Contain.”

    The H1N1 vaccine is being delivered directly to local health departments and hospitals across Illinois, outside Chicago (Chicago receives its own supply), to begin vaccinating the following U.S. Centers for Disease Control and Prevention (CDC) designated priority populations:

    • Pregnant women
    • Household contacts and caregivers for children younger than six-months of age
    • Healthcare and emergency medical services personnel
    • All people from six-months through 24-years of age
    • Persons aged 25-64 years who have health conditions associated with higher risk of medical complications from influenza

    Children younger than 10-years should receive two doses of 2009 H1N1 flu vaccine. This is slightly different from CDC’s recommendations for seasonal influenza vaccination, which state that children younger than nine who are being vaccinated against influenza for the first time need to receive two doses. Infants younger than six months of age are too young to get the 2009 H1N1 and seasonal flu vaccines.

    “We encourage people to get the H1N1 vaccine for themselves and their families when it becomes available, even if that means waiting until later in the season,” said Dr. Arnold. “Since we expect to see the H1N1 virus continue to circulate throughout the winter and into next spring, it won’t be too late to get the H1N1 vaccine in the coming months.”

    Both the nasal spray and injectable form of the vaccine are available. For a list of public H1N1 vaccination sites and clinic times, as well as additional information on the 2009 H1N1 flu, log onto www.ready.illinois.gov.

    For non-medical questions about the H1N1 virus, call the Illinois Flu Hotline at (866) 848-2094 or (866) 241-2138 (Spanish).

    To stay healthy and limit the spread of flu, follow the 3 Cs:  

    • CLEAN – wash your hands frequently to prevent the spread of germs.
       
    • COVER – your cough and sneeze with a tissue or sleeve, not your hand.
       
    • CONTAIN – contain your germs. Stay home if you are sick.

     

    1027 H1N1 vax continues to trickle into state [Oregon]--The H1N1 vaccine continues to trickle into the state. So far, Oregon has received about 6 percent of the vaccine necessary for the people in priority groups, which accounts for about half of Oregon’s population.

    "We know that there isn’t enough H1N1 vaccine for everyone right now," says Dr. Mel Kohn, director of Oregon Public Health Division. "We want those at the highest risk to go to the front of the line."

    Five private manufacturers are delivering the vaccine around the country as soon as it is produced. In Oregon, counties and tribes request the supply and decide how to distribute it to individual health care providers and clinics. The amount of vaccine is allocated to counties on a per-capita basis.

    "Even if you don’t get vaccinated right away, there is still value in getting one eventually," says Dr. Kohn. "It’s likely that H1N1 will continue into the spring, so it’s not too late to get protection."

    For most people, a case H1N1 flu is no worse than seasonal flu, lasting about 7-10 days with the vast majority of people getting better without seeking medical attention.

    Since Sept. 1, 2009, 482 people in 24 counties have been hospitalized in Oregon with influenza-like illness; 15 people in eight counties have died.

    Oregon Public Health has activated the emergency operations center full time to coordinate the state’s response to pandemic H1N1 and ensure that the most up-to-date information is available. The center is working closely with local health departments and monitoring hospital capacity and supplies.

    Hospitals and health care providers in some Oregon counties have experienced a surge of patients, but so far there is enough capacity to care for people with symptoms severe enough to require hospitalization. On Oct. 26, President Obama declared a national state of emergency in response to pandemic H1N1. This action allows hospitals to waive certain regulatory requirements so they can respond better to the emergency, such as making it easier to transfer patients between facilities.

    "Until the vaccine arrives be patient, proactive and calm," says Dr. Kohn. "Protect yourself and others by washing your hands, covering your cough and staying home when you’re sick. We’ll all get through the flu season by working together."

    For more information, visit www.flu.oregon.gov or call the Oregon Public Health Flu Hotline at 1-800-978-3040.

     

    1027 Two more flu-related deaths reported [Wyoming]--Two more flu-related deaths of state residents have been reported to the Wyoming Department of Health.

    Flu contributed to the deaths earlier in October of both an adult male (Influenza A, further subtype not confirmed) and elderly male (Influenza B, not H1N1). Both were Laramie County residents and had underlying health conditions linked with higher risk of severe illness.

    Flu activity continues to climb in Wyoming, is widespread across the state and is mostly due to the H1N1 flu strain. More influenza cases have been reported to the department since May than the total in any flu season over the past ten years. Influenza symptoms include fever, cough, sore throat, body aches, headaches and fatigue. Some patients also report diarrhea and vomiting.

    Of the total 2,522 reported flu cases in Wyoming since late May, 587 have been confirmed as swine flu cases. Most other cases were not subtyped. Over the same timeframe, the department has received reports of 77 Wyoming hospitalizations in connection with the virus.

     

    The department expects the number of actual flu infections around the state to be much higher, because most ill persons do not seek medical care or are not tested. Specific swine (novel H1N1) flu counts only reflect cases confirmed by specialized lab testing as the H1N1 strain as part of the department’s ongoing surveillance activities.

    Actions recommended to slow the spread of illness include:

    · When available, get immunized with both a swine flu and a seasonal flu vaccine.
    · In general, people who develop influenza-like illness should stay home from work, school or travel until at least 24 hours after they are free of fever. Those who are severely ill (such as having trouble breathing) should seek medical care.
    · Avoid contact with ill persons.
    · Covering noses and mouths with a tissue or sleeve when coughing or sneezing, and throwing used tissues in a trash can.
    · Frequent hand washing with soap and water or the use of an alcohol-based hand gel.

    More information about flu in Wyoming is available online at www.health.wyo.gov .

     

     

    1026 Estimates indicate 115,000 residents have or have had H1N1 flu [Louisiana]--The Department of Health and Hospitals today updated the status of the state’s Fight the Flu campaign. As the H1N1 vaccination campaign moves forward, it is important for Louisiana families to be patient if their provider has not yet received the H1N1 vaccine, as more vaccine is arriving every week. Residents should stay in contact with their provider as to the vaccine’s availability and to make an appointment when the time comes.

    This Week’s Highlights

    • Of the 233,100 doses of H1N1 vaccine the state has ordered, the CDC reports that approximately 187,900 doses of H1N1 vaccine have been shipped to Louisiana as of Wednesday, October 21.
    • 362 providers in Louisiana have administered 14,843 doses of H1N1 vaccine.
    • Initial doses of the injectable vaccine have begun to arrive, with pregnant women and frontline health care workers serving as the initial target groups for injectable vaccine.

    H1N1 Vaccination Campaign Summary

    • LAIV nasal spray vaccine continues to be available through registered providers, including pediatric providers.  Most of these doses have been slated for use in young children.
    • Additional shipments of H1N1 vaccine are expected every 5-10 days for the next 2-3 months, with pregnant women, front line health care workers, and adults with pre-existing medical conditions as the next target groups for vaccination.
    • Every Louisianian who wants the vaccine should have access by the end of January.
    • Residents should check with their providers regarding the availability of H1N1 vaccine.
    • DHH will post a flu shot locator on www.FightTheFluLA.com, showing locations where vaccine will be available across the state.
    • DHH has launched a Twitter feed (FightTheFluLA) and a Facebook page to help ensure teenagers and young adults, both of which fall into high-risk groups for H1N1, have easy access to up to date information regarding the H1N1 virus and vaccine.

    Overall Influenza Activity

    • There are now 1,655 lab confirmed cases of the H1N1 flu in the state of Louisiana.
    • Estimates derived by DHH in conjunction with CDC data indicate approximately 115,000 Louisianians currently have or have had the H1N1 flu.
    • DHH has confirmed no additional H1N1-related deaths in the past week.

    DHH’s Fight the Flu campaign aims to keep Louisianians healthy by promoting immunizations and good hygiene to prevent the spread of the seasonal flu and the H1N1 virus. For more information on flu activity in Louisiana, including guidance for families and medical professionals, visit www.FightTheFluLA.com or follow the campaign at www.twitter.com/FightTheFluLA.

     

    1026 State announces toll-free H1N1 flu vax hotline [South Dakota]--South Dakotans looking for information about H1N1 vaccine opportunities can call a new toll-free state hotline, 1-866-320-2740. The line is available from 8:30 a.m. to 5 p.m., central time, Monday through Friday.


    “Vaccine is still limited in South Dakota but supplies are slowly increasing. Right now, most vaccinations are being given in doctors' offices and clinics to high risk patients but by mid-November we hope to begin offering public clinics,” said Doneen Hollingsworth, Secretary of Health.

     

    “This hotline will give South Dakotans one more resource to find out about those vaccination opportunities.”


    Hollingsworth said South Dakotans can also check the web at http://h1n1.sd.gov  for information about H1N1 flu and vaccination. As clinics are scheduled they will be posted at that site.


    In addition to vaccination, personal precautions should be taken to help stop the spread of influenza and other illnesses:
    · Wash hands often with soap and water or use alcohol-based hand gel.
    · Cough and sneeze into a tissue or your sleeve, not into your hands.
    · Stay home when you’re sick. – until 24 hours after symptoms are gone – without fever-reducing medicine.

     

     

    1026 H1N1 update - activity in province beginning to increase [New Brunswick]--The following update on the H1N1 flu virus was issued by the Office of the Chief Medical Officer of Health for New Brunswick on Monday, Oct. 26:

    • Canada is experiencing a second wave of pandemic influenza activity;
    • there is significant variation in numbers of cases across the country. In New Brunswick, activity is still low, but we are starting to see it pick up. This means we are on the cusp of a second wave of pandemic H1N1 activity in New Brunswick;
    • fortunately, we have access to a good, safe and effective vaccine;
    • our H1N1 flu vaccine clinics have started today across the province;
    • the province will receive a third shipment of vaccine this week. This will allow us to continue to expand our clinic coverage;
    • we encourage New Brunswick residents to access clinic information and more information about the H1N1 flu virus and its symptoms by using the flu website www.gnb.ca/flu or the toll-free telephone number, available 24/7, set up for New Brunswickers seeking information about H1N1 flu virus, 1-800-580-0038;
    • the information including dates, times, locations, and eligible groups for H1N1 clinics is available by region through the web or the toll-free number. The clinic listings were significantly updated over the weekend and will be continuously updated over the course of the H1N1 vaccination program;
    • New Brunswickers are reminded that there will be sufficient vaccine for all who want or need to be immunized against the H1N1 flu. If you do not see your community or target group listed, please recognize that these listings are frequently updated and know that it will be coming. The absence of your community or target group just means that it has not been added to the website yet. No one will be forgotten or overlooked. This website will be continuously updated as more clinics are scheduled and the vaccine is extended to other groups as well as the public;
    • we are aware that heavy demand for information may occasionally cause longer wait times than usual on the toll-free line. Extensive improvements were made over the weekend and continue to be made;
    • we know that pregnant women, especially in the second half of pregnancy, are at highest risk for severe disease if they contract the virus. Additionally, maternal immunization while pregnant may help to protect the infant after birth;
    • in view of the likelihood of increased circulation of virus, as of today we are recommending that women in the second half of their pregnancy (more than 20 weeks), and those less than 20 weeks with a pre-existing condition, should be offered the H1N1 vaccine at the earliest clinics;
    • in Canada, original plans were to offer pregnant women a more traditional unboosted vaccine as there was a lack of data in pregnancy with boosted vaccines. However the adjuvanted vaccine is authorized for use in pregnancy and the World Health Organization (WHO) has indicated that it does not have any special concerns about the safety of adjuvanted H1N1 flu vaccines in general;
    • the WHO has recommended that pregnant women be immunized against the H1N1 flu virus, even if no non-adjuvanted vaccine is available;
    • this recommendation is a recognition that waiting for the future delivery of unadjuvanted vaccine is a greater risk than having them vaccinated now. We also know that the adjuvanted vaccine will give better protection;
    • however, it is still a personal choice. If a pregnant woman chooses to wait, then she will still be offered the unadjuvanted vaccine when it becomes available. If she should become ill with influenza-like symptoms in the meantime, she should seek medical attention as soon as possible;
    • we have just become aware that the Government of Canada has procured an additional supply of unadjuvanted vaccine, which may be available in the provinces as early as mid-next week;
    • New Brunswickers should continue to protect themselves and those around them by washing hands thoroughly and often, coughing or sneezing into sleeves, staying home if sick, and keeping common surfaces clean;
    • persons at high risk of complications from influenza-like illness should seek medical attention promptly. Those at risk include pregnant women, people with underlying medical conditions such as diabetes, chronic lung conditions or those with compromised immune systems;
    • persons with influenza-like symptoms should stay home and minimize contact with family members as much as possible. If symptoms worsen, they should visit their physician or nurse-practitioner, a walk-in clinic or the nearest hospital emergency department;
    • it is recommended that sick people limit contact with other people until they are free of symptoms; and they are feeling well;
    • it is important for New Brunswickers to understand that if they do not have influenza-like symptoms, they can continue to go to work and school as normal, to participate in activities and to socialize; and
    • more information on the H1N1 flu virus may be found online or by calling the 24-hour H1N1 line, 1-800-580-0038.

     

    1026 Overall flu activity increased for fifth consecutive week [Canada]--Summary of FluWatch Findings for the Week ending October 17, 2009

    * The overall influenza activity has increased for a fifth consecutive week. All indicators (proportion of positive influenza tests, national ILI consultation rate, number of regions reporting widespread and localized activity and number of influenza outbreaks) were higher this week compared to the previous weeks. There is increased influenza activity across the country, particularly in the West (BC, AB, SK, NT).
    * This week, 99.9% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009.
    * The intensity of Pandemic (H1N1) 2009 in the population was moderate with sixty-four hospitalizations and three deaths reported this week. Hospitalized cases were reported from BC, AB, MB, ON and NT while the deaths were from BC and SK. As of October 17, 2009, a total of 1,604 hospitalized cases including 312 cases admitted to an intensive care unit (ICU) and 164 cases required ventilation as well as 83 deaths had been reported since the beginning of the pandemic.
    * The Minister of Health announced on October 21, 2009, that Health Canada has approved AREPANRIX, a vaccine against the Pandemic (H1N1) 2009 virus.

    Pandemic (H1N1) 2009 virus Surveillance and Epidemiology

    A total of 1,604 hospitalized cases including 312 (19.5%) cases admitted to ICU and 164 (10.2%) cases required ventilation as well as 83 deaths of Pandemic (H1N1) 2009 were reported to PHAC as of October 17, 2009. The proportion of females affected, the median age and the proportion of cases with underlying medical conditions was still increasing with severity of illness this week (see Characteristics table). While women and men had similar hospitalization rates, more females were admitted to ICU, required ventilation and died compared to men (approximatively 60% females vs. 40% for males for all these outcomes). As well, for those with severe outcomes, females had more underlying medical conditions than males; 74.2% vs. 68.4% of ICU admissions and 81.6% vs. 71.8% of deaths. In the Canadian population, there are more females than males in older age groups which may partially explain the differences observed.

    The national crude hospitalization rate was 4.8 per 100,000 population with the highest rates in children under 15 years of age (11.2 per 100,000). The national crude mortality rate was 0.25 per 100,000 population; those 45 years and older had the highest mortality rate (0.36 per 100,000). ICU admission rate and ventilation rate were also elevated in children under five years of age (1.7 and 1.1 per 100,000, respectively).

    There were 85 (27.8%) hospitalized pregnant women out of 306 hospitalized women between 15 and 44 years of age for whom the information on pregnancy was available. The median age among all pregnant cases was 28 years (range 16 to 42 years). Information on pregnancy trimester was available for 39 hospitalized women: 28 (71.8%) of these 39 pregnant women were in their third trimester. Pregnant women had a higher burden of morbidity and mortality. Assuming 1% of the population is pregnant in a given year, approximately 5% of hospitalized cases and 5% of deaths occurred in this group. However, hospitalized pregnant women were admitted to ICU less frequently (18.8% vs. 30.3%), required ventilation less frequently (5.9% vs. 16.7%) and had less underlying medical conditions (36.7% vs. 58.0%) compared to hospitalized non-pregnant women between 15 and 44 years of age. The main underlying medical conditions reported by hospitalized pregnant women were pulmonary disease (including asthma) (11) and diabetes (5). Four pregnant cases resulted in death and three of these women were in their third trimester (the trimester was unknown for one case).

     

    Overall Influenza Summary - Week 41 (October 11 to October 17, 2009)

    The overall influenza activity has increased for a fifth consecutive week. All indicators (proportion of positive influenza tests, national ILI consultation rate, number of regions reporting widespread and localized activity and number of influenza outbreaks) were higher this week compared to the previous weeks.

    Four regions reported widespread activity in BC & NT and fourteen regions in BC, AB, SK, ON, NB & NL reported localized activity, while twenty-three regions reported sporadic activity in BC, SK, MB, ON, QC, NB, PEI, NS, NL, YK & NU and thirteen regions in NB, NS & NL reported no activity. The fifty-eight influenza outbreaks reported this week were all in schools except 1 in a long-term care facility (BC), 1 in an unspecified location (AB) and 1 in a workplace (NB). The schools outbreaks were in BC (38), AB (9), NT (5), SK (1), NS (1) and NL (1). Note that this is the first year that all the provinces and territories are reporting on influenza outbreak in schools (greater than 10% absenteeism on any day most likely due to ILI) which is increasing considerably the total number of outbreaks reported compared to the previous years.

     

    ILI consultation rate

    This week, the national ILI consultation rate was 48 consultations per 1,000 patient visits which is higher compared to the previous weeks and still above the expected range for this time of the year. Four provinces (AB, SK, ON and NT) had higher ILI consultation rates compared to their ILI rates in previous weeks. The ILI rates of these four provinces were also higher than the national level this week. People under 20 years of age had the highest consultations rates with 98.3 and 88.9 per 1,000 patient visits among children under 4 years of age and among those 5 and 19 years of age, respectively.

     

    Paediatric Influenza Hospitalizations and deaths

    In week 41, no laboratory-confirmed influenza-associated paediatric hospitalizations or deaths were reported through the Immunization Monitoring Program Active (IMPACT) network. 379 hospitalizations had been reported since week 17 (April 26); 93.7% of these hospitalizations were due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, four deaths due to Pandemic (H1N1) 2009 had been reported through the IMPACT network among children under 16 years of age.

     

    Vaccination

    The Minister of Health announced on October 21, 2009, that Health Canada has approved AREPANRIX, a vaccine against the Pandemic (H1N1) 2009 virus. Health Canada and the Public Health Agency of Canada are currently working with provincial and territorial governments to deliver the A/H1N1 flu vaccine to health care facility sites to begin immunization programs.

    Antigenic Characterization

    Since September 1, 2009, NML has antigenically characterized 40 Pandemic (H1N1) 2009 viruses and two seasonal influenza viruses (one influenza A/H1N1 and one B virus) that were received from Canadian laboratories. All 40 Pandemic influenza A (H1N1) viruses characterized were antigenically related to A/California/7/2009, which is the pandemic reference virus selected by WHO as Pandemic (H1N1) 2009 vaccine. The one seasonal influenza A/H1N1 virus characterized was related to A/Brisbane/59/07, which is the influenza A/H1N1 component recommended for the 2009-10 influenza vaccine. The one influenza B virus characterized was antigenically related to B/Brisbane/60/08, which is the recommended influenza B component for the 2009-10 influenza vaccine.

    Antiviral Resistance

    NML: The 40 Pandemic (H1N1) 2009 specimens were tested for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) by phenotypic assay and/or sequencing. The testing results showed that the virus was sensitive zanamivir and resistant to amantadine. One out of 21 Pandemic (H1N1) 2009 isolates tested for oseltamivir resistance was found to be resistant.

    Provinces: Three cases of oseltamivir resistant Pandemic (H1N1) 2009 were reported to date in Canada from the province of Quebec on July 21, 2009, from Alberta on September 15, 2009 and from Ontario on October 13, 2009.

     

     

    1026 Canada works with Australia to secure additional H1N1 vax for pregnant women [Ottawa ON]--Health Minister Leona Aglukkaq and Canada's Chief Public Health Officer, Dr. David Butler-Jones, announced today that the Government of Canada had secured additional unadjuvanted H1N1 flu vaccine from Australia.

    “The Government wants pregnant women across the country to have access to unadjuvanted vaccine as soon as possible,” said Minister Aglukkaq. “While our order from GSK remains on schedule, the unadjuvanted vaccine we have secured from Australia will be available ahead of the GSK order.”

    The Minister thanked both manufacturer CSL Australia and the Australian Government for their cooperation and underscored that pregnant women remain a priority group for vaccination.

    “The Government of Canada has purchased 200,000 doses of unadjuvanted H1N1 vaccine from manufacturer CSL Australia,” stated Dr. Butler-Jones. “Barring any distribution delays, the vaccine will be available to the provinces and territories as early as the first week of November.”

    This vaccine has been approved for use in Australia and the United States. Canada has authorized access to Australia's unadjuvanted vaccine to ensure that pregnant women in Canada would have access to an unadjuvanted vaccine on a timely basis. The GSK vaccine is still on target for delivery in early November, however given that the increase in cases of H1N1 flu across the country, this purchase from Australia will allow for earlier access to the unadjuvanted vaccine.

    Women more than 20 weeks pregnant, and women in earlier stages of pregnancy with risk factors for severe disease, should consider getting the adjuvanted vaccine until the unadjuvanted vaccine is available.

    An adjuvant is a substance that is added to a vaccine to improve immune response. In the case of the H1N1 flu vaccine, the adjuvant includes naturally occurring oil, water and vitamin E. All evidence suggests that adjuvanted vaccines are just as safe as unadjuvanted vaccines; however there adjuvanted vaccines have not been widely tested in pregnant women. The World Health Organization has recommended that pregnant women receive unadjuvanted vaccine where possible, but adjuvanted vaccine could be used if necessary.

     

     

    1026 Cautionary note on provincial Tamiflu supply [Vancouver, BC]--As British Columbia continues to experience increased pandemic H1N1 influenza activity, health officials are reiterating important messages regarding the use of antivirals to treat infection from this novel virus.

    “Over 9,000 prescriptions of antivirals were filled last week alone, which is a 78 per cent increase from the previous week” said Dr. Fawziah Marra, pharmacy director at the BC Centre for Disease Control, an agency of the Provincial Health Services Authority. “We want to remind British Columbians that if you have received a prescription for Tamiflu from your physician as part of your ‘flu plan’, then please do not fill the prescription unless you are experiencing moderate to severe influenza-like symptoms, or experiencing mild symptoms but have a high risk condition. Tamiflu is intended for treatment and not prevention. It is important to follow your physician’s instructions carefully to help reduce the risk of this virus becoming drug-resistant.”

    Last week, 38 influenza-like illness (ILI) outbreaks were reported in B.C. schools and, since September, over 99 per cent of all respiratory samples testing positive for influenza at the Provincial Laboratories at the BC Centre for Disease Control (BCCDC) were subtyped as pandemic H1N1 flu virus. These numbers confirm that pandemic H1N1 is by far the dominant circulating influenza strain in British Columbia at this time.


    “Earlier this month, B.C.’s stockpile of Tamiflu, an antiviral medication used to treat pandemic H1N1 influenza, was made available through community pharmacies,” explained Dr. Perry Kendall, British Columbia’s provincial health officer. “This supply is to be accessed by patients only if they are experiencing moderate to severe influenza-like symptoms, such as fever, cough, and fatigue.”

    Tamiflu may also be used in patients with mild symptoms but who are at risk of developing complications, including pregnant women and new mothers who are less than a month postpartum; people with underlying health conditions, and especially those with chronic conditions such as asthma, diabetes and morbid obesity; and children under five years of age.

    “Influenza activity in B.C. remains above the expected range for this time of year,” said Dr. Kendall. “We have mechanisms in place to monitor and respond to outbreaks throughout the province, including early treatment through antiviral use in remote communities and for those at higher risk of severe illness.”

    Tamiflu, the brand name for oseltamivir, is an antiviral medication that works by inhibiting an enzyme that the flu virus needs in order to spread through your body. Medical experts caution against widespread use of this medication as a number of cases of oseltamivir resistance have been seen within Canada and other countries, making it imperative that doctors not over-prescribe a critical medication that can be used for treatment of influenza.

    People can protect themselves the same way they can protect themselves against the seasonal flu, which includes getting vaccinated with the pandemic H1N1 flu shot, staying home when sick, proper hand washing and coughing into a sleeve or tissue.

    For more information on the H1N1 flu virus visit www.gov.bc.ca/h1n1, or call HealthLink BC at 8-1-1, 24 hours a day/seven days a week to speak to a nurse.

     

     

    1026 H1N1 vax clinics now open [Alberta]--Alberta Health Services will begin offering the H1N1 vaccination in mass vaccination clinics across Alberta on Monday, October 26.

    All Albertans aged six months and older are eligible to receive the vaccine free of charge. Individuals at high risk for influenza-related complications are encouraged to get their H1N1 vaccination as soon as possible.

    Vaccination is the best defense against influenza and Alberta Health Services is committed to vaccinating every Albertan who wants the H1N1 vaccine, as efficiently as possible. Mass vaccination clinics are the most effective way of delivering vaccine to our communities in a short period of time, however, we ask Albertans to be patient should they encounter line-ups at their local mass vaccination clinic.

    H1N1 immunization is expected to be the most prevalent strain of influenza this year, and all Albertans will benefit from the H1N1 vaccination.

    For detailed clinic information, including dates, times and locations, visit www.albertahealthservices.ca or call HEALTHLink Alberta toll-free at 1-866-408-LINK (5465), in Edmonton-area at 780-408-LINK (5465) or in Calgary-area at 403-943-LINK (5465).

    Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than 3.5 million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.

     

     

    1026 Statement on Declaration of Emergency [Massachusetts]--Governor Deval Patrick and health and human services officials in Massachusetts praised President Obama for the declaration of national emergency related to the H1N1 influenza outbreak.

     

    "The President's actions allow us to continue on the path we have been on in response to H1N1; namely working in partnership with health care providers and public health officials to prepare for an increase in the number of residents with the flu".

     

    The declaration would permit the federal government to waive specific hospital-related legal requirements. This would allow hospitals to take certain actions to respond to increased demands for care and to fully implement their disaster operations plans that enable appropriate care during emergencies.

     

    The Governor joined the President in downplaying the significance of such a declaration. "This does not mean that conditions have dramatically changed or that the public should be alarmed".

    Secretary of Health and Human Services JudyAnn Bigby, MD, emphasized that the plans to prepare and respond to the H1N1 flu have been in place for months as state health officials have collaborated with a wide spectrum of organizations - from hospitals and medical practices to local health officials to school superintendents and nurses. "Each of these sectors is actively working to reduce risk of infection and serious illness".

    The Patrick Administration has conferred with the Massachusetts Hospital Association regarding the President’s declaration and joint efforts are being made to inform hospitals of its content.

     

    The declaration does not increase the pace at which the H1N1 vaccine will become available to the public. Production delays have decreased the shipments of vaccine to Massachusetts and all other states. So far in Massachusetts, 300,000 doses of the vaccine have been distributed to clinical sites. Hundreds of thousands more are expected in the coming weeks.

     

    Public health officials reaffirmed that residents of the state can play an active role in decreasing the spread of the flu by staying home when sick and by carefully practicing health hygiene.

     

     

    1024 State has received only 5 percent of requested H1N1 vax - officials ask for patience [Alaska]--The Alaska Department of Health and Social Services is continuing to receive H1N1 flu vaccine from the federal Centers for Disease Control and Prevention.


    This week the state received additional supplies of both injectable and nasal vaccine. To date, Alaska has received 30,800 doses of vaccine.


    “We have only received about 5 percent of what we ultimately expect to get,” said Sally Abbott, manager of the Division of Public Health’s preparedness program. “We are still targeting all vaccine for use by our five priority groups. We’re asking everyone else to wait until we have larger supplies.”


    The state will be sending 2,800 injectable and 5,700 nasal spray vaccine doses to pharmacies and public health centers around the state. The vaccine is expected to be in those locations before the end of October.


    The five groups considered to be priorities for receiving the H1N1 vaccine include:
     

    • pregnant women;
    • anyone who lives with or cares for children younger than 6 months old;
    • health-care and emergency service workers;
    • everyone age 6 months–24 years old; and
    • adults age 25–64 who have chronic health disorders or compromised immune systems.


    Other actions that can help prevent the spread of viruses include:


    • Cough or sneeze into your sleeve, or cover your nose and mouth with a tissue. Throw the tissue
    in the trash after you use it.
    • Wash your hands often with soap and water or use an alcohol-based hand sanitizer.
    • Avoid touching your eyes, nose or mouth.
    • Disinfect hard surfaces using a diluted bleach solution or commercial sanitizer.
    • Stay home if you get sick.


    For more information go to: www.pandemicflu.alaska.gov or call the Pan Flu Hotline at 1-888-9PANFLU.

     

     

    1023 Four more H1N1-related deaths reported [Nebraska]--Four H1N1 deaths have been reported to the Nebraska Department of Health and Human Services:

    • A woman from Lancaster County in her 60s with serious underlying health problems.
    • A man from South Central Nebraska in his 40s with chronic underlying health conditions including cardiac disease.
    • A Sarpy County woman in her 50s with a blood disorder.
    • The fourth death was announced by the Douglas County Health Department yesterday.

    Because of state statutes, names and other details about the patients can’t be released. So far, there have been a total of seven H1N1 flu deaths in Nebraska.

    “This is a sad situation, and our thoughts are with the families,” said Dr. Joann Schaefer, Chief Medical Officer for the Nebraska Department of Health and Human Services (DHHS). “It’s important to remember that H1N1 can be a severe illness for those with chronic underlying health conditions or compromised immunity.”

    H1N1 flu activity is widespread across the state. DHHS no longer keeps track of individual cases and follows the CDC’s policy for reporting levels of flu. DHHS will continue to track deaths from H1N1.

    Vaccine
    H1N1 vaccine continues to arrive in Nebraska. Vaccination not only offers protection against H1N1 flu, but it also reduces the spread of the flu to others.

    The CDC recommends the following groups be among the first to receive H1N1 vaccine:

    • People 6 months-24 years old
    • Pregnant women
    • People who live with or provide care for infants younger than 6 months
    • Health care and emergency medical services personnel
    • People 25-64 years old with underlying medical conditions.

    Other Protective Measures
    There are also other things people can do to protect themselves:

    • Wash your hands often or use an alcohol-based hand sanitizer
    • Avoid close contact with people who are coughing or otherwise appear sick
    • Avoid touching your eyes, nose and mouth
    • Cover your mouth and nose when you cough with a tissue, not your hands
    • Stay home from work, family gatherings and social functions if you’re sick

    Feeling sick?
    Most people who get H1N1 recover on their own without additional treatment. If you are only mildly ill, you don’t need to seek treatment.

    If you are moderately to severely ill with a cough or sore throat and a fever over 100 degrees, particularly if you have underlying medical conditions, call your physician. A physician may prescribe an antiviral, which can lessen the symptoms and possibly shorten the duration of your illness. Your physician may feel comfortable treating you without being seen if you have serious underlying health conditions.

    People who are sick should stay home from work or school for 24 hours after their fever ends. Parents should have a plan on how to keep their child home if he or she becomes ill.

    Additional symptoms of H1N1 are body aches and sometimes may include vomiting and diarrhea.

    For more information, see the DHHS Web site:
    http://www.dhhs.ne.gov/H1N1Flu/ and subscribe to updates for the most current information. For a list of local health departments go to: http://www.dhhs.ne.gov/puh/oph/lhd.htm.

     

    1023 Dept for Public Health urges patience on H1N1 while reporting two additional H1N1-related deaths [Frankfort KY]--Kentucky Department for Public Health (DPH) officials provided an update today on H1N1 (swine flu) activity in the state, including the reporting of two additional H1N1-related deaths.


    The deaths involved a woman in her 80s from Knox County with significant underlying health issues who died in September, and a man in his 40s from the Kentucky State Reformatory in Oldham County who was being treated off-site. The state now has 10 recognized H1N1-associated deaths.
     

    "It is always a tragedy when we lose any Kentuckian to illness," said DPH Commissioner William Hacker, M.D.. "We know that seven of the 10 individuals we have lost in Kentucky are in target groups for the H1N1 vaccine. People in these groups are at higher risk for complications from the swine flu and should get the H1N1 vaccine as soon as it is available in their community. While we don't yet have as much of the swine flu vaccine on hand as we would like, we know more will arrive in the coming weeks."
     

    Kentucky has been allocated 177,400 doses of the swine flu vaccine so far, with more than 138,000 doses of that having shipped to health departments and health care providers in the state. 
     

    "Kentucky continues to experience widespread flu activity at the moment. I'd like to remind everyone that your mother's advice—washing your hands, covering your cough and staying home when sick—is very effective at preventing the spread of flu," said Dr. Hacker. "The flu vaccine is also one of the most effective tools we have against influenza, and while there are a few clinics already taking place in the state, we hope to begin immunizing more Kentuckians in the weeks ahead. We ask that people find out if they or their family members are in a target group for the H1N1 vaccine, and that we all let those higher-risk individuals get vaccinated first."
     

    The state's allotment of vaccine so far has been about half nasal spray vaccine, which can only be taken by healthy individuals ages 2-49, with the rest in the form of the H1N1 flu shot vaccine. The target groups that health officials are recommending receive vaccine first are:
          - pregnant women;
          - people who live with or care for children younger than 6 months old;
          - health care and emergency medical services workers;
          - children and young adults 6 months to 24 years old, especially those with chronic health problems; and
    - people 25 to 64 years old with chronic health problems.
     

    People over the age of 65 appear to be at lower risk of catching the swine flu, and should receive the vaccine once those in the target groups have received it.
     

    Kentuckians can always visit http://healthalerts.ky.gov for information on H1N1 and Kentucky, including updated information about H1N1 vaccine clinics, or follow KYHealthAlerts on Twitter. Kentucky's toll-free influenza hotline number is 1(877)843-7727, and operates from 8 a.m.-10 p.m. daily.        

     

     

    1023 Children ages 5-18 with underlying medical conditions will receive H1N1 vax as supplies permit [Little Rock, Arkansas]--In order to reach more children with underlying medical conditions and possible risk for complications from H1N1 flu, the Arkansas Department of Health (ADH) will be offering H1N1 vaccine as supplies permit to children ages 5-18 with underlying medical conditions at the Mass Flu Clinics on October 29, 30, 31. We will have seasonal vaccine available for the general public, and, the H1N1 vaccine available for pregnant women and children ages 6 months through 4 years.

    Previously scheduled school clinics scheduled through December statewide will continue to give seasonal flu and H1N1 vaccine as supplies allow to students whose parents request the vaccine for their children. Additionally, the ADH will work with public and private schools that have not scheduled a clinic and work towards meeting their needs.

    As Arkansas gets more H1N1 vaccine, those doses will continue to be given to priority groups first. Priority groups include pregnant women, children ages 6 months through 24 years, health care workers and emergency medical responders, people caring for infants under 6 months of age, and people ages 25-64 years with underlying health conditions.


    If your child is experiencing flu-like symptoms (fever over 100 degrees, headache, body aches, sore throat, dry cough, runny nose, and in some instances vomiting and diarrhea) and especially if they have underlying medical conditions, call your private physician for advice on what to do.

     

    Children with underlying medical conditions include those with: chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, cognitive, neurologic/neuromuscular, hematological or metabolic disorders (including diabetes mellitus); are immunosuppressed (including immunosuppression caused by medications or by human immunodeficiency virus); are receiving long-term aspirin therapy and therefore might be at risk for experiencing Reye syndrome after influenza virus infection; are residents of long-term care facilities.


    Vaccine supplies are expected to increase in the coming months, and there will be plenty of vaccine for any Arkansan that would like to receive it.

    Additional Mass Flu Clinics will be scheduled at later dates.
    For more information go to www.healthyarkansas.com or www.flu.gov .

     

     

    1023 Mayor Menino urges patience in light of delays in vax delivery [Boston, Massachusetts]--Mayor Thomas M. Menino today urged Boston residents at high risk of getting the 2009 H1N1 virus to be patient in light of anticipated delays in the delivery of the H1N1 vaccine, as he joined public health officials in outlining the city’s vaccination plans once ample supplies of the H1N1 vaccine arrive.

    "When we get the H1N1 vaccine, we will move it out as quickly as we can,’’ Mayor Menino said during a visit to a clinic at the Boston Public Health Commission offering free seasonal flu vaccinations. "We will work in partnership with community health centers, hospitals, and primary care providers to ensure that these providers are able to vaccinate their patients, particularly those at high risk.’’

    Of the roughly 270,500 doses of the H1N1 vaccine shipped to Massachusetts so far, about 27,000 doses have been distributed to healthcare providers in Boston for pregnant women, children, and health care workers. The Boston Public Health Commission has been told it can expect its first doses - 200 doses of the nasal spray - this week. Those at highest risk for 2009 H1N1 influenza include children 6 months through 24-years old, adults under 65 with underlying health conditions, people in close contact with infants under 6 months, and health care and emergency medical responders.

    Dr. Barbara Ferrer, executive director of the Boston Public Health Commission, said that in addition to working with local healthcare providers, the agency’s H1N1 vaccination plan will include a series of free public flu clinics in neighborhoods across the city, once the vaccine is available.

    She said the initial doses the Public Health Commission receives will go to front-line public health clinical staff and emergency medical responders who have direct contact with patients. Community health centers will also be assisted if they need additional vaccine for patients at high risk and once there are enough vaccine doses, the Commission will sponsor public health clinics.

    "Our promise today is that once vaccine arrives at the Boston health department, we will keep residents informed about where and when they can get vaccinated,’’ Dr. Ferrer said. "And although initial efforts will prioritize vaccinating those at risk of complications from flu or transmitting it to those at high risk, we have been told by the US Centers for Disease Control and Prevention that later in the season, there should be enough doses available to vaccinate all who request H1N1 vaccine.’’

    So far this season, the Public Health Commission has vaccinated 30,000 people, significantly more than in previous years. Many more Boston residents have been vaccinated by their primary care provider or at other sites. The Public Health Commission is continuing to provide seasonal vaccine to community health centers for free flu clinics for Boston residents. To find out where they are, visit bphc.org.

     

     

    1023 Many school H1N1 vax clinics postponed due to limited vaccine supply [Vermont]--The Vermont Department of Health has been notifying a number of schools today that H1N1 vaccine clinics that had been planned to take place next week will be postponed, due to the limited supply of vaccine in the state. Schools that are participating in the vaccination effort will be notifying parents about changes in clinic scheduling.

    Of 30 clinics that had been scheduled for the week of Oct. 26, 19 have been postponed. A list of the schools with clinics scheduled next week that have been postponed will be posted on the Health Department's website at www.healthvermont.gov.

    "Our goal is to offer vaccine first to those groups of people who need it most, including school-age children, as vaccine continues to come into the state" said Health Commissioner Wendy Davis, MD. "The delay is challenging for everyone, and we will be working with schools to reschedule in the coming weeks, as vaccine supply allows."

    Extensive information, tools and resources about seasonal and pandemic flu, healthy habits and preparedness are available at the Health Department’s website: healthvermont.gov or dial 2-1-1. You can also follow us on Twitter at twitter.com/healthvermont.

     

    1023 DoH continues statewide distribution of H1N1 vax [Pennsylvania]--The Department of Health today announced the Centers for Disease Control and Prevention, or CDC, has allocated more than 566,000 doses of H1N1 vaccine to Pennsylvania. While delays in vaccine production have occurred, the department is placing orders as soon as vaccine is allocated to ensure it reaches Pennsylvania residents as quickly as possible. 

     
    The department continues to target the Advisory Committee on Immunization Practices’, or ACIP, priority groups for vaccination — individuals between the ages of six months and 24 years, household contacts and caregivers for children younger than six months of age, pregnant women, healthcare providers and emergency services personnel, and those under 65 with underlying health conditions.
     
    The vaccine was distributed to 570 certified providers, including pediatricians, family health practitioners, obstetricians, hospitals, schools, colleges and universities who agreed to target the ACIP recommended groups. The certified providers are those that have registered with the Department of Health to provide H1N1 vaccine and have completed the required vaccine user agreement. The vaccine was also distributed to state health centers and local, county and municipal health departments to help reach the target populations.
     
    To date, Pennsylvania has received multi-dose injectable vaccine and a small number of preservative-free doses for children four years of age and older.  Most of the vaccine received has been Live Attenuated Influenza Vaccine, (LAIV, also known as FluMist) for use in healthy persons between 2-49 years of age.
     
    As a result of vaccine production delays, the commonwealth is not expected to receive as much vaccine by the end of October as earlier reported. The CDC continues to allocate vaccine as it is released by the manufacturers. Based on information provided by the CDC, eventually there will be enough vaccine for everyone who wants to receive it, including persons outside the priority groups.
     
    To find an H1N1 vaccination site, people in the recommended target groups should contact their healthcare provider.  If their provider does not plan to administer the vaccine or if an individual does not have a healthcare provider, please call 1-877-PA HEALTH or visit www.H1N1inPA.com.

      

    1023 Gov Paterson issues disaster declaration for Essex County and area impacted by Lake Champlain bridge closure [Albany NY]--Governor David A. Paterson today declared a State Disaster Emergency in Essex County and the neighboring areas adversely affected by the emergency closure of the Lake Champlain Bridge. In addition, at the Governor’s direction, the State has established a toll-free hotline for residents and businesses and has opened an outreach center at the site of the bridge.

    “The closure of the Lake Champlain Bridge has disrupted the lives of many North Country residents and has affected their businesses,” Governor Paterson said. “I am firmly committed to protecting the safety of those who drive across the bridge daily. With this disaster declaration, we are working to expedite repairs and to provide the highest level of assistance possible to the community.

    “I have directed the New York State Department of Transportation (NYSDOT) to expedite the repair of the bridge to re-open it to traffic and to work with Vermont to put alternative transportation in place while the bridge is closed. In addition I have directed NYSDOT to work with Vermont and the federal government to expedite the study and design of a permanent solution,” the Governor continued. “In the meantime, I have directed State agencies to provide assistance to those affected by the closure.”

    The toll-free hotline number - 1-888-769-7243 - will be open Monday through Friday from 9 a.m. to 5 p.m. Those calling from the 518 area code may dial 518-485-1159. The State outreach center is located in the Lake Champlain Visitors Center at 814 Bridge Rd. in Crown Point.

    Representatives from the Governor’s Office and State agencies remain on site to assist the community in dealing with the closure. For information about State assistance, residents may call the hotline or visit the outreach center. In addition, callers may contact the hotline to provide the State with information about the impact of the bridge closure on their lives. This information will be immensely helpful as the State moves forward in assessing the magnitude of the disruption caused by the closure, determining what temporary and remedial actions can be taken to assist the community and seeking federal assistance to mitigate the impact.

    On Monday, State officials met with local leaders at the Crown Point Historic Site to discuss the closure and the impact the lengthy detour would have on commuters, the farming community, businesses, emergency service providers and the general public. Representatives from the Governor’s Office, NYSDOT, State Police, Department of Labor, Department of Health, Empire State Development Corporation, Office of Fire Prevention and Control, Department of Agriculture and Markets and the State Emergency Management Office attended the meeting.

    The Lake Champlain Bridge, also known as the Crown Point Bridge, spans the lake between Crown Point, New York, and Chimney Point, Vermont. On Friday, NYSDOT and the Vermont Agency of Transportation decided to close it indefinitely after finding problems with the foundation. The emergency closure was necessary for the safety of those who use the bridge.

    NYSDOT is designing repairs and developing a timeline for re-opening. A signed detour is in place that will divert motorists on U.S. Route 4 through Whitehall, New York, and on Vermont Route 22A and 17, a distance of about 100 miles.

     

     

    1023 New Castle County death of 15-year-old boy examined for H1N1 [Delaware]--Following notification today, Delaware’s Division of Public Health (DPH) is reviewing the Oct. 19 death of a 15-year-old New Castle County boy to determine if the cause of death is related to H1N1 influenza.

     

    The boy, who had a number of underlying health conditions, went to his doctor on Oct. 19 and was later transported to a Delaware hospital where initial testing for strep infection was positive and influenza was negative. Post-mortem test results Friday were positive for H1N1 influenza and the death will be reported to the CDC as H1N1-related since flu was present.

    "I want to extend my sympathies to the family and friends of the boy," said Dr. Karyl Rattay, DPH director. "DPH is still exploring the role the H1N1 virus had in this case, since there were multiple other existing medical conditions."

    Dr. Rattay urged those dealing with flu-like symptoms to monitor the severity of their illness.

    Signs of serious flu illness in children are:

    • Fast breathing or trouble breathing
    • Bluish skin color
    • Not drinking enough fluids
    • Not waking up or 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
    • Fever with a rash

    In adults, signs of serious flu are:

    • Difficulty breathing or shortness of breath
    • Pain or pressure in the chest or abdomen
    • Sudden dizziness
    • Confusion
    • Severe or persistent vomiting

    Certain groups of people are at higher risk of complications from the H1N1 flu, including people with chronic underlying health conditions such as asthma, diabetes, heart disease, obesity, and those who are immunosuppressed. For most healthy people this has been a mild infection.

    From Aug. 30 to Oct. 10 in the U.S., there were 292 flu-related deaths, seasonal and H1N1 combined, according to the Centers for Disease Control and Prevention. The death of a 35-year old Kent County woman Thursday from H1N1 influenza was announced by DPH yesterday. Precautions to help stop the spread of flu include:

    • Get vaccinated against both H1N1 and seasonal flu.
    • Wash your hands frequently with soap and warm water or use an alcohol-based hand sanitizer.
    • Cover your cough/sneeze with a tissue, or cough/sneeze into your inner elbow and not into your hands.
    • If you are sick, stay home for at least 24 hours after your fever goes away. This means no fever for at least 24 hours after you have stopped taking any fever-reducing medication. Employers are encouraged to be flexible with their employees on the issue of staying home when ill.

     

    1023 SOGC recommends that all pregnant women over 20 weeks gestation receive the H1N1 vax immediately [Ottawa ON]--After discussion with the Public Health Agency of Canada, and based on the evidence for other adjuvanted vaccines as well as experience around the world to date with the adjuvanted H1N1 vaccine, Canadian experts say that both the adjuvanted and non-adjuvanted H1N1 vaccines are safe for pregnant women.

    Earlier this week in Ottawa, Health Minister Hon. Leona Aglukkaq announced the approval of the adjuvanted H1N1 vaccine which has been judged to be both safe and effective. Provinces and territories will start rolling out their vaccination programs in a matter of days.

    An adjuvant is a substance that helps stimulate the body's immune response; it helps boost and speed up the body's ability to fight a virus. It is a natural product made of fish oil, water and vitamin E. While it is the first time these substances are being used in an influenza vaccine, these adjuvants have been used in other vaccines for decades. Countries around the world are stating that both types of H1N1 vaccine are safe, even for pregnant women.

    "Women should be provided with the option to receive either H1N1 vaccine based on facts, not fear about safety. More important than the decision about which H1N1 vaccine a pregnant woman should take is the decision to get vaccinated, regardless of the vaccine type selected," said Dr. Michel Fortier, President of the Society of Obstetricians and Gynaecologists of Canada.

    Considerations for pregnant women when it comes to which H1N1 vaccine to
    choose are:

    - The amount of viral inoculate required to protect an individual: The
    adjuvanted vaccine includes 4 times less viral material than the non-
    adjuvanted vaccine.
    - The number of doses required to achieve immunity: One single dose of
    the adjuvanted vaccine and possibly multiple doses of the non-
    adjuvanted vaccine.
    - The potential for cross-protection against mutations of the virus:
    The adjuvanted vaccine has a greater likelihood for cross-protection
    against mutations.

    Safety

    The adjuvant used by GSK has been tested in approximately 45,000 people around the world and has been evaluated by Health Canada and other regulatory authorities as part of the review of the H5N1 vaccine in the pre-pandemic period. No significant safety concerns regarding the use of the adjuvanted vaccine were detected.

    In June 2009, the World Health Organization (WHO) held consultations on the safety of adjuvanted influenza vaccines to review and discuss known and theoretical safety concerns and prospective vaccine safety evaluation. The outcome - no significant safety concerns or barriers to evaluating or using adjuvanted vaccines for the current H1N1 virus were raised.

    All evidence suggests that adjuvanted vaccines are just as safe as non-adjuvanted vaccines. The WHO's Strategic Advisory Group of Experts (SAGE) recommended in July that pregnant women should receive non-adjuvanted vaccine where possible, but that an adjuvanted vaccine could be used if necessary.

    Dr. Butler-Jones stated that "vaccination is truly the best defence for mother and baby from the potentially devastating effects of the H1N1 virus. The perceived risks associated with either H1N1 vaccine are clearly outweighed by the expected benefits of receiving the vaccine."

    SOGC Recommendations for Pregnant Women

    Vaccination

    The SOGC recommends that all pregnant women over 20 weeks gestation and those less than 20 weeks with underlying risk conditions be vaccinated against H1N1 as soon as a vaccine is available, whether or not it includes an adjuvant. In areas where H1N1 flu rates are high or increasing, health-care providers should offer immediate vaccination with adjuvanted vaccines and not wait for non-adjuvanted vaccines which may only be available in November.

    Antiviral Prescriptions

    The SOGC recommends that each pregnant woman be given a prescription to be used only if H1N1 symptoms appear. Antivirals should not be used for prophylaxis. Women and their families should be aware of serious symptoms of H1N1, leading patients to seek emergency care.

    Posters, Information Tear-Out Sheets

    Public information materials about H1N1 and pregnancy have been produced and will be mailed to health-care providers this week. If by the end of next week, information materials have not yet been received, providers are invited to notify the SOGC.

    Leading by Example

    The SOGC recommends that health-care providers, family members, and office staff get immunized as soon as possible. Dr. Michel Fortier (SOGC President), Dr. André Lalonde (SOGC Executive Vice-President), and Dr. Vyta Senikas (SOGC Associate Executive Vice-President) plan on receiving the H1N1 vaccine in the next few days.

     

     

    1023 Début de la campagne de vaccination volontaire contre le virus de la grippe A(H1N1) dans la région de l'Outaouais [Gatineau QC]--Réunis en conférence de presse aujourd'hui, les représentants de l'Organisation régionale de sécurité civile (ORSC) et de l'Agence de la santé et des services sociaux de l'Outaouais ont présenté les actions actuellement en cours pour lutter contre la pandémie de grippe A(H1N1), de même que l'information générale sur l'importante campagne de vaccination qui se déploiera progressivement dans la région à partir du 26 octobre prochain.

    Les cinq centres de santé et de services sociaux, soit le CSSS du Pontiac, le CSSS de la Vallée de la Gatineau, le CSSS des Collines, le CSSS de Papineau et le CSSS de Gatineau, vont amorcer progressivement, à compter du lundi 26 octobre, la vaccination des travailleurs de la santé.

    Par la suite, les personnes du groupe 1 seront invitées, par leur CSSS, à se faire vacciner. Les informations seront disponibles au fur et à mesure dans les médias locaux et dans le site de Pandémie Québec. Les personnes du groupe 1 sont les suivantes :

    - Les personnes atteintes d'états chroniques âgées de moins de 65 ans;
    - Les femmes enceintes;
    - Les enfants âgés de 6 mois jusqu'à moins de 5 ans;
    - Les personnes qui résident dans des localités ou des communautés
    éloignées et isolées;
    - Les personnes qui résident avec des personnes à risque élevé qui
    pourraient ne pas bien répondre au vaccin (les personnes
    immunocompromises) ou les personnes qui ne peuvent pas être vaccinées
    (nourrissons âgés de moins de 6 mois).

    En ce qui concerne le groupe 2, soit les 5 ans et plus, c'est au cours du mois de novembre que des centres de vaccination de masse seront déployés au fur et à mesure de la disponibilité des vaccins. La directrice de la Santé publique de l'Outaouais, la Dre Hélène Dupont, encourage fortement toute la population à se faire vacciner puisqu'il s'agit de la meilleure protection contre la grippe A(H1N1) : "Le virus a recommencé à circuler dans la région de l'Outaouais et en attendant de se faire vacciner, il est d'autant plus important d'appliquer les mesures d'hygiène comme le lavage régulier des mains pour en limiter sa propagation", a soutenu la Dre Dupont.

    Le président directeur de l'Agence de la santé et des services sociaux, le Dr Guy Morissette, a souligné les efforts de tout le réseau régional pour l'organisation de cette campagne de vaccination : "Nous sommes confiants en notre capacité d'unir nos forces et d'offrir les soins nécessaires à la population pour faire face à la deuxième vague de la pandémie de grippe A(H1N1)."

    L'ORSC de l'Outaouais, composée des ministères et des organismes du gouvernement du Québec présents dans la région, multiplie ses efforts afin d'épauler les autorités régionales de la santé dans la présente opération de vaccination : "La mobilisation de tous est essentielle dans la lutte au virus H1N1. J'assure les docteurs Dupont et Morissette de l'entière collaboration des membres de l'ORSC de l'Outaouais tout au long de la présente campagne de vaccination, mais aussi dans chacune des actions entreprises pour contrer la grippe A(H1N1)", a déclaré la coordonnatrice régionale de l'ORSC, Mme Diane Barbeau.

    Il est possible d'obtenir toute l'information en lien avec la vaccination et les mesures d'hygiène dans le site www.pandemiequebec.gouv.qc.ca. Les détails sur la tenue des cliniques de vaccination (dates, lieux, horaires) seront disponibles, dès le 24 octobre, dans la section "Dans ma région - Outaouais" du site Internet et par téléphone, en communiquant avec Services Québec, au numéro sans frais 1 877 644-4545. Pour toute question relative à la santé, il faut cependant contacter Info-Santé au 811.

     

     

    1023 Students continue to learn about H1N1 prevention at schools [Saskatchewan]--Deputy Premier and Education Minister Ken Krawetz talked with young students today during Education Week to reinforce how they can protect themselves and others from influenza and H1N1.

    "I want to acknowledge the work being done by schools across the province in supporting students and their families to prevent H1N1," Krawetz said. "Today's visit to Deshaye Catholic Elementary School highlights how school divisions and schools province-wide are making a difference by talking to students about H1N1 preventive measures. Regina Catholic School Division is doing an excellent job by helping to Spread the Word, Not the Germ through their pandemic awareness updates."

    "At the school level we are focused on prevention and sharing the information that we are provided with by our local health region," School Operations Superintendent Ray Pitre said. "In our school communities we are working to make families aware of the work of our division's Pandemic Influenza Committee and our operational plans in the event of a resurgence of the H1N1 virus."

    The Ministry of Education has numerous stakeholders including PreK-12 education, early learning and child care, libraries and literacy sectors. The Ministry of Education continues to provide H1N1 information updates on a regular basis to sector stakeholders.

    "I want to recognize school divisions, schools and all of our sector partners for their interest in creating awareness by providing H1N1 information within their communities at the grassroots levels," Krawetz said.

    The Ministry of Health is the lead in providing H1N1 public health guidance.

    H1N1 Information Web Sites:

    Where can I get more information?
    http://www.health.gov.sk.ca/influenza-monitor

    For information regarding the Saskatchewan School Boards Association (SSBA) - A Guide for School Board Pandemic Influenza Preparedness visit
    http://www.saskschoolboards.ca/insurance/riskmanagement/08-07.pdf

    For information regarding Regina Catholic Schools and their flu information, see http://www.rcsd.ca/

     

    1023 Everyone encouraged to get vax'd [Prince Edward Island]--H1N1 Vaccine Clinics are scheduled to begin on Monday and Chief Health Officer, Dr. Heather Morrison is encouraging everyone to get vaccinated in the coming weeks to protect themselves and their families.

    “Similar to other provinces across the country, we are seeing an increase in Influenza Like Illness (ILI) in Prince Edward Island,” said Dr. Morrison. “During the past week specifically, we have noticed that surveillance data for the province is showing an increase in the amount of ILI activity here in PEI. We know that immunization is one of the most effective ways to prevent the spread of infectious disease and we’re hoping that people will decide to get vaccinated over the coming weeks.”

    As part of ongoing surveillance efforts, the Chief Health Office collects information from various sources across the province to get an overall picture of how much flu activity is happening in the community. This includes collecting information from the provincial laboratory, hospitals, pharmacies, schools and early learning centres, and sentinel physicians and tracking calls to the toll-free information line.

    “Based on surveillance information to date, including the number of confirmed H1N1 cases, we have seen a recent increase in influenza-like activity on PEI,” said Dr. Carolyn Sanford, Provincial Epidemiologist for the Department of Health.“The information we collect is analyzed and interpreted to assist in informing health officials as to how much influenza activity is happening locally, nationally and internationally.” Dr. Sanford works in the Epidemiology Unit of the Department of Health, which is primarily responsible for surveillance of both communicable and chronic disease.

    In addition, national information is collected through participation in Federal Provincial and Territorial groups and through surveillance programs by the Public Health Agency of Canada, such as Fluwatch, which is a program designed to inform health professionals on how much flu activity is happening on a national level. The Chief Health Office monitors international data on influenza activity as well.

    Clinics will begin on Monday for those who would benefit most from the vaccine as well as those who care for them. The program will be rolled out over the next four to six weeks and the schedule is based on the recommendations of the Public Health Agency of Canada.

    The vaccine will be delivered by Public Health Nurses and others at no cost, at various sites across the province, including Public Health Nursing clinics, schools, health centres, correctional facilities and healthcare facilities. For a complete list of the times and locations of upcoming clinics, watch the newspaper, visit www.gov.pe.ca/flu or call 1-888-748-5454 for further information.

     

     

    1023 Tamiflu to be available free of charge with prescription [New Brunswick]--H1N1 flu vaccination clinics will open in New Brunswick on Monday, Oct. 26, following Health Canada's approval of AREPANRIX, a vaccine against the pandemic H1N1 flu virus. Dr. Eilish Cleary, chief medical officer of health, made the announcement today.

    The approval means that the adjuvanted vaccine has been judged safe and effective for use in Canada by the Canadian manufacturer, GlaxoSmithKline, as well as by the Health Canada regulator.

    "Our H1N1 flu immunization campaign will begin with healthcare workers, First Nation communities and school-aged children," Cleary said. "Clinics will then be extended to other higher-risk groups, followed by the public. We ask for the public's patience and co-operation as we move through the vaccinations of these groups."

    Clinic listings will be posted online at www.gnb.ca/flu or be available by calling 1-800-580-0038.

    Recommendations about the use of H1N1 flu vaccine have been developed based on the latest scientific evidence, including clinical trial results. The recommendations include:

    • all Canadians 10 years of age and older should receive one dose of adjuvanted vaccine;
    • children from six months and up to 10 years of age should receive the adjuvanted vaccine in two half-doses, administered at least 21 days apart;
    • children age up to six monthss - immunization not authorized; and
    • pregnant women should receive one dose of the unadjuvanted vaccine.

    The Government of Canada has ordered 1.8 million doses of unadjuvanted vaccine for pregnant women; they will be available in early November. In communities where the unadjuvanted vaccine is unavailable and H1N1 flu rates are high or increasing, women more than 20 weeks pregnant should be offered one dose of the adjuvanted vaccine.

    Earlier this week, the Department of Health delivered antiviral medication to community pharmacists across New Brunswick so the medication would be ready and available if it is needed.

    "A portion of the Tamiflu stockpile will be released on Monday," Cleary said. "This means that Tamiflu will be available at pharmacies to treat H1N1 flu for all New Brunswickers with a prescription from a doctor, free of charge. Your physician or nurse practitioner will determine whether antivirals are an appropriate treatment option in your specific case."

    For more information on the pandemic H1N1 flu vaccine, visit www.gnb.ca/flu.

     

    1023 Plans for H1N1 flu clinics being finalized with launch next week [Manitoba]--Manitoba Health and Healthy Living has released the list of Manitobans who would benefit the most from getting the H1N1 flu shot and has confirmed the province’s regional health authorities will begin delivering H1N1 immunizations the week of Oct. 26.

    The H1N1 flu shot is expected to help protect Manitobans against the new pandemic strain of the flu now in circulation. Manitobans are strongly encouraged to get the H1N1 flu shot at no charge at flu clinics run by their regional health authorities.

    Plans for the flu clinics are now being finalized by regional health authorities (RHAs). RHAs will have the most current information about flu clinics and vaccine delivery in their areas.

    The vaccine is expected to arrive in batches and the early clinics will be for Manitobans who should get the shot first. Once these Manitobans are immunized over the course of a few weeks, the H1N1 flu shot will be made available to every Manitoban who needs or wants to be vaccinated and will benefit from vaccination.

    Manitobans who should get the H1N1 flu shot first include:
    · children aged six months to under five years old;
    · anyone of Aboriginal ancestry (First Nations, Métis or Inuit);
    · disadvantaged individuals (for example, the homeless);
    · people living in remote or isolated areas;
    · people under 65 with a chronic medical condition or other risks including severe obesity, substance abuse or alcoholism;
    · anyone with a weakened immune system or those who live with or care for them;
    · those who live with or care for infants under six months old;
    · single parents or anyone solely responsible for a dependent;
    · health-care workers and medical first responders; and
    · pregnant women

    In November, an unadjuvanted shot recommended for pregnant women will be available. Women who are pregnant can wait until that shot arrives or they can talk to their health-care provider about the pros and cons of getting the adjuvanted vaccine sooner.

    It is recommended that children between the ages of six months and nine years receive two half‑doses of the shot with 21 days between the first and second shot.

    Manitoba expects to have 134,000 vaccine doses the week of Oct. 26 and subsequent deliveries of vaccine will continue weekly.

    Manitoba’s priority groups are based on national recommendations and have been tailored to address the province’s conditions and experiences with H1N1 flu so far.

    As more vaccine arrives, the H1N1 shot will be offered at flu shot clinics to other Manitobans who need or want it and are expected to benefit from it. Later, it may also be available from family doctors and other health-care providers.

    The H1N1 flu shot will be available for all adults and children five years of age or older who need or want it and are expected to benefit from it, once additional batches of vaccine arrive. All employers are encouraged to identify people who provide services that are critical to meeting the necessities of life and support the daily operation of Manitoba communities, particularly where there are limited numbers of people who can perform those jobs if someone becomes ill. People who work directly with swine and poultry should also be vaccinated once additional batches arrive because this can help limit the spread of illness in these animals. Individuals in these groups are encouraged to get an H1N1 flu shot early.

    The H1N1 flu vaccine is not licensed for infants under six months of age. People who are allergic to eggs or other influenza vaccine components should not be vaccinated. The H1N1 vaccine is also not recommended for anyone who has had a lab-confirmed diagnosis of H1N1 flu.

    During the H1N1 flu clinics, Manitobans who are eligible for the seasonal flu shot may be offered both flu shots if they have not yet received their seasonal shot this year. Both flu shots have been designed to provide protection against the known flu viruses expected to be circulating in Manitoba this year. Manitobans aged 65 and older should also get a pneumococcal shot at the same time as the seasonal flu shot unless they have had a pneumococcal shot in the past. Most adults only need one pneumococcal shot in their lifetime.

    Health Canada has assessed available data on the safety, quality and effectiveness of the H1N1 vaccine and concluded the benefit-to-risk profile is favourable for active immunization against the H1N1 in an officially declared pandemic situation. As part of the authorization, the manufacturer will be required to continue submitting data on the safety and effectiveness of the vaccine. This approach is similar to that used in other countries.

    For more information about H1N1 or to find links to flu shot clinics operated by regional health authorities, visit www.manitoba.ca.

     

     

    1023 Province sends first shipment of 700,000 doses of H1N1 vax to health units [Ontario]--Ontario has shipped 700,000 doses of H1N1 flu vaccine to the province's public health units since October 21 in order to allow immunization clinics to begin next week.

    Beginning the week of Oct. 26, H1N1 flu vaccine will be offered to all Ontarians that need and want it, starting with:

    * People under 65 with chronic conditions;
    * Pregnant women;
    * Healthy children 6 months to under five years of age;
    * People living in remote or isolated communities;
    * Health care workers; and
    * Household contacts and care providers of persons at high risk who cannot be immunized or may not respond to vaccines.

    All pregnant women with pre-existing health conditions and healthy pregnant women in the second half of their pregnancy (more than 20 weeks) should speak to their health care provider about receiving the adjuvanted vaccine. Healthy pregnant women in the first half of their pregnancy are at less risk of complications from the flu, and should wait to receive the unadjuvanted vaccine, when it is available. Ontario has developed a fact sheet for pregnant women that will be available on the ministry website.

    On October 21, Health Canada approved the use of the H1N1 flu vaccine.

    A province-wide advertising campaign will be launched next week to remind people of the importance of getting the H1N1 flu vaccine. The campaign features Chief Medical Officer of Health Dr. Arlene King and includes print, radio and online ads.


     

     

    1023 Persons at risk for complications and healthcare workers - H1N1 vax to be offered beginning Oct 26 [Quebec]--“Given the onset of a second wave of outbreaks in the influenza A(H1N1) pandemic, in the coming days, the Gouvernement du Québec will launch a far-reaching public vaccination campaign,” announced Minister of Health and Social Services Dr. Yves Bolduc in a joint press briefing with the Direction nationale de la santé publique and the Organisation de la sécurité civile du Québec (OSCQ).

     

    Vaccination against the influenza A(H1N1) virus will begin Monday, October 26 and initially target persons at risk for complications and health-care workers. Once this first phase has been completed, the entire population will be summoned to vaccination centres throughout Québec.

     

    “This will be the most widespread vaccination campaign in Québec history. We will join the rest of the world in fighting the influenza A(H1N1) pandemic”, declared Dr. Bolduc.

     

    National Public Health Director Dr. Alain Poirier encouraged the public to get vaccinated according to the proposed sequence because vaccination is currently the most effective means of protection against influenza A(H1N1).

     

    The Gouvernement du Québec has more than 400 000 doses of the vaccine, which has just been validated by the federal government. In the coming weeks, Québec will receive more doses to meet the population’s vaccination needs. The vaccine will be offered free of charge and on a voluntary basis. Vaccination procedures and locations will vary, reflecting the specific characteristics of each region.

     

    Government Civil Safety Coordinator Michel C. Doré joined Dr. Poirier in encouraging the public to get vaccinated: “The fight against the virus will inevitably require Quebeckers’ involvement. Mass vaccination remains one of the best means of uniting to meet the pandemic head on, thereby minimizing its potential consequences for Québec society. In addition to providing individual protection, vaccination constitutes respect and solidarity with those around us, since it limits the virus’ spread.”

     

    To this end, all OSCQ and ORSC member departments and agencies have stepped up their efforts to support health authorities in this major influenza A(H1N1)vaccination operation.

     

    In the coming days, health and social services agencies will release vaccination-related details for their territories. Beginning Saturday, October 24, information on the next steps in the vaccination procedure (dates, locations, times) will be available in the “In my region” section of the www.pandemiequebec.gouv.qc.ca  website, which will be updated on a daily basis as the situation evolves, and repeated in local newspapers.

     

    Necessary information can also be obtained by calling Services Québec, 644-4545, available in area codes 418 and 514 and, toll-free, under 1 877. To underpin these communications efforts, an information campaign (TV, Internet, radio) will run in November.


    “Much is being said about influenza A(H1N1). Because the media and the Internet give all kinds of information, the government has activated the website www.pandemiequebec.gouv.qc.ca and set up a toll-free phone line to inform the public about influenza A(H1N1) prevention, symptoms and protection measures. Making sure you get the most recent information available is also your responsibility”, said Minister Bolduc.

     

     

    1023 KDHE announces additional H1N1-related death [Kansas]--The ninth death in Kansas of a person infected with the pandemic H1N1 influenza virus has been confirmed by state public health officials.

    The death occurred in a 62 year-old man from northeast Kansas who had underlying health conditions that put him at greater risk for serious complications from the virus. The H1N1 virus was determined to be a contributing factor in the man’s death. Laboratory testing conducted yesterday confirmed that the man had the H1N1 virus.

    KDHE Secretary Roderick Bremby and Dr. Jason Eberhart-Phillips, Kansas State Health Officer, expressed sympathy and offered their deepest condolences to the man’s family.

    “This death reminds us that this virus can be extremely severe for people with underlying health conditions,” Dr. Eberhart-Phillips said. “As more vaccine becomes available across the state we hope everyone who is able will choose to get vaccinated. Until that time, it is very important that people take seriously the potential dangers of the disease and recognize the importance of working towards preventing its further spread.”

    The national Advisory Committee on Immunization Practices (ACIP) has recommended that certain people who are at greater risk from H1N1 flu receive the vaccine earlier than others, as the amount of H1N1 vaccine is currently very limited. Those who should receive the vaccine first include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons 6 months through 24 years of age, and people ages of 25 through 64 years of age who are at higher risk for H1N1 flu because of chronic health disorders or compromised immune systems.

     

    KDHE has established a phone number for concerned Kansans to call with questions about the 2009 H1N1 influenza A virus. The toll-free number is 1-877-427-7317. Operators will be available to answer questions from 8 a.m. – 5 p.m. Monday through Friday. Persons calling will be directed to press “1” on their touch-tone phone to be directed to an operator who can answer questions.


    Kansans with questions about the virus can email H1N1fluinfo@kdheks.gov.  Information is also available from KDHE at www.kdheks.gov.

     

     

    1022 Limited availability of flu vax - Focus on the highest priority groups immediately [Maine]--Vaccine has begun to arrive in Maine and is slowly becoming available. Approximately 21,800 doses of H1N1 vaccine arrived this week, both injectable and nasal spray. This additional supply should bring the total to about 55,500 doses in the state, which are being shipped to registered health care providers immediately.


    State CDC estimates that Maine will receive about 340,000 doses of various formulations of H1N1 vaccine by early December (although this estimate could change). There are approximately 700,000 people in Maine who are in the high priority groups for receiving vaccine, out of about 1.3 million people total. The state will eventually receive enough vaccine to be able to offer it to all Mainers who want it.


    In the meantime, it is important that the vaccine be focused on those in the highest priority groups: pregnant women; household members and caregivers of infants less than six months old; children ages six months to 25 years; people ages 25-65 with severe underlying conditions, especially respiratory and neurodevelopmental conditions; and health care workers, especially those with
    frequent direct contact with patients and infectious material who work in hospital emergency departments, pediatric, labor/delivery, and intensive care units.

     

    This list means that many people who work in health care settings, first responders, and even those administrating vaccine at this point in time will not be vaccinated. Over the next few weeks, this will change, but it is very important to focus the limited vaccine supplies on where it will be most effective, and that is
    primarily protecting pregnant women as well as children who are both disproportionately affected by novel H1N1 and are also major transmitters of influenza to others.


    The highest priority populations for H1N1 vaccine are children and pregnant women. We are asking that health care providers receiving shipments of this vaccine make sure it is immediately available to schools if they are serving as a distribution site for schools, and that in general, pregnant women and children be prioritized. About 90% of the H1N1 vaccine supply arriving in Maine these first few weeks should be directed to pregnant women and children. We encourage pediatric providers to collaborate with other practitioners who see relatively few pre-schoolers to ensure access to vaccine.


    Because supplies are limited and 40% of the vaccine that is currently available is the nasal spray form that is contraindicated for pregnant women, children under two, and people with health conditions, it is possible that there will not be sufficient supplies of vaccine for even the highest priority people until December.


    Maine CDC is providing vaccine to obstetrical health care providers for pregnant women; to pediatric providers for very young and some high-risk children; and the majority of vaccine is going to schools.


    Several school districts are starting their vaccine clinics for H1N1 on October 26. They include some schools in Portland, Lewiston, and the Augusta area. Some of these clinics are listed on the clinic locator at www.maineflu.gov.


    While waiting for your H1N1 vaccine, the best precautions you can take are to avoid close contact with those who are ill and to frequently wash or sanitize your hands.

     

     

    1022 Flu activity widespread - H1N1 confirmed in all regions [Vermont]--The Vermont Department of Health has confirmed cases of H1N1 influenza in all regions of the state, and increased levels of influenza-like illness are being reported in most regions.  

    Vermont will report “widespread” influenza activity for the week ending October 17 to the Centers for Disease Control and Prevention (CDC).  Most U.S. states (41) have already reported widespread activity levels.

    New England is among the last regions in the country to report widespread activity, with all but New Hampshire reporting “regional” activity for the week ending Oct. 10.

    The increased activity level was based on influenza surveillance from provider offices, hospitals and schools statewide, as well as additional confirmed H1N1 samples at the Vermont Department of Health Laboratory in Burlington. The 2009 H1N1 influenza virus continues to be the predominant type of flu circulating nationwide and in Vermont.

    The Health Department continues to urge Vermonters to take the necessary precautions to keep illness from spreading:

    • Wash your hands often and well
    • Cover your cough when you cough or sneeze
    • Stay home from work or school and away from others when you are sick – for at least 24 hours after your fever has gone.

    The Health Department continues to encourage Vermonters to protect themselves and their families by getting vaccinated against seasonal flu and 2009 H1N1 flu.

    Due to a delay in vaccine production announced last week, the scheduled school-based 2009 H1N1 vaccination clinics for children will need to be adjusted in the coming weeks.

    “A number of school-based clinics will be postponed and pushed back into November and we are asking Vermonters to be patient as we work through the delay,” said Health Commissioner Wendy Davis, MD. 

    Some parents may choose to have their child vaccinated by their usual health care provider. The 2009 H1N1 vaccine may or may not be available at provider offices. Please check with your local provider for vaccine supply, as the Health Department has planned for a variety of avenues for school-aged children to receive vaccine.

    “The delay is challenging, but we have to stay focused on protecting as many people as possible from becoming ill in the coming weeks,” Dr. Davis said.

    Extensive information, tools and resources about seasonal and pandemic flu, healthy habits and preparedness are available at the Health Department’s website: healthvermont.gov or dial 2-1-1. You can also follow us on Twitter at twitter.com/healthvermont.

     

    1022 DHHS takes steps to limit H1N1 spread at state facilities [North Carolina]--State-operated hospitals, residential schools, developmental disability centers, neuro-medical treatment centers and alcohol and drug treatment centers have already implemented plans to limit the potential spread of H1N1 flu at their facilities as North Carolina prepares for the fall flu season.

    A case of H1N1 flu has been confirmed in more than one of the 14 state-operated facilities, and preparation and procedures are already in place to limit the potential spread of the flu to unaffected patients/residents and employees.

    State-Operated Healthcare Facilities Division Director Luckey Welsh says that the goal is to “stop the disease at the door” and, if it does get in, limit its ability to spread.

    Beginning Fri., Oct. 23, all state facilities will actively screen all staff and visitors to identify people exhibiting signs of respiratory infections.  Visitors with flu symptoms will not be permitted to visit patients or residents until they are no longer sick. Employees who develop fever or influenza-like symptoms are being instructed not to come to work or, if already on the job, to make arrangements to leave and avoid contact with other employees and patients/residents. 

    “All facility employees have been briefed with the goals and procedures regarding the flu plans and their duties and responsibilities. We have posted notices throughout our facilities with common sense steps all of us can take to avoid catching or spreading the flu,” Welsh said.  “These include thorough washing of hands with soap or alcohol-based hand cleaners, covering coughs and, if required or advised, to wear surgical face masks. So far these procedures have worked extremely well at limiting the spread of H1N1 at our facilities.”

    State facilities are particularly vulnerable to a potential H1N1 outbreak because they are closed environments and include patients and residents who are considered high risk and medically fragile, said Dr. Susan Saik, MH/DD/SAS medical services manager.

    “All our state facilities are meeting all current recommendations of the Centers for Disease Control and Prevention (CDC) and the N.C. Division of Public Health for responding to the H1N1 flu,” she said. “We plan to match and meet any changes either the CDC and our state public health experts recommend.“

    “Our watchword is ‘Be Prepared’,” Welsh added. “So far, all our visitors and guests have understood the importance of trying to reduce the potential introduction and spread of the flu. They have been cooperative and supportive of our efforts to protect their family and loved ones.”

    There are more than 3,400 patients or residents at any given time and more than 12,000 employees in DSOHF facilities.

    “I am confident that we have taken the wise and appropriate measures to prepare as best we can to protect the health and well-being of our patients, residents and employees,” Welsh added.  “We will continue to be vigilant. We will notify the media immediately for changes in visitation status as a means of letting families and others know if they will be able to visit residents or patients. We also plan to use the state’s facilities website as a rapid means of posting information concerning flu, breaking news or other information a person may need to know about the status at one of our hospitals, developmental centers, residential schools or substance abuse treatment centers or neuro-medical treatment centers.”

     

    1022 Rumor control: Letter concerning H1N1 vax and prison inmates [Massachusetts]--October 19, 2009

     

    Dear Colleague, 

    You have probably seen the incorrect media reports stating that the Department of Public Health intends to make the H1N1 vaccine available to prison inmates before it is available to members of the general public.  These reports are misleading and factually inaccurate.    

    The Department of Public Health has already distributed tens of thousands of H1N1 vaccine doses to hundreds of medical sites around the state to begin the vaccination of children, pregnant women and health care workers, consistent with the federal guidance.  Our ability to share H1N1 vaccines is dependent on the vaccine manufacturers’ ability to produce the vaccine and the federal Centers for Disease Control's (CDC) distribution plan to states.  Unfortunately, the timeline associated with the distribution of the vaccines is quite fluid as production estimates vary week to week due to the unprecedented volume and short timetable for planning.  Our top priority is and will remain those members of the public who are at greatest risk.  Initially that category includes children, pregnant women and health care workers.  As supplies allow, we will also target young adults below the age of 25, and 25-64 year olds with certain underlying health conditions.  Public clinics will only be held at the point that there is sufficient volume to shift beyond the focus on these target groups.  Eventually, the CDC projects that there will be enough H1N1 vaccine to protect anyone in the population who wishes to be immunized.    

    We will not be sending vaccines to prison settings to vaccinate the general prison population before the vaccine has been made available to the general public.  However, health care workers in prison settings will be treated the same as health care workers in other clinical settings and offered the vaccine as supplies allow.  As supplies become available, small amounts of vaccine will be made available to prisons for the vaccination of those inmates at greatest risk.  For example, female inmates who are pregnant will be offered the vaccine as part of the statewide effort to reduce the likelihood of serious illness among those most vulnerable.  Because of national supply shortages, we have not yet determined the date for the distribution of small quantities of vaccine to segments of the prison population at highest risk.     

    Again, we want to emphasize that plans to vaccinate the general population of prisoners will not begin before there have been opportunities for the general public in the state to be vaccinated.    

    Sincerely,

    John Auerbach

    Commissioner

     

     

    1022 State reports first H1N1-related death [Delaware]--Delaware's Division of Public Health (DPH) has learned of the first H1N1- related death in the 2009 season, a 35 year old female from Kent County who died this morning. The individual had a number of underlying health conditions and had been hospitalized on October 12 in Delaware but was later transferred to a Maryland hospital.

    "We are sad to have learned of this, the first H1N1-related death of a Delaware resident. This news is a reminder that while in many cases the flu can be mild, in some cases the flu can be serious, even life threatening. Our heartfelt sympathy is with the family and friends of this individual, " said Dr. Karyl Rattay, DPH director.

     

     

    1022 National H1N1 vax supply not adequate enough to meet public demand [Texas]--Texas continues to order its full allocation of H1N1 vaccine, but the national supply still isn't adequate to meet the public demand.

    “We know that the best way for people to protect themselves from the flu is to get the vaccine, but the national supply is still very low,” said Dr. David Lakey, Texas Department of State Health Services commissioner.

    Texas had expected to receive 3.4 million doses of the vaccine by mid-October, according to the initial projections from the U.S. Centers for Disease Control and Prevention (CDC). However, the state has received less than 1 million doses so far.

    The CDC allocates the vaccine to states based on population and tells states each week how much vaccine is available for them to order. As of today, the state has ordered about one million doses allocated to the state and provided the CDC with information on where to ship those doses. The vaccine is still in the process of being shipped out.

    “Given the limited national supply at this point, we want to make sure we use our first shipments to protect those at highest risk of complications from the flu – pregnant women and children,” Dr. Lakey said.

    About 12,000 doctors and other health care providers have signed up to provide the vaccine in Texas. The state directed the first shipments to 5,000 providers who serve primarily pregnant women, children and health care workers who provide patient care.

    Dr. Lakey said the state hopes to receive 15 million doses of the H1N1 vaccine by mid-January, assuming that production meets initial projections.

    “Vaccine will be available to the general public as soon as production catches up with the demand,” he said. “The process is driven by the manufacturers' capacity.”

     

     

    1022 Culebra Meat Market recalling certain beef products for E.coli 0157:H7 [San Antonio, Texas]--Culebra Meat Market is recalling three beef cuts it produced and distributed in the San Antonio area earlier this month because of possible contamination with E. coli O157:H7, a bacterium that can cause severe illness.

    Products included in the recall are beef stew meat, carne asada and ground beef produced by the company from Oct. 2 through Oct. 17. Products were sold to some San Antonio-area restaurants and in the company's retail store, 2800 Culebra Road in San Antonio.

    The Texas Department of State Health Services is investigating whether the products also were sold at other Culebra retail store locations in San Antonio.

    People are advised to discard or return the products. Cooking the beef is not recommended.

    Products sold to consumers at the company's retail store were packaged in various weights and wrapped in white butcher paper with no markings. Products sold to restaurants were packed in 10-pound boxes labeled with the company and product names and lot codes 100209 through 101709. The boxes have the inspection label “TEXAS INSP. & PSD. 740” located inside an outline of the state of Texas.

    The recall volume is approximately 4,000 pounds.

    DSHS laboratory testing detected E. coli O157:H7 in samples collected from the meat company. The testing was done as part of a routine DSHS inspection.

    DSHS is not aware of any illnesses associated with the recalled product.

    Symptoms of E. coli O157:H7 illness include bloody diarrhea and stomach pains. People with these symptoms should seek medical attention immediately. Symptoms typically occur two to nine days after exposure.

    Infection can lead to serious kidney damage or death. Most healthy adults recover in five to 10 days, but children under age 5 and the elderly are more likely to develop a severe illness.

    Infected people can pass E. coli O157:H7 to others through contaminated feces.

    More information is available from the company by calling 210-432-2170.

     

     

    1022 Response to new FluLine service is “very heavy” - efforts underway to expand system [Minnesota]--Officials at the Minnesota Department of Health (MDH) report that the response to their new phone-based service for people with flu symptoms has been “very heavy.”

    As of 8:00 a.m. today, the new Minnesota FluLine had received over 2,100 calls. The FluLine number was first made available to the public at 11:00 a.m. yesterday.

    As a result, some users of the service have been reporting long wait times or busy signals. MDH officials are urging users of the service to be patient, as the agency works to expand the capacity of the system.

    “This is the first service of its kind in the country, so we had anticipated the need to make some adjustments when the FluLine number went live,” said Craig Acomb, Assistant Commissioner of Health. “What we couldn’t have predicted was the magnitude of the response. We are monitoring use of the system very closely, and looking at a number of possible strategies for increasing our capacity.”

    Acomb said the overwhelming majority of calls to the FluLine number were from people seeking help for flu symptoms.

    “The fact we had so many callers seeking help for flu symptoms only underscores the importance of having a service like this,” said Ruth Lynfield, Minnesota State Epidemiologist. “Those are the people for whom this service was intended, and we are glad that people got that message.

    “We know that some people have experienced some frustration in trying to access the system since we launched the FluLine yesterday,” Lynfield said. “We are hoping that people will bear with us as we work to increase capacity. This is an important service, and we want to make it work.”

    The number for the Minnesota FluLine is 1-866-259-4655.

     

    1022 State records three more deaths associated with H1N1 novel influenza [Minnesota]--Three more Minnesota residents have died from complications due to infection with the H1N1 novel influenza virus, the Minnesota Department of Health (MDH) reported today. They were a Martin County woman in her early sixties, a Steele County child and a Freeborn County child, both under 7 years of age. All died within the last two weeks and all had underlying health conditions. These cases bring to 10 the total Minnesota deaths related to the H1N1 outbreak since last April.

    The department has been awaiting medical confirmation on the causes of the deaths before announcing them.

    “We are sad to report these deaths and we extend our sympathies to the families and loved ones,” said Dr. Sanne Magnan, Minnesota Commissioner of Health.

    To date, MDH has received reports of 611 hospitalized cases of confirmed H1N1 novel influenza in Minnesota. In addition, 230 schools reported last week to MDH that they had either five percent of their student body absent or three students in an elementary school classroom absent due to flu-like illness.

    “We continue to follow this pandemic closely, and although we are seeing widespread infection due to H1N1 influenza, we are not seeing a change in the severity of the disease. Most people recover without complications, but unfortunately some people, particularly those who are pregnant, those who are very young or elderly, or those who have underlying medical conditions, are at risk for more severe illness or complications,” said Dr. Ruth Lynfield, state epidemiologist for MDH. “This is why we urge people to help stop the spread of this virus by staying home when they are sick and covering their coughs and washing their hands and by getting vaccinated.”

    Getting vaccinated is the best protection against the virus. While the vaccine for H1N1 is not yet available for the general public, it is being provided to health care workers and some of the very highest risk pediatric patients and pregnant women. Priority groups will then include the remaining children and adults under 25 years, and those under 65 who have certain medical conditions; and following these groups anyone else who wishes vaccination. Vaccine shipments are expected to continue over the coming months.

    Until vaccine is more widely available, it is important for people to continue to take steps to protect themselves and reduce the spread of influenza:
     

    • Stay home from work or school – and generally avoid going out in public – if you are sick. Remain home until 24 hours after your symptoms resolve without the aid of fever-reducing medications.
    • If you are an employer, encourage your employees to stay home if they are sick.
    • Limit your contact with others who may be ill.
    • Cover your nose and mouth with your sleeve when you cough or sneeze.
    • Clean your hands frequently and thoroughly with soap and water or an alcohol-based hand sanitizer.
    • Clean your hands after shaking hands or having other close contact with other people, before eating or preparing food, or touching your eyes, nose or mouth.
    • Make sure to take enough fluids while you’re sick.
    • If you develop possible flu symptoms and you want to consult your health care provider, call before going in for an office visit. You may not need to go in, and if you do need to be seen, a time should be set up when you will not risk exposing others to influenza in the waiting room.
    • People at risk for severe flu or flu complications should contact their health care provider promptly if they develop flu symptoms or have been closely exposed to people with flu symptoms to determine whether they should receive antiviral medication.
    • People who develop severe symptoms or who develop new symptoms after initial improvement should seek medical care without delay.
    • Get vaccinated for both seasonal and H1N1 novel influenza as soon as vaccine becomes available for you.
    • If you do have flu symptoms and want to speak with a nurse about your illness, call your health care provider or the Minnesota FluLine at 866-259-4655.

     

     

    1022 FluLine to offer support and treatment options for people with possible symptoms of influenza [Minnesota]--A new phone-based service is now available for Minnesotans who think they may have the flu.

    Beginning today, people with possible flu symptoms can call the Minnesota FluLine (MN FluLine) at 1-866-259-4655 for information and treatment options. Professionals will be available 24 hours a day, seven days a week. People with limited English skills will be connected with an interpreter. There is no charge for the call.

    Callers with flu symptoms will be connected with a participating nurse at MN FluLine, or a nurse at a triage line operated by their own provider network or health plan. The nurses will evaluate the health concerns of callers and discuss treatment options, using consistent criteria to determine which treatment option is most appropriate for each individual.

    Possible treatment options can include rest and fluids at home, a prescription for an antiviral medication, or medical evaluation in a clinic or hospital.

    FluLine was developed in response to the first global influenza pandemic in over 40 years. Officials are concerned that the pandemic could overwhelm the health care system, and they believe that FluLine can reduce some of the demands on the system.

    FluLine is also expected to help decrease the spread of the flu. By providing assistance over the phone, the new service is expected to limit the number of potentially infectious people who gather in emergency rooms, urgent care centers and clinics.

    “We have been concerned that this flu season could place a huge burden on our health care system,” said Dr. Sanne Magnan, Minnesota Commissioner of Health. “By providing support and treatment options to people over the phone, we hope this new service will allow our health care providers and facilities to focus on those people who most need their attention.”

    MN FluLine is the first influenza triage line in the country providing statewide reach and the option of prescribing anti-virals drugs under standing orders from a physician. It is a unique public-private partnership involving the Minnesota Department of Health (MDH), the Minnesota Hospital Association, the Minnesota Council of Health Plans, health care providers, local health departments, and the Children’s Physician Network (CPN). CPN is responsible for the actual operation of FluLine. The service was developed with input and advice from a number of other partners, including the U.S. Centers for Disease Control and Prevention (CDC).

    “This unprecedented collaboration means that Minnesotans with flu-like symptoms have another tool in their tool kit to fight the flu – a place to have questions answered about their illness and be evaluated for possible treatment,” said Dr. Aaron DeVries, medical epidemiologist at MDH. “We’re grateful to have the support of so many partners in making the FluLine available to the people of our state.”

    The Minnesota FluLine was created specifically to meet the needs of people with possible symptoms of the flu. By definition, those symptoms include a fever of 100 degrees or more, along with a cough or sore throat. Flu symptoms can also include runny or stuffy nose, body aches, headache, chills and/or fatigue. In some cases, symptoms of novel H1N1 influenza can also include vomiting and diarrhea in addition to respiratory symptoms.

    In most cases, people can recover from the flu at home without needing to visit a health care provider. Those who may be at highest risk for complications from the flu include children under two years of age, people 65 years of age or older, pregnant women, and people with underlying medical conditions.

    Health officials continue to emphasize prevention measures as the first line of defense against the flu: stay home if you're sick with a flu-like illness, cover your coughs and sneezes with a sleeve or a tissue, and wash your hands frequently.  

    For most people, staying home when they are sick means staying home from work or school, and avoiding other locations where they could expose others to the flu, until at least 24 hours after their fever resolves, without the aid of medications like acetaminophen or ibuprofen. People are being encouraged to get vaccinated now against seasonal flu, and get the H1N1 vaccine as it becomes available. The H1N1 vaccine will be an extremely valuable tool for preventing infection.

    People who need information about the flu, but do not have symptoms, are encouraged to visit the flu information page on the MDH Web site at www.mdhflu.com. The Web site offers a wide range of information and resources, including an interactive flu shot clinic finder.

     

    1022 Anticipated supplies of H1N1 vax slow to arrive [Arkansas]--Anticipated supplies of the H1N1 Influenza A (Swine Flu) vaccine have been arriving in the state but in limited quantities, according to public health officials.

     

    James Phillips, M.D., Branch Chief, Infectious Disease at the Arkansas Department of Health (ADH) said, “We would like to be ready to vaccinate everyone who wants to get the vaccine at next week’s mass seasonal flu clinics, but right now we don’t see how that can happen.

     

    "We are requesting the maximum amount of vaccine doses that we can order each week, but supplies are limited.

     

    "At the Mass Flu Clinics on October 29, 30, 31, we will have seasonal vaccine available for the general public; however, the H1N1 vaccine will be available only for pregnant women and children ages 6 months to 4 years until supplies run out.”

    Previously scheduled school clinics statewide will continue to give seasonal flu and H1N1 vaccine as supplies allow to students whose parents request the vaccine for their children.

    As Arkansas gets more H1N1 vaccine, those doses will continue to be given to priority groups first. These include pregnant women, children ages 6 months to 24 years, health care workers and emergency medical responders, people caring for infants under 6 months of age, and people ages 25-64 years with underlying health conditions (like asthma and diabetes).

    The ADH expects to eventually receive enough H1N1 vaccine for any Arkansan that would like to receive vaccine. It is important that every Arkansan get both the seasonal and H1N1 flu vaccine during this flu season. Additional Mass Flu Clinics will be scheduled at later dates.

    Flu is a sickness that infects the nose, throat and lungs and is caused by the influenza virus. If you’re young and healthy, the flu vaccine may be 70 to 90 percent effective in preventing illness.

    Children less than 9 years who have never received a seasonal flu shot before will need a second seasonal flu shot for full protection. Children less than 10 years will also need to receive a second H1N1 shot. Parents will need to contact a local ADH health unit or health care provider, see if vaccine is available and take their children in for a second shot 4 weeks after the first shot.


    The 2009 H1N1 vaccine is produced in the same manner as regular seasonal flu in the same manufacturing plants. The H1N1 vaccine simply contains a different strain of influenza virus. Reactions to all flu vaccines might include a mild soreness and redness near the site of the shot and perhaps a little fever or slight headache. The flu shot cannot give you the flu.


    Persons who should not receive influenza vaccine for health reasons are: persons with a severe allergy (i.e. anaphylactic allergic reaction) to hens’ eggs and persons who previously had onset of Guillain-Barre syndrome.

     

     

    1022 Public health director warns of potentially contaminated baby food - Plum Organics recalling Apple & Carrot Portable Pouch baby food [Illinois]--Dr. Damon T. Arnold, Director of the Illinois Department of Public Health (IDPH), is urging parents to check their pantry shelves for packets of 4.22-ounce Apple & Carrot Portable Pouch baby food made by Plum Organics and sold individually at Toys-R-Us and Babies-R-Us locations nationally.

    Plum Organics recalled the batch of baby food as a precaution due to the risk of potential contamination with Clostridium botulinum, which can cause botulism, a serious and sometimes life-threatening condition. Consumers should not use these products, even if they appear to be normal, because of the possible health risk.

    Symptoms of botulism poisoning include general weakness, dizziness, double vision, and trouble speaking or swallowing. People who have ingested this product and are experiencing these symptoms should seek immediate medical attention.

    Consumers who have purchased the Plum Organics Apple & Carrot pouch-based baby food with a “best by” date of May 21, 2010 and with the UPC #890180001221, can return the product for a full refund at any Toys-R-Us or Babies-R-Us store. Consumers with questions can call Plum Organics at 888-974-3555 between 8 a.m. - 5 p.m. PST or e-mail info@plumorganics.com.

     

    1022 State's 211 'clinic finder' connects public to flu shot clinics statewide [Wisconsin]--Looking for a flu shot clinic? Finding a location in your area is as easy as picking up the phone and dialing "2-1-1." Calling 2-1-1 is a free and confidential service in all 72 Wisconsin counties. Translators are available.

    More communities will begin to host community vaccination clinics as H1N1 vaccine becomes available. The Centers for Disease Control and Prevention (CDC) has announced there are some delays in H1N1 vaccine manufacturing, but it continues to ship vaccine to states as more becomes available. Call 2-1-1 to find out when your community is hosting an H1N1 vaccine clinic and a location nearest you. 2-1-1 will also have information about seasonal flu shots as they become more readily available.

    In addition, 2-1-1 Wisconsin has broadened its call services to include a “clinic finder,” which is available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info. You can search by zip code for either seasonal or H1N1 flu clinics nearest you.

    Health care providers and other organizations across Wisconsin are calling 2-1-1 and providing detailed information on the type of flu shot that is available (seasonal or H1N1), date, time and locations of vaccination clinics. Flu clinic information can be submitted directly by providers at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

    The flu clinic finder, along with all the human services information available from 2-1-1, is supported by United Way, community foundations, hospitals, local government and the Wisconsin Department of Health Services.

     

    1022 Another death linked to H1N1 flu [Wyoming]--The death of a third Wyoming resident infected with the swine (novel H1N1) influenza virus has been reported to the Wyoming Department of Health. The adult female resident of Laramie County had underlying health conditions linked with higher risk of severe illness.

    Flu activity continues to be high and widespread across the state and is almost 100 percent due to the H1N1 flu strain. Influenza symptoms include fever, cough, sore throat, body aches, headaches, and fatigue. Some patients also report diarrhea and vomiting.

    Actions recommended to slow the spread of illness include:

    · When available, get immunized with both a swine flu and a seasonal flu vaccine.
    · In general, people who develop influenza-like illness should stay home from work, school or travel until at least 24 hours after they are free of fever. Those who are severely ill (such as having trouble breathing) should seek medical care.
    · Avoid contact with ill persons.
    · Covering noses and mouths with a tissue or sleeve when coughing or sneezing, and throwing used tissues in a trash can.
    · Frequent hand washing with soap and water or the use of an alcohol-based hand gel.

    Of the total 1,614 reported flu cases in Wyoming since late May, 419 have been confirmed as swine flu cases. Most other cases were not subtyped. Over the same timeframe, the Department has received reports of 28 Wyoming hospitalizations in connection with the virus. The Department expects the number of actual flu infections around the state to be much higher, because most ill persons do not seek medical care or are not tested. Specific swine (novel H1N1) flu counts provided by the Department only reflect cases confirmed by specialized lab testing, as the H1N1 strain is part of the Department’s ongoing surveillance activities.

     

     

    1022 State releases cache of N95 respirators from emergency stockpile to combat spread of H1N1 in healthcare settings [California]--Following an announcement by Governor Schwarzenegger, the California Department of Public Health (CDPH) is deploying half of the state’s emergency stockpile of N95 respirators to local health departments for dispersal to hospitals and clinics so they will have them on hand to ensure they can protect patients and themselves from the spread of H1N1 in health care settings and continue to safely provide care to those infected with H1N1.

    “These 25 million respirators are tools of the trade for the safety of patients and health care workers,” said Dr. Mark Horton, director of CDPH. “We were forward-thinking when we purchased these devices; we have the largest supply in the country, and the time is now to use them wisely.”

    Truckloads of the N95s, part of the state’s stockpile of emergency medical supplies, are on their way around the state to be used by health care workers as needed. Meanwhile, Horton said, California Occupational Health and Safety Administration (Cal OSHA) has released new guidance to the health care community for the proper use of the respirators. In 2006, the State purchased the cache of respirators as part of its pandemic planning.

    The California Department of Public Health (CDPH) continues to observe widespread activity from the H1N1 (2009) influenza virus in the state. To date, there have been more than 3,500 H1N1-related hospitalizations, and 233 deaths. Although H1N1 is causing more severe illness in young children, persons with underlying medical conditions and pregnant women, and healthy persons can also have serious illness.

    The California Department of Public Health also continues to coordinate with the federal Centers for Disease Control and Prevention on the distribution of H1N1 vaccine.

    Horton said as of this week, California has registered more than 12,000 providers who will be able to administer vaccine. Vaccinators had ordered more than 1.7 million doses of H1N1 vaccine in California, but because of delays in manufacturing the vaccine Californians will have to remain patient and check with their providers and public health departments for availability.

    “We fully expect that, in time, enough vaccine will be available for everyone who wants to get vaccinated,” said Horton. “Meanwhile, continue to fight the flu by using common sense—washing hands, covering coughs and sneezes and staying home when sick until 24 hours after symptoms and fever pass.”
     

     

    1021 Flu pandemic requires national plan, say Atlantic mayors [Charlottetown, PEI]--With the effects of the seasonal flu starting to be felt in the region, mayors from across Atlantic Canada are concerned that the lack of a national pandemic plan could leave many communities in the region vulnerable to a potential H1N1 outbreak.

    The mayors, in Charlottetown for a meeting of the Atlantic Mayors Congress (AMC) say that an outbreak of the deadly H1N1 virus could leave many front-line municipal workers, from police to emergency personnel to health workers sick and unable to do their jobs.

    "With flu season on us, we cannot wait much longer for a national H1N1 pandemic plan," said Halifax mayor and Chair of the AMC Peter Kelly. "Municipal workers are at the front lines of any potential health emergency but we have yet to see any strategy to keep them safe and on the job."

    The mayors are calling on the federal government to quickly roll out a comprehensive plan that takes into account the critical role of municipal front-line workers as well as the need for factual and timely information and communication.

    The mayors say that while many municipalities have developed or are developing their own pandemic plans this is being done in a largely uncoordinated way, without any national support. This has left many smaller communities across the region and the country, struggling to prepare for the potential health emergency.

    Compounding the problem, the mayors say that there is so much, sometimes conflicting, information on H1N1 that confusion could set in with catastrophic health consequences.

    "We cannot rely on a patchwork of pandemic responses or a deluge of conflicting information" said mayor Kelly. "Municipalities from St. John's to Edmunston must be assured that their citizens and the services they rely on will be protected and only the national government can provide the leadership, the resources and the coordination necessary."

     

     

    1021 H1N1 outbreak on turkey farm confirmed [Kitchener ON]--Hybrid Turkeys is confirming that a case of H1N1 is located at one of their barns in Ontario. The firm is asking the media to respect the strict biosecurity measures in place at their turkey farms.

     

    The Canadian Food Inspection Agency (CFIA) has confirmed that the cause of an egg production drop in a flock in a single barn of Hybrid Grand Parent Breeding turkeys in Ontario was due to the novel H1N1 influenza virus. Recently novel H1N1 was reported as the cause of an egg production drop in turkey breeding hens in Chile where employees also were seen as the source.

    The only symptom in the affected Ontario flock was a decrease in egg production with no associated illness or mortality. The flock is showing normal feed and water consumption and is expected to fully recover, consistent with other flus that are more common in turkeys.

    The most likely source of the virus is from human transmission. A limited number of employees prior to the egg production drop exhibited "cold-like" symptoms and one sought medical attention. Employee health is being monitored and some employees are now being tested for the virus.

    Influenza is not transmissible from hatching eggs nor through the consumption of turkey meat which continues to be a safe, healthy product.

    The firm has been working closely with the CFIA since the identification of the egg production drop. They received notification of the novel virus late yesterday. A self-imposed quarantine remains in effect and will until the flock is fully recovered.

    Hybrid Turkeys is a division of Hendrix Genetics Ltd, a primary breeder of turkeys based in Kitchener, Ontario, Canada. The company produces eggs and poults for parent stock customers around the world. Hybrid Turkeys has approximately 180 employees working in various locations across Canada, USA, France and Germany.

     

     

    1021 Province announces rollout of H1N1 vax campaign [Prince Edward Island]--The province has announced the rollout of its H1N1 Influenza Vaccine campaign following an announcement made today by Health Canada that regulatory approval has been received and the H1N1 vaccine is now approved for use.

    “We are pleased to announce the launch of our H1N1 influenza vaccine campaign here in PEI,” said Doug Currie, Minister of Health. “We know that there is enough vaccine for every person who needs and wants it in PEI and, starting next week, staff will begin to offer the vaccine to those who would benefit most from immunization against the H1N1 Flu Virus.”

    The vaccine program will be rolled out over the next four to six weeks and the schedule is based on the recommendations of the Public Health Agency of Canada. The vaccine will be delivered by Public Health nurses and others at no cost, at various sites across the province, including public health nursing clinics, schools, health centres, correctional facilities and healthcare facilities.

    “Each year there are different strains of influenza going around and, this year, the predominant strain is H1N1,” said Dr. Heather Morrison, Chief Health Officer for the Department of Health. “Over the past few weeks, there has been an overall increase in H1N1 activity in Canada and for most people, the H1N1 vaccine is the vaccine they need first that will offer the best protection against influenza this fall.”

    The H1N1 vaccine is developed the same way as the regular seasonal influenza vaccine but offers protection against the H1N1 influenza virus. It is important to note that for those who receive the vaccine, it often takes up to two weeks to develop immunity to the virus.

    Most people will require only one dose of the vaccine, with the exception of children who are six months up to 10 years of age, who will require two half doses of the vaccine to develop adequate immunity. The vaccine is usually given into the arm of adults and children over one year of age and into the thigh for infants, six months to one year of age. The vaccine is not given to infants under the age of six months.

    The H1N1 Vaccine Schedule in PEI will be the following:

    Week of October 26

    • Health Care Workers

    • Household contacts of children less than 6 months

    • Children six months old up to school entry

    • People with chronic conditions under the age of 65

    • Household contacts and care providers of people who are immune compromised

    • First Nations and Aboriginal Population

    Week of November 2

    • Elementary Schools

    • First responders

    Week of November 9

    • Junior and Senior High Schools

    • Pregnant women

    Week of November 16

    • Mass public clinics

    Week of November 23

    • Second dose for children six months of age to school entry

    Week of November 30

    • Second dose for children school entry to nine years of age

    A specialized clinic for people with egg allergies will be offered as well to ensure that every person can receive the vaccine if they wish.

    Announcements will start next week on the times and locations for upcoming clinics. The public is advised to watch the newspapers, visit www.gov.pe.ca/flu or call 1-888-748-5454 for further information.

     

     

    1021 Province to start H1N1 vax program next week [Newfoundland and Labrador]--The Provincial Government confirmed today that the province will begin administering the H1N1 influenza vaccine starting the week of October 26. The Honourable Jerome Kennedy, Minister of Health and Community Services, and Dr. Faith Stratton, Chief Medical Officer of Health, made the announcement following Health Canada’s official authorization today for use of the H1N1 influenza vaccine.

    “As the Minister of Health and Community Services, I am committed to updating the people of Newfoundland and Labrador on a regular basis about the status of H1N1 in the province, how our government is responding and the latest information available,” said Minister Kennedy. “We have secured enough H1N1 vaccine for anyone in the province who wants it so that we can protect all of our residents against the pandemic virus.”

    H1N1 Vaccine


    Starting the week of October 26, the province’s regional health authorities will begin the H1N1 vaccination program. The vaccine will not be available through physician offices. It will be offered through public health mass immunization clinics. As the program expands in the coming weeks, residents can expect to see detailed clinic information through their local media and their regional health authorities. The H1N1 vaccination is not mandatory but is recommended for all residents of the province. There is no charge to receive the vaccine.

    “The H1N1 influenza vaccine is the best protection against the pandemic virus and we are encouraging residents to avail of it,” said Dr. Stratton. “Health Canada has officially authorized this vaccine which means it has proven to be both safe and effective.”

    “Our regional health authorities have been diligently planning for the delivery of the H1N1 influenza vaccine across the province,” said Minister Kennedy. “I am pleased to say that we will be ready to begin the immunization program next week at the same time as other provinces and territories.”

    Consistent with all other jurisdictions, Newfoundland and Labrador will receive the vaccine in stages. The first supply of the H1N1 vaccine contains 28,000 doses and these will be distributed to the health regions by next week. Immunizations will begin on a limited basis and will expand as more vaccine arrives in the province.

    Based on recommendations from the Public Health Agency of Canada, the vaccine will be offered first to people who will benefit most from it. These groups include:

    • Individuals under 65 with chronic health conditions;
    • Individuals living in remote and isolated settings or communities;
    • Children six months up to five years of age;
    • Health care workers involved in pandemic response or the delivery of essential health care services;
    • Pregnant women; and
    • Household contacts and caregivers of persons at high risk who cannot be immunized or may not respond to vaccines and populations otherwise identified as high risk.

    The H1N1 vaccine in Canada is an adjuvanted vaccine which means it includes a substance which provides a more rapid and increased immune response to the vaccine. The adjuvant in Canada’s H1N1 vaccine is made up of natural ingredients such as water, oil and vitamin E. Women who are pregnant are recommended to receive a vaccine that is unadjuvanted. The supply of unadjuvanted vaccines will be made available to all jurisdictions for pregnant women as soon as it is available in early November.

    “The recommendation for pregnant women was made based on the fact that there is less data available on how pregnant women respond to adjuvanted vaccines and so we want to be very cautious,” said Dr. Stratton. “It does not mean there are any safety issues with the adjuvanted vaccine. If there are high levels of pandemic influenza in a community, pregnant women may be offered the adjuvanted vaccine to reduce their risk of disease.”

    Antivirals


    Antivirals are oral medications that are used to treat moderate to severe disease. Due to increased influenza-like-illness activity and laboratory confirmed H1N1 cases in the province, Newfoundland and Labrador’s share of the National Antiviral Stockpile (NAS) was released on October 16.

    “As we indicated in our media briefing earlier this week, our province has enough antivirals to treat anyone who may require it,” said Minister Kennedy. “This is in addition to the many other measures we have put in place to ensure our province is ready to respond to potentially more severe disease virus this flu season.”

    Dr. Stratton added: “The release of antivirals was done as a precautionary measure following the confirmation of new cases of H1N1 influenza in the province late last week. The experience to date with H1N1 in Canada is that it is a mild disease. However, we do want to be ready in the event that the H1N1 cases become more severe.”

    Health care providers will determine if individuals require antiviral treatment for H1N1 influenza and it must be prescribed by a physician. The prescription can be filled at pharmacies across the province. Antiviral medications include Tamiflu (Oseltamivir) and Relenza (Zanamivir). Residents and visitors of the province who meet the criteria for antiviral treatment will be eligible to receive the medication free of charge.

    “Currently the use of anti-virals is indicated only for those patients who have severe disease, or who are at risk of complications,” said Dr. Stratton. “Not all patients with H1N1 influenza need to either see their doctor, or receive an antiviral medication. People with mild influenza-like-illness and no chronic health conditions should stay at home to prevent spread to others and should contact their health care provider if their disease becomes more severe.”

    People at a higher risk of complications for the H1N1 influenza virus include:

    • Individuals with chronic conditions such as heart or kidney disease, diabetes, asthma and chronic lung disease, suppressed immune systems, neurological disorders, liver disease, blood disorders and severe obesity;
    • Children under five years of age; and,
    • Women who are pregnant.

    Antivirals are taken by mouth and can reduce influenza symptoms, shorten the length of illness, and reduce the serious complications of influenza if taken within 48 hours of getting sick. Antivirals do not provide immunity against the virus and should not be confused with the H1N1 vaccine.

    The province invested $800,000 in 2006 to increase the stockpile of antivirals for use during a pandemic and have added to this supply since that time. There are over 800,000 doses in supply, with 10 doses required for each treatment.

    “The Provincial Government has plans in place to deal with an influenza pandemic and in the past several months we have ramped up our efforts to deal specifically with the H1N1 influenza virus,” said Minister Kennedy. “We will continue work in co-operation with our federal and regional counterparts to do whatever is necessary to ensure the people of our province have the best and timeliest protection from and treatment for H1N1.”

    Minister Kennedy added that the province has secured a stockpile of all necessary equipment and supplies to respond to H1N1 for laboratories, pharmacies, housekeeping and front line service providers. This includes personal protective equipment for its health care workers and enough ventilators for every ICU bed in the province.

    In November 2007, the Department of Health and Community Services established Planning Guidelines Roles and Responsibilities for the health care sector in the event of a pandemic. In addition, the Provincial Government invested $4.7 million in 2006 to respond to health emergencies such as a pandemic. This investment included the purchase of antivirals, establishing four regional health emergency professionals and required supports to develop regional emergency response plans, adding 39 public health nurses across the province; and, establishing new positions in the public health division of the department.

    For further information regarding the H1N1 vaccine visit www.fightflu.ca

     

     

    1021 Province completes test of tsunami notification system [Victoria, BC]--The Provincial Emergency Program has successfully completed a test of the B.C. Provincial Emergency Notification System (PENS).

    In total, more than 1,100 calls were made using the state-of-the-art phone notification system to local governments, local emergency officials, police and fire departments, federal and provincial ministries, First Nations, utilities, regional health authorities and the media. In addition, approximately 300 email and fax notifications were sent to these same stakeholders.

    These tests are run on a regular basis to verify the system’s capabilities to send timely tsunami bulletins to coastal communities at risk, key stakeholders and the news media. The media is a key partner in getting critical information to the public during emergency situations.

    Monitoring for tsunamis is done by the West Coast and Alaska Tsunami Warning Center, located in Palmer, Alaska. This organization immediately notifies the Provincial Emergency Program (PEP) of any tsunami activity in the Pacific Basin.

    In the event coastal British Columbia could be impacted by a tsunami, PEP activates PENS. Local authorities are required to have community emergency response plans that they will activate in the event of a tsunami.

     

     

    1021 Province to begin H1N1 immunization campaign [Halifax, NS]--With the announcement of federal authorization of the pandemic H1N1 vaccine, Nova Scotia is set to begin its biggest immunization campaign yet, Dr. Robert Strang, the province's chief public health officer, announced Oct. 21.

    The federal authorization order for H1N1 vaccine means the government of Canada is satisfied the vaccine is safe and effective.

    Specifics of the Nova Scotia plan include:

    * H1N1 vaccine will be available for free to all Nova Scotians who want it;
    * People in high-risk groups for seasonal flu can get seasonal flu and H1N1 shots at the same time;
    * H1N1 vaccine will be available through community clinics, some doctor offices and workplace clinics;
    * Community clinics will begin across Nova Scotia within the next two weeks.

    "I have every confidence that the H1N1 vaccine is safe and effective for Nova Scotians," said Dr. Strang. "I urge all Nova Scotians to get the H1N1 vaccine. It is the best way to protect yourself and your community."

    Nova Scotia has ordered 1.4 million doses of the vaccine. The first shipment, 52,000 doses, arrived Oct. 19. The province will pay about $4.5 million for the vaccine.

    District health authorities are organizing community immunization clinics. Doctors will also have the option to offer the vaccine in their offices. Private nursing agencies can also get the vaccine for workplace clinics. H1N1 vaccine is also being provided to hospitals and long-term care facilities to immunize staff.

    Each district health authority will organize its immunization program, including clinic dates and times. Nova Scotians should check with local district health authorities for dates and times.

    "Every Nova Scotian who wants the H1N1 vaccine will be able to receive it," Dr. Strang said. "Our priority is to ensure that all Nova Scotians have the opportunity to receive the vaccine in a timely manner."

    If Nova Scotians have questions about the vaccination, they can go to www.gov.ns.ca/h1n1 , call their local public health unit or call HealthLink 811.

    Groups at high risk for seasonal flu can receive that vaccine at the same time.

    "In the weeks past, we were recommending that only people above the age of 65 and those in long-term care facilities get the seasonal flu vaccine," said Dr. Strang. "Our decision was based on the best information we had available to us at that time.

    "New data indicates that we can offer the vaccines concurrently. In an effort to make it easier for Nova Scotians, both the H1N1 vaccine and seasonal flu vaccine will be offered at the mass immunization clinics."

    As in previous years, the seasonal flu vaccine will also be available through doctors' offices.

    We are now starting to see signs of H1N1 activity in Nova Scotia. There have been 17 cases of H1N1 in the province since Aug. 29. There has been one death in Nova Scotia associated with the virus.

    Dr. Strang continues to advise Nova Scotians to make every effort to minimize the spread of the virus. The most important step is to stay home if sick with flu-like symptoms, which are fever and/or cough with unusual tiredness, head/muscle/joint aches or sore throat.

    Along with immunization, people are also encouraged to take the following precautions to prevent illness:

    * Wash hands often with soap and water, especially after a sneeze or cough. When soap and water are not handy, alcohol-based hand sanitizers are an acceptable alternative.
    * Cough and sneeze into elbow or sleeve.
    * If using tissues, dispose of them appropriately and wash hands.
    * Limit touching eyes, nose and mouth.
    * Do not share drinking glasses, water bottles, mouth guards, cosmetics or eating utensils.
    * If concerned that medical advice or care is needed, contact HealthLink 811. Like any illness, should symptoms worsen, visit a doctor or walk-in clinic.
     

     

    1021 Vax will be available in province starting Oct 26 [Edmonton, AB]--Alberta will begin rolling out the H1N1 vaccine following today’s announcement by the Public Health Agency of Canada that the H1N1 vaccine is safe, effective and authorized for use across Canada.

    “The availability of this vaccine is the boost we have been waiting for to help win the battle against pandemic H1N1 for all Albertans,” said Minister of Health and Wellness Ron Liepert.

    As H1N1 is expected to be the most prevalent strain of the influenza virus this year, Alberta is focusing its efforts on providing this vaccine to as many Albertans as possible.

    “This vaccine has undergone rigorous testing processes and clinical trials around the world and is established to be safe,” said Dr. André Corriveau, Alberta’s Chief Medical Officer of Health. “Getting immunized is one of the most effective ways of preventing the spread of this virus.”

    Clinics will begin immunizing all Albertans over six months of age against H1N1 as early as October 26. High-risk groups are encouraged to get their immunization as soon as possible.

    Alberta Health Services has been delivering the seasonal influenza vaccine for the past several weeks to people identified as high risk, as well as others who want it.

    “These programs will shift their priority to H1N1 vaccine delivery,” said Dr. Gerry Predy, Senior Medical Officer of Health for Alberta Health Services. “However, seasonal influenza immunization will still be available at these sites to those who want it.”

    Clinic timing may differ slightly in some areas. For detailed information on locations and times of H1N1 influenza immunization clinics near you, or to find out more information about high-risk groups that will receive priority immunization, visit www.albertahealthservices.ca or www.healthlinkalberta.ca, or call Health Link Alberta in Edmonton at 780-408-5465, in Calgary at 403-943-5465, or toll free at 1-866-408-5465.

    For more information on Alberta’s plans for pandemic H1N1 influenza, please visit www.health.alberta.ca , or www.albertahealthservices.ca.

     

     

    1021 H1N1 vax approved and timing confirmed [Victoria, BC]--Following today’s approval by Health Canada regulators, the pandemic H1N1 influenza vaccine will be made available to British Columbians beginning the week of Oct. 26, announced Minister of Healthy Living and Sport Ida Chong and Provincial Health Officer Dr. Perry Kendall.

    “Now that the H1N1 flu vaccine has been approved, I encourage British Columbians to get immunized and protect themselves against this novel flu virus,” said Kendall. “Even if some of the population has already contracted H1N1 so far, we know that most British Columbians have not been infected yet and can still benefit from receiving the vaccine to protect themselves.”

    The first batch of vaccine has arrived in British Columbia and is currently being distributed around the province to regional health authorities, based on population numbers in each region. Beginning Monday, it will be available first to those people who would benefit most from immunization: individuals under 65 years of age with chronic disease, pregnant women and individuals – including First Nations people – living in remote or isolated communities. These groups are at high-risk for suffering complications from pandemic H1N1 infection.

    “B.C. will receive the H1N1 vaccine shipments in phases. Our plan is to first immunize those individuals considered to be at most risk to ensure that more vulnerable groups are protected,” said Chong. “During this time, we would ask that those people who are not at highest risk to wait until mid-November to get immunized when we receive our full orders.”

    The pandemic H1N1 vaccine is an adjuvanted vaccine. Adjuvants are compounds that boost the immune system’s response to vaccine, allowing smaller doses to be used per person. A version of the H1N1 vaccine without adjuvant will also be available in B.C. beginning the second week of November. While the unadjuvanted H1N1 vaccine is recommended for pregnant women, the adjuvanted version, available early next week, is approved for everyone who wants to protect themselves from this pandemic.

    Once clinics begin next week, British Columbians who fall into the high-risk groups listed above who need and want the H1N1 vaccine, and for whom the seasonal flu shot is also recommended, will be able to receive both at the same time.

    “The national expert committees that are providing guidance on the use of the pandemic vaccines have recommended that giving seasonal and pandemic vaccines together is not expected to affect the immune response to either one. This is in keeping with what we know about almost all other vaccines.” said Dr. Monika Naus, director of immunization at the BC Centre for Disease Control, an agency of the Provincial Health Services Authority. “By getting the seasonal and pandemic vaccines together, the risk from both sorts of influenza can be reduced at the same time.”

    When B.C.’s seasonal influenza campaign launched in mid-October, the seasonal flu shot was only recommended for seniors and those living in long-term care facilities.

    “While I can understand there may be some confusion in the public about how and when to get vaccinated, and with which vaccine, this decision to offer the H1N1 and seasonal vaccines together addresses these concerns,” said Kendall. “B.C.’s initial recommendation to delay the seasonal vaccine campaign for everyone under the age of 65 was made using the best available evidence and before the pandemic vaccine was available. Now that pandemic vaccine is here, we can give protection against both seasonal and pandemic viruses at the same time”

    For more information on the H1N1 flu vaccine, visit www.gov.bc.ca/h1n1. To find where you can get your H1N1 and/or seasonal flu shot, visit the Flu Clinic Locator at www.ImmunizeBC.ca or contact your local public health unit. More locations will be added as they are confirmed.

     

     

    1021 Pharmacists to give H1N1 vax [Victoria, BC]--Specially-trained pharmacists in British Columbia can now provide patients with vaccine injections.

    “As we are facing both regular flu season and the H1N1 flu pandemic, pharmacists can now help administer the annual flu vaccine, including vaccinations for H1N1,” said Health Services Minister Kevin Falcon. “Expanding the role of pharmacists gives patients more choice for, and increased access to health care.”

    About 150 pharmacists from across the province have already completed the training to meet the certification program. More pharmacists are expected to complete the training in additional sessions scheduled over the next couple of months.”

    “Expanding the role of pharmacists to give preventative injections will increase access to safe health-care services,” said Suzanne Solven, deputy registrar of the College of Pharmacists British Columbia. “Our focus is on ensuring that pharmacists can continue to provide the safe, high level of care British Columbians have come to depend on.”

    Changes are effective following a 30-day public consultation that resulted in amendments to regulations that govern the scope of practice for pharmacists, in addition to changes and processes required by the College of Pharmacists of British Columbia.

    The BC Pharmacy Association is the first to offer an accredited training program for pharmacists to learn injection skills.

    “We are pleased to assist in the training of pharmacists to safely administer injections,” said Marnie Mitchell, CEO of the BC Pharmacy Association. “Given pharmacists’ medication expertise, and with the advanced training, they are a logical choice for British Columbians seeking safe and convenient access to flu vaccine and other injections.”

    To be able to give vaccines, pharmacists are required to successfully complete the training program before receiving authorization from the college to administer injections for vaccination purposes. The college has also established standards of practice for injection based on the recommendation of an inter-professional committee.

    The H1N1 flu vaccine will be made available to British Columbians beginning the week of Oct. 26. It will be available first to those people who would most benefit from immunization (individuals under 65 years of age with chronic disease, pregnant women and individuals – including First Nations people – living in remote or isolated communities).


    Following that, it will be available to other groups who would benefit most (children under five years old, health-care workers and household contacts and care providers of infants and immunocompromised people) and then to members of the general public in a phased approach. When people are eligible for their H1N1 vaccine and if they fall under the usual guidelines for seasonal flu, it will now also be possible for them to receive both shots at the same time.

    For information about upcoming flu clinics at your local pharmacy, talk to your pharmacist.

     

     

    1021 H1N1 vax to begin on Oct 26 [Whitehorse, Yukon]--Yukon health centres will begin administering the H1N1 vaccine on October 26, Health and Social Services Minister Glenn Hart announced today.

    Health Canada authorized the release of the vaccine today, and Canada’s medical officers of health followed by endorsing use of the vaccine in their own jurisdictions.

    “I am pleased at the speed with which federal authorities moved to obtain, test and release the vaccine,” Yukon Medical Officer of Health Dr. Brendan Hanley said. “As Yukon is starting to see a rise in influenza, the timing for protecting Yukoners could hardly be better.

    The seasonal flu vaccine will be offered at the same time as the H1N1 flu vaccine, for convenience to Yukoners.

    “Yukon is ready to start administering the doses,” Hart added. “We have 55,000 doses on hand, enough to vaccinate every Yukoner who wants or needs the vaccine, and we are encouraging all Yukoners to get vaccinated.”

    The H1N1 vaccine was produced by pharmaceutical company GlaxoSmithKline at its Quebec plant.

    The H1N1 immunization campaign will start unrolling in community health centres starting on Monday, October 26. Clinic dates, locations and times will be advertised in newspapers and on the Health and Social Services web site at www.hss.gov.yk.ca.

     

     

    1021 Guidelines for H1N1 and sporting events [Northwest Territories]--Q: What steps can sport organizers take to help prevent participants, coordinators, and chaperones from getting sick?

    A: There are a number of steps organizers can take to prevent the spread of illness at all times and not just during a flu pandemic. These steps include: ensure that there are adequate hand-washing stations and hand sanitizers for event participants and that there is signage to remind people of the proper hand-washing technique; encourage good hygiene by providing all organizers, participants, and chaperones with educational material (i.e. posters or brochures) and reminders about covering coughs and sneezes; washing hands with soap and water; and not sharing drinks, food or chapstick; keep additional tissue supplies and waste receptacles at the venue; have all coordinators, chaperones and organizers on alert to recognize flu symptoms and isolate anyone with flu symptoms; arrange to have parents/guardians pick-up sick participants as quickly as possible; get any organizers, chaperones, or coordinators who are ill to go home, and if that is not possible, ensure they self-isolate; if you have out-of-town participants, have a room with a cot available in case somebody gets sick and needs to be isolated; and advise all participants, organizers, coordinators, chaperones and families that sick people must stay at home until at least 24 hours after they no longer have flu symptoms. It is especially important that they no longer have a fever or signs of a fever. This should be determined without the use of fever-reducing medicines, like any medicine that contains ibuprofen or acetaminophen.

     

    Q: What happens if a participant becomes sick while en route to/from or at the organized event?

    A: Participants who are feeling somewhat sick before an event should not attend. If the participant becomes sick during the event, the person should be isolated right away. Participants who are competing in their home town should be picked up by a family member right away. Out-of-town participants should be isolated from the other participants.

     

    Q: Who will pay for a participant to go home early if he/she becomes sick?

    A: Out-of-town participants who become sick while at a sporting event should not be sent home immediately. Travel should be avoided while sick. Participants from out-of-town should be isolated from the other participants. If the participant must travel while sick, the participant should wear a surgical mask or a bandana over the nose and mouth to avoid making other people sick.

     

    Q: Will families be notified if a participant becomes sick at an event?

    A: Organizers should work with chaperones to advise parents/guardians if a participant becomes ill at an event. Participants who are competing in their home town should be picked up by a family member right away. Out-of-town participants should be isolated from the other participants.

     

    Q: Should we cancel sports events because of H1N1?

    A: There is no need at this time to cancel sports events. Simple precautions at the individual level, like frequent hand washing, coughing and sneezing into the arm instead of hands, and staying home when sick will help slow the spread of the H1N1 flu virus.

     

    Q: I hear Edmonton Soccer is banning shaking hands after the game. Should we do the same?

    A: Banning shaking hand after the game is not necessary; however, all participants should be encouraged to wash their hands after each game, and to avoid touching their mouth, nose and eyes to avoid spreading germs.

     

     

    1020 Thirty-three new severe cases of H1N1 since Oct 13 [British Columbia]--British Columbia continues to monitor and respond to the spread of the pandemic H1N1 flu virus. Since Oct. 13, there have been 33 new severe cases of H1N1 identified in B.C. – thirteen in Fraser Health, twelve in Vancouver Coastal Health, six in Interior Health and two on Vancouver Island – with two new deaths, both in Fraser Health.

     

    The majority of lab-confirmed cases in B.C. have been mild or moderate in severity, with the patients either having already recovered or currently recovering.

     

    In total, BC Centre for Disease Control (BCCDC) has confirmed 111 severe H1N1 cases in British Columbia since April 2009, including:

    Forty-four in Fraser Health, including five deaths.

    Twenty in Interior Health, including two deaths.

    Five in Northern Health.

    Thirty-one in Vancouver Coastal Health, including one death.

    Eleven on Vancouver Island, including one death.

    Of these 111 lab-confirmed cases admitted to hospital, 30 of those have been admitted to the ICU. Six new cases have been admitted to the ICU in the last week.

    To date, nine laboratory-confirmed H1N1 cases in B.C. are reported to have died. In eight of those cases, there were underlying medical conditions.

     

     

    1020 Seasonal flu vax manufacturers notify DoH of delay and reduction in shipments [Rhode Island]--Three vaccine manufacturers have notified the Rhode Island Department of Health (HEALTH) of changes in previously scheduled seasonal flu vaccine shipments. HEALTH’s adult immunization program was notified that approximately 18% of the total amount of vaccine ordered for the season will not be delivered.

     

    This change in delivery was based on two manufacturers, GlaxoSmithKline (GSK) and Novartis, ending shipments of injectable flu vaccine to distributors. In addition, Sanofi Pasteur, makers of injectable seasonal flu vaccine that was ordered for children and adolescents ages 3 through 18, says remaining shipments to HEALTH’s pediatric program will be delayed.

     

    HEALTH anticipates delivery sometime in December. HEALTH purchases the seasonal influenza vaccine from several different manufacturers every year to lessen the impact on the state when there are vaccine shortages or delays.

    Public demand for the seasonal flu vaccine has been up this year from years past creating some shortages and cancellations of clinics. By the end of this year’s flu season in Rhode Island, HEALTH will have provided more seasonal flu vaccine than in any previous flu season even with this reduction announced today.

    “While this news is not what we would have hoped for,” said Director of Health David R. Gifford, MD, MPH, “we are confident that HEALTH will receive all the seasonal vaccine that was ordered for children. We are asking all providers to prioritize current supplies of vaccine for high-risk individuals. In addition, even with the reduction in the amount of vaccine we will receive for adults, we will still have more doses than what was used last year. And we have ordered 10,000 additional doses for adults and 14,000 additional doses for children.”

    At this time, HEALTH is recommending that healthcare providers reserve injectable vaccine for the elderly and patients who are pregnant or have underlying medical conditions, as they are at higher risk of complications from seasonal influenza. Providers should contact individuals with underlying medical conditions who still need a seasonal flu vaccine. People who have not gotten a seasonal flu shot can contact their providers or consult the schedule of public clinics at www.projo.com/news/flu/clinics/. People should check this website which will continue to be updated as clinic dates and times change.

    Almost all of the influenza illness occurring in Rhode Island right now is due to H1N1, not to seasonal flu. Rhode Islanders are encouraged to receive the H1N1 vaccine once it becomes available to them. Nasal spray H1N1 vaccine is currently available for children ages 2-5 in pediatric provider offices. More shipments will be arriving to the state weekly and will be allocated first to pregnant women (starting next week) and children. School-based vaccination clinics for children in K-12 are expected to begin sometime in early November and run into December.
    Visit http://www.health.ri.gov/flu/about/vaccination/index.php for the most up-to-date information on H1N1 and seasonal flu vaccination
     

     

    1020 Bloomberg launches Flu Fighters initiative to bolster flu prevention efforts [New York City]--Mayor Michael R. Bloomberg, Deputy Mayor for Health and Human Services Linda I. Gibbs, Commissioner of the Department of Health and Mental Hygiene Dr. Thomas Farley and the City’s Chief Service Officer Diahann Billings-Burford last week launched Flu Fighters, an NYC Service initiative to help combat the spread of influenza this season.  The program will mobilize hundreds of volunteers to conduct outreach at community events, schools, senior centers and houses of worship in New York City to raise awareness about influenza and the importance of getting vaccinated.  Flu Fighters is one of the 40 initiatives of NYC Service announced by Mayor Bloomberg in April and is a component of the City’s comprehensive influenza prevention plan outlined by the Mayor in early September. 

    “Our biggest goal for NYC Service is to strategically and methodically direct volunteers to the areas of our city where they are needed the most – something that had never really been done before,” said Mayor Bloomberg.  “Flu Fighters will address a critical area – flu prevention – serving as a needed extension of City efforts to protect the public. The more New Yorkers we can get to take steps to protect themselves against the flu, the better chance we have of containing any outbreak.  If you want to make a real difference in this city and possibly save lives, then please sign up to be a Flu Fighter.”

    “Our diligent work over the past six months has allowed us to create a comprehensive and strategic citywide response to reduce the health risks of both H1N1 and seasonal flu,” said Deputy Mayor Gibbs.  “By enlisting the help of 800 flu fighters across the five boroughs, we’ll be able to make an even greater impact in raising public awareness about the importance of vaccination and the preventive ways to stop the spread of flu.”

    “Influenza is unpredictable, and we want all New Yorkers to be up to date on the latest information about the virus.  Vaccination is the best defense against the flu, so we need to inform New Yorkers of where to go to get vaccinated,” said Commissioner Farley. “Flu Fighters will play a key role in delivering these important messages throughout the city.”

    “Public health is one of the six impact areas we are channeling our volunteers, in this case to address the annual threat from the flu, which is even more relevant this year.  We are asking any New Yorker who can lend a hand to become a Flu Fighter,” said the City’s Chief Service Officer Diahann Billings-Burford.

    The Flu Fighter program aims to engage 800 or more volunteers in the program.  Volunteers can start work on some opportunities right away. New Yorkers interested in helping prevent the spread of influenza this season by becoming a Flu Fighter should visit www.nyc.gov or call 311.

    The volunteer Flu Fighters will work in four areas:

    • Community Outreach: Volunteers will be provided with posters and brochures on how to prevent the spread of influenza and the importance of vaccination, which they will distribute at places of work, places of worship, senior centers, pharmacies, local stores, and other community hubs.
       
    • Vaccination Pledge: Volunteers will pledge to take individuals they know to get vaccinated. Volunteers will receive information about high-risk groups and will be encouraged to bring friends or family members who wish to protect themselves and others from influenza and its complications.
       
    • Vaccination Center Assistance: Volunteers will help distribute screening forms or manage the flow of people in and out of one of the weekend vaccination centers (also known as Points of Dispensing) that will take place across the city. Multi-lingual volunteers can assist those with limited English proficiency.
       
    • Parent Outreach: Volunteers will promote flu awareness at school events and ensure other parents are aware of the due date for consent forms for school-based vaccination.   

    In addition to the Flu Fighter volunteer effort, the City has developed a protocol for selecting, deploying and tracking volunteers with professional medical experience through its Medical Reserve Corps, a volunteer network that includes 8,700 physicians, pharmacists, dentists, nurses, nurse practitioners, mental health providers and other credentialed health professionals. These health professionals will volunteer in hospitals, clinics and dispensing centers to expand treatment capacity. The City’s public and private hospitals are finalizing protocols for accepting the volunteers to work in their facilities.

    Each year, more than 1,000 New Yorkers die from influenza and its complications, and many others become ill. While many parts of the country are now battling high rates of influenza infection, so far, there is no sign that the flu has taken hold in New York City.  Information about influenza should is also available at www.nyc.gov or by calling 311.

    About NYC Service

    NYC Service was launched by Mayor Bloomberg in April 2009 to meet his State of the City pledge for New York City to lead the nation in answering President Obama’s national call to service. The program has three core goals: channel the power of volunteers to address the impacts of the current economic downturn, make New York City the easiest city in America in which to serve, and ensure every young person in New York City is taught about civic engagement and has an opportunity to serve. NYC Service aims to drive volunteer resources to six impact areas where New York City’s needs are greatest: strengthening communities, helping neighbors in need, education, health, emergency preparedness and the environment. New Yorkers can find opportunities to serve their communities by visiting www.nyc.gov or by calling 311.

    The City’s Influenza Prevention Strategy

    In September, Mayor Bloomberg outlined the City’s comprehensive influenza prevention strategy, including offering free flu shots and nasal spray for H1N1 to elementary school students whose parents want them to receive it; encouraging New Yorkers to protect themselves and their loved ones by getting flu shots or nasal spray for H1N1 and seasonal flu; helping people with influenza-like illness manage their symptoms and find care; working with hospitals to ensure the availability of expanded emergency room capacity if it is needed; and designating primary-care clinics as “flu centers” that can give flu shots, information and outpatient care. The program was the result of the work performed by 15 interagency working groups that met throughout the summer.

    The City has begun implementing the strategy outlined by the Mayor.  Hospitals and health care providers have already received initial doses of vaccine, and children and health care workers are starting to be vaccinated.   Last week, the Health Department and the Department of Education launched a vaccine distribution pilot program in six schools in preparation for this fall’s school-based H1N1 vaccination effort.

    Additionally, the City is tracking rates of influenza-like illness and the different types of influenza viruses that are circulating; posting daily and weekly updates on the City’s new influenza web portal; providing a daily public report listing all schools reporting five or more cases of influenza like illness; and launching an influenza-prevention campaign that includes signs, posters and classroom instruction.

    Vaccination Information

    The seasonal flu vaccine is especially important for people in these groups. 

    • Children aged 6 months to 18 years.
    • Pregnant women.
    • Health care workers.
    • People aged 50 and older.
    • People with long-term health problems.
    • People in nursing homes and other long-term-care facilities.
    • Household members and caregivers of children under 5 – especially infants younger than 6 months. (Babies this age can get the flu, but are too young for a flu shot.)
    • People living with or caring for others who are over 50.
    • People living with or caring for others who have long-term health problems.

    The seasonal influenza vaccine does not provide immunity against H1N1 infection. New Yorkers wanting protection will need to get a separate vaccine. Like the seasonal vaccine, the H1N1 vaccine is available by injection or nasal spray. Because certain people are at increased risk of complications from H1N1 influenza, vaccination is especially important for them. In addition to receiving a seasonal flu vaccination, the following people should receive the H1N1 vaccine:

    • Pregnant women.
    • People aged 6 months to 24 years.
    • People aged 25 to 64 years with long-term health problems.
    • People who live with or care for children younger than 6 months.
    • Health care and emergency medical workers.

    Once demand for these high priority groups is met, the Centers for Disease Control and Prevention recommends that everyone from 25 through 64 years be vaccinated against H1N1. After this wave of vaccinations, those 65 years and older are encouraged to be vaccinated. More details are available at www.cdc.gov/h1n1flu/.

    The Health Department emphasizes that the best place for people to be vaccinated is at the office of their regular health care provider. In order to ensure that as many children as possible are vaccinated quickly, the City is also taking the extra steps of offering vaccines in elementary schools and in special weekend clinics. The city-wide, school-based vaccination program is planned to start in late October or early November and will last approximately eight weeks. Weekend clinics for middle-school and high-school children will open in early November at sites in all five boroughs and will continue for approximately five weeks. Parents of elementary school children will soon receive consent forms to sign and return if they want their children to be vaccinated at school.

     

    1020 School-based H1N1 vax efforts ready for launch [New York City]--This week, New York City’s elementary school students will begin taking home H1N1 information packets that include vaccination consent and screening forms for the City’s upcoming school-based vaccination initiative. By signing and returning the forms – also available in 10 languages at nyc.gov/flu – parents can have their children vaccinated free-of-charge against the H1N1 influenza virus. The packets will be sent home with children over the next two weeks, starting today. All materials are available in Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish and Urdu.

    As part of the comprehensive influenza-prevention plan that Mayor Bloomberg outlined before school started this fall, the City will provide the H1N1 vaccine at no cost to public and non-public school students beginning in late October. Elementary schools will schedule vaccination clinics during regular school days. Weekend vaccine clinics for middle-school and high-school students will be held in each borough during November and December.

    “Vaccination is the best weapon we have against influenza,” said Dr. Thomas Farley, New York City Health Commissioner. “Children are especially susceptible to the H1N1 strain, so we hope parents will ensure that their kids are protected. Getting vaccinated is safe, effective and simple. Thanks to this initiative, it’s also free.”

    “Our schools are working closely with the Health Department to make sure all of our students receive the vaccine if their parents want them immunized,” said Schools Chancellor Joel Klein. “The program is voluntary and we will not vaccinate children without parental consent, so we encourage families to sign the consent forms and send them back within three days of receiving them.”

    The Health Department encourages parents to have their children vaccinated by their regular health care providers if possible. By the end of this week, more than 600 providers who requested H1N1 vaccine will have doses in stock and ready to administer. These providers include some hospital clinics and community health centers as well as private pediatricians. Though H1N1 vaccine is now increasingly available for children and health care providers who want to be immunized, the federal government has yet to distribute enough vaccine to cover other populations. Federal authorities expect allocations to increase in coming weeks. The school vaccination program is intended to ensure that no child goes unvaccinated for lack of access. Public elementary schools are participating, and non-public schools have the option to participate. The city-wide, school-based vaccination program will last approximately eight weeks. The weekend clinics for middle-school and high-school students will open in early November at sites in all five boroughs.

    Besides protecting children from the H1N1 virus, the school vaccination effort could help prevent children from infecting others. The novel H1N1 virus typically causes only a few days of fever, cough and sore throat, and most people get better without any treatment. But influenza can cause severe illness or death, especially among people with underlying health conditions.

    The H1N1 vaccine comes in two forms: an injection and a nasal spray. Children may receive one form or the other; the nurse administering the vaccine will determine which form is appropriate for each child by reviewing information on the consent and screening forms completed by parents. Children under 10 years old will need two doses of the vaccine to get full protection. Once children are vaccinated, it takes about 10 days to develop immunity to the H1N1 virus. After school-based vaccination, parents will receive written confirmation that their children have received the vaccine. Parents are instructed to give a copy of the medical document to the child’s medical provider.

    The H1N1 vaccine is produced in exactly the same way that seasonal influenza vaccines are routinely produced, and it has been rigorously tested. The only difference is that this vaccine helps the immune system recognize and combat the H1N1 virus. As with any vaccine, influenza vaccines can cause mild side effects, but serious reactions are exceedingly rare.

    Each year, an estimated 1,100 New Yorkers die from influenza and its complications, and many others become ill. While many parts of the country are now battling high rates of influenza, New York City has yet to see an increase in infections this fall.  Nonetheless, the Health Department expects influenza to return to the city at some time and is strongly encouraging parents to have all children immunized to protect them from it.

    The seasonal influenza vaccine does not provide immunity against the H1N1 virus. New Yorkers wanting protection will need to get a separate vaccine. The seasonal influenza vaccine is available through health care providers and pharmacies.

    Because certain people are at increased risk of complications from H1N1 influenza, vaccination against this type of influenza is especially important for them. The following people should receive the H1N1 vaccine:

    • Pregnant women.
    • People aged 6 months to 24 years.
    • People aged 25 to 64 years with long-term health problems.
    • People who live with or care for children younger than 6 months.
    • Health care and emergency medical workers.

    More details are available at cdc.gov/h1n1flu/.

    Although students will be given consent forms to bring home, parents can download the forms from nyc.gov/flu, sign printed copies and send them back to school with their children. Consent forms will also be available on site at the weekend vaccination clinics for middle-school and high-school students. More information about influenza is available at nyc.gov/flu or by calling 311.

     

    1020 State officials understand and share frustration associated with H1N1 vax shortages [Massachusetts]--From the Mass.gov Commonwealth Conversations Public Health: "We have received many phone calls and comments on this blog from people across the Commonwealth who have been unable to locate the H1N1 and Seasonal flu vaccines. We understand -- and share -- in this frustration and would like to provide some general information on how vaccine distribution takes place in the state.

    As background, this is an unprecedented flu season. There are five major vaccine manufacturers who are working day and night to produce both seasonal and H1N1 (swine) flu vaccines during the same time period. This has never been done before and, as a result, there have been some interruptions in the supply chain for both vaccines.

    It's important to note that all vaccines are shipped directly from the manufacturer to the vaccine provider site -- DPH does not physically receive and then redistribute any vaccines. DPH does play two important roles in the vaccine distribution process: we serve as a registration point for health care providers who wish to receive vaccines for their patients and/or client populations, and we communicate with these providers about the weekly projected total amount of vaccine expected in the state.

    The availability of vaccine at any given provider site at any given time may be sporadic at this time. Every effort is being made to ensure that providers who serve high-priority groups will receive vaccine as soon as possible. The single most effective way that you can stay informed about the availability of seasonal and H1N1 flu vaccine in your community is by staying in touch with your health care provider, and by visiting http://flu.masspro.org where you'll find a database of locations currently offering flu vaccines, searchable by your zip code.

    It's important to note that there are no public H1N1 vaccination clinics currently scheduled in the state. This is because, like all other states, we have only received a very small allotment of the total amount of H1N1 vaccine expected.

    Again, we share your concern and frustration about these delays. However, we are confident that the federal government will continue to do everything they can to ensure the efficient distribution of safe and effective flu vaccines as they become available. This situation is sure to continue to evolve, and we pledge to keep you updated on this blog as it does.

     

    Comments

     
    Q. please confirm no prisoners will receive the shot until all school children (in high risk) receive theirs and statement made by spokeperson jennifer manley (dph)regarding prisoners is not accurate ----------------------------------------
     

    DPH RESPONDS: Thank you for your question. The reports stating that the Department of Public Health intends to make the H1N1 vaccine available to prison inmates before it is available to members of the general public are misleading and factually inaccurate.

    We will not be sending vaccines to prison settings to vaccinate the general prison population until after the vaccine has been made available to the general public and after there are public clinics around the state. However, health care workers in prison settings will be treated the same as health care workers in other clinical settings and offered the vaccine as supplies allow. At some point, small amounts of vaccine will be made available to prisons for the vaccination of those inmates at greatest risk. For example, female inmates who are pregnant may be offered the vaccine as part of the statewide effort to reduce the likelihood of serious illness among those most vulnerable. We have not yet determined the date for the distribution of such small quantities of vaccine to that limited segment of the prisoner population.

    But, again, we want to emphasize that plans to vaccinate the general population of prisoners will begin only after there have been opportunities for the general public in the state to be vaccinated.

     

    Q. Would someone please clarify for me whether or not I am in a high priority group to receive the H1N1 vaccine? I am the mom of a 9yr. old with asthma, a 2 year old with kidney issues, and a 4 mos. old. Last week the 2 older kids got their H1N1. But I have not been able to get one for myself. My pediatrician has stressed to me more than once that I need to have one as soon as I can get one, but my primary care office keeps telling me I am not a priority. Which is it??? Does anyone at MDPH have any suggestions as to how I could go about receiving a vaccine?
    -----------------------------------------------------------------------
    DPH RESPONDS: Thank you for your questions. There are five groups that have been identified by the CDC as high priority to get the H1N1 vaccine:
    • pregnant women; persons who live with or provide care for infants under 6 months of age (e.g., parents, siblings, and daycare providers)
    • health-care and emergency medical services personnel;
    • persons age 6 months to 24 years
    • persons age 25 to 64 years who have medical conditions that put them at higher risk for influenza-related complications.

    Every effort is being made to ensure that providers who serve high-priority groups will receive vaccine as soon as possible. The single most effective way that you can stay informed about the availability of vaccine in your community is by staying in touch with your health care provider, and by visiting http://flu.masspro.org  where you'll find a database of locations currently offering flu vaccines, searchable by your zip code.
     

    Q. You are telling us to check with our health care providers and both my primary care physician and pediatrician are telling me to check with the MA dept of health. So who is telling the truth? Doctors are saying they have no clue when they will get shipments of H1N1 and it's up to the health dept to tell them and you give a different story. It has been drilled into people's minds that we need this vaccine, expecially for my 5 & 3 year old but as ususal with any program left to the state and fedral government it is screwed up beyond belief and our children are sitting ducks as this virus continues to spread because no one is organized or informed!! DISGUSTING!!!!!

     

    Q. My daughter was diagnosised yest w H1N1, is it safe for her younger siblings to receive the H1N1 mist as that is all our pediatrician has?? -------------------------------------------------
    DPH RESPONDS: Thank you for your question. The H1N1 nasal spray vaccine is approved for people from 2 through 49 years of age. You can find more information specifically on the H1N1 nasal spray vaccine on the CDC’s website at http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-laiv-h1n1.pdf

     

    Q. Why can't I find any information on when shots will be available for H1N1 for children under 10? Given that two shots are required, it seems like we might want to vaccinate children asap.
    ------------------------------------------------------------------------
    DPH RESPONDS: Thank you for your question. Every effort is being made to ensure that providers who serve high-priority groups, such as children, will receive vaccine as soon as possible. The single most effective way that you can stay informed about the availability of the H1N1 flu vaccine in your community is by staying in touch with your health care provider, and by visiting http://flu.masspro.org where you'll find a database of locations currently offering flu vaccines, searchable by your zip code. Once public H1N1 vaccination clinics are taking place they will also appear on the website.

     

    Q.

    My daughter (4 years old) pedatric office is out of seasonal vaccine. Every CVS and Walgreen in Massachusetts is out of seasonal vaccine. Clinic's are being cancelled the day of the clinic as they do not have supply.

    Do you have an estimated date of when seasonal and H1N1 vaccine's will be available????

    If they have shipped when will http://flu.masspro.org/clinic provide updated clinic information for people????????????
    -------------------------------------------------------------------------
    DPH RESPONDS: Thank you for your questions and we appreciate your frustration. Like all other states, we have only received a very small allotment of the total amount of H1N1 vaccine expected. The most up to date H1N1 vaccine supply information can be found on the CDC website at http://www.cdc.gov/h1n1flu/vaccination/vaccinesupply.htm


    They will be updating this page regularly so be sure to check back to see the latest numbers of vaccine being shipped across the country. Every effort is being made to ensure that providers who serve high-priority groups, such as children, will receive vaccine as soon as possible.

    In terms of the seasonal flu vaccine, we have been informed by the manufacturers that we can expect additional shipments over the course of the next 4-6 weeks with the balance of our vaccine arriving at the end of November. This leaves plenty of time to be vaccinated against the seasonal flu since the majority of seasonal flu cases take place later in the flu season.

    For both the H1N1 and seasonal flu vaccines, the single most effective way that you can stay informed about the availability of seasonal and H1N1 flu vaccine in your community is by staying in touch with your health care provider, and by visiting http://flu.masspro.org. As soon as clinics receive more vaccine, this will be reflected on the website.

     

    Q. Is there any truth to the story that a large shipment of flu vaccine to Massachusetts providers was destroyed by overheating, due to an error by the shipper/driver, and that this explains why Massachusetts seems to have so much less available right now than other states?
    -----------------------------------------------------------------------
    DPH RESPONDS: Thank you for your question. We have not heard anything in regards to this rumor. Like all other states, we have only received a very small allotment of the total amount of H1N1 vaccine expected. There are five major vaccine manufacturers who are working day and night to produce both seasonal and H1N1 (swine) flu vaccines during the same time period. This has never been done before and, as a result, there have been some interruptions in the supply chain for both vaccines. However, we are confident that the federal government will continue to do everything they can to ensure the efficient distribution of safe and effective flu vaccines as they become available.
     

     

    1020 Finding flu shots in the face of increased demand for H1N1 vax [Delaware]--A number of developments this week increased the demand for both H1N1 and seasonal flu vaccine while also reducing supply. Those factors include:

    * The Centers for Disease Control and Prevention (CDC) previously informed Delaware's Division of Public Health (DPH) that nearly 32,000 doses of H1N1 vaccine would arrive in Delaware this week from the federal government through various influenza vaccine manufacturers; however due to vaccine production delays with those manufacturers, the CDC now informs DPH only about 10,000 doses are now expected to arrive this week. While this slows the vaccine's distribution, it is only a delay, not a reduction in Delaware’s allotment.
     

    * Many health care providers have run out of seasonal flu vaccine, for which there has been higher than normal demand this year due to increased public awareness of flu illnesses.
     

    * Recent media coverage of the flu has spurred an increase in public demand for both H1N1 and seasonal flu vaccine from health care providers and from the Division of Public Health.

    DPH provides the following information and guidance regarding flu vaccinations to Delawareans:

    H1N1 vaccine:

    * All pediatricians and family doctors who had requested H1N1 vaccine this week will still receive it, but in smaller quantities.
    * Because of these reduced quantities, DPH has temporarily narrowed the target population for H1N1 vaccine to those most at risk. People in the following groups should contact their health care providers about H1N1 vaccine availability:
    1. Pregnant women
    2. People who live or care for children younger than 6 months of age
    3. Children 6 months to 4 years of age
    4. Children 5 to 18 years of age who have chronic medical conditions
     

    * Quantity of vaccines will increase in coming weeks. By early November, H1N1 vaccines should be more widely available at health care providers, in clinics that will be conducted in schools, and in pharmacies. Delawareans are urged to receive H1N1 vaccine from their regular medical provider, and current vaccination efforts by medical providers should be directed at the narrowed target groups . Please note that the H1N1 vaccination from DPH will only be available to the priority populations described above. If those in the priority groups for H1N1 vaccines are unable to obtain it from their regular medical provider or a local pharmacy, they should call the following DPH offices to determine whether they qualify to receive the vaccine from DPH.

    * New Castle County Hudson State Service Center, by appointment only, call (302) 255-4555 for age 6 months and above. Northeast State Service Center, by appointment only, call (302) 552-3600 for age 8 years and above

    Kent County
    * James Williams State Service Center, by appointment only, call (302) 857-5130 for ages 6 months and above

    Sussex County
    * Georgetown State Service Center, by appointment only, call (302) 856-5213 for ages 6 months and above Milford State Service Center, by appointment only, call (302) 424-7150 for ages 6 months and above.

    Seasonal flu vaccine:
    * Because a number of doctor’s offices and health care providers have run out of seasonal flu vaccine, current DPH flu clinics must also narrow their priority populations.
    * For seasonal flu, the temporarily narrowed priority populations are individuals without insurance who are:
    1. Pregnant women
    2. Children 6 months to 18 years of age
    3. People any age with chronic conditions (lung, heart, diabetes, compromised immune systems)
    4. People 65 or older
    5. If those in the targeted groups above for seasonal flu vaccines are unable to obtain it from their regular medical provider or a local pharmacy, they may qualify to receive the vaccine from DPH. Please note that the seasonal flu vaccination from DPH will only be available to the priority populations. If those in the seasonal priority groups are unable to obtain vaccination from their regular medical provider or a local pharmacy, they should call the following DPH offices to determine whether they qualify to receive the vaccine from the DPH.

    New Castle County Hudson State Service Center, by appointment only, call (302) 255-4555 for age 6 months and above. Northeast State Service Center, by appointment only, call (302) 552-3600 for age 8 years old and above

    Kent County James Williams State Service Center, by appointment only, call (302) 857-5130 for ages 6 months and above

    Sussex County Georgetown State Service Center, by appointment only, call (302) 856-5213 for ages 6 months and above Milford State Service Center, by appointment only, call (302) 424-7150 for ages 6 months and above.

    Delaware's flu vaccine shortages are similar to situations being faced in other states based on high nationwide demand. CDC expects this to be temporary and to ease in coming weeks. In the meantime, it is important that the priority groups above (which are different for the two types of flu) be given access to what vaccine there is in Delaware.

    There are many things we can all do to slow the spread of influenza:

    * Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
    * Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
    * Avoid touching your eyes, nose or mouth. Germs spread this way.
    * Try to avoid close contact with sick people.
    * If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. Your fever should be gone without the use of a fever-reducing medicine. Keep away from others as much as possible to keep from making others sick.
     

     

    1020 At-risk group will be focus of first public H1N1 vax clinic [Marion County, Indiana]--The Marion County Health Department will hold a H1N1 vaccination clinic on Thursday, October 22 at the Lafayette Square Shopping Mall, 3919 Lafayette Road, inside the former Steve and Berry's retail-clothing store.

    The H1N1 vaccine will be provided at no charge.

    The vaccination clinic will be held from 8 a.m. until Noon. This clinic is intended for:

    Women who are pregnant
    People who live with or provide care for infants younger than 6 months (parents, siblings and day care providers)
    Health care and emergency medical services personnel with direct patient contact.
    Those ages 6 months to 24 years old
    Persons aged 25 through 64 years who have certain medical conditions that put them at higher risk for influenza-related complications.

    "Those not in the at-risk groups are asked to wait for additional H1N1 vaccine to arrive. It is critically important that those in the at-risk group have the opportunity to be vaccinated first," said Virginia A. Caine, M.D., director, Marion County Health Department. Health department officials will screen those wanting an H1N1 vaccination to ensure they are in the at-risk group.

    Individuals coming to the Lafayette Square H1N1 Flu Clinic should be prepared to fill out paperwork and stand in long lines. Those coming to the clinic should follow the direction of informational signage and health department staff.

    The clinic will function on a first come, first serve basis and vaccinations will be offered until the end of the clinic or in the unlikely situation where the supply of vaccine is exhausted.

    HealthNet to Offer H1N1 and Seasonal Flu Vaccine Saturday

    Indianapolis HealthNet's six community health centers will offer H1N1 and seasonal flu vaccine Saturday, October 24 from 10 a.m. until 2 p.m.

    The H1N1 vaccine will be available only for those in the at-risk group. Vaccinations will be given on a first-come, first serve basis.

    The HealthNet Clinic sites include:
     

    Barrington Health Center, 3401 East Raymond Street
    Martindale-Brightwood Health and Dental Center, 2855 North Keystone Ave
    HealthNet Pediatric and Adolescent Care Center, 1633 North Capitol Avenue
    Peoples Health and Dental Center, 2340 East 10th Street
    Southeast Dental and Health Center, 901 Shelby Street
    Southwest Health Center, 2202 West Morris Street

    For more information on the HealthNet clinic sites, visit www.indyhealthnet.org

     

     

    1020 DSHS officials expect weekly availability of H1N1 vax to be low for next few weeks [Texas]--The U.S. Centers for Disease Control and Prevention allocated an additional 454,200 H1N1 vaccine doses to Texas last week bringing the total vaccine allocation for Texas to 960,400.

    Last week’s allocation of doses included 233,100 of the injectable, or shot, form and 221,100 doses of the mist form.

    Texas’ allocation for the week that ended Oct. 9 was 363,800 and included 235,000 doses of the injectable form and 128,800 doses of the mist form.

    Texas’ allocation for the week that ended Oct. 2 was 142,400 doses, all of it the nasal mist form of the vaccine.

    Using a strategic approach to reach priority vaccine groups and subsets of those groups, DSHS has allocated the limited supply of vaccine to providers who serve pregnant women, children 2 years through 4 years of age, children 5 years through 18 years of age who are at higher risk of serious consequences should they get the flu and health care workers who provide direct patient care.

    The 960,000 doses have been allocated to some 5,053 providers, with some of it distributed to local health departments as a safety net to meet special needs in communities. Some 12,000 Texas providers have registered to receive the vaccine.

    The H1N1 vaccine distribution steps are:

    * CDC allocates vaccine to the various state health departments each week.
    * DSHS accepts the entire allocation and further apportions it to registered providers in Texas based on vaccine formulation, priority vaccination groups, geography and other factors.
    * DSHS then notifies those providers to go online to confirm that they still want the vaccine, giving them a few days to confirm.
    * Once confirmation is received, DSHS issues shipping instructions to a distributor to send the vaccine to the provider.

    DSHS officials expect the weekly availability of the vaccine to be low for the next few weeks, adding that initial vaccine quantities are not high enough for public vaccination clinics to be held. They are urging providers and the public to be patient.

    Texas expects to receive 15 million doses of the vaccine by the end of January.

     

     

    1020 DoH recommends revax of some individuals against H1N1 [North Dakota]--On Oct. 19, 2009, the North Dakota Department of Health notified vaccine providers that some of the injectable H1N1 vaccine they received last week may be ineffective because of temperature issues while being shipped.


    The vaccine that is affected is safe but may not be effective at preventing H1N1 influenza. The vaccine was shipped to the Department of Health, where it was repackaged October 14 and sent to 99 vaccine providers across the state. On October 15, the department received calls from some of the providers reporting that the freeze indicator in the packages showed temperatures below safe shipping and storage range. Fifty-five providers reported that their vaccine was not affected; 30 providers reported that temperature indicators showed their vaccine was frozen; and the department is still checking with 14 additional providers. About 1,700 doses of injectable vaccine are estimated to be affected out of a total 24,100 doses of injectable and Flumist vaccine received in the state.

     

    The Flumist (nasal spray) vaccine was not affected.


    The Department of Health is trying to determine why some of the monitors showed temperatures out of range. In the meantime, the department has recommended that providers not use the injectable vaccine they received if a temperature indicator showed frozen temperatures. Acting on the side of caution, the department also is recommending that people who received the affected vaccine be revaccinated and has asked providers to contact any patients who need to be
    revaccinated. The Department of Health is working to determine how many people are recommended to be revaccinated.

     

     

    1020 DNR and City of St Louis warn of high methane levels near demolition landfill [Missouri]--The Missouri Department of Natural Resources is working with the City of St. Louis to notify nearby residents of dangerously high methane levels at the St. Louis Demolition Landfill. The facility is located in the far northeast part of the city between Hall Street and the Mississippi River.

    After receiving the results of testing done Monday Oct. 12 at the facility, the DNR found high methane levels. The DNR has ordered the city to notify all nearby homeowners and businesses of the risk and supply them with methane monitors. The monitors will alert homeowners if methane enters the home. The DNR found potentially high levels of methane Oct. 6, and immediately ordered the city to begin a notification plan for nearby residents and businesses. Further tests were performed, and DNR got confirmation of high methane levels on Oct. 14.

    The landfill has three methane testing wells, and the City of St. Louis conducted sampling on Oct. 12. The southernmost well showed 4.3 percent methane by volume; the second and third wells to the north had readings of 11.3 and 46 percent methane by volume. Methane is a byproduct of the decomposition of waste and is explosive at concentrations between 5 and 15 percent. The regulatory limit for methane at a landfill property boundary is 2.5 percent by volume.

    "The City of St. Louis is working cooperatively with the DNR to address this matter as quickly as possible and determine whether methane gas has reached the nearby homes," said Bill Bryan, DNR Deputy Director.

    Additional investigation by the city is needed to determine if the methane is spreading off-site. The DNR has required the city to develop a plan to determine the extent of the spread and develop an appropriate cleanup plan. The city is also required to continue monitoring the wells and report the readings to the department on a weekly basis.

    The department's Solid Waste Management Program has been working with the City of St. Louis to properly close Demolition Landfill and move the facility into post-closure status. The landfill was built before the current landfill design and operating requirements took effect, so it was grandfathered in and not required to monitor for methane gas. As part of the process of properly closing the landfill, the DNR required the city to prepare an investigation plan and install three gas-monitoring wells along the western perimeter of the facility.

    The DNR and the city of St. Louis are encouraging residents and business owners to use caution and call 911 if they smell gas or the St. Louis Fire Department at 314-533-3406 if they have concerns with their monitoring device.

    The department is encouraging citizens who live in the area and have questions or concerns to contact the city at 314-647-3111 or call the DNR Solid Waste Management Program at 800-361-4827 or 573-751-5401.

     

     

    1020 DHH updates states of Fight The Flu campaign [Louisiana]--State Health Officer Jimmy Guidry, M.D., held a press briefing to update influenza activity in Louisiana as well as the state’s H1N1 vaccination campaign. Dr. Guidry emphasized that as the H1N1 vaccination campaign moves forward, it is important for Louisiana families to be patient if their provider has not yet received the H1N1 vaccine, as more vaccine is arriving every week. Residents should stay in contact with their provider as to the vaccine’s availability and to make an appointment when the time comes.

    This Week’s Highlights

    • The CDC reports that approximately 79,400 doses of H1N1 vaccine have been shipped to Louisiana as of Wednesday, October 14.
    • The state has ordered a total of 180,100 doses on behalf of providers since vaccine became available.
    • 259 providers in Louisiana have received vaccine.
    • 3,945 doses have been administered thus far.
    • The first doses of injectable vaccine are arriving now, with pregnant women and frontline health care workers serving as the initial target groups for injectable vaccine.
    • DHH has launched a Twitter feed and a Facebook page to help ensure teenagers and young adults, both of which fall into high-risk groups for H1N1, have easy access to up to date information regarding the H1N1 virus and vaccine. You can follow the campaign on Twitter at www.twitter.com/FightTheFluLA and on Facebook at http://www.facebook.com/pages/Fight-The-Flu-LA/154425074450.

    H1N1 Vaccination Campaign Summary

    • Additional shipments of H1N1 vaccine are expected every 5-10 days for the next 2-3 months, with pregnant women, front line health care workers, and adults with pre-existing medical conditions as the next target groups for vaccination.
    • Every Louisianian who wants the vaccine should have access by the end of January.
    • Residents should check with their providers regarding the availability of H1N1 vaccine, and DHH will be posting a link on www.FightTheFluLA.com showing which providers across the state have received vaccine in the coming weeks.

    Overall Influenza Activity

    • There are now 1,557 lab confirmed cases of the H1N1 flu in the state of Louisiana.
    • Estimates derived by DHH in conjunction with CDC data indicate approximately 105,000 Louisianians currently have or have had the H1N1 flu.
    • DHH has confirmed four additional H1N1-related deaths in the past week: two adult males from Region IX (St. Tammany, Washington, Tangipahoa, St. Helena, and Livingston Parishes), an adult female from Region IV (the seven-parish area including Lafayette), and an adult female from Region VIII (the 12-parish region including Monroe). The total number of H1N1-related deaths in Louisiana is now 24.

    DHH’s Fight the Flu campaign aims to keep Louisianians healthy by promoting immunizations and good hygiene to prevent the spread of the seasonal flu and the H1N1 virus. For more information on flu activity in Louisiana, including guidance for families and medical professionals, visit www.FightTheFluLA.com or follow the campaign at www.twitter.com/FightTheFluLA.

     

    1020 H1N1 vax coming more slowly than expected [Oregon]--Last week the Centers for Disease Control announced that H1N1 vaccine yield is lower than earlier anticipated.


    According to the CDC, nationwide 40 million doses had been estimated by the end of October but only about 28 to 30 million doses will be available during that time frame. To date, Oregon has received approximately 80,000 doses of H1N1 vaccine and more is scheduled to arrive next week.


    At a news conference at the state public health department’s H1N1 center, Mel Kohn, MD, director of the Oregon Public Health Division discussed the state’s response to the delay. He was joined by Kathleen O’Leary, RN, Washington County Public Health Administrator and Gary Oxman, MD, health officer for Multnomah, Clackamas and Washington counties.


    Dr. Kohn said that in spite of the delay in manufacturing more H1N1 vaccine is on the way to Oregon, some vaccine clinics are opening next week around the state and more will be opening throughout October and November.


    “This kind of delay commonly occurs during flu vaccine production. It’s just the biology of the virus,” said Dr. Kohn. “No corners are being cut when it comes to the safety of manufacturing this vaccine. It’s meeting the same high standards as the seasonal flu vaccine.”

     

    “The H1N1 vaccine is coming, but not as quickly as we would like,” added Dr. Kohn. “We know that demand for the vaccine is very high and we are asking people to be patient until it comes to their community and to keep checking back with the Web site or hotline for more information. Although we wish we had more vaccine to give now, there will still be value in vaccinating people in the coming months.”


    The state sponsors a Web site at www.flu.oregon.gov that posts public flu clinics as well as a statewide hotline at 800-978-3040 – both have the most recent information so that people can stay informed about open flu clinics.


    “People are disappointed that there isn’t more vaccine available – we are too,” said Ms. O’Leary. “Every county health department has a team working to make sure it is getting out to providers, hospitals, and clinics. Once received, we’re moving it out quickly.”


    Until the vaccine arrives in adequate quantity, officials say that the other prevention measures become even more important.


    “If you’re even thinking about going to work or to school if you’re sick, don’t,” said Dr. Oxman. “We all have to take responsibility for ourselves, our families and our communities and stop the spread of H1N1 flu.”


    Dr. Oxman also reminded people to wash their hands, use hand sanitizer whenever possible, and to cover their coughs and sneezes.


    For more information, call the Oregon Public Health Flu Hotline at 1-800-978-3040 or visit www.flu.oregon.gov.

     

     

    1020 H1N1 vax available for people with no health insurance and significant health problems [King County, Washington]-- As private providers begin to receive H1N1 influenza vaccine for their patients at highest risk for complications, starting Wednesday, Oct. 21, Public Health - Seattle & King County is making vaccinations available for people without health insurance who are at increased risk because they have significant health problems.

    Four Public Health vaccination clinics will be open to people up through 64 years of age who have significant health problems that put them at greater risk for serious complications for H1N1. Examples would include heart disease, lung disease, asthma, kidney disease, diabetes and HIV/AIDS.

    Most children and pregnant women have public or private health care coverage, so it is anticipated that the clinics will primarily serve uninsured adults. People over age 65 are at relatively low risk for H1N1 influenza and so should not seek vaccination at this time.

    For people who have health insurance, local health care providers are receiving initial, small shipments of vaccine for their existing patients who need protection most. Vaccine availability from health care providers is expected to improve gradually as additional supplies arrive in upcoming weeks.

    Public Health clinic details

    Four Public Health H1N1 vaccination clinics will be operated at the following locations:

    White Center Public Health Center (10821 8th Ave. S.W., Seattle)
    Alder Square Public Health Center (1404 Central Ave. S., Suites 101 & 112, Kent)
    North Public Health Center (10501 Meridian Ave. N., Seattle)
    Federal Way Public Health Center (33431 13th Place S., Federal Way)

    All clinics will be open 8:30 a.m. - 5:30 p.m. on Monday, Tuesday, Wednesday and Fridays and 8:30 a.m. - 7:00 p.m. on Thursday. All clinics are walk-up and appointments will not be needed or scheduled. Visit the Public Health H1N1 influenza website at www.kingcounty.gov/health/H1N1 for clinic directions.

    Vaccinations at these clinics will continue over time, pending vaccine availability from the federal government.
    Clinic locations may also expand with demand. As supply increases, more vaccine will be available in Public Health clinics and other community locations. The Public Health website will be updated regularly with information on vaccine availability.

    Last Friday, the Centers for Disease Control and Prevention (CDC) announced that vaccine production is proceeding slower than originally expected, which will result in smaller amounts of vaccine in ongoing deliveries over the next two months.

    Call center activation

    Beginning Wednesday morning, Oct. 21, the Flu Hotline at 877-903-KING (5464) will be staffed with operators to answer questions about H1N1 influenza and provide information about Public Health - Seattle & King County vaccine clinic locations for people without insurance and with significant health problems. Hours of operation with operators will be 9 a.m. to 5 p.m. weekdays; recorded information will be available 24 hours a day.

     

     

    1017 H1N1 flu is widespread [Northwest Territories]--The Office of the Chief Public Health Officer (OCPHO), would like to update the residents of the NWT on the escalating H1N1 pandemic.


    The H1N1 flu virus has spread to 22 of 33 NWT communities and is the dominant flu strain in the NWT at this time. At this point, there have been 19 hospitalizations and two cases of severe respiratory illness. There have been no deaths associated with the virus.


    The Chief Public Health Officer would like to remind residents of the NWT that they can help stop the spread of influenza by washing their hands with soap and warm water, staying home if you feel sick, cover your mouth and nose when cough or sneeze, cleaning surfaces that may harbor influenza or other viruses.


    For additional information on H1N1 influenza residents can call the Tele-Care Health Line at 1-888-255-1010 or the NWT’s Influenza Information Line at 1-888-920-3026. The Chief Public Health officer recommends calling these lines before visiting your local heath centre.

     

    For the week of October 5-9, the flu line processed 120 calls. Of those calls, 77 residents were referred to their local health centre or hospital.

     

     

    1017 Province issues updated guidance H1N1 documents to healthcare providers [Ontario]--Ontario has issued updated guidance documents to the province's health care sector including ambulatory care settings like doctors' offices, long-term care settings and emergency departments which set out recommendations for managing flu cases. Health care professionals can apply this guidance to diagnose, test, treat and advise their patients about the flu.

    On September 24th, the province announced the rollout of its seasonal and H1N1 flu shot programs using a three phased approach. A bilingual brochure started arriving in mailboxes across Ontario last week outlining who can be vaccinated and when their flu shots will be available.

    As part of phase one, Ontario is calling upon seniors 65 years and older and residents in long-term care homes of any age to be vaccinated against the seasonal flu in October. People 65 years and older should contact their local public health unit to find out how to get their seasonal flu shot.  During phase two, the province-wide rollout of the H1N1 vaccine will follow in early November.  Finally, phase three will offer the seasonal flu vaccine to all Ontarians six months of age and older.

     

    1017 H1N1 flu update - vax may be available earlier than November [New Brunswick]--The following update on the H1N1 flu virus was issued by the Office of the Chief Medical Officer of Health for New Brunswick on Thursday, Oct. 15:

    • The H1N1 vaccine may be available earlier than the beginning of November.
    • Plans are in place to deliver the H1N1 vaccine whenever it becomes available. Operational decisions were made so that New Brunswick would have the capacity to offer both the seasonal and H1N1 vaccines.
    • Preparations are underway to hold vaccination clinics throughout the province.
    • A public awareness campaign will be launched to give New Brunswickers the specifics on where, how and when they may obtain the H1N1 vaccine.
    • At-risk groups should receive the H1N1 vaccine as soon as it becomes available. Those groups include pregnant women, people with underlying medical conditions such as diabetes, or those with compromised immune systems.
    • The provincial government has invested $17.1 million to provide the H1N1 flu vaccine free to all New Brunswickers who choose to be immunized.
    • There have been reports and public speculation about the safety of the H1N1 vaccine. The contents of the H1N1 vaccine will protect against contracting H1N1. The included additives and preservatives are there to help the vaccine work, and are not cause for alarm.
    • As a multi-dose vaccine, the H1N1 influenza vaccine will contain a mercury-based preservative, called thimerosal, to prevent contamination of the vaccine by serious infectious agents from the growth of bacteria. Thimerosal also has a stabilizing effect on the vaccine, ensuring its effectiveness.
    • The seasonal flu vaccine and most hepatitis B vaccines are also multi-dose vaccines, and thimerosal is added during the manufacturing process to maintain sterility of the vaccine.
    • There is no safety reason to avoid using vaccines containing thimerosal. The best available scientific evidence to date shows no link between thimerosal-containing vaccines and any adverse health condition, including neurodevelopmental disorders such as autism.
    • The National Advisory Committee on Immunization has reviewed the safety of thimerosal, and concluded that, "There is no legitimate safety reason to avoid the use of thimerosal-containing products for children or older individuals, including pregnant women."
    • International bodies such as the World Health Organization and the U.S. Food and Drug Administration share this opinion.
    • Most of the H1N1 vaccine available in New Brunswick will also contain an adjuvant. An adjuvant is a substance that is added to a vaccine in order to boost the individual's immune response. It also means that less of the virus, or antigen, is needed to make a dose of the vaccine. Unadjuvanted vaccine has no booster element, and more antigen is needed to create this kind of vaccine.
    • By developing an adjuvanted vaccine, Canada has used less of the virus material (antigen), allowing us to immunize more people in a timely manner.
    • Adjuvants are not new. Many commonly used vaccines in Canada contain an adjuvant. Adjuvants have been used for several decades to boost immune response to vaccines. However, adjuvants have not previously been used with influenza vaccines in Canada.
    • All evidence suggests that adjuvanted vaccines are just as safe as unadjuvanted vaccines; however, there is no safety data for the use of adjuvanted vaccine in pregnant women.
    • The Government of Canada has purchased a small quantity of unadjuvanted H1N1 vaccine (about 1.2 million doses) as part of its total order of 50.4 million doses.
    • There is a possibility that the unadjuvanted vaccine may not arrive until the H1N1 vaccine campaign is in its second or third week.
    • The Office of the Chief Medical Officer of Health recommends that pregnant women and new mothers receive the H1N1 vaccine as soon as possible.
    • This recommendation follows the advice of the World Health Organization when vaccinating pregnant women against the H1N1 flu virus.
    • New Brunswickers should continue to protect themselves and those around them by washing their hands thoroughly and often, coughing or sneezing into sleeves, staying home if sick, and keeping common surfaces clean.
    • Persons at high risk of complications from influenza-like illness should seek medical attention promptly.
    • Persons with influenza-like symptoms should stay home and minimize contact with family members as much as possible. If symptoms worsen, they should visit their physician or nurse-practitioner, a walk-in clinic, or the nearest hospital emergency department.
    • It is recommended that persons with influenza-like symptoms limit contact with other people, including other household members until they are free of symptoms and are feeling well.
    • Those experiencing influenza-like illness should consider ending self-isolation when they are able to participate fully in all of their normal daily activities.
    • It is important for New Brunswickers to understand that if they do not have influenza-like symptoms it is safe to go to work and school, to participate in activities and to socialize.

    More information on the H1N1 flu virus may be found online or by calling the 24-hour H1N1 line, 1-800-580-0038.

     

    1017 Clinical features of severe cases of pandemic influenza [Global]--To gather information about the clinical features and management of pandemic influenza, WHO hosted a three-day meeting at the headquarters of the Pan American Health Organization in Washington, DC on 14–16 October. Findings and experiences were presented by around 100 clinicians, scientists, and public health professionals from the Americas, Europe, Asia, Africa, the Middle East and Oceania.

    The meeting confirmed that the overwhelming majority of persons worldwide infected with the new H1N1 virus continue to experience uncomplicated influenza-like illness, with full recovery within a week, even without medical treatment.
    Need for intensive care

    However, concern is now focused on the clinical course and management of small subsets of patients who rapidly develop very severe progressive pneumonia. In these patients, severe pneumonia is often associated with failure of other organs, or marked worsening of underlying asthma or chronic obstructive airway disease.

    Treatment of these patients is difficult and demanding, strongly suggesting that emergency rooms and intensive care units will experience the heaviest burden of patient care during the pandemic.

    Primary viral pneumonia is the most common finding in severe cases and a frequent cause of death. Secondary bacterial infections have been found in approximately 30% of fatal cases. Respiratory failure and refractory shock have been the most common causes of death.

    Presentations during the meeting explored the pathology of severe disease in detail, with findings supported by work in experimental animals. These findings confirm the ability of the new H1N1 virus to directly cause severe pneumonia.


    Clinical picture different from seasonal influenza

    Participants who have managed such cases agreed that the clinical picture in severe cases is strikingly different from the disease pattern seen during epidemics of seasonal influenza. While people with certain underlying medical conditions, including pregnancy, are known to be at increased risk, many severe cases occur in previously healthy young people. In these patients, predisposing factors that increase the risk of severe illness are not presently understood, though research is under way.

    In severe cases, patients generally begin to deteriorate around 3 to 5 days after symptom onset. Deterioration is rapid, with many patients progressing to respiratory failure within 24 hours, requiring immediate admission to an intensive care unit. Upon admission, most patients need immediate respiratory support with mechanical ventilation. However, some patients do not respond well to conventional ventilatory support, further complicating the treatment.

    On the positive side, findings presented during the meeting add to a growing body of evidence that prompt treatment with the antiviral drugs, oseltamivir or zanamivir, reduces the severity of illness and improves the chances of survival. These findings strengthen previous WHO recommendations for early treatment with these drugs for patients who meet treatment criteria, even in the absence of a positive confirmatory test.

    In addition to pneumonia directly caused by replication of the virus, evidence shows that pneumonia caused by co-infection with bacteria can also contribute to a severe, rapidly progressive illness. Bacteria frequently reported include Streptococcus pneumoniae and Staphylococcus aureus, including methicillin-resistant strains in some cases. As these bacterial co-infections are more frequent than initially recognized, clinicians stressed the need to consider empiric antimicrobial therapy for community acquired pneumonia as an early treatment.
     

    Groups at greatest risk

    Participants agreed that the risk of severe or fatal illness is highest in three groups: pregnant women, especially during the third trimester of pregnancy, children younger than 2 years of age, and people with chronic lung disease, including asthma. Neurological disorders can increase the risk of severe disease in children.

    Evidence presented during the meeting further shows that disadvantaged populations, such as minority groups and indigenous populations, are disproportionately affected by severe disease. Although the reasons for this heightened risk are not yet fully understood, theories being explored include the greater frequency of co-morbidities, such as diabetes and asthma, often seen in these groups, and lack of access to care.

    Although the exact role of obesity is poorly understood at present, obesity and especially morbid obesity have been present in a large portion of severe and fatal cases. Obesity has not been recognized as a risk factor in either past pandemics or seasonal influenza.

    WHO and its partners are providing technical guidance and practical support to help developing countries better detect and treat illness caused by the pandemic virus. Patient care advice that can be applied in resource-limited settings is being rapidly compiled.

     

     

    1017 States advised of production delays for the new H1N1 vax [Vermont]--The Vermont Department of Health was alerted Thursday that vaccine manufacturers are experiencing ongoing delays in the production of the 2009 H1N1 vaccine.

    The Centers for Disease Control & Prevention (CDC) confirmed today that states will not be receiving vaccine shipments – in the amounts that have been expected – as early as expected.

    “We know flu is here – and vaccine for both the regular flu and the new H1N1 flu is coming into the state, but more slowly that we had hoped and planned for,” said Health Commissioner Wendy Davis, MD. “We are working with our many partners to adjust our vaccination plans so we can move vaccine as quickly as possible to those who need it the most.”

    Right now, the 2009 H1N1 influenza virus is the predominant type of flu circulating nationwide. This week the Vermont Department of Health reported an increase in influenza activity, especially in the southwest and northwest portions of the state.

    Flu activity in Vermont is now characterized as regional, while most other states are experiencing widespread flu activity.

    “It’s more important than ever to take the everyday actions that can truly help keep illness from spreading,” said Dr. Davis. “Wash your hands often and well, cover your cough when you cough or sneeze, stay home from work or school and away from others when you are sick – for at least 24 hours after your fever has gone.”

    There are two flu vaccines recommended this season.Vaccine for the seasonal flu is recommended – as soon as it’s available – for nearly everyone 6 months and older, but especially for the very young, the very old, pregnant women and people with chronic medical conditions.

    As soon as vaccine for the new H1N1 flu is available, it will go first to people who could be most seriously affected if they become ill:

    • Pregnant women
    • Caregivers and household contacts of children under 6 months
    • Anyone age 6 months through 24 years
    • Health care workers and emergency medical services personnel
    • Adults age 25 through 64 who have chronic medical conditions such as asthma, chronic heart, kidney or liver disease, diabetes, compromised immune systems due to disease or treatment, or neuromuscular conditions

    The vaccine production delays are not safety related. The vaccine will continue to go through all the normal testing and FDA clearances, and will be shipped to states as soon as it is available.

    Extensive information, tools and resources about seasonal and pandemic flu, healthy habits and preparedness are available at the Health Department’s website: healthvermont.gov or dial 2-1-1. You can also follow us on Twitter at twitter.com/healthvermont.

     

    1017 H1N1 flu vax clinics getting underway [Connecticut]--Governor M. Jodi Rell today announced that vaccination clinics for the H1N1 virus – the so-called swine flu – are getting underway in Connecticut and more are expected to be scheduled over the next several weeks as shipments of the vaccine continue to arrive in the state.

    “These clinics are a great sign that the campaign to begin vaccinating Connecticut’s residents from H1N1 flu is off the ground,” the Governor said during a stop at a clinic for toddlers in Old Saybrook today. “We expect to see many more clinics around the state as shipments continue to come in to doctors and other health care providers. It is critical that those most at risk are given priority for the initial doses.”

    The state Department of Public Health (DPH) says that the state has already received more than 83,000 doses of intranasal and injectable vaccines. Orders for the next shipment of vaccine are being placed and will include more intranasal vaccine.

    The Old Saybrook Clinic, sponsored by the Connecticut River Area Health District, was by appointment only and targeted children between the ages of 2 and 4 years old, household contacts of children under the age of 6 months, and emergency and medical service and healthcare personnel with direct patient care.

    The health district serves residents of the towns of Clinton, Chester, Deep River, Essex, Killingworth, Old Saybrook and Westbrook and used the intranasal, or nasal spray, form of the H1N1 flu vaccine. The intranasal vaccine has received federal approval for use in healthy persons 2-49 years of age, who are not pregnant.

    The state expects to receive several thousand more doses of vaccine in weekly shipments. Shipment quantities may vary depending on the vaccine manufactures’ supply. As more vaccine is received, it will first be made available to those who are at greatest risk due to complications of H1N1 influenza: pregnant women, caregivers of children younger than age of six months, health care and emergency medical services personnel with direct patient contact, children aged six months to four years and children aged 5 to 18 with chronic medical conditions.

    “People who belong to these priority groups should contact their healthcare provider or local health department for more information,” DPH Commissioner Dr. J. Robert Galvin said. “The vaccine is just now beginning to arrive into the state and we expect to receive more every week. People may need to be patient and persistent to get the vaccine in these early rounds of vaccine supply.”

    Providers who have not pre-registered with the Department of Public Health and who are interested in receiving the H1N1 vaccine may still pre-register with the department. Information on pre-registering for the vaccine is available online at www.ct.gov/ctfluwatch/providers or by calling (860) 509-7929.

    A public hotline for H1N1, staffed by representatives from DPH, is also available for people with questions about H1N1 flu or the H1N1 vaccine. The number for the H1N1 Hotline is: 800-830-9426. The public can call the hotline Monday through Friday, 7 a.m. to 7 p.m.

    The H1N1 vaccine is only effective against the H1N1 virus and does not protect against seasonal influenza. Public health officials also encourage Connecticut residents to get their seasonal flu vaccination, as well as the H1N1 vaccination.
     

    For more information on the H1N1 virus or the seasonal flu in Connecticut visit: http://www.ct.gov/ctfluwatch

     

     

    1017 Bureau of Insurance announces progress and positive actions to cover H1N1 flu vax [Maine]--Bureau of Insurance Superintendent Mila Kofman is highlighting steps being taken by the Bureau and Maine insurance companies to facilitate access to the H1N1 vaccine for those individuals who voluntarily choose to be vaccinated. The Bureau of Insurance has been working with insurers and other State agencies on actions that will reduce or eliminate costs for health plan members, while also simplifying and streamlining the process.

    Superintendent Kofman explained that Aetna, Anthem, CIGNA, Harvard Pilgrim, and United Health Care are taking important steps to eliminate barriers for their members who choose to be vaccinated as supplies become increasingly available. These companies are waiving copays, coinsurance, and deductibles for the administration of the H1N1 vaccine.

    “These significant actions are very encouraging for Maine’s consumers, and they demonstrate how Maine insurers continue to take voluntary steps in the face of a potential public health emergency. Although receiving the vaccine is a voluntary decision, we want to make the process as easy as possible for people,” said Superintendent Kofman.

    Beginning as early as August, these insurance companies began making exceptions to the requirement that vaccinations have full Food and Drug Administration (FDA) approval before coverage would be authorized. The vaccination has since been approved by the FDA.

    In September, they additionally began voluntarily accepting roster billing in order to streamline the billing process for vaccination clinics. Vaccination clinics and mass immunization allow individuals to receive the H1N1 vaccination without having to schedule an appointment with their primary care providers.

    Roster billing is a simplified billing process that can make it easier for clinics and mass immunizers–such as schools, pharmacies, or workplaces–to get people immunized quickly while still providing the information insurance companies need to pay claims, in this case to pay the fee for administering the vaccine.

    “Clinics and mass immunizations take the pressure off the traditional delivery system, and we want to recognize that Maine insurers are going the extra mile by modifying their systems to accept this method of billing,” said Dr. Dora Mills of the Maine Center for Disease Control.

    “My staff and I have been working closely with insurance companies and with the Maine Association of Health Plans to address H1N1 issues and to be fully prepared,” said Superintendent Kofman. “We are also working closely with other State agencies, including the Maine Health Data Organization to ensure that by accepting roster billing health plans are not inadvertently violating other laws.”

    The Bureau of Insurance Web site is updated regularly with information for insurance carriers, care providers and consumers. For more information, visit www.maine.gov/insurance.

     

     

    1017 Free H1N1 vax clinics for youth, pregnant women [Washington DC]--Mayor Adrian M. Fenty and Pierre Vigilance, MD MPH, director of the DC Department of Health (DOH) announced locations where District residents can receive a free vaccination for the H1N1 influenza based on priority categories. The District will have a clinic in each ward, beginning next week, which will be open to all youth and pregnant women in the District. Fenty also received his seasonal flu shot to remind residents that two flu vaccines are needed this year to protect themselves from the flu.

    Our youth and expectant mothers are some of the most susceptible to H1N1,” said Mayor Fenty. “We are proud to be able to provide this important service through community health centers, primary care providers and vaccine clinics to make sure we can help prevent the spread of this new virus.”

    The school-based vaccine clinics will serve youth ranging in age from 6 months to 24 years old and pregnant women. The H1N1 vaccine will be offered in both the injection and nasal spray forms at no cost. Many community health clinics and primary care providers in the District have signed up to provide the vaccine to their patients. Parents and members of the priority groups are encouraged to call their providers to see if they have the vaccine.

    The District should eventually have enough vaccine for everyone in the District who wants it,” said Vigilance. “Residents in priority groups are strongly encouraged to seek out the vaccine to help protect themselves and the rest of the community from H1N1.”

    Over the coming weeks, the H1N1 vaccine will be distributed to pharmacies in drugstores and groceries that have agreed to carry the vaccine. To help residents find a location, DOH will launch the Flu Shot Finder at flu.dc.gov next week to allow residents to search for the nearest location to get the seasonal or H1N1 influenza vaccine. Once the priority groups have been vaccinated, DOH will have clinics for the general public to receive the H1N1 vaccine.

    Priority Groups
    Individuals considered a priority by DOH and the CDC are:
     

    • Health care workers and emergency medical responders
    • Pregnant women
    • Children and young adults from 6 months to 24 years
    • People caring for infants under 6 months of age
    • People aged 25 to 64 years with underlying medical conditions, such as asthma or diabetes

    Select one of the links below to view :

    DOH continues to monitor cases of influenza like illness (ILI) in the District and will keep residents updated on any new information regarding H1N1. For more information residents can go to flu.dc.govor call 311 to reach the Mayor’s Citywide Call Center.  

     

    1017 Additional H1N1 flu vax coming to state [Oklahoma]--State health officials confirmed today an additional 65,900 doses of the novel H1N1 influenza vaccine is expected to arrive in the state next week. The doses will include both nasal spray and injectable vaccines.

    Local county health departments will continue to target delivery of the vaccine to healthy school-aged children, pre-K through grade12, at school locations that are experiencing elevated absenteeism rates due to children and staff out with influenza. They also will focus on children 6 months through 18 years with chronic medical conditions, pregnant women, and health care workers in direct contact with acutely ill patients.

    The vaccine will be available through clinics conducted by local county health departments and the Indian Health Service. In addition, beginning next week, county health departments will also be able to transfer some vaccine to a small number of health care providers who have signed Provider Agreements on file with the Oklahoma State Department of Health and serve patients in the targeted groups. Once larger quantities of vaccine arrive in the state, additional private providers will be added to the vaccine distribution network.         

    The Oklahoma State Department of Health is projected to receive H1N1 vaccine in weekly shipments through early January 2010. Initial doses will be provided to those priority groups most at risk from complications of H1N1 influenza, including the following:

    • Pregnant women
    • People caring for infants less than 6 months of age
    • Children and young adults from 6 months to 24 years of age
    • Persons aged 25 to 64 who have underlying medical conditions
    • Health care workers and emergency medical responders

    For more information about the availability of H1N1 influenza vaccine in your area, call your local county health department or visit www.health.ok.gov, or call the Oklahoma State Department of Health toll-free H1N1 hotline at: 1-866-278-7134. Phones are answered Monday through Friday from 8 am to 5 pm.

     

    1017 State receives fewer than anticipated H1N1 vax doses this week [Colorado]--State health officials today reported the amount of H1N1 vaccine received this week, 50,000 doses, is well below the 183,300 doses that were expected. They advised local health departments and hospitals to continue to provide available vaccine to health care workers who provide direct patient care and to other high-risk groups as vaccine supplies in individual locations allow.

    The following individuals who are in the high-risk group for experiencing complications from H1N1 were advised to be the first in line to receive an H1N1 vaccine:

    • Preschool children ages 6 months to 4 years
    • School age children and young adults ages 5 to 18 with chronic health conditions
    • Health care workers with direct patient contact
    • Pregnant women
    • Parents/caretakers for children younger than 6 months

    Joni Reynolds, Immunization Program director at the Colorado Department of Public Health and Environment, said, “The federal government is doing everything it can to provide as much vaccine to states as possible. However, the vaccine estimates have changed nearly daily and have been lower than that anticipated and planned for.”

    Ned Calonge, the state’s chief medical officer, said, “This is frustrating, especially for those individuals who know they have an increased risk and are anxious to get the vaccine. It is also proving difficult for local health departments and others who have set up flu clinics and now may not have enough vaccine this week to conduct them. However, we continue to be assured by our federal partners that we will receive the vaccine we need to provide immunizations for those Coloradans who need them, though later than originally anticipated.”

    In the meantime, Calonge advised people to prevent the flu by practicing good hygiene, staying home when sick and avoiding others who are ill.

    Good hygiene habits to prevent the flu include

      • frequently washing hands;
      • coughing and sneezing into the crook of your arm, rather than uncovered or in your hand;
      • avoiding people with respiratory illness;
      • staying home from work or school when sick, returning only after fever has subsided for 24 hours without the use of a fever-reducing medication.

    Calonge said, “As soon as we have the vaccine needed to support community clinics, we will update our flu clinic finder at www.immunizecolorado.com.”

    Two resources to assist the public during H1N1 flu season are available online, including the Colorado Department of Public Health and Environment’s Home Care Guide about caring for sick individuals at home and a link to CDC’s Web-based H1N1 flu self-evaluator, an online tool that will help people decide if they need to see a doctor for symptoms that might be caused by the flu. The Home Care Guide is available in English and Spanish at and CDC’s Flu Self-Evaluation is at http://www.flu.gov/evaluation/

    For additional information about flu clinics or answers to other questions about H1N1 or seasonal flu, individuals may call the CO HELP hotline at 1-877-462-2911.

     

    1017 H1N1 flu vax distribution underway - flu activity high [Wyoming]--As flu activity continues to be high across the state, the Wyoming Department of Health says swine (novel H1N1) vaccine distribution is underway in Wyoming at the same time delays in seasonal flu vaccine delivery are being reported here and around the country.

    “Vaccines are the single most effective weapon around to help fight influenza,” said Dr. Brent Sherard, Wyoming Department of Health director and state health officer. Wyoming flu activity is currently very high and is almost 100 percent due to the novel H1N1 flu strain.

    “For the best possible protection over the coming months, people will need to get the H1N1 flu vaccine and a seasonal flu vaccine,” Sherard said. “However we realize it will take a little effort and some patience for most people to get both of these immunizations. We ask residents to understand this flu season will not be business as usual.”

    “We believe enough H1N1 vaccine will eventually be available for all our residents who wish to be immunized, but the first shipments have been small,” Sherard said. “Individuals at higher risk for complications from this flu strain should be first in line for the available H1N1 vaccine.”

    Target groups include:

    ·         Pregnant women

    ·         Persons who live with or provide care for infants under the age of 6 months (This includes parents, siblings and day-care providers.)

    ·         Healthcare and emergency medical services personnel

    ·         Persons aged 6 months through 24 years

    ·         Persons aged 25 through 64 years who have medical conditions that put them at higher risk for influenza-related complications

    Sherard reported 3,400 doses of the nasal spray form of H1N1 vaccine were shipped to Wyoming the first week it was available; 8,400 doses with both the nasal spray form and injectable vaccine arrived this week and 12,200 doses have been ordered for delivery next week. Shipments should continue to increase in the coming weeks.

    The Wyoming Department of Health is ordering the swine flu vaccine for shipment to approved providers with amounts based on population. To help ensure the available vaccine gets to those who need it most, county public health officials are coordinating much of the distribution. The federal government is paying for the H1N1vaccine; some providers may charge a small administration fee.

    Seasonal flu vaccine distribution is being handled as in previous years with private healthcare providers ordering much of the vaccine directly from manufacturers. “Unfortunately, we are hearing reports of delays in seasonal flu vaccine shipments both here in Wyoming and around the United States. At this time it does not appear to be a long-term shortage and we ask people to be patient,” Sherard said.

    Sherard also noted influenza vaccines have been available for many years and have a proven track record of safety. “Novel H1N1 vaccine is essentially no different. No corners were cut in its development,” he said.

    Of the total 1614 reported flu cases in Wyoming since late May, 419 have been confirmed as swine flu cases. Most other cases were not subtyped. Over the same timeframe, the department has received reports of 28 Wyoming hospitalizations in connection with the virus. The department expects the number of actual flu infections around the state to be much higher because most ill persons do not seek medical care or are not tested. Specific swine (novel H1N1) flu counts provided by the department only reflect cases confirmed by specialized lab testing as the H1N1 strain as part of the department’s ongoing surveillance activities.

    Actions recommended to slow the spread of illness include:

    ·         When available, get immunized with both a swine flu and a seasonal flu vaccine.

    ·         In general, people who develop influenza-like illness should stay home from work, school or travel until at least 24 hours after they are free of fever. Those who are severely ill (such as having trouble breathing) should seek medical care.

    ·         Avoid contact with ill persons.

    ·         Covering noses and mouths with a tissue or sleeve when coughing or sneezing, and throwing used tissues in a trash can.

    ·         Frequent hand washing with soap and water or the use of an alcohol-based hand gel.

    Influenza symptoms include fever, cough, sore throat, body aches, headaches and fatigue. Some patients also report diarrhea and vomiting. 

    More information about swine (novel H1N1) flu and vaccination in Wyoming is available online at www.health.wyo.gov .

     

    1017 First local H1N1 flu death this fall [King County, Washington]--A King County male in his 20s died yesterday from complications of H1N1 influenza (swine flu) and his underlying health conditions. This is the first reported H1N1 death in King County this fall as flu activity picks up.

    "Our hearts go out to this man's loved ones," said Dr. David Fleming, Director and Health Officer for Public Health - Seattle & King County. "Flu activity is increasing locally, and this tragedy is a reminder that H1N1 influenza can be a very serious illness and that people with underlying health conditions are at higher risk for severe complications and death. Vaccine is the best protection, and more doses will be arriving weekly to immunize people, beginning with people who need the protection most."

    In King County from April 25 to October 2, 2009, there have been 82 hospitalizations of patients with H1N1 influenza. Nearly 1 in 4 required intensive care, and 3 of the 82 patients died.

    Initially, vaccine is being prioritized to protect people most at risk for H1N1 influenza, as recommended by the Centers for Disease Control and Prevention (CDC). Vaccine availability will be opened up to everyone who wants it as soon as supplies are sufficient to cover demand in risk groups. The priority groups include:

    • Pregnant women
    • People who live with or care for children younger than 6 months of age
    • People between the ages of 6 months and 24 years old
    • People between 25 through 64 years of age with chronic health conditions or weakened immune systems
    • Healthcare and emergency workers

    H1N1 vaccine availability

    At this time H1N1 vaccine is still being manufactured and is not yet widely available for the general public in King County. Public Health is working with the State Department of Health and CDC to assure shipments to King County immunization providers on a rolling basis and as vaccine is produced.

    Small, initial shipments totaling 20,000 doses of H1N1 vaccine began arriving in King County late last week for immunization of health care workers. A second shipment of 30,000 doses of vaccine may begin to arrive as soon as late this week to a limited number of health care providers so they can vaccinate their most at-risk patients.

    Based on the best information currently available from CDC, larger supplies of vaccine needed for broader-scale administration to the public will begin to arrive in King County within the next several weeks. As more vaccine becomes available, vaccine will be provided through pharmacies, Public Health clinics and special community vaccination clinics.

    Please visit www.kingcounty.gov/health/H1N1 or call the Flu Hotline at 877-903-KING (5464) for frequent updates about vaccine availability and, once more vaccine arrives, locations where you can get H1N1 vaccinations.

    Flu activity

    Through its monitoring, Public Health has found that flu activity is rising in King County.

    • Emergency department visits for influenza-like illness have been increasing since the beginning of September and are higher than the 2008-09 seasonal flu peak. Emergency department visits have not reached the peak levels observed during the spring H1N1 outbreak.
    • In recent weeks hospitalizations for flu have been at a level comparable to the height of the spring H1N1 outbreak.
    • Public Health is asking local hospitals to report all patients admitted with influenza of any type. Since the beginning of September, there have been reports of 51 hospitalizations for influenza. Twenty-five of these were confirmed to be H1N1, and most of the others are expected to be H1N1 as well.

    When to seek care

    Persons with influenza do not need to see a doctor unless their symptoms are unusually severe or if they are at increased risk of severe illness due to an underlying health condition. Most people experience and recover from H1N1 flu without medication just as they do from seasonal flu. When antiviral treatment is necessary, it is most effective if started within 48 hours of the first symptoms of illness.

     

    1017 State response to H1N1 continues, Joint Info Center opens [Arizona]--Since the discovery of the new strain of H1N1 influenza in April 2009, the Arizona Department of Health Services has responded to the 2009 H1N1 at all levels. The Office of Infectious Diseases and the Arizona State Public Health Laboratory are tracking influenza cases and evaluating the severity of the disease. The state has been using its emergency pandemic plan as a roadmap for serving the needs of the public.

    The 2009 H1N1 vaccine is beginning to arrive in Arizona. ADHS is working with county health departments to make sure that the vaccine is going first to the priority groups that have the highest risk of infection and complications. As expected, the initial vaccine shipments are small. As larger shipments of vaccine arrive, the vaccine distribution will expand until everyone who wants the vaccine can get it.

    "We’re getting a lot of calls at the Department from people who want the H1N1 vaccine. We want them to have it, but they need to be patient," said Will Humble, ADHS Interim Director. "The quantities of vaccine coming into the state continue to grow, but slowly. And in the meantime, use good health hygiene: Stay home where you are sick, cover your cough and wash your hands thoroughly."

    The only type of influenza circulating right now is H1N1. People should not ask for a test because the results will not impact the treatment. If someone does want a test, they have to work with a private laboratory; the state is only testing the most severe cases and fatalities.

    If you are normally healthy and think you have the flu, stay home and drink lots of fluids and treat your symptoms. If you feel worse after a day or two or have trouble keeping fluids down, contact your doctor. If you have problems breathing, chest pains or can’t take care of yourself, get immediate medical attention. If children are sick and become less responsive or cannot hold down fluids, contact a health care provider right away.

     

     

    1015 FDA warns of unapproved and illegal H1N1 drug products purchased over the internet [USA]--The U.S. Food and Drug Administration today warned consumers to use extreme care when purchasing any products over the Internet that claim to diagnose, prevent, treat or cure the H1N1 influenza virus. The warning comes after the FDA recently purchased and analyzed several products represented online as Tamiflu (oseltamivir), which may pose risks to patients.

    One of the orders, which arrived in an unmarked envelope with a postmark from India, consisted of unlabeled, white tablets taped between two pieces of paper. When analyzed by the FDA, the tablets were found to contain talc and acetaminophen, but none of the active ingredient oseltamivir. The Web site disappeared shortly after the FDA placed the order. At the same time, the FDA also purchased four other products purported to diagnose, prevent, treat or cure the H1N1 influenza virus from other Web sites.

    These products contained various levels of oseltamivir but were not approved for use in the United States.  Several of the products purchased did not require a prescription from a health care professional. Additionally, the products did not arrive in a timely enough fashion to treat someone infected with the H1N1 influenza virus, or with an immediate exposure to the virus.

    “Products that are offered for sale online with claims to diagnose, prevent, mitigate, treat or cure the 2009 H1N1 influenza virus must be carefully evaluated,” said Commissioner of Food and Drugs Margaret A. Hamburg, M.D. “Medicines purchased from Web sites operating outside the law put consumers at increased risk due to a higher potential that the products will be counterfeit, impure, contaminated, or have too little or too much of the active ingredient.”

    Consumers may not know exactly what they are getting when buying such antiviral products on the Internet from an unfamiliar company. Patients who buy prescription drugs from Web sites operating outside the law are at increased risk of suffering life-threatening adverse events, such as side effects from inappropriately using prescription medications, dangerous drug interactions, contaminated drugs, and impure or unknown ingredients found in unapproved drugs. This may particularly be the case in the event of a public health emergency, such as an influenza outbreak, where approved treatment options would be in high demand and expensive, and where drug shortages could occur. 

    Drugs that are in high demand are vulnerable to counterfeiting and diversion because buyers may be desperate to stock the product, and criminals capitalize on the situation.

    The FDA urges consumers to only purchase FDA-approved products from licensed pharmacies located in the United States. Consumers should contact their health care provider if they have any questions or concerns about medical products or personal protective equipment.

    The two antiviral drugs approved by the FDA for treatment and prophylaxis of the 2009 H1N1 influenza virus are Tamiflu (oseltamivir phosphate) and Relenza (zanamivir).

    Tamiflu and Relenza, in addition to their approved label, have Emergency Use Authorizations that describe specific authorized uses during this public health emergency.

    The FDA actively monitors the Internet, and where appropriate, will purchase and analyze drug products.

    Consumers can also visit FDA's Web site for tips about how to protect themselves when buying medicines online.

    FDA 2009 H1N1 (Swine) Flu Page
    Fraudulent H1N1 Products Widget

     

    1015 Dept of Health announces AmbuBus evacuation program [Mississippi]--The Mississippi State Department of Health (MSDH) has partnered with the Mississippi State Department of Education, individual school districts and several County Emergency Management Agencies in a new program called “AmbuBus” to help provide mass patient evacuations in the event of a public health emergency such as a hurricane.

     

    “Many lessons were learned from previous hurricanes, one of these being the additional need for medical transportation to evacuate non-ambulatory individuals,” said Jim Craig, Director of the MSDH Office of Health Protection. “These new kits offer Mississippi an economical solution in addressing this need. Converting buses into medical transportation during disasters offers emergency responders an added resource to effectively and efficiently evacuate a large number of the special needs population at once and in as little time as possible.”

     

     



     

     

     

     

     

     

     

     

     

     

    Installing the AmbuBus conversion kit

     

    A completely converted AmbuBus

     

    Utilizing a quick installation kit, local school districts can convert a bus into ambulance style transportation with room for up to18 stretchers, medical equipment, and a team of up to eight medical personnel. In the event of an emergency, the Mississippi Department of Education’s Transportation Department will provide buses for conversion as well as drivers. Currently, kits are located in the Jackson, Hattiesburg, Grenada, Lauderdale, Pearl and Rankin school districts. The AmbuBus program will soon expand to Harrison, Hancock and Covington counties. AmbuBuses can be dispatched anywhere they’re needed within the space of a few hours.

    The AmbuBus conversion kits are a product of First Line Technology, LLC, of Chantilly, VA. They were purchased by MSDH through federal grant funds.

     

     

    1015 Dept of Health to launch public health hotline [North Dakota]--The North Dakota Department of Health encourages North Dakotans to call a new toll-free hotline with questions about H1N1 and seasonal influenza, according to State Health Officer Terry Dwelle, M.D.


    The toll-free hotline number is 866.207.2880, and it will operate from 8 a.m. until 5 p.m. Monday through Friday beginning tomorrow, October 16. Information about influenza also is available on the Department of Health’s hotline website at
    www.ndhealth.gov/EPR/HealthHotline or its influenza website at www.ndflu.com.


    “We want North Dakotans to be able to access the most current information available about H1N1 influenza, seasonal influenza and vaccinations,” Dwelle said. “The hotline and the department’s website are designed to provide easier access to the information they are seeking.”


    The hotline is staffed with Department of Health personnel who will answer questions based on information provided by the North Dakota Department of Health’s Division of Disease Control, the U.S. Centers for Disease Control and Prevention, and local public health units. If an operator does not have the information a caller is requesting, the call will be referred for appropriate follow-up by a disease epidemiologist on staff.


    “The hotline is not designed to give medical advice,” Dwelle said. “The purpose of the hotline is to answer questions about topics such as caring for someone who is ill, the symptoms of H1N1 flu, and vaccine safety. People who think they may be ill should contact their physicians.”

     

     

    1015 New toll-free number to provide 24/7 H1N1 flu and vax info [Missouri]--issouri residents can call a new toll-free number for information about the H1N1 flu, from symptoms and basic medical advice to the availability of the new H1N1 vaccine.

    The number, 1-877-FLU-4141 (1-877-358-4141), will be answered 24 hours a day, seven days a week.

    Specialists with the H1N1 InfoLine will answer questions about flu symptoms, when to seek medical care and ways to limit the spread of the flu, including the new vaccine. Medical professionals will be available to assist the specialists with callers’ questions.

    The information line is sponsored by the Missouri Department of Health and Senior Services.

    “As we get further into flu season, we know many Missourians will have questions about the H1N1 flu,” said Margaret Donnelly, director of the state health department. “We urge Missouri residents to do everything they can to prevent the spread of the flu and keep their families healthy. The Flu InfoLine can help answer questions they might have.”

    Health care professionals can also call the toll-free number for more information about the H1N1 flu and vaccine.

    The state health department is encouraging Missourians to get the vaccine as it becomes available. Pregnant women, children and young adults are the most at risk of contracting the H1N1 flu, so they will be given priority to receive the vaccine first. Studies show that older people are less at risk because they appear to have some degree of resistance to the virus.

    Missouri received its first shipment of aerosol mist vaccine early this month. Additional shipments of the aerosol mist and the injectable form of the vaccine began arriving from drug manufacturers this week.

    The mist version of the flu vaccine can be used by healthy children and adults ages 2 through 49. Because it contains live virus, it is not appropriate for pregnant women, children under 2 years old or anyone with an underlying health condition such as asthma. Those groups should receive an H1N1 flu shot.

    “Adequate supplies of the flu vaccine will be available for the high-risk groups,” Donnelly said. “As additional shipments of the vaccine arrive in Missouri, flu shots or vaccine mist should be available to everyone who wants them.”

    H1N1 flu symptoms include fever, cough and sore throat. Most cases are relatively mild to moderate and do not require treatment. Most people with the H1N1 flu can recover at home. They should get plenty of fluids, take over-the-counter medication to reduce their fever and stay home and rest.

    Pregnant women and people with underlying health conditions who think they might have the flu should contact their health care provider.

     

     

    1015 Flu activity increases in state - 56 schools reporting more than 10 percent absenteeism due to illness [Iowa]--The number of Iowa schools with absences due to influenza-like illness is rising. Monday, October 12, 56 schools in 23 counties reported to the Iowa Department of Public Health (IDPH) that at least 10 percent of their enrollment was absent due to illness. The average percent absent for the schools reporting was 15 percent of students out due to illness.

    “This is not unexpected,” said IDPH Medical Director, Dr. Patricia Quinlisk. “So far with H1N1 influenza, the largest number of cases has been in people between the ages of 5 and 24. Schools are a typical place where viruses spread among students, from students to their teachers, and from students to their families.” Because the H1N1 vaccine is being allocated to states on a staggered basis and may not be immediately available to all school children, it is important for students to be watchful for the signs of influenza and take action to prevent the spread of the virus at their schools.

    By planning ahead, child care can be easier for everyone. Parents can contact others in the neighborhood or parents from their children’s classroom to make prior arrangements for ill children. For example, parents can stagger their time off from work by arranging for several children to go to one parent’s home one day, and someone else’s the next. If you have several ill children in one home, it’s a good idea to keep them in separate rooms if possible. This will help slow the spread of any additional viruses circulating among the kids.

    Symptoms of H1N1 influenza are similar to seasonal flu and include a fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people with H1N1 flu may also have diarrhea and vomit. Because H1N1 is spread by person-to-person contact, it is important for students who are ill to stay home from school until their cough significantly improves and they are fever-free for 24 hours without the use of fever-reducing medication.

    For more information about H1N1 influenza, visit www.idph.state.ia.us/h1n1/.

     

    1015 WNv - Tests confirm state's first death from disease [Washington]--The Washington State Department of Health has confirmed the first death due to West Nile virus within the state. The Yakima County woman in her 70s died last month. Confirmatory tests to specifically identify West Nile virus as the cause of her infection were performed at the Washington State Public Health Laboratories and at the national Centers for Disease Control and Prevention.

    Before her illness, the woman spent time in both Yakima County and Colorado. She couldve been exposed to the virus in either area, both of which have virus-carrying mosquitoes.

    In addition to this case, 31 other West Nile infection cases have been reported with exposure in Washington during 2009, bringing the total this year to 32 human cases. Among these cases, 25 have had severe disease, including encephalitis, meningitis, and/or paralysis. Seven cases had mild illnesses, mostly with symptoms of fever and headache.

    This is the states highest yearly confirmed human case total since West Nile virus was first detected in Washington early this decade. A count of three cases in 2008 had been the previous top annual count.


    Washingtons West Nile virus monitoring program shows the virus was active this year in 15 counties, mostly in Eastern Washington Yakima, Benton, Franklin and Grant counties have had the most detections of the virus. The Department of Health tracks West Nile virus in the environment in mosquitoes, birds, and horses or other mammals. This year, there have been 341 positive mosquito samples, 22 positive birds, and 67 positive horses. Five infected birds have been found in Western Washington — in King, Lewis, Grays Harbor, Pierce and Mason counties.

    West Nile virus is primarily a bird disease that can be spread to people who are bitten by an infected mosquito. Most infected people do not become ill or have only mild symptoms, but West Nile virus can cause serious infections in the brain (encephalitis) or in the spinal cord (meningitis) and can be fatal. People over age 50 are at highest risk for these serious infections, though younger people can also develop severe illness.

    There is no vaccine to prevent West Nile virus infection in people. The best way to prevent infection is to avoid mosquito bites. Now that cooler fall weather has arrived, mosquito activity is winding down. However, some mosquitoes may still be out. People should protect themselves against West Nile virus and other mosquito-borne illnesses by avoiding mosquito bites.

     

     

    1015 H1N1/ILI status report - Level of flu activity very unusual for this time of year and increasing [Utah]--Status summary as of Wednesday, October 14: Utah:

     

    Circulation:
     

    Influenza is currently circulating at a level that is typical for what is seen during regular flu seasons. This level of influenza activity is not typical and is considered very unusually for this time of the year, and is more common with levels seen much later in the flu season. At this time influenza activity appears to be increasing from week to week.


    The indicator used by public health to measure the circulation of influenza in the community is influenza-like illness (ILI) as reported by sentinel clinics. (An ILI sentinel clinic is a clinic that reports to public health the percentage of patient visits seen for influenza-like illnesses).


    For the past week (MMWR week 40), the ILI rate for Utah is 3.0% (up from 1.6% last week).

    This value is above the ILI outbreak threshold of 1.1%.
    ILI is up for the second consecutive week.
     

    Severity:


    The severity of an influenza outbreak (epidemic or pandemic) is measured by the number of influenza infections that result in hospitalization or death. To date, severity for the 2009 H1N1 Pandemic is comparable to or slightly greater than the severity seen during regular flu seasons.
     

    At this time there is no evidence that severity for the 2009 H1N1 Pandemic is changing.
     

    There have been 127 influenza-associated hospitalizations (IAHs) (due to both seasonal and 2009 pandemic strains) reported this season. The current number of IAHs is very unusual for this early in the influenza season. 41 have occurred during the past week.

     

    2009 Pandemic A (H1N1) deaths:
     

    The severity measure listed above is for influenza caused by all strains (regular seasonal flu and the 2009 Pandemic A (H1N1)). In addition, Utah is collecting data on patient deaths (whether hospitalized or not) known to have been caused by the 2009 Pandemic A (H1N1) strain.


    3 deaths occurred in Utah during the past week in which the persons had confirmed 2009 Pandemic Influenza A (H1N1).

     

    There have been a total of 3 deaths related to 2009 Pandemic Influenza A (H1N1) since the beginning of the 2009-2010 influenza season (which began August 30, 2009).
     

    Circulating strains:
     

    There were 65 total specimens submitted to the Utah Public Health Laboratory for confirmatory influenza testing during the past week. Of the 65 specimens tested, 27 specimens or 41% were positive for influenza, all of which were 2009 Pandemic A (H1N1) 100% due to 2009 Pandemic A (H1N1)
    0% due to seasonal A (H1)
    0% due to seasonal A (H3)
    0% due to Influenza B
     

    National/international surveillance:
     

    Influenza illness is ongoing in the United States. At this time, national ILI levels are higher than what is expected during this time of year. During the past week, widespread influenza activity was reported in 37 states, with regional influenza activity being report in 11 states.

     

    Nationally, the proportion of deaths attributed to pneumonia and influenza (P&I) during the past week was at the epidemic threshold, which is an increase from previous weeks in which P&I attributed deaths were below the epidemic threshold.


    Viral circulation and resistance:
     

    Data in this section comes from the CDC and is collected nationally:
     

    99.7% of all influenza isolates typed at national reference labs this week were Influenza A:
    99.8% of the subtyped isolates were 2009 Pandemic A (H1N1).
    0.1% were seasonal A (H1)
    0.1% were seasonal A (H3)
    0.3% were Influenza B
     

    The majority of influenza viruses currently circulating in the U.S. are 2009
    Pandemic A (H1N1).

     

     

    1015 With pandemic H1N1 on the rise, Public Health stresses importance of prevention and vaccination [Utah]--New statewide data released today by the Utah Department of Health (UDOH) indicate a substantial increase in the spread of the pandemic H1N1 virus throughout the state. Public health officials want Utahns to know there are specific actions they should take to protect against the flu.


    The best protection comes in the form of the pandemic H1N1 vaccination. However, vaccine supplies are still very limited, and are being made available initially only to certain Utahns at most risk of influenza and serious complications of influenza. The U.S. Food and Drug Administration (FDA) has licensed four manufacturers to produce the vaccine – and each manufacturer produces vaccine that is only approved for use in certain age groups. Each of the state’s 12 local health departments is working within manufacturer parameters to target the initial, limited amount of vaccine to the people in their jurisdictions who stand to benefit most from receiving a vaccine.


    “We know certain populations, such as infants and toddlers, are at a much higher risk of becoming severely ill if they are infected with the pandemic H1N1 virus,” said Salt Lake Valley Health Department Executive Director Gary Edwards. “It makes the most sense for us to vaccinate those who are high risk first. We hope the public will be patient, understanding that over the next few weeks we should have enough vaccine to start immunizing everyone who falls into a priority group.”


    The UDOH’s weekly release of influenza data suggests the spread of pandemic H1N1 virus is accelerating throughout the state. Utah’s rate of influenza-like illness (ILI), a key indicator in determining how widely the virus is circulating, shows the state is above the “outbreak” level for the second consecutive week. Disease severity, which is measured by influenza-associated hospitalizations and deaths does not appear to have changed, but because more people are becoming ill with pandemic H1N1 influenza, more are developing severe disease. Since the beginning of September, 127 Utahns have been hospitalized and three have died from H1N1-associated causes.


    “If you think of an outbreak occurring on a bell-shaped curve, we appear to be at the base of what could be a steep climb to the peak,” said UDOH Deputy State Epidemiologist Dr. Rachel Herlihy. “With vaccine in short supply, it’s critical people start taking proactive steps to protect themselves and their families against the disease. It is especially important that people stay home when they are sick with influenza symptoms.”


    Simple, everyday preventive actions will help limit the spread of germs that cause influenza, such actions include:
    • Coughing or sneezing into a tissue or your shirt sleeve;
    • Avoiding touching your eyes, nose or mouth – germs spread this way;
    • Avoiding close contact with sick people;
    • Staying home from work or school when you are sick with influenza-like illness for at least 24 hours after your fever has broken and;
    • Washing your hands regularly, especially after sneezing or coughing, using soap and water or alcohol-based hand sanitizers.


    Families should prepare for what they would need if they are required to spend time isolated at home due to illness. Items like food, water, tissue, sanitizers, over-the-counter medications and prescription medications are all useful items to have on hand in the event you become ill and are confined to your home. Having these items in the home will also help to ensure sick people don’t need to go out into public to buy them.


    Businesses should also consider how they would cope with increased absenteeism due to
    potentially high rates of illness among their employees or their employee’s children. Having flexible leave policies or telecommuting policies will help protect healthy workers and will contribute to the health of the business as well.


    More information on steps for preventing influenza can be found at www.health.utah.gov/h1n1. To find out where to get either an H1N1 or seasonal influenza vaccine, Utahns can visit www.immunize-utah.org or call 2-1-1.

     

     

    1015 First H1N1 flu death of patient with no serious prior medical problems [Kansas]--The first H1N1 flu death in a Kansan with no serious prior medical problems was reported today by the Kansas Department of Health and Environment (KDHE). The death, which occurred in a 50-year-old woman from the Kansas City area, is the seventh in the state to be confirmed as due to the pandemic virus. It came after more than a week of hospitalization.

    Laboratory testing confirmed that the woman had the H1N1 virus on October 5, and her death was reported to KDHE yesterday afternoon.

    KDHE Secretary Roderick Bremby and Dr. Jason Eberhart-Phillips, Kansas State Health Officer, expressed sympathy and offered their deepest condolences to the woman’s family.

    “The death being reported today reminds us of the importance of taking this virus very seriously,” Dr. Eberhart-Phillips said. “The H1N1 vaccine has started arriving in the state and it is important for Kansans to know that this is a safe and effective tool we have for fighting this virus. While supplies of the vaccine are very limited at this time, we will soon have sufficient quantities to starting vaccinating larger groups and I encourage Kansans to stay informed.”

    The pandemic H1N1 virus is causing widespread illness throughout Kansas and the United States. Visits to healthcare providers for influenza-like illness have been increasing in most regions of Kansas as well as throughout the United States over the past few weeks and are substantially higher than what is typically seen at this time of year.

    The symptoms of infection with the pandemic H1N1 virus are similar to the symptoms of seasonal flu and include fever greater than 100 degrees, body aches, coughing, sore throat, respiratory congestion, and in some cases, diarrhea and vomiting. Most people who have been ill with pandemic H1N1 influenza have recovered without medical treatment.

    However, some people develop serious complications that require hospitalization or may lead to death, as today’s report illustrates. Although serious complications are more likely among persons with certain underlying chronic health conditions, this pandemic influenza virus has caused serious complications and deaths among persons without such factors.

     

    In a recent review of hospitalized patients with confirmed 2009 H1N1 influenza virus infection across the U.S. that was published online October 8 by the New England Journal of Medicine, more than one-fourth of patients (27 percent) had no underlying chronic health conditions that are recognized to increase the risk of complications from influenza. And unlike typical seasonal influenza, the 2009 H1N1 virus is causing a greater disease burden among adolescents and young adults. Today’s report provides more evidence that severe illness from H1N1 virus infection among relatively young, healthy persons can occur.

     

     

    1014 Central Region health directors encouraging parents to complete H1N1 vax permission forms [Virginia]--In an effort to protect the health of Central Virginia's children, the area's eight health district directors are encouraging all parents of school-age children to take advantage of the free novel H1N1 vaccination programs being offered in cooperation with K-12 schools throughout the region. The first step to doing so is to complete the novel H1N1 influenza vaccination form being sent home with students. While the vaccination is not mandatory, health officials are advising that everyone consider getting the vaccine.

    "The most recent vaccine shipment received will allow us to protect the health of our children and young adults who are among the groups most at risk", said Crater Health District Director, Kay Rankin, M.D., MPH. "They are the ones who tend to be in close contact at school and the workplace," Dr. Rankin added. The CDC recommends those between the ages of 6 months and 24 years old be vaccinated as soon as vaccine becomes available. Other groups at risk are pregnant women, children's care givers, healthcare and emergency personnel.

    Local health departments and schools are sending out a two page permission form that will require a signature on the front and back of the form. "Filling out the vaccination permission form is the first step for our residents to protect their families and their community," said Richmond Health District Director, Donald Stern, M.D., MPH. Dr. Stern urges parents to complete a form for each student and return them to the school quickly to take advantage of the opportunity for free H1N1 vaccination.

    Local health departments are partnering with schools to offer vaccination clinics in the coming days. "Our goal is not only to protect the health of our children but to accommodate our parents' busy schedules by offering clinics at their child's school," said Thomas Jefferson Health District Director, Lilian Peake, M.D., MPH. "We want to make the process as convenient as possible," Dr. Peake added.

    For those children unable to participate in school-based clinics, novel H1N1 vaccine will also be available through local health departments, private physician offices, and other vaccinators. While free through the health department, a small administration fee may be charged by other vaccinators.

    The Central Region's eight health districts are Chesterfield, Chickahominy (located in Hanover), Crater (located in Petersburg), Henrico, Thomas Jefferson (located in Charlottesville), Piedmont (located in Farmville), Richmond and Southside (located in Boydton).

    For more information on the vaccine or the school vaccination clinics, call your local health department or log onto www.vdh.virginia.gov and click on novel H1N1 information.

     

    1014 State University of New York launches H1N1 pandemic flu strategy [Albany]--In order to get out in front of a potential pandemic flu outbreak, The State University of New York has undertaken a comprehensive, collaborative system-wide campaign to prepare for all forms of flu; to educate about the virus and to respond effectively to parents, students, employees and the general public.

    “SUNY’s response to all forms of the flu has been focused on three critical themes: Prepare, Educate, and Respond,” said Chancellor Nancy L. Zimpher. “Our first priority is to help keep students, faculty and staff healthy and safe. When there is illness, SUNY’s advanced planning and preparation aims to minimize it.” Chancellor Zimpher stressed that the potential for flu events to escalate rapidly requires a coordinated and collaborative response across the 64 SUNY campuses, as well as with state and federal agencies.

    All SUNY policies and procedures undertaken to prepare, educate, and respond to pandemic flu follow medical guidelines from The Centers for Disease Control, U.S. Department of Health and the New York State Department of Health.

    "Chancellor Zimpher's proactive efforts are a model for all academic institutions and will provide valuable situational awareness for SUNY campuses, maximizing the prevention of outbreaks and minimizing spread of illness in campus communities. We are working with SUNY and providing guidance. Together we are enhancing students' access to flu vaccinations on SUNY campuses. We look forward to collaborating in SUNY's surveillance efforts. The data being collected by SUNY and shared with the New York State Department of Health will greatly enhance our ability to provide consultation and will facilitate rapid response when it is warranted," said State Health Commissioner Richard F. Daines, M.D.

    SUNY’s Three-pronged approach to pandemic flu

    Prepare

    * SUNY created a pandemic flu website last year, which is updated daily – http://www.suny.edu/h1n1

    * A University-wide planning group was convened last year to provide system-wide guidance on critical issues pertaining to pandemic flu and other crises.

    * At the Chancellor’s request, campuses are reporting cases of “Influenza-Like Illness” (ILI) centrally via a tool developed by SUNY System.

    * SUNY monitors daily campus trends and is reporting overall illnesses to the NYS Department of Health.
     

    To date, the daily reported new cases of ILI are minimal. SUNY educates nearly 440,000 students across 64 campuses. Average reported daily ILI cases thus far have amounted to less than 0.02 percent of that population (average of 83).
     

    There have been no SUNY-related deaths reported from ILI or H1N1.

    Educate

    * The Chancellor has formed an H1N1 Medical Advisory Group that includes international experts on infectious diseases and public health. The group provides assistance to campuses and advises the Chancellor.

    * SUNY held a symposium on H1N1 on September 14th in Syracuse that attracted 167 participants from 54 SUNY colleges. Speakers from the Centers for Disease Control and the U.S. Department of Health provided information and counsel, and a higher education expert from Carnegie Mellon University described their planning and response to a severe outbreak of H1N1 on that campus.

    * SUNY campuses have been taking preventive steps to help educate students, faculty and staff regarding how to limit the spread of all types of flu. Campuses are:
    o Publishing campus websites for H1N1;
    o Holding ongoing meetings of campus emergency and planning groups;
    o Providing education and outreach to their campus communities;
    o Expanding respiratory protection efforts;
    o Increasing inventories of essential items, such as face masks and hand sanitizers;
    o Preparing to use their online course management systems to continue instruction;
    o Becoming points of distribution for vaccines;
    o Exploring alternative housing for ill students.

    * Poster campaigns help educate people about how to properly wash hands, and cough and sneeze to limit germ spread.

    Respond

    * Seasonal flu shots are being offered on campuses.

    * SUNY NY-Alert allows campuses to send text, email, voice messaging directly to students in the event of a emergency. SUNY NY-Alert is the largest such effort in the country. This system has been in place for more than two years now and enjoys nearly 100% campus participation.

    * SUNY has launched a comprehensive system of daily reporting to assist campuses in monitoring Influenza Like Illness across the system.

    About the State University of New York

    The State University of New York is the largest comprehensive university system in the United States, educating nearly 440,000 students in 7,669 degree and certificate programs on 64 campuses. To learn more about how SUNY creates opportunity, visit www.suny.edu

     

     

    1014 Indianapolis area hospitals modify visitation policies in response to flu season [Indiana]--All Marion County hospitals have adopted a plan to limit visitors who might infect hospital patients or staff with communicable diseases like the H1N1 flu. The announcement was made October 13 after Marion County members of the Indiana Coalition for Patient Safety completed the policy.

    "The Marion County coalition members have been meeting for the last several months to develop a policy on visitor restriction that emphasizes a unified approach to protecting hospitalized patients and hospital staff," said Glen J. Bingle, MD, PhD and Chairman of the Indianapolis Coalition for Patient Safety.

    The policy, reviewed and supported by the Marion County Health Department's Scientific Advisory Group, exemplifies the coordinated approach local healthcare providers are implementing to protect the best health interests of the community.

    "This consensus policy is a collaborative response on the part of local healthcare and public health leadership to the rapidly evolving needs of our community," said Charles Miramonti, MD, Deputy Medical Director of Wishard Emergency Medical Services and Assistant Professor of Clinical Emergency Medicine in the Department of Emergency Medicine at Indiana University.

    Health officials agree that even with the standard of excellent care and the rigorous preparation exemplified by public and private healthcare providers, a key to success remains the public's cooperation.

    "At St. Vincent, our goal is to ensure the health and safety of our patients, associates and visitors at our facilities. We appreciate the opportunity to collaborate with other area hospitals in achieving this goal. By temporarily restricting visitors during a public health emergency, we can help to limit risk and continue to provide the appropriate level of care to our patients," said Robert M. Lubitz, MD, MPH, FACP, and Vice President, Academic Affairs and Research; Medical Director, Joshua Max Simon Primary Care Center and Executive Sponsor, Emergency Preparedness at St. Vincent Indianapolis Hospitals.

    Local health officials agree that while the restrictions may create some inconveniences, protecting patients who have a weakened immune system or at a higher risk for infection such as pregnant women and newborn infants, is a critical step in controlling the spread of flu this season.

    "Since this specific influenza virus is preferentially affecting children, adolescents and young adults, we have deemed it necessary to initiate a visitation restriction policy. Only parents, spouses, domestic partners and spiritual counselors will be allowed to visit. The cooperation of everyone during this pandemic will help prevent the spread of this serious and potentially deadly virus," said John C. Christenson, MD, Director of the Ryan White Center for Pediatric Infectious Disease, Riley Hospital for Children, and professor of Clinical Pediatrics, Indiana University School of Medicine.

    The hospital visitation policy is one example of changes that the general public is likely to see during the flu season.

    "We know our community will respond, as they have to other health issues. These steps are being taken to protect those vulnerable to infectious disease and to lower the risk of spreading communicable diseases like the flu," said Virginia A. Caine, MD, Director, Marion County Health Department.

     

     

    1014 Seasonal flu shots now available at county health depts [Mississippi]--Seasonal flu shots are now available at all Mississippi State Department of Health (MSDH) county clinics. The seasonal flu vaccine is recommended for anyone age six months and older.

    “This year it is important for everyone to get both the seasonal and swine flu vaccines,” said MSDH State Epidemiologist Dr. Mary Currier. “Seasonal flu usually peaks in January through March in Mississippi, but it sometimes reaches high levels as early as December. Mississippians should take the threat of any type of flu very seriously.”

    Those particularly at risk for influenza complications include young children, adults 50 and older, pregnant women, and those with chronic illnesses.

    Seasonal flu vaccinations for adults are $25. Those 18 and under can receive seasonal flu vaccinations for $10. Medicare and Medicaid recipients are asked to bring their cards with them to the clinic.

    According to the Centers for Disease Control and Prevention (CDC), about 36,000 deaths nationwide are attributed to seasonal flu and pneumonia each year. In Mississippi, more than 600 deaths were attributed to flu and pneumonia last year.

    Symptoms of seasonal flu include fever, cough, and often, extreme fatigue. Sore throat, headache, muscle aches, and a runny or stuffy nose are also often present.

    While shots are the best protection, basic infection control measures can also reduce the spread of flu. These measures include covering your mouth when coughing and sneezing, staying at home when you or your children are sick and washing your hands frequently.

    To locate a county health department clinic in your area or for more information on flu and pneumonia, visit the MSDH website at www.HealthyMS.com or call 1-866-HLTHY4U (1-866-458-4948).

     

    1014 Schools providing free flu shots to state's children beginning today [Arkansas]--Beginning October 14, 2009 and continuing through December, the Arkansas Department of Health in conjunction with the Arkansas Department of Education and local school districts statewide will be providing free seasonal flu shots and H1N1 vaccine if supplies are available to school children at 1094 schools. This effort is funded by the tobacco tax passed during the recent legislative session and federal monies and is part of Governor Mike Beebe’s health initiative.

    Dr. James Phillips, branch chief, infectious disease, said, “Flu is serious. Each year we lose some 36,000 Americans to complications from flu. H1N1 flu is placing an additional burden on the safety and well being of our school children. We have seen 9 deaths due to complications from H1N1 flu this season. Flu shots are not required for children to attend school, but they are highly recommended.”

    Arkansas Department of Education commissioner Dr. Tom W. Kimbrell said, “Schools are already dealing with student and staff absences due to the flu and similar ailments, and any day missed by either affects the level of teaching and learning that can occur. The fact that these vaccines are available to all of our students and school personnel is tremendously positive and should prove helpful for both the physical and academic health of our students.”

    The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatricians (AAP) recommend that all children aged 6 months and older receive a seasonal flu shot every year. Seasonal flu causes children to miss school and their parents to miss work. The seasonal flu shot will not protect against the novel H1N1 influenza A (Swine Flu) virus. The H1N1 flu vaccine is a separate vaccine. The ADH is working to make sure the high priority groups that are most at risk for complications for H1N1 flu receive the H1N1 vaccine first. Children ages 6 months to 24 years are one of the priority groups. 

    The fastest, most efficient way to vaccinate the most children will be through the upcoming statewide school flu clinics beginning October 14th at Fair Park Elementary School in Little Rock, and the initial H1N1 vaccine supply will be for the first of these clinics. For a complete listing of all school clinics statewide, click on www.healthyarkansas.com and click on “Find Flu Clinics.”

    Margo Bushmiaer, Coordinator of Health Services for the Little Rock School District, said, “Families in the Little Rock School District will have the opportunity to be vaccinated at one of our five after school clinics or during school hours for middle school and high school students who return their consent forms. We hope that all our parents will take advantage of this convenient way to protect their families from the flu this year.”

    As Arkansas gets more H1N1 vaccine, those doses will be given to other priority groups first. These include pregnant women, health care workers and emergency medical responders, people caring for infants under 6 months of age, and people ages 25-64 years with underlying health conditions (like asthma, diabetes). Pregnant women and people with chronic medical conditions cannot receive the nasal flu mist.

    The ADH expects to eventually receive enough H1N1 vaccine to offer to any Arkansan that would like to receive vaccine.

    Flu is a sickness that infects the nose, throat and lungs and is caused by the influenza virus. If you’re young and healthy, the flu vaccine may be 70 to 90 percent effective in preventing illness.

    Children less than 9 years who have never received a seasonal flu shot before will need a second seasonal flu shot for full protection. Children less than 10 years will also need to receive a second H1N1 shot. Parents will need to contact a local ADH health unit or health care provider, see if vaccine is available and take their children in for a second shot 4 weeks after the first shot.

    Parents should not be concerned about the safety of the H1N1 vaccine. All flu vaccines are made the same way. The 2009 H1N1 vaccine simply contains a different strain of influenza virus and is made exactly like all previous seasonal influenza vaccines.

    Reactions to all flu vaccines might include a mild soreness and redness near the site of the shot and perhaps a little fever or slight headache. The flu shot cannot give you the flu.

    Persons who should not receive influenza vaccine for health reasons are: persons with a severe allergy (i.e. anaphylactic allergic reaction) to hens’ eggs and persons who previously had onset of Guillain-Barre syndrome.

    Influenza symptoms include fever over 100 degrees, headache, extreme fatigue, sore throat, muscle aches, dry cough, runny or stuffy nose, and occasionally stomach symptoms such as nausea, vomiting, or diarrhea.

    The influenza virus is spread through coughing or sneezing and by touching a hard surface with the virus on it and then touching the nose or mouth. The best way to prevent the flu is to get vaccinated each year.

    For more information go to www.healthyarkansas.com or www.flu.gov .

     

    1014 Two additional deaths related to H1N1 [Arkansas]--The Arkansas Department of Health (ADH) is providing the following update on seasonal and H1N1 flu and the arrival of flu vaccine in the state.

    Arkansas is reporting two additional deaths from complications of H1N1 flu. This brings the total deaths to 9 this flu season. The number of illnesses and deaths associated with H1N1 flu continues to rise in Arkansas and nationwide. The Centers for Disease Control and Prevention (CDC) has developed a flu hospitalizations and deaths tracking system that can be found at http://www.cdc.gov/flu/weekly/

    The ADH has received H1N1 vaccine. This vaccine is being sent to local health units and OBGYN offices for distribution to children and pregnant women—two of the priority groups at most risk for serious complications from H1N1 flu. If you or a family member fit these priority groups, please call your local health unit or your private provider to see if vaccine is available. We will be giving seasonal flu and H1N1 vaccine at our school clinics beginning October 14 and continuing through December. We will also be giving H1N1 vaccine at our local health unit maternity clinics as supplies are available. We will be giving seasonal flu and H1N1 flu vaccine at our Mass Flu Clinics in every county statewide on October 29, 30, 31 as supplies are available. Go to www.healthyarkansas.com and click on Find Flu Clinics to see about dates, times and locations of school clinics for your children and Mass Flu Clinics in each county.

    It is important for every Arkansan to receive both the seasonal and H1N1 flu vaccine. CDC is advising people to get the vaccine even if it is suspected that that individual has had the H1N1 flu. Lab testing conducted in your physician’s office is not designed to test for H1N1 flu and, therefore, is not reliable. Taking the vaccine will not hurt you even if you have had the flu.

     

     

    1014 Cherokee County death linked to H1N1 flu [Alabama]--The Alabama Department of Public Health was notified this week about the death of a man in his 50s from Cherokee County who tested positive for 2009 H1N1 influenza. This brings the total number of deaths of persons with H1N1 influenza in Alabama to 17.


    Previous deaths of persons positive for H1N1 influenza have occurred during 2009 to residents of Bullock, Calhoun, Dale, Houston, Jackson, Jefferson, Macon, Madison, Mobile, Montgomery, Russell and Talladega counties.


    When H1N1 influenza vaccine becomes available, locations, dates and times of clinics will be announced at www.adph.org. Please check this site regularly to find a provider near you.

     

     

    1014 Stop flu at school vax clinics begin [Hawai'i]--Now in its third year, Protect Hawai‘i’s Keiki: Stop Flu At School kicked off today with thousands of Hawai‘i elementary and middle school students receiving their free seasonal flu vaccine this week through the Hawai‘i State Department of Health (DOH) program. In all, 334 public, private and charter school clinics are scheduled across the state between now and December 3, 2009 and more than 68,000 students are expected to participate this year.

    Last year, more than 62,000 children were vaccinated in the free and voluntary program. Additionally, more than 9,500 teachers and school staff received the flu vaccine, pushing the total number of vaccinations at school-based clinics over 71,500.

    "This year more than ever, the current H1N1 pandemic has presented us with a formidable set of circumstances," said Health Director Chiyome Fukino, M.D. "It is a credit to our public workers and private partners that in the face of this challenge they are still able to put together and carry out such a comprehensive, critical program that helps keiki across the state."

    "An added benefit of this program is that by working with our partners in the private sector to develop this program we are well-positioned with respect to the H1N1 situation," continued Fukino. "The system is in place to where we can switch gears once we complete this seasonal flu program and seamlessly begin to administer H1N1 vaccine to one of our initial priority groups: Hawai‘i’s keiki."

    "Ensuring the health and well-being of our keiki is a top priority for the State, and providing students with free flu vaccinations is one way to protect them and their families from the seasonal flu," said Governor Linda Lingle, who attended the flu vaccination kick off at Kalihi Kai Elementary School and proclaimed today "Influenza Vaccination Day." "Getting a seasonal flu shot or nasal spray is a safe, common sense preventive step that all of our keiki and adults can take to protect themselves and help keep our communities healthy."

    Recent studies show school children vaccinated for flu have fewer illnesses, fewer school absences, and lower rates of illness in their families during flu season, compared with unvaccinated children.

    "Our goal has always been to have kids healthy and in class as much as possible. The reduction in instructional time brought on by teacher furloughs makes that directive even more important," said Patricia Hamamoto, superintendent of Hawai‘i public schools. "We believe the extra precautions schools are taking this year to prevent the spread of illness will pay dividends in the classroom."

    "We are pleased with the success of this program and expect it will continue as a critical component in our fight against flu," said State Epidemiologist Dr. Sarah Park. "The students and faculty participating in this program are examples of how best to protect against flu."

    Stop Flu at School partners include the Hawai‘i State Department of Health, Hawai‘i State Department of Education, Hawai‘i Association of Independent Schools, and Hawai‘i Catholic Schools with support from the CDC, Hawai‘i chapters of the American Academy of Pediatrics and American Academy of Family Physicians, the Hawai‘i Medical Reserve Corps, the University of Hawai‘i Nursing Program, the Hawai‘i Pacific University Nursing Program, UH Hilo Nursing Program, Kaua‘i Community College Nursing Program, Maui Community College Nursing Program, MedImmune, Sanofi Pasteur, Kaiser Permanente, and the Hawai‘i Medical Service Association (HMSA).

    School-based 2009 H1N1 flu vaccination clinics are scheduled to begin in mid-November. Parental consent forms will go out to parents the week of October 19 and must be returned to the school by October 30. The DOH urges parents to look for, sign and return consent forms so their children can receive the 2009 H1N1 flu vaccination.

    Information about the Stop Flu at School program and the upcoming school-based H1N1 vaccine program is available online at www.stopfluatschool.com or by calling Aloha United Way’s 2-1-1 hotline.

     

    1014 H1N1: Tips for when to seek medical advice [Oregon]--As more people experience flu-like symptoms that could be pandemic H1N1 influenza, Oregon Public Health officials are reminding people of what they can do to protect themselves and others.


    “So far, the H1N1 flu is not more serious than regular flu, so if you are sick, stay home to avoid spreading it to others and take good care of yourself,” says Mel Kohn, M.D., Oregon Public Health director. “If you have other conditions that put you at high risk or if symptoms get serious, that’s when you should call your doctor.” (See list of conditions below.*)


    H1N1 influenza is now spreading across the country. Oregon public health officials urge people to stay home when sick.“So far, we’ve seen relatively mild cases of H1N1 flu,” says Dr. Mel Kohn, Oregon Public Health Director. "But that could change as the season progresses."


    Public health officials are asking people to take the guidelines seriously about staying home, says Kohn.


    “The issue with this flu is not that it’s more dangerous,” says Kohn. “It’s that few of us have immunity until we get vaccinated. That means high absenteeism in our schools and businesses unless we all take this seriously and do everything we can to stop the spread.”

     

    People who become ill with influenza-type symptoms should stay home and avoid contact with other people. Kohn reminds people that staying at home when sick means not leaving your residence the building except to seek medical care in the rare cases that it is necessary. Ill people should avoid normal activities including work, school, travel, shopping, and social and public gatherings. They should stay home for at least 24 hours after fever (over 100 degrees) subsides. While at home, they should get plenty of rest, drink plenty of liquids, cover coughs and sneezes, and watch for emergency warning signs (see below) that might indicate the need for medical attention.


    Most people will recover completely on their own after a week or so of illness and don’t need to see a doctor.


    *Some health conditions increase the risk of severe illness from influenza:
    • Pregnancy;
    • Long-term aspirin therapy in children and adolescents (aged 6 mos.--18 yrs.);
    • Chronic lung disease (including asthma), heart, kidney, liver, blood, or metabolic disorders (including diabetes);
    • Immuno-suppression (including that caused by medications or HIV);
    • Any condition (e.g., cognitive dysfunction, spinal cord injuries, seizures or neuromuscular disorders) that affects respiratory function or handling of respiratory secretions or that increases the risk for aspiration; and
    • Residence in a nursing home or other chronic-care facility.
    • Also, children aged 6-59 months (up to 5 years) and adults aged 65 years and older are considered at increased risk for severe illness from influenza.


    People who have severe illness or are at high risk for flu complications should contact a health care provider who will determine whether treatment is needed. If you are directed to see a health care provider, ask if the facility has any special procedures for flu sufferers who visit.


    People who become ill and experience any of the following warning signs should seek emergency medical care.


    In children, emergency warning signs that need urgent medical attention include:
     

    • Fast breathing or trouble breathing;
    • Bluish or gray skin color;
    • Not drinking enough fluids;
    • Severe or persistent vomiting;
    • Not waking up or not interacting;

    • So irritable that the child does not want to be held;
    • Flu-like symptoms improve but then return with fever and worse cough;
    • Fever with a rash.
     

    In adults, emergency warning signs that need urgent medical attention include:
    • 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 cough.
     

    People with severe symptoms should call 911 or go to the nearest emergency department.
     

    Those who feel a need to see a doctor regarding flu symptoms, but don’t have health insurance or a regular doctor, should call 1-800-SAFENET (723-3638) for referral to a nearby, low-cost clinic.
     

    The Oregon Public Health Division also has provided the following guidelines for people who must care for someone else with H1N1 influenza: should follow these guidelines:


    • Check with that person’s health care provider about any special care he or she may need for certain health conditions such as pregnancy, diabetes, heart disease, asthma or emphysema — and to determine if the ill person should take antiviral medication. Antiviral medications can lessen flu-like symptoms and can be helpful for people at high risk but they are not recommended for the general public.


    • Treat the flu sufferer with over-the-counter pain and fever relievers such as acetaminophen or ibuprofen, but NEVER never give children or teenagers aspirin, which can cause a serious illness called Reye’s Syndrome. Do not give children younger than 4 years of age over-the-counter cold medications without first checking with your health care provider.


    • Avoid being face-to-face with the sick person and try to provide good ventilation. Wash hands after touching the sick person and keep surfaces clean. Keep the ill person at home but away from others in the house as much as possible, as least until fever (over 100 degrees) is absent for 24 hours. Make sure the sick person drinks plenty of liquids.


    Antiviral drugs such as Tamiflu and Relenza are prescription medicines that fight against the flu by preventing flu viruses from reproducing in one’s body. When people get sick with the flu, taking antiviral drugs within 48 hours of first developing symptoms can lessen the severity of the illness. Antiviral drugs may also prevent serious flu complications. They are recommended for people who are at increased risk for complications from flu, or who are sick enough to be hospitalized.


    However, antivirals are not a “magic bullet.” It is impractical to take antivirals to prevent getting the flu because an individual would have to take them constantly and they are expensive. Also, the misuse of antivirals can lead to the development of flu viruses that can’t be treated The State of Oregon has purchased antiviral medicine and federal stockpiles are available if necessary.


    Public health officials do not recommend the use of masks in the community to prevent exposure to H1N1 influenza.


    Vaccination is the best way to prevent against H1N1 as well as the seasonal flu. In addition, public health experts continue to advise the public to take basic precautions to help slow the spread of all influenza:


    • Wash your hands;
    • Cover your cough;
    • Stay home if you are sick.
     

    For more information, please visit the Oregon Department of Human Services Web site http://www.flu.oregon.gov or call the Oregon Public Health Flu Hotline: 800-978-3040.

     

     

    1014 Dept of Health completes critical resource shortages planning guide and implementation toolkit [Virginia]--The Virginia Department of Health (VDH) and Troutman Sanders LLP announced today that they have completed a project funded by the U.S. Center for Disease Control and Prevention (CDC) to improve the provision of medical services during a pandemic.

    The one-year project built on work that VDH had begun in 2006 to help address the shortage of critical resources that are likely to arise during a pandemic or other large scale disaster.

    “Virginia has long been a leader in helping healthcare providers prepare for disasters,” said Mark Levine, MD MPH, Virginia’s Deputy Commissioner for Emergency Preparedness and Response Programs. “We were among the first to realize that shortages of staff and other resources will make it more difficult for healthcare providers to perform their essential function during disasters. This impacts all of us, since our healthcare providers are essential to our ability to respond and recover from disasters.”

    Troutman Sanders served as the project facilitator. The project required that the Critical Resource Shortages Planning Guide – which VDH developed with Troutman Sanders and the Virginia Hospital and Healthcare Association – be implemented at a pilot site. Sentara Norfolk General Hospital served as the pilot site.

    The project involved the work of more than 50 hospital personnel, who served on several planning committees that developed detailed draft algorithms which could be used to modify, or allocate, essential services in a pandemic or other major disaster. Physicians, nurses, ethicists, respiratory therapists, emergency planners and administrators worked together to evaluate the complex issues that resource shortages create as healthcare providers struggle to continue to deliver care.

    These tools were tested in complex “tabletop” exercises that tested the accuracy of the algorithms and their ability to be implemented. The project also created a comprehensive Implementation Guide and a Toolkit with draft presentations that will help others more easily prepare for Critical Resource Shortage Events.

    “We are eager to share our learning with providers nationwide,” said Steven Gravely, head of Troutman Sanders’ health care practice. “Planning for resource shortages is very complex and requires that many stakeholders work together. We hope that the tools that we have developed in this project will help advance this work across the country.”

    To learn more about the Toolkit, go to: http://www.vdh.virginia.gov/criticalresourceshortagesplanning

     

     

    1014 H1N1 vax to be more widely available over next few weeks [Delaware]--As Delaware continues to see cases of H1N1 flu occur throughout the state, many residents are asking when and where they might have the opportunity to receive an H1N1 vaccination, which is the best way to avoid the flu. Vaccine is being received on a week-by-week basis from the federal government, but the current plan is as follows:

    • For pregnant women, H1N1 vaccine should be available at participating OB-GYN offices by the week of October 19. Pregnant women should check with their OB-GYN regarding availability and ask for their doctor to provide the vaccine if they had not planned to make it available.
    • For children and young people up to age 24 as well as adults with chronic health conditions and those who live or work with children under 6 months of age, vaccine should be available at participating pediatricians and family physicians offices by the week of October 26.
    • In November, we expect H1N1 vaccine to be more widely available, including in schools, at colleges, in pharmacies, and at some public health clinics.

    Because of limited quantities, H1N1 vaccine is initially reserved for those in the target groups most susceptible to H1N1 virus: pregnant women; children and young people between the ages of 6 months and 24 years old; people who live with or care for children younger than 6 months of age; healthcare and emergency medical personnel; and people age 25 through 64 years with chronic health disorders or compromised immune systems.

    Eventually, once enough vaccine is available, the H1N1 vaccine is expected to be made available to anyone who wants to receive the vaccine. Flu season runs through May, so DPH will urge residents to be vaccinated for H1N1 some months to come. Note that the H1N1 vaccine is comparable to the seasonal flu vaccine in safety and effectiveness.

    Seasonal flu vaccine is currently available from many medical offices, at pharmacies and at public health clinics. The schedule for those clinics can be found at www.flu.delaware.gov.

    H1N1 is shown to affect people much like the seasonal flu virus. Most cases of H1N1 flu, like seasonal flu consist of symptoms that can be treated with rest or recovery. However, either flu can be very serious. Emergency medical care is only necessary if the following symptoms are seen.

    Severe illness warning signs in children are:

    • Fast breathing or trouble breathing;
    • Bluish skin color;
    • Not drinking enough fluids;
    • 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; or
    • Fever with a rash.

    Severe illness warning signs in adults are:

    • Difficulty breathing or shortness of breath;
    • Pain or pressure in the chest or abdomen;
    • Sudden dizziness;
    • Confusion; or
    • Severe or persistent vomiting.

    The www.flu.delaware.gov.website contains a wealth of information and tips regarding the flu, as does the federal government flu website at at www.flu.gov.

     

    1013 Province hosts 2009 Atlantic 911 conference [Prince Edward Island]--The Prince Edward Island Office of Public Safety is pleased to host more than 100 representatives and administrators of various 911 services from Prince Edward Island, Nova Scotia and New Brunswick at the Brudenell River Resort, October 14 - 16, says Communities, Cultural Affairs and Labour Minister Carolyn Bertram.

    “The annual Atlantic 911 conferences give the delegates in our region an opportunity to learn more about a broad range of 911 services available on both the national and international scale,” said Minister Bertram. “It is also a valuable networking and learning opportunity for everyone involved.”

    Delegates at this week’s conference represent all aspects of the 9-1-1 service industry, including 911 call takers and 911 system and service administrators, telecommunication service providers, Public Safety Answering Point (PSAP) equipment providers and others directly involved with 911 systems services. Some of the issues conference delegates will be learning more about include the Amber Alert Program, Pandemic Telephone Triage, Radio Inoperability, Business Continuity Planning, H1N1 Influenza, Critical Incident Stress Management and plans for a Maritime-wide mobile radio communications system.

    “This is the third time Prince Edward Island has hosted the conference, since its inception in 2001,” said Minister Bertram. “I welcome all delegates and thank the organizers and sponsors for their efforts to organize and host this important conference.”

    For more information, visit www.gov.pe.ca/911.

     

    1013 Fire and emergency services training school to be hosted in Stephenville [Newfoundland and Labrador]--The Provincial Government, through Fire and Emergency Services - Newfoundland and Labrador (FES-NL), will partner with the Town of Stephenville and the Marine Institute’s Safety and Emergency Response Training (SERT) Centre to host the 2009 fall Fire and Emergency Services Training School from October 24 through November 1, in Stephenville.

    "Training is an essential part of the fire protection and emergency services of our province," said the Honourable Dianne Whalen, Minister of Municipal Affairs and Minister Responsible for Fire and Emergency Services - Newfoundland and Labrador. "Fire and Emergency Services will offer courses that are of particular interest to local service districts, municipal councillors, and staff and fire department members."

    The Provincial Government has also provided a $30,000 targeted training grant to the Municipal Training Development Corporation (MTDC) to assist municipalities with the cost of sending firefighters to the upcoming Fire and Emergency Services training school. The targeted funding provides a 50% cost-shared reimbursement of eligible actual costs within the MTDC program guidelines.

    "As stated in a recent report released by the Newfoundland and Labrador Association of Fire Services regarding recruitment and retention of volunteer firefighters, one of the biggest barriers for rural fire departments attending our training schools is funding," said Minister Whalen. "We feel the $30,000 training grant will encourage more municipalities and their fire departments to take advantage of these very worthwhile training opportunities and bring the skills back to their communities for the safety of their residents."

    The training school will run for nine days with a wide variety of courses ranging from three-hour seminars to seven-day courses on various topics. Applicants may attend as many courses as they wish during the tenure of the training school.

    "Fire and Emergency Services - Newfoundland and Labrador is committed to providing high quality training that meets the needs of the ever-changing fire and emergency management services of Newfoundland and Labrador," said Minister Whalen. "The last training school in Clarenville during the spring of 2009 was an enormous success. I encourage all municipalities, local service districts and fire departments to consider taking advantage of this opportunity."

    The 2009 FES-NL training schedules, an application and a comprehensive course listing, can be found at: www.gov.nl.ca/ma/fes/pdf/expanded_schedule_fall_2009.pdf, or can be obtained by calling 709-729-1608.

     

    1013 New directory for persons with disabilities launched [New Brunswick]--The 26th edition of the Directory of Services Offered to Persons with Disabilities in New Brunswick was launched on Friday, Oct. 9, by the Premier's Council on the Status of Disabled Persons.

    The council has been producing the free annual directory since 1984. It contains information on programs and services offered by government and community groups. The amount of information has increased steadily, with recent editions well over 200 pages. Each listing has a description of the program or service being offered, with the relevant contact information.

    "The directory of services is a valuable resource for all persons with disabilities in New Brunswick," said Michelle Horncastle, chairperson of the council. "We hope that this directory helps many individuals find the programs and services they need on their path to becoming more self-sufficient."

    Programs and services may be searched by index, general subject or the alphabetical index. The subjects included are children; counselling; education and learning; employment; funding and financial assistance; housing and residential services; professional associations; recreation, sport and active living; rehabilitation equipment and services; respite; seniors; support groups and hotlines; transportation; and a generic category of disability groups offering multiple services.

    "The directory is currently offered for free," said Christyne Allain, executive director of the council. "However, the actual combined cost of printing and mailing a directory is about $16. Taking this into account, we hope that users will use the online directory, which is always the most up-to-date version."

    The Directory of Services Offered to People with Disabilities in New Brunswick is available online in both official languages, or by calling the office of the Premier's Council on the Status of Disabled Persons, toll-free, at 1-800-442-4412.

     

    1013 Province supports doctors to treat more H1N1 patients [British Columbia]--In anticipation of a resurgence of the H1N1 virus, B.C. doctors will receive additional compensation to provide increased access to care for patients.

    As part of an agreement between the Province and the BC Medical Association, two new temporary fee codes, “Telephone Advice Regarding H1N1 Virus” and “Office Visit for H1N1 Virus”, have been introduced into the Medical Services Commission payment schedule. The new fee codes will enable physicians to more appropriately diagnose and treat pandemic H1N1 patients.

    “Providing the option of telephone advice for H1N1 patients is a sensible alternative to having symptomatic patients visiting a doctor’s office, while the 8-1-1 service remains available for general symptom queries from the public,” said provincial health officer Dr. Perry Kendall. “As we saw in the spring outbreak of H1N1, doctors play a critical role in treating H1N1 patients. Together, the two new measures offer H1N1 patients increased access to care.”

    Both family physicians and specialists will be able to bill the “Telephone Advice Regarding H1N1 Virus” fee starting Oct. 1, 2009. The H1N1 office visit fee is a family-doctor-specific fee that is not subject to the daily volume office visit restriction. It will be turned on upon the advice of the provincial health officer when the number of flu cases exceeds the historical average of seasonal influenza cases.

    “We are pleased to work with the BCMA in establishing new fee codes as one step in ensuring that physicians across the province have appropriate support to manage this year’s flu season,” said Health Services Minister Kevin Falcon.

    Healthy Living and Sport Minister Ida Chong shares Falcon’s views.

    “Increased access to health professionals will help ensure that public health and safety remains a priority and patients get the most appropriate care quickly,” said Chong.

    Physicians will receive $14.74 to provide telephone advice to high-risk patients with suspected or active H1N1 symptoms. This amount is equivalent to other telephone advice fees for B.C. doctors. Doctors will also receive $31.15 for each H1N1 office visit, a fee rate that is equivalent to the weighted average of all age-related general office visits. Currently, there is a cap of a daily maximum of around 50 patients a day for office visits. The H1N1 office visit will be exempt from this cap.

    The telephone advice fee is especially useful to physicians when they speak to their high-risk symptomatic patients who have received advanced anti-viral prescriptions and want to know if they need to fill their prescriptions and start taking the medication.

    “If you’re sick with the flu, quite frankly the last thing you want to do is pack yourself up and head for the doctor’s office. In this instance, telephone advice makes perfect sense,” said Dr. Brian Brodie, president of the BC Medical Association. “If the doctor feels you should come in, then the visit can be arranged for a convenient time and co-ordinated to limit spreading the virus to other patients.”

    The fee codes are specifically designed to support physicians in diagnosing and treating patients who have active symptoms of H1N1. Patients who feel they may have symptoms, or want general non-emergency health information on H1N1 may contact HealthLink BC by phoning 8-1-1 or visiting www.healthlinkbc.ca.

     

     

    1013 H1N1 flu under surveillance [British Columbia]--British Columbia continues to monitor and respond to the spread of the pandemic H1N1 flu virus.

     

    Since Oct. 6, there have been 14 new severe cases of H1N1 identified in B.C. – five in Interior Health, four on Vancouver Island, three in Vancouver Coastal Health and two in Fraser Health – with one new death in Interior Health.

     

    The majority of lab-confirmed cases in B.C. have been mild or moderate in severity, with the patients either having already recovered or currently recovering.

     

     

    1013 Town hall meeting in Iqaluit tackles H1N1 vax myths [Canada]--Health Minister Leona Aglukkaq and Dr. David Butler-Jones, Canada's Chief Public Health Officer, addressed some of the myths around vaccine safety, effectiveness, and side effects at a town hall meeting with community members in Nunavut today.

    "It's important that Canadians learn the facts about immunization," said Minister Aglukkaq. "Immunization is a very safe and effective way for Canadians to protect themselves and their families against the virus."

    When looking for information on vaccine-related issues, Canadians should refer to credible sources such as the Public Health Agency of Canada, Health Canada, provincial and territorial departments of health and/or public health officials.

    "The dangers of vaccine-preventable diseases like the H1N1 flu are much greater than the small risk of a serious reaction to a vaccine," said Dr. David Butler-Jones. "Vaccines are among the safest tools of modern medicine. They are thoroughly tested and reviewed by companies, regulators and the Government before being administered to the public and they are tracked carefully afterwards."

    The town hall discussion followed an announcement by the Minister earlier in the day about the release of a comprehensive preparedness guide that provides Canadians with information about the H1N1 flu virus, steps they can take to protect themselves, and what to do if they, or their family members, get sick. For more information and to access the guide online, go to www.fightflu.ca.

    "Over the coming weeks, we will continue to address the concerns Canadians have around the H1N1 flu virus, including the issue of vaccination," said Minister Aglukkaq. "Canadians will be provided with the information they need to protect themselves from the H1N1 flu virus."

     

     

    1013 Govt of Canada launches H1N1 preparedness guide [Canada]--Health Minister Leona Aglukkaq today announced the release of a comprehensive preparedness guide that will provide Canadians with information about the H1N1 flu virus, steps they can take to protect themselves, and what to do if they, or their family members, get sick.

    “Every Canadian has a role to play in preventing the spread of the H1N1 flu virus,” said Minister Aglukkaq. “This guide gives Canadians the information they need to make the right decisions to protect themselves and their families.”

    The guide, which was developed by the Public Health Agency of Canada with input from provincial and territorial governments, can be obtained online at www.fightflu.ca, or by calling 1-800-O-Canada. Starting today, the guide will be widely distributed directly to health care professionals, organizations that support populations at risk (e.g. people with underlying medical conditions, young children, and pregnant women), other health care stakeholders. In the coming days, the guide will also be available at Canada Post offices across Canada.

    “We have consulted experts, the provinces and territories, and Canadians from all walks of life to ensure we have consistent, plain language and effective information in the guide,” said Canada’s Chief Public Health Officer, Dr. David Butler-Jones. “I encourage all Canadians to inform themselves about the H1N1 flu virus through the use of this guide.”

    Providing Canadians with basic information on infection prevention and preparedness related to the H1N1 flu virus is a key objective for the Government of Canada and its provincial and territorial partners going into the fall. The government has ordered an initial print run of 1.2 million copies of the guide and anticipates it will become a "go-to" document on the H1N1 flu virus.

    Canadians will be reminded to get a copy of the guide later this month in a pamphlet that the Public Health Agency of Canada is sending to 13.7 million households. The pamphlet will have basic information on the H1N1 flu virus and exact details on how to obtain a copy of the guide.

     

     

    1009 FluWatch reports slightly higher flu activity [Canada]--Summary of FluWatch Findings for the Week ending October 3, 2009

    * The overall influenza activity slightly increased for a third consecutive week and was higher than expected for this time of the year. The total number of influenza outbreaks was high this week with 40 outbreaks in schools. The national ILI consultation rate was slightly higher compared to the previous weeks and above the expected range for this time of the year. However, the proportion of positive tests for influenza remained stable low during week 39.


    * BC had a particularly high influenza activity this week with approximatively 15% of positive influenza tests and eighteen influenza outbreaks. NT was also affected with their two regions reporting widespread activity and 16 outbreaks.


    * This week, approximatively 97% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009, and the remainder were seasonal A (H1N1).


    * The intensity of Pandemic (H1N1) 2009 in the population was low with twenty-five hospitalizations and no deaths reported this week. Hospitalized cases were reported from BC, AB, MB and ON. As of October 3, 2009, a total of 1,504 hospitalized cases including 295 cases admitted to an intensive care unit (ICU) and 155 cases required ventilation as well as 78 deaths had been reported since the beginning of the pandemic.


    * The influenza activity remained elevated in the U.S. for a fifth consecutive week.


    * The number of confirmed cases in Mexico reached higher levels in September than the Pandemic (H1N1) 2009 peak in April.
     

     

    1009 Seasonal flu vax now available for those over 65 [Prince Edward Island]--Doctors’ offices, Family Health Centres and long-term care facilities on Prince Edward Island have received their first shipment of seasonal influenza vaccine. Starting this week, the vaccine will be available to those who are 65 years and older and residents in long-term care facilities.

    “Our decision to provide the seasonal influenza vaccine first to those over 65 and in long-term care facilities is based on the scientific evidence available to us and is in the best interest of the health of all Islanders,” said Dr. Heather Morrison, chief health officer for the Department of Health. “Evidence has shown this group is at a low risk for getting the H1N1 Flu Virus, but at greatest risk of becoming seriously ill with seasonal influenza, which is still likely to arrive at some point this flu season.”

    As announced last week, this year’s immunization program will be a phased-in approach.

    The program will focus first on providing the regular seasonal influenza vaccination to those at highest risk for seasonal influenza and will be followed closely by the H1N1 vaccine. After the H1N1 vaccine has been offered to all Islanders, it is anticipated that the seasonal influenza vaccine will be offered to the remaining high risk groups and others who wish to receive it.

    “Delivering the vaccine campaign this way allows us to offer the best protection to Islanders most at risk from seasonal influenza, while still ensuring that everyone who wants and needs the H1N1 vaccine will be able to receive it as soon as it’s available,” said Dr. Morrison. “This year, the predominant strain of influenza will likely be the H1N1 Flu Virus,” said Dr. Morrison. “While those people who are 65 and older and those who live in long-term care facilities should continue to receive the seasonal influenza shot as usual this year, for the rest of the population, the flu virus they need to protect themselves against early in this influenza season is the H1N1 Flu Virus.”

    As in past years, the Department of Health has provided the vaccine free of charge. However, there will be a fee to cover the cost of administering the vaccine in doctors’ offices and Family Health Centres. Family Health Centres across the province will provide the vaccine by appointment to those without a family physician. Announcements will be made in the near future regarding dates and times of clinics. The public is advised to watch the newspapers for further information.

    One of the simplest steps Islanders can take to limit the spread of both H1N1 and seasonal influenza is good hand washing with soap and warm water or an alcohol-based hand rub. Islanders are reminded to cough and sneeze into their arm or sleeve and stay at home if they are sick.

     

     

    1009 Delays in shipments of and high demand for season flu vax cause confusion [New Hampshire]--The seasonal flu vaccine campaign in New Hampshire has been progresssing. The unusually early availability of the seasonal flu vaccine, the push to have people get the vaccine as soon as possible, and the changeover by manufacturing companies to the H1N1 vaccine has caused some confusion and delays, however. The New Hampshire Department of Health and Human Services (DHHS) urges people to continue looking for the seasonal vaccine until they find one over the coming weeks because there should still be plenty over time.

    “While DHHS is only involved in seasonal flu vaccines for children through our Vaccines for Children Program,” said DHHS Commissioner Nicholas Toumpas, “the vaccine is an important prevention tool to keep people from getting seasonal flu. Part of our mission is to help our citizens stay healthy so we want to encourage everyone, especially people in high-risk categories for complications from flu, to get the vaccine.”

    Influenza is a very serious disease of the lungs, nose, and throat. The illness is spread from person to person through coughing and sneezing. Typical flu symptoms include fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, and muscle aches.

    The federal Centers for Disease Control and Prevention (CDC) has confirmed that a number of vaccine manufacturers have switched over to making H1N1 vaccine instead of seasonal flu. There are still many doses of seasonal flu vaccine that have been received, administered, and are continuing to be produced. Approximately 70 million doses of seasonal flu vaccine have been distributed across the country as of September 25, 2009. This is approximately 61% of the doses that are expected to be distributed for this season.

    “Providers should work directly with the manufacturers to determine the timing for the delivery of their orders,” said Dr. Jose Montero, Public Health Director. “DHHS does have a supply of seasonal flu vaccines for the pediatric age group, which can be ordered through the New Hampshire Immunization Program. We encourage providers not to hold vaccine clinics unless they have adequate supply of vaccine and we will update them on this issue once we have more information.”

     

     

    1009 H1N1 State changing the way it reports flu hospitalizations and deaths [North Carolina]--North Carolina is changing the way it reports flu deaths and hospitalizations, in response to a new nationwide directive from the Centers for Disease Control and Prevention.

    When the new flu virus first surfaced in the state in April 2009, North Carolina began reporting flu cases and deaths, and later hospitalizations, due to laboratory confirmed H1N1 influenza A virus. Starting this week, the state is reporting hospitalizations and deaths from all influenza-like illnesses, including both H1N1 and seasonal influenza. The state will no longer be reporting separately the number of hospitalizations and deaths among patients with lab-confirmed pandemic H1N1. However, the 2009 H1N1 strain of flu accounts for more than 99 percent of all flu currently circulating in the state and the country.

    “The laboratory confirmed numbers underestimate the real number of cases,” said State Epidemiologist Megan Davies. “While this reporting change will result in what seem to be larger numbers, it will give us a truer picture of the impact of flu in the state over the coming weeks and months.”

    The North Carolina Division of Public Health continues to track emergency department visits and visits to designated healthcare providers for flu-like symptoms. Flu activity is also monitored by running laboratory tests on a sample of patients from across the state each week to determine which types of flu are circulating.

    “This is basically the same type of flu surveillance that North Carolina and the United States have used for years to track influenza,” Davies said. “Now it has been expanded to include flu-related hospitalizations and all influenza deaths.” Reporting of all flu-related deaths is now required by a temporary order from the State Health Director. In previous years, only pediatric flu deaths were reported.

    The reporting on influenza-associated deaths is based on reports from doctors and local health departments of people who died from an illness identified as influenza (either seasonal or pandemic) through medical testing.

    The hospitalization numbers are based on electronic monitoring of the number of patients with influenza-like-illness (ILI) who are admitted to hospitals through emergency departments. ILI is not the same as laboratory confirmed influenza. Patients who are identified as having ILI might have other diseases, so this number may overestimate the actual number of influenza hospitalizations, but is useful for monitoring trends.

     

     

    1009 Salmonella Typhimurium outbreak linked to consumption of raw alfalfa sprouts [Michigan]--The Michigan Department of Community Health (MDCH) and Michigan Department of Agriculture (MDA) are issuing a public health alert regarding illness from Salmonella infections among people who have reported raw alfalfa sprouts consumption in Michigan.

     

    At this time, MDCH and MDA are recommending that people, especially young children, frail or elderly people, and others with weakened immune systems, avoid consumption of raw alfalfa sprouts until we have further information about the origin of the contaminated sprouts. Other types of sprouts have not been implicated.

    Michigan has 12 confirmed Salmonella Typhimurium cases from seven jurisdictions in Michigan (Bay, Genesee, Kent, Macomb, Oakland, Washtenaw and Wayne Counties) involved in the current outbreak. The illness onset dates range from Aug. 17 to Sept. 18, 2009. There have been two known hospitalizations. MDCH and MDA are working closely with local health departments, the CDC and the FDA to determine the source of the outbreak.

    "Eating raw sprouts is a known risk for exposure to Salmonella or E. coli O157:H7 bacteria," said Dr. Gregory Holzman, chief medical executive for MDCH. "We want to educate people about this known risk in order for them to make informed decisions concerning their health."

    Sprouts are the germinating form of seeds and beans and are frequently eaten raw in sandwiches and salads. Past sprout-related outbreaks of foodborne illness have been linked to seeds contaminated by fecal materials in the field, during storage, or as a result of poor hygienic practices in the production of sprouts. In addition, the warm and humid conditions required to grow sprouts are ideal for the rapid growth of bacteria.

    In general, the FDA recommends these guidelines for those who choose to continue to eat sprouts:

    - Cook all sprouts thoroughly before eating to significantly reduce the risk of illness.

    - Sandwiches and salads purchased at restaurants and delicatessens often contain raw sprouts. Consumers who wish to reduce their risk of food borne illness should specifically request that raw sprouts not be added to their food.

    - Homegrown sprouts also present a health risk if eaten raw or lightly cooked. Many outbreaks have been attributed to contaminated seed. If pathogenic bacteria are present in or on seed, they can grow to high levels during sprouting even under clean conditions.

    Salmonellosis is a disease caused by the bacterium is an infection with bacteria called Salmonella. Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, and most people recover without treatment. The elderly, infants, and those with weak immune systems are more likely to have a severe illness. Anyone who has recently eaten raw alfalfa sprouts and is experiencing symptoms should contact their healthcare provider and their local health department.

     

     

    1009 Seasonal flu vaccine is in short supply for now [Vermont]--The Vermont Department of Health has received reports from a number of health care providers and agencies around the state that they have run out of supplies of the regular, seasonal flu vaccine – as some manufacturers including the largest supplier, Sanofi Pasteur, have delayed shipments or reduced the number of doses they will ship.

    As a result, many public flu shot clinics have been postponed, and many patients and health care workers will get vaccinated later than first anticipated. As of Sept. 30, more than 76,000 doses of adult and pediatric seasonal flu vaccine had been shipped from various manufacturers to Vermont. The remainder of the flu vaccine supply is expected to arrive in the state during October and November.

    “We have been encouraging nearly everyone to get vaccinated for the regular seasonal flu as soon as vaccine is available to them, but it is still very early in the flu season,” said Health Commissioner Wendy Davis, MD. “Now we are asking Vermonters to be patient and persistent in locating vaccine.”

    October is the traditional time when seasonal flu vaccine clinics open, but this season vaccination started unusually early as some vaccine supplies became available in August and September.

    The regular flu season typically starts in Vermont each year in December or January, and may continue through April. While flu outbreaks can happen as early as October, illness typically peaks in January.

    As of Oct. 5, flu activity in Vermont is characterized as “local.” This means that there are recent reported increases in influenza activity, along with confirmed cases, in the southwest region of the state – as well as sporadic cases of both H1N1 and seasonal flu around the state.

    This spring, the 2009 H1N1 flu virus started causing illness in April in the U.S., spread around the world and into the southern hemisphere throughout the summer, and has overtaken the usual flu virus strains as the predominant strain. Nearly all of the influenza detected is the new flu, 2009 H1N1.

    Vaccine for the seasonal flu is recommended for nearly everyone 6 months and older, but especially for the very young, the very old, pregnant women and people with chronic conditions that put them at greater risk of serious complications.

    Vaccine for the new H1N1 flu is recommended to go first to people who could be most seriously affected if they become ill:

    • Pregnant women
    • Caregivers and household contacts of children under 6 months of age
    • Anyone age 6 months through 24 years
    • Health care workers and Emergency Medical Services personnel
    • Adults age 25 through 64 with chronic medical conditions such as asthma, chronic heart, kidney or liver disease, diabetes, compromised immune system due to disease or treatment, or neuromuscular conditions

    Taking simple every day actions can help keep flu and other infectious illnesses from spreading:

    • Wash you hands often and well with soap and water for as long as it takes to sing the “ABC” song. Or use an alcohol-based hand sanitizer.
    • Cover your cough or sneeze with a tissue, and throw the tissue away. Or cough into your sleeve or the crook of your elbow.
    • Stay home when you’re sick until at least 24 hours after your fever is gone. A person is most infectious while having a fever.

    Most people who are sick with flu will not need to see a health care provider and can be cared for at home. If you need medical attention, call your health care provider first. It is important for anyone at risk for serious complications to get treatment with antiviral medications early, within 48 hours of first symptoms.

    “For anyone who is at greater risk for serious complications, it is well worth discussing antiviral treatment and making a plan with your health care provider now,” said Dr. Davis.

    People who are sick with influenza can spread the virus through coughs and sneezes. If you are sick with flu-like symptoms – fever of 100° F plus sore throat or cough, and often headache, muscle and joint aches, fatigue, sometimes vomiting or diarrhea – stay home from work or school for at least 24 hours after fever has gone away without the use of fever-reducing medications.

    Extensive information, tools, and resources – including guidelines for deciding about medical care – are available at the Health Department’s Web site: healthvermont.gov or dial 2-1-1. You can also follow us on Twitter at twitter.com/healthvermont.

     

    1009 H1N1 DPH reports two additional flu-related deaths [Kentucky]--The Kentucky Department for Public Health (DPH), the Pennyrile District Health Department and the Christian County Health Department announced today that the state is reporting two additional deaths related to 2009 H1N1 influenza (swine flu). The deaths involved a Caldwell County teenager with no known health issues and a Christian County woman in her late 20s who had underlying health issues.
     

    “Influenza always has the potential to cause serious illness or complications that can result in hospitalization, and even death. It is a tragedy when we lose Kentuckians to any illness, especially children and young adults," said William Hacker, M.D., commissioner of DPH. "Kentucky continues to experience widespread flu activity at the moment, and is working with federal, state and local partners in the public and private sectors to prepare for the 2009 H1N1 vaccination campaign. Flu vaccine is one of the most effective tools we have against influenza and we hope to begin immunizing Kentuckians in the weeks ahead."
     

    Although more than 1,300 deaths associated with H1N1 influenza have been reported nationwide, the severity of H1N1 influenza illness appears comparable to seasonal influenza, which is responsible for about 200,000 hospitalizations and 36,000 deaths each year, according to the Centers for Disease Control and Prevention (CDC). The state reported its first swine flu-associated death in early September, involving a Fayette County woman in her 50s who had underlying health conditions. The state's second H1N1-associated death was reported last week, and involved a Jefferson County woman in her 40s with no known health issues.
     

    Limited quantities of the swine flu vaccine will become available this week, with an increase in supply anticipated toward the end of the month and into November. The earliest shipments will be of the nasal spray vaccine, which can be taken by healthy individuals ages 2-49, with H1N1 flu shot vaccine following in larger quantities. Health officials are recommending that individuals under 65 who are at higher risk for complications of the flu—such as pregnant women, health care workers, caretakers of children younger than six months and those with chronic illnesses—be among the target groups to receive vaccine first. Health care providers interested in providing H1N1 vaccine should contact their local health department as soon as possible. Seasonal flu vaccine is already available in many locations, and health officials are encouraging individuals, including those over 65, not to delay receiving their annual flu shot.
     

    "Although we are continuing to see an increased number of cases of the flu, to date the illness H1N1 causes is comparable to seasonal flu and will usually not require the closure of schools for public health reasons," said Dr. Hacker.
     

    The symptoms of both seasonal and H1N1 influenza include fever, chills, headache, sore throat, cough, body aches, and may include vomiting or diarrhea. Individuals at higher risk for complications—such as those with chronic health conditions or who are pregnant—should contact a health care provider early, in case treatment with antiviral medication is necessary. 
     

    Common sense precautions to prevent illness include: avoiding close contact with those who are ill; staying home when sick; covering the mouth and nose when coughing or sneezing; avoiding touching the eyes, nose or mouth; and frequent hand washing.


    Individuals can visit
    http://healthalerts.ky.gov for information on H1N1 and Kentucky, or follow KYHealthAlerts on Twitter. Kentucky's toll-free influenza hotline number is 1(877)843-7727, and operates from 8 a.m.-10 p.m. daily.      

     

     

    1009 H1N1 DPH launches new public toll free hotline [Kentucky]--The Kentucky Department for Public Health (DPH) encourages Kentuckians to call a new toll-free hotline with their questions related to 2009 H1N1 influenza (swine flu) and seasonal flu for the latest news and information about flu. The toll-free hotline number is 1(877)843-7727, and it will operate from 8 a.m.-10 p.m. daily.

     

    Information on the H1N1 virus is also readily available by visiting the redesigned Health Alerts Web site at http://healthalerts.ky.gov.
     

    "We want Kentuckians to be able to access the most current and accurate information related to the ongoing 2009 H1N1 flu situation," said Gov. Steve Beshear. "Particularly now that vaccine is beginning to become available, we know that citizens will have questions about whether the H1N1 flu vaccine is right for them and when they might be able to receive it. The hotline and Health Alert Web site will provide easier access to the information they need."
     

    The flu hotline will be staffed by nurses and administered by Kosair Children’s Hospital, a part of Norton Healthcare, through a contract with DPH funded by a federal grant award related to H1N1 activities. Kosair Children’s Hospital also operates the state's Regional Poison Center hotline. The flu hotline will be active through at least the end of December.
     

    “As an advocate for children and families across the state, we are committed to ensuring that the public has access to the most accurate, up-to-date information about health issues, including H1N1influenza,” said Thomas D. Kmetz, president of Kosair Children’s Hospital and pediatric services at Norton Healthcare. “We are pleased to be able to partner with the state to help people get their questions and concerns about H1N1 answered.”
     

    The Health Alerts Web site has also been relaunched in an easy-to-navigate format, and will be updated daily with new information about swine flu, seasonal flu and flu vaccines, as well as any other breaking health news. It includes resources for families and individuals, health care professionals, schools and day cares, other community organizations and business owners. It also provides information for the media.
     

    Kentucky was eligible to begin ordering 24,300 doses of nasal spray H1N1 vaccine last week, and expects shipments to begin arriving this week. The nasal spray vaccine can be taken by healthy individuals ages 2-49.  The first doses will be targeted mainly at health care workers under age 40 who are healthy, with broader availability as supplies increase. The H1N1 flu shot vaccine is expected to be available mid- to late October, with vaccine clinics for the public likely to be scheduled in early November.
     

    The symptoms of both seasonal and H1N1 influenza include fever, chills, headache, sore throat, cough, body aches, and may include vomiting or diarrhea. Individuals at higher risk for complications—such as those with chronic health conditions or who are pregnant—should contact a health care provider early, in case treatment with antiviral medication is necessary.
     

    Common sense precautions to prevent illness include: avoiding close contact with those who are ill; staying home when sick; covering the mouth and nose when coughing or sneezing; avoiding touching the eyes, nose or mouth; and frequent hand washing.
     

    For more information on seasonal and swine flu, visit http://healthalerts.ky.gov or follow KYHealthAlerts on Twitter.        

     

     

    1009 H1N1 Fourth flu death reported [Iowa]--The Iowa Department of Public Health (IDPH) has received laboratory results confirming the fourth death associated with the 2009 H1N1 virus in Iowa. The victim was an adult in Pottawattamie County with medical conditions that increased the risk of complications. The 2009 H1N1 virus continues to circulate in Iowa; IDPH surveillance indicates influenza and influenza-like illness are increasing across the state.

    These deaths serve as a reminder the virus has the potential to cause severe disease and even death. "Some H1N1 vaccine is arriving in Iowa this week," said IPDH Medical Director, Dr. Patricia Quinlisk. "Vaccine will continue to arrive on a staggered basis in the coming weeks."

    Until more vaccine becomes available, it's important to continue to take personal action to prevent the spread of illness. These steps include cleaning your hands frequently; covering your coughs and sneezes with a tissue or your sleeve; and containing germs by staying home when ill.

    Symptoms of H1N1 influenza are similar to seasonal influenza and include a fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people with H1N1 flu also have diarrhea and vomit.

    For more information about H1N1 influenza, visit www.idph.state.ia.us/h1n1. Iowans with questions about H1N1 may also call the toll-free Influenza Hotline at 1-800-447-1985.

     

    1009 H1N1 Mobile death linked to flu [Alabama]--The Alabama Department of Public Health was notified Tuesday about the death of a man in his 50s from Mobile County who tested positive for 2009 H1N1 influenza. This brings the total number of deaths of persons with H1N1 influenza in Alabama to 16.


    Previous deaths of persons positive for H1N1 influenza have occurred during 2009 to residents of Bullock, Calhoun, Dale, Houston, Jackson, Jefferson, Macon, Madison, Mobile, Montgomery, Russell and Talladega counties.
     

    The continued widespread incidence of 2009 H1N1 influenza in Alabama and the number of known deaths in the state serve as reminder of the need for everyone to take steps to prevent transmission of disease and to be immunized for both seasonal and H1N1 influenza when vaccine becomes available.

     

     

    1009 H1N1 State Health dept activates hotline [Oklahoma]--The Oklahoma State Department of Health (OSDH) announced today that it has established a statewide, toll-free hotline for Oklahomans who have questions about the new H1N1 influenza, or “swine flu.”

    The toll-free number is 1-866-278-7134.

    Phones will be answered from 8 am to 5 pm, Monday through Friday. Hours of operation may be expanded if necessary.

    Additional information on H1N1 influenza is available by visiting the OSDH Web site at www.health.ok.gov or www.flu.gov, or by calling your local county health department.

     

     

    1009 H1N1 DHH confirms arrival of limited doses of vax [Louisiana]--The Louisiana Department of Health and Hospitals today confirmed that the first doses of the state’s initial allotment of H1N1 vaccine—26,000 doses of nasal spray—have begun arriving at pediatric providers across the state who chose to provide H1N1 vaccine and are ready to administer it to their patients.

    These providers will use the H1N1 flu vaccine with patients in their practices who meet the requirements for target populations for this particular vaccine—healthy 2 to 5 year olds. These providers ordered this vaccine specifically for their patients, and will be contacting their patients directly to set up appointments for vaccination.

    "One of the best steps residents can take to keep themselves healthy and prevent the spread of both the seasonal and H1N1 flu is to get their flu shots," said DHH Secretary Alan Levine. "Residents should determine if their provider will offer the vaccines, when they expect vaccine to be available and how to make an appointment to receive the flu shots. Please check regularly with www.FightTheFluLA.com for up to date information."

    Seasonal flu shots for children and adults in nasal spray and injectable forms are available now through many private medical providers and clinics, pharmacies, and other locations.

    Over the next few weeks, H1N1 flu shots will also be available in nasal spray and injectable forms for children and adults through a large network of participating providers.

    H1N1 Vaccinations will be available initially to target groups, people who are at highest risk for transmitting and complications from the new virus.

    Those in target groups for the H1N1 vaccine should begin contacting their private provider or retail locations now to inquire about availability of the new vaccine, and should make an appointment to get it.

    Target groups for the H1N1 vaccine include:

    • Pregnant women
    • Health care and emergency medical services personnel
    • People from the ages of 6 months to 24 years
    • People who live with or care for children younger than 6 months of age
    • People from ages 25 through 64 years who are at higher risk for flu complications because of chronic health disorders or compromised immune systems

    State Health Officer Jimmy Guidry, M.D., emphasized that the H1N1 vaccine is just as safe as the seasonal flu vaccine. "The H1N1 vaccine was made and licensed utilizing the same production methods as the seasonal flu vaccine, which have been used safely for decades," Dr. Guidry said. "Studies by the CDC show that the vaccine is very safe and very effective, and we certainly encourage all Louisianians to get both their seasonal and H1N1 flu shots this flu season. This will not only help protect the individual receiving the vaccine, but their friends, family and neighbors as well."Vaccine Distribution

    DHH officials also announced details today on how the H1N1 vaccine is being distributed. The H1N1 vaccine is a federal asset that is being sent from the federal government through a distribution company directly to the 1,600 Louisiana providers that ordered the most amount of vaccine. More than 2,000 providers registered to administer the vaccine in Louisiana, and the state will begin working in three to four weeks to break down smaller shipments to the remaining 400 providers.

    There are five separate formulations of the H1N1 vaccine, and not every preparation will be appropriate for every target population.  Each week, DHH will work with providers across the state to assess the demand for the H1N1 vaccine, and will place orders with the federal government based on that demand and the amount of each type of vaccine available that week.

    Following the initial shipment received this week, providers in the state will continue to receive more vaccine every five to ten days for the next three months, including formulations that are appropriate for more groups, such as the injectable vaccine in both adult and child doses. Next week, the state expects providers to receive more than 40,000 doses of H1N1 vaccine.

    Groups targeted for vaccination with these next doses include more young children, pregnant women and front line health care workers, those with direct patient care responsibilities.

    The H1N1 vaccine will be available at a wide variety of providers within three to four weeks (late October to early November) for other target groups, such as parents and caregivers of infants and  non-elderly adults with chronic medical conditions like asthma, diabetes, and heart conditions.

    Vaccination campaigns in Louisiana schools will also take place. The department expects to begin these in elementary schools in mid-November, and continue for a month into middle and high schools.

    Dr. Frank Welch, the state medical director for pandemic preparedness, said, "Thousands more doses of nasal and injectable forms of the H1N1 vaccine will be shipped across the state each week over the next several months, making vaccine available for target populations in every parish and for every provider who registered with the state. The entire H1N1 vaccination campaign will take around four months, and by the end of January every Louisianian who wants a vaccine should have access to it."

    In the coming weeks, the department will launch an online search tool with Google®-style maps showing the location of providers who have registered to administer the H1N1 vaccine. In the next four to six weeks, vaccine will be offered to the public at selected locations, which will be posted at www.FightTheFluLA.com. Retail locations and public health-sponsored sites that have registered to distribute vaccine when it becomes available include Walgreens, CVS, parish health units, and school-based health clinics.

    It is estimated that more than 97,000 Louisianians have already had the H1N1 virus, with 1472 lab-confirmed cases.

    Twenty Louisianians have died from complications related to the H1N1 virus. Six H1N1-related deaths were confirmed today: three adult women from DHH Region II (the seven-parish area including Baton Rouge), an adult male from DHH Region VII (the nine-parish region including Shreveport), a female child from DHH Region VIII (the 12-parish Northeast Louisiana region), and a male child from DHH Region IX (Livingston, St. Helena, St. Tammany, Tangipahoa and Washington Parishes).

    DHH recently launched the state’s Fight the Flu campaign, which is aimed at keeping Louisianians healthy by promoting immunizations and good hygiene to prevent the spread of the seasonal flu and the H1N1 virus. For more information on flu activity in Louisiana, including guidance for families and medical professionals, visit www.FightTheFluLA.com.

     

    1009 H1N1 DHH confirms three deaths from flu [Louisiana]--The Louisiana Department of Health and Hospitals today confirmed three deaths in the state from H1N1: an adult female from DHH Region I, the Greater New Orleans area, an adult male from DHH Region III, the seven-parish area including Houma and Thibodaux, and an adult female from DHH Region IV, consisting of the seven-parish area surrounding Lafayette. There have been a total of 14 H1N1-related deaths statewide.

    The department will not release other personal details about the individuals to protect the privacy of the residents and their families.

    "Our hearts go out to the families dealing with these tragic loses," said DHH Secretary Alan Levine. "The losses we have seen in our state seem to be consistent with national trends. We strongly encourage those with pre-existing conditions to contact their medical provider for advice immediately, as they are more likely to develop severe complications from H1N1."

    Levine added, "Also, if you are pregnant and experience flu-like symptoms, please see your physician as soon as you can. Our state’s health care professionals are responding and are aware of the CDC guidelines for treatment for people who are at risk. In most cases, treatment for high risk populations involves the use of antivirals, which are readily available."

     

     

    1009 H1N1 Additional doses of vax expected to arrive next week [North Dakota]--The North Dakota Department of Health has received information from the Centers for Disease Control and Prevention (CDC) that approximately 7,900 doses of H1N1 influenza vaccine will be arriving in the state late next week. This shipment will consist of 3,700
    doses of the nasal spray FluMist and 4,200 of the injectable flu shot.


    FluMist vaccine cannot be given to infants younger than 2, pregnant women, people with chronic health conditions or those 50 and older. Therefore, the FluMist will continue to be prioritized for healthcare workers. The injectable doses will be allocated as follows: 3,700 doses for children ages 6 months through 18 and 500 doses for pregnant women.


    “It’s very good news that we are starting to receive vaccine for children and pregnant women,” said Molly Sander, Immunization Program manager. “The supplies of H1N1 vaccine are still very limited, but we expect to continue receiving shipments each week, so if people in these high risk groups can’t find the vaccine right away, they should keep checking.”

     

    North Dakota received 4,000 doses of FluMist this week which were prioritized for healthcare workers in the state. The CDC estimates that more than 150 million doses ultimately will be available in the U.S., and North Dakota should receive more than 380,000 doses.


    The North Dakota Department of Health has developed a flu shot clinic locator for the public to use when looking for vaccine. Local public health units and private providers have been encouraged to post their clinic information at that site. Information will be updated frequently as more vaccine is received in the state and more clinics are scheduled. The public is encouraged to check the site frequently for updates. The information can be found by visiting www.ndflu.com and clicking on the Flu Shot Clinic Locator in the Frequently Requested Box.

     

     

    1009 H1N1 DSHS provides vax update [Texas]--A total of 142,400 doses of the H1N1 vaccine were earmarked for Texas in the U.S. Centers for Disease Control and Prevention’s first weekly allocation to states announced last week. Texas had expected to get 237,000 in the first allocation.

    The bulk of the 142,400 doses for Texas will be sent to some pre-registered doctors, clinics and other providers to vaccinate healthy 2- and 3-year-olds, part of a priority group to receive the vaccine. All of the doses are the FluMist brand nasal spray form of the vaccine. FluMist is only approved for use in vaccinating people 2 years through 49 years of age who are not pregnant and do not have certain chronic health conditions.

    That vaccine is expected to be received over the next two weeks as the selected, pre-registered providers confirm with DSHS that they still want the vaccine in the quantities allotted.

    Some 10,600 of the 142,400 doses are being sent to local public health departments and some DSHS regional sites, but DSHS officials said the quantities are not enough for public vaccination clinics and that each local department can determine how best to use the limited, initial supply.

    A few of the local health departments received the vaccine Monday. State health officials had not expected any doses to be received in Texas till later this week at the earliest.

    DSHS officials expect the weekly availability of the vaccine to be low for the first few weeks with volume predicted to increase later this month. They are urging providers and the public to be patient.

    DSHS will provide another update early next week to announce the final Texas vaccine allocation for this week.

    Texas expects to receive 15 million doses of the vaccine by the end of January.

     

     

    1009 H1N1 DoH provides recommendations for people sick with flu symptoms [New Mexico]--The New Mexico Department of Health is advising residents about when they need to seek medical care if they are experiencing influenza symptoms. Several hospitals in New Mexico have reported to the Department of Health that they are seeing increased activity of people coming to the hospital with flu symptoms. Some of these people do not need to visit a clinic or emergency room and should stay home until 24 hours after their fever has subsided.
     

    “We’re seeing widespread flu activity in the state and it is import for people to follow our recommendations for seeking medical attention and staying home when sick,” said Health Secretary Alfredo Vigil, MD. “We have to all work together to minimize the spread of the disease and manage our medical resources in the best way possible so we can care for those most at risk for serious complications.”
     

    The Department of Health is recommending the following:
     

    People who are experiencing typical, mild symptoms of influenza and are not at higher risk for flu complications should stay home and avoid public places until they are well. Typical, mild symptoms include fever, sore throat, and cough.
     

    People who are experiencing typical, mild symptoms of influenza and are at higher risk for complications should call their healthcare provider or Nurse Advice New Mexico for consideration for treatment with antiviral medications. Nurse Advice New Mexico can be reached toll-free at 866-681-5872.
     

    People who develop severe symptoms of influenza should seek care immediately from their healthcare provider or the emergency room. Severe symptoms include shortness of breath, rapid breathing, dehydration, or decreased responsiveness.
     

    People who are at higher risk for developing complications from H1N1 and seasonal flu are:
     

    Children younger than 2 years of age
    Adults 65 years of age and older, and
    Persons with the following conditions:
    Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus)
    Immunosuppression, including that caused by medications or by HIV
    Pregnant women
    Persons younger than 19 years of age who are receiving long-term aspirin therapy
    Residents of nursing homes and other chronic-care facilities


    People with influenza in a higher risk group should be treated with antiviral medications ideally within 48 hours after developing symptoms.

     

    To prevent the spread of the flu everyone should wash their hands frequently and cover their mouth and nose when sneezing and coughing. Stay home if you are ill and keep your kids home when they’re sick until 24 hours after the fever is gone.


    The Department of Health reported Oct. 7 that visits to healthcare providers for influenza-like illness increased to 10. 5 percent this week, which is an increase from approximately five percent from the week prior. During the peak of last year’s flu season in March of 2009, approximately three percent of all visits to providers were due to influenza-like illness. The number of people who have been hospitalized increased from 85 to 140 people this week.


    The hospitalizations by county are as follows: Bernalillo County (16), Chaves County (5), Cibola County (4), Doña Ana County (13), Eddy County (5), Guadalupe County (1), Lea County (2), Lincoln County (2), Los Alamos County (1), Luna County (1), McKinley County (21), Otero County (6), Rio Arriba County (5), Roosevelt County (2), San Juan County (12), Sandoval County (3), Santa Fe County (6), Sierra County (4), Socorro County (4), Taos County (9), Valencia County (3) and 15 cases where residence has not yet been determined.


    For more information about H1N1 flu in New Mexico, go online to http://nmhealth.org/h1n1/index.shtml

     

     

    1009 Health improves in some but not all realms for King County residents, as shown by new Community Health Indicators [King County Washington]--King County residents continue to enjoy generally improved health in many areas with long life expectancies and low mortality from injuries and some chronic diseases. However, some trends are worsening or not improving, and health gains are not being experienced equally by all communities.

    These and other health trends can be found in the completely-updated Community Health Indicators, a project that provides comprehensive data and health trends in accessible formats to members of the community, organizations and researchers. Visit: www.kingcounty.gov/health/indicators.

    "A key strategy in creating healthier communities is to identify and measure areas of work and for improvement," said Dr. David Fleming, Director and Health Officer for Public Health Seattle & King County. "The Community Health Indicators provide us and our residents with user-friendly information that can lead to actions."

    Community Health Indicators provides information on a range of health indicators including life expectancy, causes of death, maternal and child health, chronic diseases, communicable diseases, access to care, and risk factors such as obesity, physical activity and smoking. Data, graphs, and maps show how these indicators vary by age, race/ethnicity, poverty, gender, and geography in the county.

    King County residents are doing relatively well compared to U.S. statistics and similar counties nationwide, but the county is not meeting many of the national Healthy People 2010 goals.

    Community Health Indicators reports:

    * In 2007, King County residents overall had a life expectancy at birth of 81.5 years, but African Americans and American Indian/Alaska Natives on average had lower life expectancies.
    * Cancer and heart disease are the leading causes of death in King County. Unintentional injuries are the leading cause of death for residents between the ages of 1 and 44.
    * Health gains are not being experienced equally. Large racial, income and geographic inequities continue.

    Health improvements:

    * Injuries: Deaths from homicide, suicide, and motor vehicle accidents continue to decline.
    * Chronic diseases: Deaths from breast cancer, colorectal cancer, heart disease and stroke continue to decline.
    * Smoking continues to decline among King County adults.

    Health concerns:

    * 12.5%, or about 153,000 King County adults age 18-64, reported no health insurance coverage in 2008.
    * The adolescent birth rate is no longer continuing a decade-long decline and is rising in portions of the county.
    * Increasing percentages of mothers/infants received either no prenatal care during pregnancy or began prenatal care late, in the third trimester. Late or no prenatal care can lead to worse pregnancy outcomes.
    * Both obesity and deaths related to diabetes continue to increase.
    * Almost 70% of King County residents met physical activity recommendations in 2007, and 85% reported at least some physical activity in the last month. However, 20-30% of the people of color, low income individuals, and south county residents did not participate in any physical activity.

    Community Health Indicators at www.kingcounty.gov/health/indicators also includes links to AimsHigh, the King County performance indicator website, where users can view closely related data on Public Health performance.

     

     

    1009 H1N1 Flu infection contributes to death of Bannock County teen [Idaho]--The 2009 H1N1 pandemic flu virus has contributed to the death of a Bannock County teen. The adolescent, who had underlying risk factors, died from flu complications during the past week. This is the second Idaho death related to H1N1 infection, but the first in a person under the age of 25.

    “Deaths in children and young adults are especially tragic,” says Dr. Christine Hahn, M.D., Idaho State Epidemiologist. “Our hearts go out to the family and community. The H1N1 virus has caused a concerning number of serious illnesses in young people, so it is important for all of us to do our part and stop the spread of flu infections.”

    A total of 620 people in Idaho have lab confirmed infections from the 2009 H1N1 pandemic flu virus since April, with 283 of those reported since September 1. Idaho’s first H1N1-related death occurred in late September in a Canyon County man in his 50s whohad an underlying medical condition.

    The first shipments of vaccine for the H1N1 virus began arriving in the state this week. Although the initial supply is limited, larger quantities of vaccine are anticipated to be available for public vaccinations over the next two to three weeks. Children and young adults under the age of 25 are considered high risk and are among the groups for whom vaccine is recommended.

    Because of the initial limited vaccine supply, parents of children with underlying medical conditions should be extra vigilant in monitoring their children for flu-like symptoms. This includes children with asthma, diabetes, cerebral palsy or other chronic neurodevelopmental condition.

    In the coming weeks as it becomes available, vaccine is recommended for people who are high-risk for 2009 H1N1 pandemic flu infection. This includes:
    · Pregnant women,
    · Children and young adults from 6 months through 24 years of age,
    · Household contacts and caregivers for children younger than 6 months of age,
    · Healthcare and emergency medical services personnel,
    · Persons aged 25 through 64 who have health conditions associated with higher risk of medical complications from influenza.

    Symptoms of H1N1 pandemic infection are similar to seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue, with some reports of diarrhea and vomiting. “Most children and adults with the flu who are generally in good health will recover without needing to visit a doctor or other health care provider,” Dr. Hahn says. “Children and adults who are ill and at high risk for flu complications, and people with more severe flu symptoms, should call their regular health care provider.” Dr. Hahn recommends that when possible, people should contact their health care provider to get advice on whether they need to be seen.

    Detailed information about the 2009 H1N1 pandemic virus is available from:
    · The Idaho Department of Health and Welfare’s website at www.panflu.idaho.gov.
    · The Centers for Disease Control and Prevention’s website at www.cdc.gov/h1n1lflu/
    · U.S Dept. of Health and Human Services website at www.flu.gov
    · Centers for Disease Control and Prevention Hotline: 1-800-CDC-Info (1-800-232-4636).

     

     

    1009 H1N1 Second death reported as flu is widespread in state [Wyoming]--The second death of a Wyoming resident infected with the swine (novel H1N1) influenza virus has been reported to the Wyoming Department of Health as flu activity continues to be high and widespread across the state.

    The adult female resident of Laramie County had underlying health conditions linked with higher risk of severe illness.

    “This death is certainly sad to acknowledge. Unfortunately, a few people die in Wyoming every year due to flu complications,” said Dr. Tracy Murphy, state epidemiologist with the Wyoming Department of Health. “We have known this would also be likely with H1N1.” In the previous nine years, up to 11 flu-related deaths have been reported per year in Wyoming.

    “Flu activity around Wyoming right now is high. In fact, case numbers are as high or higher than the peaks reported during a number of recent winters with seasonal influenza,” Murphy said.

    Since late May, 1014 cases of influenza have been reported to the department. A very large (58 percent) portion of this total has been reported over the last three weeks. The department expects the number of actual flu infections around the state to be much higher because most ill persons do not seek medical care or are not tested.

    Over the same timeframe, the department has received reports of 19 hospitalizations among Wyoming residents in connection with the swine flu virus. “As our overall flu numbers climb, we can expect to see more hospitalizations and possibly deaths in our state,” Murphy said.

    Murphy said the department’s surveillance shows Wyoming’s flu activity is almost 100 percent due to the novel H1N1 flu strain. “The illness remains similar to seasonal flu, and isn’t showing any indications of change,” he added. Influenza symptoms include fever, cough, sore throat, body aches, headaches and fatigue. Some patients also report diarrhea and vomiting. 

    “Everyone should watch for signs and symptoms of flu and take proper precautions should illness appear,” Murphy said. Recommended measures to slow the spread of illness include:

    When available, get immunized with both a swine flu and a seasonal flu vaccine.

    In general, people who develop influenza-like illness should stay home from work, school or travel until at least 24 hours after they are free of fever. Those who are severely ill (such as having trouble breathing) should seek medical care.

    Avoid contact with ill persons.

    Frequent hand washing with soap and water or the use of an alcohol-based hand gel.

    Covering noses and mouths with a tissue or sleeve when coughing or sneezing, and throwing used tissues in a trash can.

    Of the total 1014 reported flu cases in Wyoming since late May, 341 have been confirmed as swine flu cases. Specific swine (novel H1N1) flu counts provided by the department only reflect cases confirmed by specialized lab testing as the H1N1 strain as part of the department’s ongoing surveillance activities.

    More information about swine flu in Wyoming is available online at www.health.wyo.gov.

     

    1009 H1N1 Both seasonal flu and H1N1 vax to be available [Colorado]--While some scheduled seasonal influenza vaccination clinics have been postponed, the Colorado Department of Public Health and Environment reports there should be adequate seasonal influenza vaccine available as we proceed through the rest of October and into November.

    There appears to be a delay, not a shortage, of seasonal flu vaccine, said Chief Medical Officer Ned Calonge. The estimated seasonal flu vaccine production for 2009-10 influenza season is approximately 114-115 million doses nationwide, a record number of doses and more than we have ever given in a single season.

    Approximately 70 million doses of seasonal flu vaccine have been distributed as of Sept. 25. This is approximately 61 percent of the doses that are expected to be distributed for this season, so a substantial amount still will become available.

    Typical seasonal flu vaccination efforts are in full swing in October and November, said Calonge. We anticipate this year seasonal flu vaccination efforts will follow this trend and will continue through the next couple of months.

    This year, with both seasonal and H1N1 influenza circulating in the state, it is important for people to get both vaccines to protect themselves from these viruses. Seasonal influenza vaccines already have been available in the state, and more doses will continue to arrive through the fall, said Calonge.

    Coloradans can go to http://www.immunizecolorado.com and click on the link for find a flu clinic. They can search by city, town or zip code to find locations where vaccines are available. People also can call the CoHELP hotline at 1-877-462-2911.

    2009 H1N1 vaccine

    Later this week, local public health agencies and hospitals in Colorado will begin receiving the first doses of the H1N1 vaccine. These initial doses will be used to protect health care workers who can protect themselves and their patients by getting the vaccine.

    People should know that with just 50,000 doses of the H1N1 vaccine arriving in the state this week, under federal guidance these are intended for health care workers, said Calonge. The initial doses are a live, attenuated influenza vaccine that is recommended only for healthy individuals, ages 2 through 49, with no underlying health conditions.

    Colorado will receive more than one million doses of H1N1 vaccine arriving in increments into mid-November, with the biggest shipments arriving in November.

    We are currently seeing an H1N1 flu wave, with virtually no seasonal flu, said Calonge. We usually do not start our campaigns for seasonal vaccine until October and on average give most of our vaccine in late October through mid-November. The seasonal and 2009 H1N1 flu vaccination campaigns will overlap this year.

    To help people anticipate when the seasonal and H1N1 vaccines are likely to be available, please consider the following.

    Seasonal influenza vaccine

    Doses of this vaccine already have been arriving in the state and are available at some locations. Visit http://www.immunizecolorado.com to find the dates and locations for availability. As doses continue to arrive, please continue to check the Web site or call CoHELP at 1-877-462-2911 for information.

    2009 H1N1 influenza vaccine

    The initial doses arriving this week are nasal flu mist that is not appropriate for pregnant women, those with underlying health conditions or children under 2 years of age. These initial doses are intended for health care workers with direct patient care responsibilities.

    When the additional shipments arrive in the coming weeks, health departments will begin to make vaccine available for high-priority groups. The Colorado Department of Public Health and Environment expects significantly larger shipments of the vaccine supply to arrive in November. Through the winter, there will be an adequate supply to vaccinate all those who are interested.

    In addition to health care workers involved in direct patient care, high-priority groups include pregnant women; household contacts of children under age 6 months; children, adolescents and young adults age 6 months to 25 years; and adults up to age 65 years if they have underlying chronic illness that puts them at increased risk for complications of the flu. Within this group of individuals, the vaccine will first go to pregnant women; caregivers for infants under 6 months (because young children cannot receive the vaccine); other children under age 5; and individuals 5 to 18 years of age with chronic conditions, who seem to be having more difficulty dealing with the flu.

    Once supplies are available, getting vaccinated is the single best way to protect yourself against the flu, said Calonge. Please check the Immunize Colorado Web site or call CoHELP for vaccination locations and dates. Until then, we continue to urge good handwashing, keeping ill children at home, and not going to work when you are ill.

     

    1009 ER staff can help detect and prevent domestic violence [Utah]--New data released today by the Utah Department of Health (UDOH) show that emergency department staff are in an important position to uncover and ultimately stop the cycle of domestic abuse.


    A survey conducted in Utah EDs found 58% of staff in urban areas (Davis, Salt Lake,
    Utah, and Weber counties) report they routinely ask patients about domestic/intimate
    partner abuse. However, the opposite was seen in rural EDs, where just 43% report
    bringing up the subject of domestic abuse with patients.


    “Emergency doctors and nurses have a unique opportunity to broach the subject of abuse when a patient comes in for treatment of an injury,” said UDOH Violence Prevention Specialist Katie McMinn. “While it’s terribly sad when a patient admits to being hurt by a partner, it’s a chance for specialists to intervene and get the victim help.”
     

    And, says McMinn, it’s critical that ED staff receive the proper training to recognize
    domestic and intimate partner violence. The survey found that more than half (55%) of
    ED staff members feel they’re inadequately trained to screen, assess, and make referrals
    for victims of abuse. At the same time, 84% say they want to receive such training.
     

    “Emergency department staff can be important allies for battered women,” said Barbara
    Ferrara, Emergency Room Care Manager at Intermountain Medical Center.

     

    The UDOH and the Utah Domestic Violence Council Health Care Committee provide
    training to health care providers on how to screen and assess patients suspected of being victims of domestic and intimate partner violence. A training manual is available free of
    charge to providers at http://health.utah.gov/vipp.


    “The manual gives doctors and nurses the skills they need to properly treat families of
    domestic violence,” said University of Utah pediatrician Kathy Franchek, M.D. “When
    health care providers know what to look for, we’re able to ask the right questions to
    identify victims of abuse, and then give these individuals and families the care and
    support they need to get out of abusive situations.”
     

    The survey also showed:


    • 81% of EDs in urban areas had printed information about local domestic violence
    resources available for patients. This was an increase of 20% from 2003.
    • Despite the increase in available resources for patients, EDs in urban areas
    reported a 25% decrease in the amount of materials actually given to patients
    since 2003.
    • In rural area EDs, an increase of 53% was seen in printed resources available and.
    the amount of materials given to patients increased 37%.
    • Overall, the top five obstacles for identifying abuse were:
    Patient didn’t want to talk about the abuse (96%);
    Patient was under the influence of drugs or alcohol (92%);
    Patient feared repercussions (88%);
    ED staff were not trained to interview victims of abuse (82%); and
    ED staff felt it was frustrating to screen for abuse because they could do little to help (76%) and there were language barriers (76%).


    To download a report of the survey results or the updated training manual, visit
    http://health.utah.gov/vipp.

     

     

    1009 H1N1 Flu vax is safe and important during pregnancy [Utah]--This flu season, new mothers and mothers-to-be should be among those who are first in line for influenza vaccine. The Utah Department of Health (UDOH) encourages women who are pregnant or breastfeeding and anyone caring for infants under six months of age to get both the H1N1 and seasonal influenza vaccines.
     

    Pregnant women in Utah were at increased risk of medical problems from H1N1 infection during the outbreak last spring and summer. Twenty-one pregnant women were hospitalized with H1N1 infection, representing 7% of all hospitalizations in Utah. In addition, the Centers for Disease Control and Prevention reports that, nationally, previously healthy mothers-to-be made up 13 percent of all H1N1 deaths. That increased risk is of great concern to health experts in Utah.
     

    “The hormonal changes that occur in pregnancy increase stress on the heart and lungs,
    speeding up the heart rate, lowering lung capacity, and potentially creating serious illness for pregnant women who get influenza and their unborn children,” said Dr. Michael
    Varner of the University of Utah Department of Obstetrics and Gynecology.
     

    Health officials around the state want women to be confident that the vaccines are safe, and necessary, in pregnancy.
     

    “Both the H1N1 and seasonal influenza vaccines are produced using standard methods
    that have been unchanged for many years,” said Dr. David Sundwall, Executive Director,
    UDOH. “And in all those years, no influenza vaccine has ever been known to increase
    the risk of birth defects or any other pregnancy problem,” he added.

     

    Dr. Al Romeo, counselor with the UDOH Pregnancy Risk Line, says experts across the
    country agree that the benefits of getting vaccinated against influenza and keeping
    pregnant women healthy outweigh any risk to a developing fetus. “In fact, researchers
    have looked at previous influenza outbreaks and documented a higher rate of
    miscarriages and premature births during influenza pandemics,” said Romeo.
     

    Each year, new influenza strains are identified and added to the seasonal influenza
    vaccine “mix” for the following year. Because the H1N1 virus appeared too late to be
    added to the mix, adults will need two vaccines this year; the seasonal and H1N1.
     

    Two types of vaccines are available for seasonal and H1N1 influenza infection; injectable
    and nasal spray. The injectable vaccine is made from dead influenza virus and is
    recommended for pregnant women, while the nasal spray form contains live virus and is
    not approved for use in pregnant women.
     

    In addition to getting vaccinated, take these steps to reduce exposure to influenza:
    Wash hands frequently,
    Cover mouth while coughing and sneezing,
    Limit contact with others in the household who may be ill, and
    Stay home when ill (except when seeking medical care).


    To find out where to get either an H1N1 or seasonal influenza vaccine, visit
    www.immunize-utah.org or call 2-1-1.


    For answers to questions about the safety of vaccines and medications in pregnancy and breastfeeding, call the Pregnancy Risk Line 1-800-822-2229.


    See the H1N1 and Seasonal Flu Vaccine: What Every Pregnant Woman Must Know
    brochure at http://www.health.utah.gov/rhp/pdf/H1N1_Vaccine.pdf.

     

     

    1009 H1N1 DoH confirms additional death related to flu [Hawai'i]--The Hawai‘i State Department of Health (DOH) has confirmed novel H1N1 influenza infection in an adult male in his 50s who died at Tripler Army Medical Center on O‘ahu. This brings the total number of deaths in Hawai‘i with laboratory confirmed 2009 H1N1 Influenza to 11.

    The O‘ahu resident had a number of underlying medical conditions that contributed to his decline and death. No further information about patient medical conditions before death or identification will be released due to patient privacy considerations and federal law.

    "The patient had multiple, additional co-morbidities and these conditions were contributing factors to his death," said Dr. Sarah Park, Chief of the Disease Outbreak Division and State Epidemiologist. "We are continuing to monitor critical case testing and focused clusters to help identify if this pandemic virus changes into something that causes more severe disease."

    Similar to what has been observed nationally, underlying conditions such as obesity, smoking, asthma, heart disease, diabetes, and respiratory difficulties have been contributing factors in novel H1N1-related hospitalizations and deaths in Hawai‘i.

    The U.S. Centers for Disease Control and Prevention has information at cdc.gov/h1n1flu/pregnancy/ for pregnant women, who may also be at increased risk for complications from H1N1 influenza infection.

    The public is urged to take the following steps to prevent spreading illness to others:

    • Get a seasonal flu vaccination and the 2009 H1N1 flu vaccination when it becomes available. This is especially important for high-risk groups.

    • If you become sick, stay at home; isolate yourself from others whenever possible;

    • Cover your cough or sneeze with a tissue and dispose of used tissues;

    • Wash your hands frequently, or use an alcohol-based hand sanitizer;

    • Avoid touching your eyes, nose, and mouth;

    • Seek care if you have flu-like illness (fever > 100°F plus cough or sore throat); and

    • Stay healthy by eating a balanced diet, drinking plenty of water, and getting plenty of rest and exercise.

    On October 5, Hawai‘i received its first shipment of H1N1 vaccine. DOH continues to place vaccine orders according to demand and allocation numbers. Initially, priority groups will be the first to receive the vaccine, and as more becomes available and demand is met, the entire public will be encouraged to receive the vaccine.

    In accordance with CDC guidelines, the DOH will give first priority to the following high-risk groups for H1N1 vaccination:

    • Healthcare and emergency medical services personnel with direct patient contact;

    • Pregnant women;

    • Household contacts and caregivers for children younger than age 6 months;

    • All people from age 6 months through 24 years; and,

    • Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

    For more information on H1N1 influenza or the vaccine, please visit flu.hawaii.gov, or call Aloha United Way at 2-1-1. The DOH also is on Twitter. Follow us at www.twitter.com/HIgov_Health.

     

    1009 H1N1 Get vax'd - state public health director [California]--With the state's H1N1 death toll at 206, the director of the California Department of Public Health (CDPH), Dr. Mark Horton, on Thursday urged Californians to get vaccinated against the H1N1 flu virus in the weeks ahead.

     

    He also highlighted new tools to fight the flu, including features on the Department’s Web site and a video contest aimed at promoting steps people can take to prevent illness.

    “We face an unusual challenge that requires all of us to be prepared in the months ahead,” said Horton in reference to the widespread infection of the H1N1 virus in California that has now hospitalized 2,748 people and killed 206. “Part of that response is staying informed, learning if you are in a targeted group for vaccination and making plans to get vaccinated as the vaccine continues to arrive in our state.”

    Approximately 400,000 doses of H1N1 nasal spray vaccine arrived in California this week. More doses are expected in the coming weeks, including the injectable version of the vaccine.

    “As vaccine will be delivered to us in weekly allotments through the fall and early winter, we need to ensure that the early doses get to the targeted groups,” said Horton, “but, we fully expect that, in time, enough vaccine will be available for everyone.”

    Children from two through 18 years of age are the targeted group for the initial doses of the nasal spray vaccine. Healthy people under 50 years of age who are parents and caregivers of children younger than 6 months of age are also part of the initial target group. Pregnant women and healthcare workers should be at the head of the line for the first doses of injectable vaccine when it arrives in the state later this month.

    Horton also directed the public to the CDPH Web site as a source of information. The site includes audio recordings from doctors, videos and printed materials for businesses, schools, health professionals, pregnant women and travelers. Much of the information is available in both English and Spanish.

    The “CDPH Film Fest — Lights, Camera, Save Lives” is another CDPH effort underway to help Californians learn more about preventing the H1N1 virus. The deadline for the video competition is October 16. Contestants are asked to produce a short video that will motivate people to take steps to help prevent the spread of H1N1 and seasonal flu.

     

     

    1009 Lights, camera, save lives! Video contest deadline approaching [California]--The deadline to post videos to the “CDPH Film Fest — Lights, Camera, Save Lives” video contest is Friday, October 16.  The contest, launched by Governor Schwarzenegger in early September, challenges Californians to create a short video in English or Spanish that highlights the steps to avoid H1N1 and seasonal flu. There will be four winners selected from two language categories, English and Spanish, and a gold and silver award will be granted in each category.

     

    The grand prize is a $500 gift card provided by the non-profit California Immunization Coalition and all four of the selected winning videos will air on television and be featured on Web sites.

    “As the flu season swings into high gear, it is critical that Californians learn about the simple but effective ways of protecting themselves from the seasonal flu and H1N1 virus,” said Dr. Mark Horton, director of CDPH.  “I have been impressed by the high level of creativity shown in the initial entries, and look forward to receiving more submissions.”

    Both amateur and professional California residents age 14 and older are invited to create a 15, 30 or 60 second video that will motivate people to take steps that will help prevent the spread of H1N1 and seasonal flu. The video must promote one or more of the following health messages:

    • Get vaccinated
    • Wash your hands frequently, especially after you cough or sneeze
    • Cover your cough or sneeze with a tissue or your sleeve
    • Stay home if you are sick

    For contest details, including rules, resources and video ideas, visit
    CDPHfilmfest.org. 

     

     

    1009 CDPH publishes study on autism and maternal and paternal age [California]--Reviewing a larger population than in any other study of its kind, the California Department of Public Health (CDPH) has found that as parents age their risk of giving birth to a child with autism increases modestly.


    Published in the American Journal of Epidemiology, the new CDPH study shows that for each 10-year increase in a mother’s age, the risk of autism increased by about 38 percent.  For each 10-year increase in a father’s age, the risk of autism increased by about 22 percent.

    In the past, experts agreed that about 1 in 160 young children in the United States have an autism spectrum disorder. Recent data, however, from two government studies, the
    federal government's 2007 National Survey of Children's Health, and the Centers for Disease Control and Prevention, suggest that the frequency of these disorders may be as common as 1 in 100 children.

    “The causes of autism remain largely unknown,” said Dr. Mark Horton, director of CDPH. “This study provides clues to further our understanding of this disease. Additional research is needed to learn more about how parental age is linked to autism.”

    Using data from the California Department of Developmental Services (DDS), researchers examined birth certificate records for 20,701 children with autism and 6,505,555 children without autism born from 1989 to 2002. The increased risk of autism was greatest among first-born children and declined among second-born and later-born children. In addition, the link between parental age and autism was not due to other factors such as education, sex, race or ethnicity.

    “This study adds another piece of information to the body of research on autism,” said Dr. Linda Rudolph, deputy director of CDPH, Center for Chronic Disease Prevention and Health Promotion. “We do not know why the risk for giving birth to a child who will be diagnosed with autism seems to increase modestly as parents age. There are still more questions than answers; there is far more work to be done to better understand autism and autistism spectrum disorders.”

    Once considered rare, autism and autistism spectrum disorders (ASD) now are more prevalent than Type I diabetes, Down syndrome or childhood cancer. People who have autism now outnumber people with cerebral palsy, and are soon projected to exceed those diagnosed with epilepsy. Currently there are more than 38,000 people in California receiving services from the state’s Department of Developmental Services for autism and ASD, growth that has averaged 13.4 percent annually since 2002.

    Autism is a neurological or brain disorder that profoundly affects a person’s ability to communicate, form relationships with others, and respond appropriately to the environment. Children who have the neurodevelopmental disorder associated with autism generally show little interest in other people and fail to learn from their natural environments as successfully as other children. Although some children with autism can develop typical or advanced skills, the majority exhibit a wide range of behavioral, cognitive, and emotional challenges. 

    Parents should consult their health care provider if developmental delays are suspected and also contact their local
    Regional Center which serve persons with developmental disabilities and their families. 

    Click here for additional information about autism and DDS resources.

    The study is called “
    Risk of Autism and Increasing Maternal and Paternal Age in a Large North American Population.” 

     

    1003 H1N1 : State records three new deaths associated with H1N1 flu [Minnesota]--The Minnesota Department of Health (MDH) today announced that three people have died recently from complications due to infection with the H1N1 novel influenza virus. They were a Watonwan County woman in her 40s, a Dakota County woman in her 50s and a Ramsey County man in his 50s. All died within the last two weeks and all had underlying health conditions. These cases bring to six the total of deaths related to the H1N1 outbreak since last April.

    The department has been awaiting medical confirmation on the causes of the deaths before announcing them.

    "Losses such as this are always difficult to bear and to understand. Our sympathies are with their families and loved ones," said Dr. Sanne Magnan, Minnesota Commissioner of Health. "For most people, the H1N1 flu is not severe; however, it can still be very serious, especially for people with underlying health conditions. That's why we continue to monitor the situation closely."

    The deaths, while appearing to occur in a cluster, do not indicate a significant change in the course of the disease, health officials said. "We have expected that we might see additional deaths from H1N1 novel influenza when the illness became widespread," said Dr. Ruth Lynfield, state epidemiologist for MDH. "We know that H1N1 novel influenza, like seasonal influenza can cause severe illness and even death in some people. However, we are not seeing any change in the overall severity or virulence of the disease."

    To date, MDH has reported 324 hospitalized cases of confirmed H1N1 novel influenza, 39 of these hospitalizations have occurred in the past two weeks. In addition, last week 134 schools reported to MDH that they had either five percent of their student body absent or three students in an elementary school classroom absent due to flu-like illness. It is unknown how much of that illness is H1N1 or another flu-like illness; however, health officials believe that the new strain of flu that first appeared last spring is likely playing a significant role in the upsurge.

    "This flu is very widespread, and we expect to see many more cases across the state," Lynfield said. It is really important that people stay home when sick to decrease the spread of illness. We expect H1N1 vaccine to be available in the coming months and we recommend that people get vaccinated to protect themselves against H1N1 novel influenza, especially those individuals that are at high risk for severe disease from H1N1 influenza. It is also very important that health care workers get vaccinated."

     

     

    1003 H1N1 : First supply of H1N1 vaccine will go to healthcare and emergency medical workers [Minnesota]--Minnesota will soon receive its first supply of vaccine for the novel H1N1 influenza virus, according to an announcement today from the Centers for Disease Control and Prevention (CDC). The state will receive 28,000 doses of a weakened live virus vaccine in the form of a nasal spray.

    This initial shipment of the vaccine will be administered to health care and emergency medical workers. These workers are targeted because they are at risk of being exposed to the virus, and they could expose medically vulnerable patients to the virus if they get sick. In addition, there could be a significant impact on the health care system if they get sick and have to miss work.

    "By administering the vaccine first to health care and emergency medical workers, we are helping to ensure that our health care system is in good shape to care for Minnesotans who become ill," said Dr. Sanne Magnan, Minnesota Commissioner of Health. "Allocating this initial supply of vaccine to health care and emergency medical workers is consistent with the CDC's recommendations."

    The CDC estimates that more than 150 million doses of vaccine will ultimately be available throughout the U.S. This means that anyone who wants the vaccine should be able to get it. Because the vaccine will be distributed to states in various quantities over the coming weeks, those at highest risk of complications from the novel H1N1 influenza will be targeted to receive the vaccine first. High-risk individuals include:

    * Pregnant women.
    * People who live with or care for children younger than 6 months of age.
    * Health care and emergency medical services personnel.
    * People between the ages of 6 months and 24 years old.
    * People 25 through 64 years of age who are at higher risk for H1N1 because of chronic health disorders or compromised immune systems.

    More information will be made available by the Minnesota Department of Health (MDH) when additional supplies of the vaccine arrive. In the meantime, MDH officials continue to urge Minnesotans to get the seasonal flu vaccine. People should contact their health care provider or check the flu shot clinic finder at www.mdhflu.com to find a time and place where they can get vaccinated.

     

     

    1003 H1N1 : State expecting first doses of H1N1 vax to arrive next week [North Dakota]--The North Dakota Department of Health has received information from the U.S. Centers for Disease Control (CDC) that the first doses of novel H1N1 influenza vaccine will be arriving in the state next week. The state will receive an initial supply of 4,000 doses in the form of a nasal spray called FluMist.


    This initial shipment of FluMist vaccine will be given to health-care workers in North Dakota. FluMist vaccine cannot be given to young children, pregnant women, people with chronic health conditions or those older than 50. Therefore, the decision was made to give these initial doses to health-care workers who are at high risk of being exposed to the virus and who could expose patients who are at high risk because of medical conditions. This will help to ensure that doctors and nurses remain on the job to care for others.


    “Vaccine is going to come into the state in increments over the next few weeks,” said State Health Officer Terry Dwelle, M.D. “We are starting with health-care workers with these first doses, but we expect much more vaccine to be available in the coming weeks. As we receive more vaccine, more people will be able to be vaccinated, and we should have enough vaccine available for anyone who wants it. We encourage people to keep informed through our website and the media about vaccine availability and to get the vaccine when it is available for them.”


    The CDC estimates that more than 150 million doses ultimately will be available in the U.S., and North Dakota should receive more than 380,000 doses. The North Dakota Department of Health will continue to release information as more vaccine becomes available in the state.

     

     

    1003 H1N1 : DHH and LHSAA team up to beat H1N1 [Louisiana]--The Louisiana Department of Health and Hospitals (DHH) and the Louisiana High School Athletic Association (LHSAA) are teaming up to help reduce the spread of H1N1, also known as the swine flu. Beginning this month public service announcements regarding H1N1 vaccination and hygiene will be announced over the public address systems at high school football games and other sporting events throughout the state.

    DHH Secretary Alan Levine said the department wants the message to reach as many people as possible. "The U.S. Centers for Disease Control strongly advises every American take appropriate steps to protect themselves and their families. These PSAs will be heard by students, one of the high-risk groups identified by the CDC. We hope these announcements will encourage students and their families to fight the flu by getting immunized and by using good hygiene habits."

    The announcements will promote the CDC’s hygiene recommendations:

    * Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
    * Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
    * Avoid close contact with sick people.
    * If you get sick stay home, and limit contact with others to keep from infecting them.
    * Avoid touching your eyes, nose or mouth. Germs spread this way.
    * By getting both your seasonal flu shot and the H1N1 vaccine when it becomes available, you can stop yourself from getting sick and spreading the disease to others.

    LHSAA will also link from their website to DHH’s flu website, www.FightTheFluLA.com,  where people can get up-to-date information regarding H1N1 and seasonal flu.

     

     

    1003 ILI : Seasonal flu vax to be available for high-risk groups at parish health units [Louisiana]--Louisianians that are at high-risk for seasonal flu will be able to receive their seasonal flu shot beginning next week at parish health units across the state.

    The Department of Health and Hospitals (DHH) will distribute approximately 60,000 doses of seasonal flu vaccine across the state in the coming months, with health units receiving and distributing a proportionate share based on the number of high-risk residents each unit serves.

    DHH’s Immunization Program has already distributed approximately 40,000 seasonal flu vaccines to nursing homes statewide and has been providing seasonal flu vaccines to Vaccines for Children providers for the past few weeks.

    "It is especially important that everyone get a seasonal flu vaccination this year with the double threat of seasonal flu and H1N1 flu," said DHH Secretary Alan Levine. "It protects those who are vulnerable, and also protects our community by reducing spread. This will not only keep our people healthier, but will also ease pressure on hospitals and private providers this flu season."

    State Health Officer Jimmy Guidry, M.D., stated that "Most people receive the seasonal flu vaccination through private providers, including pharmacists. Seasonal flu doses administered by parish health units are made available especially for residents in high-risk groups that would not otherwise have access to the vaccine. These groups are at the greatest medical risk of influenza complications."

    The high-risk groups for seasonal flu vaccination include:

    * All children 6 months through 18 years of age
    * People 65 years and older
    * Adults and children with pre-existing medical conditions such as asthma, diabetes, and cardiovascular disorders
    * Children who are residents of chronic care facilities
    * Pregnant Women

    The seasonal flu vaccine is also recommended for people who live with or care for those at high risk for complications from flu, including health care workers, household contacts of persons at high risk for complications from the flu, and household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated). Parish health units only serve high-risk populations, not all populations that the seasonal flu vaccine is recommended for. We encourage these other target groups to get vaccinated at their private provider or a community pharmacy.

    For more information on flu activity in Louisiana, including guidance for families and medical professionals, visit www.FighttheFluLA.com.

     

     

    1003 H1N1 : State reports first H1N1 death [South Dakota]--South Dakota has its first death from H1N1 influenza, the Department of Health reports today. The patient was a Shannon County resident in the 40-49 age group who had underlying health conditions. Because of state confidentiality statutes, the name and other details about the patient can’t be released.


    “We extend our sympathy to the family. Their loss should remind us all that influenza, whether seasonal or H1N1, can be a serious illness,” said Doneen Hollingsworth, Secretary of Health. “Unfortunately, we can expect to see more cases of H1N1 and more deaths are likely as well, just as we see each year with seasonal flu.”


    Since the beginning of the 2009-2010 flu season, South Dakota has reported 191 lab-confirmed cases of H1N1 flu and 25 hospitalizations. Pregnant women, young children, and individual with chronic health conditions appear to be most at risk for the H1N1 virus – 72% of confirmed cases and 61% of related hospitalizations in South Dakota are among those younger than 19.


    The state expects to begin offering H1N1 vaccine to high risk groups such as pregnant women and young children by mid-October. As those groups are immunized, the vaccine will be available to members of the general population as well.

     

    In addition to H1N1 vaccination, the department recommends the following steps to help prevent seasonal influenza, colds, and other respiratory diseases, including H1N1 flu:
    · Get vaccinated for seasonal flu.
    · Wash your hands often with soap and water and cover your mouth and nose with a tissue when you cough or sneeze.
    · Avoid close contact with people who are sick and stay home when you’re sick.
    · Practice other good health habits – get plenty of sleep, be physically active, manage stress, drink plenty of fluids, eat nutritious foods, and avoid smoking.


    Stay informed about H1N1 flu at the department’s web site, http://doh.sd.gov.  Information is also available from CDC at 1-800-CDC-INFO (1-800-232-4636) or the web at http://www.cdc.gov.

     

     

    1003 H1N1 : State places order for first shipment of H1N1 vax [South Dakota]--The state Department of Health has ordered its first batch of the new H1N1 vaccine and expects to receive the initial shipment the week of October 4. A state health official says only a small number of doses, about 5,000, will be in that first shipment but more doses will be ordered and shipped each week after that.


    When the department receives that first shipment, it will turn around and distribute it to hospitals so they can begin vaccinating health care workers in their areas as a first line of defense against H1N1. As more doses come in each succeeding week, they will be targeted to other priority groups for vaccination – pregnant women, young children, parents and caregivers for infants younger than 6 months, and children with chronic health conditions. Vaccine will be offered to these target groups through department community health offices, private clinics, and community clinics.


    “Health care workers are at high risk for the flu because of their close contact with infected people,” said Secretary of Health Doneen Hollingsworth. “It’s essential that they are among the first vaccinated so we can assure a healthy workforce that’s able to take care of the ill.”


    Hollingsworth said the vaccine will be targeted at those workers who have direct patient care contact. The initial shipment will be the nasal spray vaccine, which can only be given to healthy individuals between the ages of 2 and 49. It is not recommended for pregnant women.


    Federal health officials expect 186 million doses of H1N1 vaccine in the United States by January 2010, a total well above the number of doses ever given during any normal flu season.


    “There should be more than enough vaccine for everyone who wants it – we need to take care of the high risk groups first and the rest of us just need to be patient and wait until a little later in the season,” said the Secretary. “Every flu season we’re still promoting flu shots in December and even January because as long as the virus is circulating, it’s never too late to get the shot and be protected. The situation is the same with the H1N1 virus.”


    Flu clinics will be listed on the department’s web site, http://h1n1.sd.gov.

     

     

    1003 H1N1 : Fifteen deaths now linked to H1N1 flu [Alabama]--The Alabama Department of Public Health was notified Friday about the deaths of four additional individuals: a woman in her 30s and a man in his 60s from Montgomery County, a man in his 40s from Calhoun County, and a man in his 30s from Mobile County. Specimens showed all tested positive for 2009 H1N1 influenza.


    Previous deaths of persons positive for H1N1 influenza have occurred during 2009 in Bullock, Dale, Houston, Jackson, Jefferson, Macon, Madison, Montgomery, Russell and Talladega counties.


    The continued widespread incidence of 2009 H1N1 influenza in Alabama and the 15 known deaths in the state serve as reminder of the need for everyone to take steps to prevent transmission of disease and to be immunized for both seasonal and H1N1 influenza when vaccine becomes available.

     

     

    1003 H1N1 : Three additional deaths linked to H1N1 flu [Alabama]--The Alabama Department of Public Health has been notified in the past week about the deaths of three individuals: a man in his 60s from Talladega County, a woman in her 50s from Madison County, and a female in her 70s from Jackson County. Specimens showed they tested positive for 2009 H1N1 influenza.
     

    Previous deaths of persons positive for H1N1 influenza have occurred this year in Bullock, Dale, Houston, Jackson, Jefferson, Macon, Montgomery and Russell counties.
     

    The continued widespread incidence of 2009 H1N1 influenza in Alabama and the 11 known deaths in the state serve as reminder of the need for everyone to take steps to prevent transmission of disease and to be immunized for both seasonal and H1N1 influenza when vaccine becomes available.

     

     

    1003 H1N1 : DOH places first order for H1N1 flu vax and launches new info website [Hawaii]--The Hawai‘i State Department of Health (DOH) began placing orders today with the U.S. Centers for Disease Control and Prevention (CDC) for 2009 Novel H1N1 Influenza vaccine. The CDC has approximately 3 million initial doses of nasal-spray flu vaccine LAIV (FluMist®) available to the nation in this first series of shipments to all states that place orders. These initial shipments are expected to arrive during the week of October 5.


    “These initial shipments of H1N1 vaccine will be used to protect emergency medical service personnel, first responders and healthcare workers,” said Health Director Chiyome Fukino, M.D. “The State will follow CDC guidance and give first priority to high-risk groups that may be more vulnerable to serious complications from the H1N1 flu."


    In accordance with CDC guidelines, the DOH will give first priority to the following high-risk groups for H1N1 vaccination:
    • Healthcare and emergency medical services personnel with direct patient contact;
    • Pregnant women;
    • Household contacts and caregivers for children younger than age 6 months;
    • All people from age 6 months through 24 years; and,
    • Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

     

    Hawai‘i hospital facilities will be some of the first to receive the novel H1N1 vaccine to immunize their healthcare workers. The DOH is also working on other avenues of distribution that will include pre-registered primary care physicians; community vaccinators such as retail pharmacy chains and community health clinics; and school-located vaccination clinics scheduled to begin in November.


    According to the CDC, the first H1N1 vaccine doses received by all states will be the nasal spray live attenuated influenza vaccine (LAIV) or FluMist®. This form of vaccine is recommended for children two years of age or older and adults up to 49 years of age. It is not recommended for pregnant women or individuals with underlying medical conditions such as asthma. In addition to LAIV, injectable vaccine doses will be available in weekly shipments to states beginning in mid-October.


    The CDC estimates 10 million to 20 million doses of both forms of vaccine will be available for distribution nationwide each week after the first week in October. Hawai‘i was allocated 14,400 doses of vaccine to be able to draw from with its first order. H1N1 vaccine allocations can and most likely will come multiple times during the course of a week, so H1N1 allocation numbers will change frequently.


    Beyond the high-risk groups who will be targeted initially to receive the H1N1 vaccine, the DOH will be encouraging everyone to get vaccinated as it becomes more widely available. Meanwhile, everyone can continue to help stop the spread of influenza by getting their seasonal flu vaccination and through simple yet effective methods like covering your cough, washing your hands frequently, and staying home if you are sick.
     

    The DOH has launched a new website dedicated solely to information on influenza and the H1N1 vaccine in Hawai‘i.

     

    The website is accessible at hawaii.gov/health/about/H1N1.html and will include the latest information available on the H1N1 vaccine, when and where it will be available. The public may also receive the updates on H1N1 vaccine availability by following the DOH on Twitter, at twitter.com/HIgov_Health. Information on 2009 Novel H1N1 influenza is also available by calling Aloha United Way’s 2-1-1 helpline.

     

     

    1002 Health warning on certain imported dried plums containing elevated levels of lead [Colorado]--The Colorado Department of Public Health and Environment today warned consumers not to eat certain imported dried plums and products containing imported dried plums because they have elevated levels of lead.

    Most of the products typically are sold as salted or candied treats in Asian and Hispanic markets but also are available in other retail outlets. Health officials believe the dried plums came from Asia, but an investigation to identify specific sources is ongoing. Test results from the the Texas Department of State Health Services laboratory show the dried plums or products containing dried plums contain lead levels ranging from 0.11 parts per million to 30.3 parts per million.

    As an example in assessing acceptable lead levels, the U.S. Food and Drug Administration established a maximum of 0.1 parts per million for candy.

    A list of products and product photographs are available online at www.dshs.state.tx.us/foods/. The health department advises consumers to discard any of the products and to check the Web page periodically for updates. More dried plum products may be added as pending laboratory test results become available.

    A preliminary investigation by the Consumer Protection Division at the Colorado Department of Public Health and Environment has determined that, due to the potential widespread distribution of the products nationwide, it is likely this product may be available in Colorado. Daniel Rifkin of the Consumer Protection Division advises consumers with these products to discard them or return the items to place of purchase.

    Officials emphasized that the warning does not apply to dried plums or prunes from the United States.

    Lead can accumulate in the body over time. Too much lead can cause health problems, including delayed mental and physical development and learning deficiencies. Pregnant women, infants and young children especially should avoid exposure to lead. People concerned about blood lead levels should contact their physician or health clinic to ask about testing.

     

     

    1002 H1N1 : State expects small amount of 2009 H1N1 vax next week [Colorado]--Colorado is getting ready for the delivery of an initial 53,800 doses of 2009 H1N1 vaccine. The first doses are expected to arrive in the state next week, and are part of 2 million doses being distributed nationally.

    The initial doses, which will be FluMist nasal spray vaccine, will primarily be made available to Denver metropolitan-area hospitals for the vaccination of health care workers who have direct patient care responsibilities and all local public health agencies in every Colorado county. Later doses of vaccine will be shipped weekly and will include both the injectable and FluMist types of vaccine. These later shipments will be distributed to enrolled private providers and local public health agencies throughout Colorado.

    State health officials said the second allocation of the vaccine will begin on Oct. 9 and is estimated to total 4 million nationally, with an estimated 64,000 doses for Colorado. Quantities are expected to jump in week 3 nationally and in Colorado.

    Overall, Colorado expects to receive 1.6 percent of the national 2009 H1N1 vaccine supply and anticipates eventually having enough vaccine for all people who want to be vaccinated.

    Because FluMist uses a live, although weakened virus, there are additional restrictions placed on its use. Health care workers who get this vaccine must be healthy, 49 years of age or younger and cannot work directly with immunosuppressed patients. Additionally, FluMist is not recommended for pregnant women. Colorado expects to receive the influenza vaccine recommended for pregnant women in the subsequent weeks following the initial shipment in early October.

    The highest priority individuals for the 2009 H1N1 vaccine including the following:

    *Pregnant women
    *Household contacts of children under 6 months of age
    *Health care workers with patient care responsibilities
    *Children between 6 months and 4 years of age
    *Children 5 years to 18 years of age with underlying risk conditions

    For ongoing information about both seasonal and 2009 H1N1 flu vaccine, visit the Colorado Department of Public Health and Environment’s Web site at www.colorado.gov/nofluforyou or call the CO HELP line for answers to seasonal and H1N1 influenza questions at 1-877-462-2911.

     

     

    1002 H1N1 : Community readies for arrival of H1N1 flu vax [Washington]--The first, small amounts of H1N1 influenza (swine flu) vaccine have been released by the federal government and will be arriving locally next week in King County for immunization of health care workers. The larger amounts of vaccine that are needed to begin broader scale vaccination for people who are at higher risk for H1N1 are projected to begin arriving in mid-October.

    "This small, initial shipment will be targeted to health care providers, and subsequent doses that arrive later in the month will be prioritized to those who most need it because they are at higher risk," said Dr. David Fleming, Director and Health Officer for Public Health – Seattle & King County. "As soon as supplies are sufficient, everyone will have an opportunity to protect themselves from H1N1 influenza, and we're working to make the vaccine as easy as possible to get."

    Vaccine arrival and priority

    A small amount of 20,000 doses of flu vaccine for King County are expected to arrive next week. These first doses will be nasal-spray flu vaccine (FluMist®) and made available to healthcare providers who are eligible for FluMist® use (i.e., healthy people 2-49 years of age who are not pregnant). Healthcare providers are a priority group for vaccination, as they are at high risk for infection and could put vulnerable patients at risk.

    In mid-October, larger shipments of vaccine are expected to begin to arrive weekly and will be available for people at higher risk of H1N1 influenza as recommended by the Centers for Disease Control and Prevention:

    * Pregnant women
    * People who live with or care for children younger than 6 months of age
    * People between the ages of 6 months and 24 years old
    * People between 25 through 64 years of age with chronic health conditions or weakened immune systems

    Vaccine availability will be opened up to everyone who wants it as soon as supplies are sufficient to cover demand in risk groups.

    Ways to get vaccine

    As larger amounts of vaccine become available, it will be initially prioritized for use by medical providers but will also be available through multiple channels in the community, so that it will be as easy as possible for people throughout the community to get protection. More information will be forthcoming as vaccine becomes available for public distribution, including on Public Health's website at www.kingcounty.gov/health/H1N1

    Channels for receiving vaccine will include:

    * From regular health care providers – such as pediatricians, family practice doctors and obstetricians.
    * Pharmacies and other commercial vendors – like seasonal flu, most major pharmacy chains will offer H1N1 vaccine to the public.
    * Community vaccination clinics – Public Health will offer public vaccination clinics at community sites, such as community centers, Public Health Centers and at schools after hours. These clinics will be focused on vaccinating people who have limited or no access to the health care system.
    * Employers of health care and emergency medical services personnel will provide vaccine to their employees who provide patient care.

    Flu vaccine will be provided at no cost. Health care providers, pharmacies and commercial vaccinator will charge an administration fee approximately $15, but most insurers will reimburse costs. To ensure that cost is not a barrier to vaccination, no administration fee will be charged at community vaccination clinic sites.

    Types of vaccine

    There are two types of H1N1 flu vaccine:

    1. The injectable "flu shot" is given with a needle, usually in the arm. There are different formulations and dosing for the shot.
    2. Nasal-spray flu vaccine (FluMist®) is a weakened live virus vaccine that can be given to healthy people 2-49 years of age who are not pregnant, including household contacts of most people who are at highest risk for serious complications of the flu.

    Seasonal flu vaccine protects against three strains of seasonal influenza virus that may circulate this fall and winter. Seasonal flu is separate from the H1N1 influenza vaccine and is widely available from pharmacies and some healthcare providers now. Seasonal flu vaccine also comes in injectable and nasal-spray forms. People in high risk groups for seasonal flu strains (such as seniors) and anyone who wants it should get both H1N1 and seasonal influenza vaccines so that they are fully protected.

    Local flu activity

    As Public Health makes preparations for vaccine delivery, local monitoring for influenza has detected increasing levels of activity in the community through September, including higher numbers of people reporting with influenza-like symptoms in local emergency rooms. Flu activity is expected to continue to increase over the coming weeks to potentially high levels.

    People can help slow the spread of H1N1 influenza until the vaccine is available by taking simple steps, including:

    * If you are sick, stay home from work or school. Remain home for at least 24 hours after fever has passed (without the use of fever-reducing medications).
    * Cover coughs and sneezes with a tissue or inner elbow.
    * Wash hands often with soap and water, especially after coughing or sneezing. If access to soap and water isn't available, use an alcohol-based hand sanitizer.

    For updates and more information on H1N1 influenza visit www.kingcounty.gov/health/H1N1 or call the Flu Hotline, 877-903-5464, 24 hours/day (English and Spanish).

     

     

    1002 H1N1 : Dept of Health announces two deaths in children related to H1N1 flu [New Mexico]--The New Mexico Department of Health announced today that a female infant from Roosevelt County and a 5-year-old female from Sandoval County died as a result of H1N1 influenza. Neither child had a chronic medical condition.
     

    “Our sympathies go out to the families who are dealing with the loss of their children,” said Health Secretary Alfredo Vigil, MD. “These tragic events should remind all New Mexicans that flu can be a serious and sometimes deadly disease.”
     

    Dr. Vigil said influenza can cause serious complications and even death in people who are otherwise healthy, so it is important for everyone to follow the prevention guidelines to minimize the spread of the disease.
     

    “Make an appointment today to get vaccinated against seasonal flu, and if you’re in a high risk group, get vaccinated against H1N1 when the vaccine is available,” Dr. Vigil said. “Everyone should wash their hands frequently and cover their mouth and nose when sneezing and coughing. Stay home and keep your kids home when they’re sick for 24 hours after the fever is gone.”
     

    The Department of Health started shipping seasonal flu vaccine to public health offices, the Department’s long-term care facilities and private providers statewide this week. New Mexicans should contact their healthcare providers to receive flu vaccine. The Department’s public health offices provide seasonal flu vaccine to people who are at high risk for serious illness and people who have no health insurance.
     

    The Department of Health expects to receive the first shipment of H1N1 vaccine in mid-October. The first group the Department of Health is advising to get vaccinated are pregnant women, household members/caretakers of infants less than 6 months old, children 6 to 59 months of age, children 5 to 18 years with certain chronic health conditions that increase their risk of complications, and healthcare workers and emergency medical service personnel with direct patient care.

     

    The Department is advising the following high risk groups get vaccinated today against seasonal flu:
    Residents of long-term care facilities
    Persons ages 2-64 years with chronic health conditions, such as asthma or other breathing problems, kidney disease, heart disease, diabetes, muscle or nerve disorders that can lead to breathing or swallowing problems, and children on long-term aspirin therapy.
    Children age 6 months up to their 19th birthday
    Persons ages 50 years and older
    Pregnant women
    Healthcare workers who provide direct patient care
    Household contacts and out-of-home caregivers of children up to age 5, or anyone at increased risk of flu complications


    So far this year, there have been seven deaths related to H1N1 influenza in the state. The other five deaths are as follows: a 45-year-old female from Sierra County with end stage liver disease, a 52-year-old female from Bernalillo County with chronic pulmonary disease, a 48-year-old female from McKinley County with asthma and diabetes, a 21-year-old female from Los Alamos County without chronic medical conditions, and a 58-year-old male from Bernalillo County with chronic conditions that put him at risk for serious complications from the flu.


    For information about scheduled flu shot clinics, call Nurse Advice New Mexico toll-free at 866-681-5872 or go online to www.nmivc.org/cliniclist.php. Public health offices are listed in the phonebook’s blue pages under state government. Contact information for public health offices is also listed at www.nmhealth.org.

     

     

    1001 American Samoa tsunami response [Washington DC]--The Department of Homeland Security's Federal Emergency Management Agency (FEMA) today updated information on the continuation of federal support to American Samoa.

    FEMA and its federal partners continue to work closely with Governor Tulafono to respond in areas of American Samoa impacted by the tsunami. The FEMA National Response Coordination Center (NRCC) and the FEMA Regional Response Coordination Center (RRCC) in Region IX have been operating around the clock since Tuesday. FEMA deployed an Incident Management Assistance Team (IMAT) as well as a Planning and Response Team (PRT) to American Samoa to provide direct support and response. Kenneth R. Tingman, the Federal Coordinating Officer (FCO) for federal response and recovery operations has toured the affected areas with the Governor of American Samoa.

    FEMA continues to facilitate the flow of resources including meals, water, blankets, shelter materials and medical supplies to meet the immediate life sustaining needs of the survivors. Medical personal and other federal responders have also been deployed directly to the territory to aid in the response.


    Reuniting Families

    FEMA’s National Emergency Family Registry and Locator System (NEFRLS) and The American Red Cross Safe and Well Program have been activated to reunite families that have become separated as a result of this disaster. Individuals and families can register with NEFRLS online at www.fema.gov or call 1-800-588-9822. Families can also register on the Red Cross Safe and Well Website at www.redcross.org or call 1-800-RED-CROSS (1-800-733-2767) to register your loved ones.

    Supplying the Island

    C-130 Flights:

    A United States Coast Guard C-130, from Coast Guard Air Station Sacramento, Calif. arrived at 7 a.m local time (2 p.m. EDT) on September 30th in Pago Pago, American Samoa. This flight carried Governor Tulafono, who was in Hawaii at the time of the tsunami, the initial response team of 50 personnel including Federal Coordinating Officer, Kenneth J. Tingman, Defense Coordinating Officer Col. James George, as well as team supplies for seven days.

    A second United States Coast Guard C-130 from Coast Guard Air Station Barbers Point, Calif. arrived in American Samoa at approximately 7 p.m. on September 30th, (2 a.m. EDT, October 1st). This flight included additional commodities and FEMA personnel including the Incident Management Assistance Team (IMAT), a regionally-based incident ‘strike team’ and the Disaster Medical Assistance Team (DMAT), medical expert volunteers that are part of the National Disaster Medical System.

    C-17 National Guard Flights:

    A Hawaii National Guard C-17 cargo flight from Honolulu arrived in American Samoa at 1 a.m. local time (8 a.m. EDT) on October 1st. This flight included over 40 National Guard personnel, four vehicles, hazmat materials, communications equipment, cots, blankets, food and water.

    An additional Hawaii National Guard C-17 cargo flight arrived at 4 a.m. (11 a.m. EDT) on October 1st in American Samoa. This flight included 20 additional National Guard personnel, five vehicles, hazmat materials, communications equipment, cots, blankets, food and water.

    A third National Guard C-17 from McChord AFB in Bothell, WA is scheduled to arrive late tonight, local American Samoa time. This flight includes FEMA and National Guard personnel including National Guard CERF-P Search and Rescue teams, vehicles, trailers and cargo.

    USS Ingraham:

    This United States Navy frigate arrived in American Samoa on September 30th with food, water, commodities and two Seahawk helicopters available for search and recovery operations. The helicopters have already allowed Governor Tulafono and Federal Coordinating Officer Kenneth J. Tingman to survey damage to American Samoa.

    FEMA Partners Respond

    · U.S. Coast Guard: Assisting with flights to deploy teams to the American Samoa and disaster relief supplies; conducting shoreline cleanup and assessments; deployed team to inspect vessels and regulated facilities; developed a plan to re-float two large fishing vessels;

    · U.S. Department of Health and Human Services: Deploying Disaster Medical Assistance Teams to provide medical support to survivors; a public health official has been deployed along with other support staff including public health experts; providing medical and pharmaceutical equipment and supplies;

    · U.S. Department of the Interior: Deploying National Park Service (NPS) specialists to assess damage to NPS facilities and resources and assist with ongoing recovery efforts; deployed staff to conduct a needs assessment with the local fire department; Interior’s Assistant Secretary for Insular Areas, Anthony Babauta and the Director, Office of Insular Affairs, Nik Pula are departing to American Samoa to coordinate with FEMA’s Federal Coordinating Officer and American Samoa’s Governor;

    · U.S. Army Corps of Engineers (USACE): At present time, USACE is deploying the 249th Engineering Battalion to support emergency power needs for critical public facilities; deploying subject matter experts in debris management, water/wastewater, and power to assist in response efforts;

    · U.S. Department of Defense (DOD): Defense Coordinating Officer has been deployed;

    · U.S. Pacific Command (DOD): Providing refrigeration support to operations; USS Ingram prepared to assist with equipment and supplies;

    · National Guard Bureau: Deployed personnel including those with medical and search and rescue experience and disaster relief supplies; deploying specialized communication gear and support staff;

    · Small Business Administration (SBA): Deploying approximately 40 assistance workers to assist in recovery efforts; SBA customer service representatives will issue disaster loan applications, answer questions about the loan program, explain the process and answer questions;

    · Internal Revenue Service (IRS): Victims of the recent tsunami in American Samoa may qualify for tax relief from the Internal Revenue Service. The IRS is postponing certain deadlines for taxpayers who reside or have a business in the disaster area. For details and additional information please visit www.irs.gov, use keyword American Samoa Tsunami;

    · American Red Cross: Deployed special liaison to American Samoa; dozens of volunteers on the ground in American Samoa providing food and supplies in affected areas; a leadership team of approximately 50 volunteers is on its way to the island to supplement the local Red Cross workforce; providing cots, flashlights, cooking supplies and clean-up supplies.

    Disability Community Update:

    · FEMA: A member of the FEMA External Affairs team is on the ground on the island and is the designated point of contact to direct disability issues back to the FEMA Senior Advisor, Disability Issues at Headquarters. The Senior Advisor is also working closely with the Interagency Coordinating Council on Emergency Preparedness and People with Disabilities (ICC), US Department of Health and Human Services, National Council on Disability, American Red Cross and disability community leaders from around the country who are knowledgeable about the disability community on the Island.

    · The National Disability Rights Network (NDRN): NDRN has heard from their Protection and Advocacy affiliate on the Island and they are “back at work, assessing the damage and trying to contact their constituents to ascertain their needs.”

    · Interagency Coordinating Council on Emergency Preparedness and People with Disabilities (ICC): The US Department of Homeland Security Office for Civil Rights and Civil Liberties in its role as Chair of the ICC has reached out to the Federal partners and information about disability related issues is being shared among the members.
     

     

     

     

     

     

     

    Headlines link directly to articles:

     

    1112 New recommendations on H1N1 vax for children [Prince Edward Island]

     

    1112 Quebec facilite la vaccination des jeunes du milieu scolaire [Quebec]

     

    1112 Nine H1N1 cases currently hospitalized with severe respiratory illnesses [Manitoba]

     

    1112 Since Nov 3, another 202 new severe cases of H1N1 in the province [British Columbia]

     

    1112 FDA expands use of H1N1 vax to include infants and children [Rockville MD]

     

    1112 First H1N1-related death in the city this fall [Boston MA]

     

    1112 Heavy rains causing Midlands-area sewage problems [Columbia SC]

     

    1112 Weekend H1N1 vax clinics expanded to cover people with underlying health conditions [New York NY]

     

    1112 Clinics to vax up to 3,000 high-risk people [Delaware]

     

    1112 Health officials recommend parents check children's vax records to verify whether booster dose of Hib vax is required [North Dakota]

     

    1112 Expanded H1N1 vax availability for all target populations [Louisiana]

     

    1112 Quantities of seasonal flu vax diminishing [Kentucky]

     

    1112 More H1N1 deaths confirmed as more vax arrives in state [Arkansas]

     

    1112 State recommends continued prioritization of H1N1 vax [Wisconsin]

     

    1112 Additional H1N1 flu death announced [Topeka Kansas]

     

    1112 Province expands H1N1 vax program to include first responders [Ontario]

     

    1112 Québec dévoile la séquence de vaccination prévue pour le deuxième groupe de population [Quebec]

     

    1112 H1N1 vax groups expanded [Nova Scotia]

     

    1112 O'Leary flu assessment site closed due to low numbers [Prince Edward Island]

     

    1111 Governor declares disaster for Kodiak storms [Alaska]

     

    1111 More than 1,000 hospitalized for ILI since Sept 1 [Oregon]

     

    1111 Two more flu-related deaths reported [Wyoming]

     

    1106 Le ministre Bolduc annonce le mise en place d'un systeme de gestion de l'acces a la vax contre la H1N1 [Quebec]

     

    1106 Assembly of First Nations and Health Canada to co-host a virtual summit on H1N1 preparedness on Nov 10 [Ottawa ON]

     

    1106 Currently 14 individuals in ICUs with severe respiratory illness [Manitoba]

     

    1106 For the week ending Nov 3 there were 183 new severe cases of H1N1 [British Columbia]

     

    1106 DNA analysis confirms positive identification on seventh foot [Burnaby BC]

     

    1106 AHS investigation into inappropriate use of H1N1 vaccine [Calgary AB]

     

    1106 More risk groups added to H1N1 vax campaign [Saskatchewan]

     

    1106 Targeted H1N1 immunization of priority groups expands [Edmonton AB]

     

    1106 HHS orders intravenous antiviral flu meds to help patients hospitalized with H1N1 [United States]

     

    1106 King County pharmacies to offer H1N1 vax for at-risk people [Washington]

     

    1106 Letter to state/local officials from CDC director re H1N1 vax [Atlanta GA]

     

    1106 Atlantic County begins to distribute H1N1 vax [New Jersey]

     

    1106 H1N1 continues to spread and worsen in state [Maine]

     

    1106 HEALTH dept issues statement regarding confusion between Tamiflu and Theraflu [Rhode Island]

     

    1106 State receives more Tamiflu for children [Connecticut]

     

    1106 Gov Patterson urges New Yorkers to take preventive measures to reduce spread of H1N1 flu [Albany NY]

     

    1106 Young adult is state's second H1N1 flu-related death [Maine]

     

    1106 H1N1 vax efforts expand as school absenteeism grows [Maine]

     

    1106 More than 3,000 people received H1N1 vax yesterday [Marion County IN]

     

    1106 Three more H1N1 flu-related deaths confirmed [Iowa]

     

    1106 State expands eligibility for H1N1 vaccine [South Dakota]

     

    1106 State health officials confirm H1N1 flu-related death in Ozaukee County [Wisconsin]

     

    1106 H1N1 (swine flu) information: easy access for residents [Washington]

     

    1106 Two additional H1N1-related deaths announced [Kansas]

     

    1106 Flu PSA advises students, workers to stay home when sick [Denver CO]

     

    1106 Two Little Diomede residents medevac'd to Nome with possible H1N1 [Anchorage AK]

     

    1106 Final state WNv numbers reported for 2009 [Wyoming]

     

    1106 Web site provides one-stop shopping for sandbag distribution sites in King County [King County WA]

     

    1106 County offering free sandbags to residents on Green River’s flood-threatened middle stretch [King County WA]

     

    1106 County heads into winter with new snow plans [King County WA]

     

    1104 Strong demand for seasonal flu vax strains supplies [New York City]

     

    1104 Healthcare workers encouraged to receive H1N1 vax [Pennsylvania]

     

    1104 Dept of Health confirms state's first pediatric death associated with H1N1 flu [Pennsylvania]

     

    1104 Four additional H1N1-related deaths reported [Iowa]

     

    1104 Protecting pets from illness [Iowa]

     

    1104 State now asking for reports of patients hospitalized with pneumonia and influenza syndrome [Alaska]

     

    1103 Marion County elementary students to begin receiving H1N1 vax Nov 9 [Indianapolis IN]

     

    1103 Almost 175,000 doses of seasonal flu and H1N1 vax given at mass flu clinics [Little Rock AR]

     

    1103 First child H1N1 death reported [Iowa]

     

    1103 Two additional H1N1 flu-related deaths announced [Kansas]

     

    1103 State health dept asks for citizens' cooperation as H1N1 vax efforts continue [Denver CO]

     

    1103 State health dept addresses confusion over nasal flu vax [Denver CO]

     

    1103 H1N1 vax continues to arrive; cases peaked week of Oct 10 [Denver CO]

     

    1103 More than 24,000 vax'd during first week of H1N1 program [Prince Edward Island]

     

    1103 Pediatric H1N1 flu-related death confirmed [Yukon]

     

    1103 MOH confirms H1N1 outbreak at Whitehorse Correctional Centre [Yukon]

     

    1103 New flu assessment clinic to lighten load [Yukon]

     

    1103 H1N1 unadjuvanted vax available by appointment this week for pregnant women up to 20 wks [Newfoundland and Labrador]

     

    1103 H1N1 priority groups further restricted [New Brunswick]

     

    1103 Initial results show pregnant women mount strong immune response to one dose of H1N1 flu vax [United States]

     

    1103 Survey: Awareness of COPD is rising but understanding is still low [United States]

     

    1103 H1N1 vax distributed to more than 900 providers [Pennsylvania]

     

    1103 H1N1-related death reported [Nebraska]

     

    1103 First H1N1-related death announced [North Dakota]

     

    1103 Families asked to be patient while waiting for H1N1 vax [Louisiana]

     

    1103 Pregnant women targeted for H1N1 vax [Iowa]

     

    1103 Statewide H1N1 vax blitz planned [Oklahoma]

     

    1103 If the Green River floods, follow the signs [King County, Washington]

     

    1103 Pediatric H1N1-related death in Bernalillo County [New Mexico]

     

    1030 NSTU wants H1N1 vaccine clinics in schools [Nova Scotia]

     

    1030 Province evaluating vax plans as supplies significantly less than expected [Saskatchewan]

     

    1030 Province extends palliative home care drug pilot project [Prince Edward Island]

     

    1030 Temporary changes to visitor guidelines at QE and Prince County Hospitals [Prince Edward Island]

     

    1030 Limited vax requires important changes to H1N1 vax criteria for coming week [Newfoundland and Labrador]

     

    1030 Significant increase in H1N1 flu activity [New Brunswick]

     

    1030 Four confirmed cases of E.coli believed to be linked to Wendy's restaurant [Fredericton NB]

     

    1030 Due to H1N1 vax shortages mass clinics may be postponed [Manitoba]

     

    1030 H1N1 flu vax update - further distribution will include phased approach [British Columbia]

     

    1030 H1N1 flu public clinics set to begin Nov 3 [Vermont]

     

    1030 Vax efforts unprecedented as H1N1 flu becomes widespread [Maine]

     

    1030 H1N1 flu shots to be offered at City colleges [Chicago IL]

     

    1030 H1N1 flu vax available at County Health depts next week [Mississippi]

     

    1030 Three more H1N1 flu-related deaths confirmed [Kansas]

     

    1030 Death of elderly female linked to H1N1 flu [Wyoming]

     

    1029 ERs at Montreal's childrens' hospitals seeing a significant increase in number of children seeking care [Quebec]

     

    1029 Statement from Ontario Medical Association on H1N1 vax delays [Toronto ON]

     

    1029 New advice on H1N1 care [Nova Scotia]

     

    1029 Significantly less H1N1 vax available than had been anticipated [Manitoba]

     

    1029 Flu Assessment Centre opening Oct 30 [Edmonton, Alberta]

     

    1029 H1N1 vax rollout continues [Alberta]

     

    1029 More details about the H1N1 vax distribution program [Massachusetts]

     

    1029 National delays in H1N1 vax distribution highlight need for continued prevention efforts [Pennsylvania]

     

    1029 While we wait for the H1N1 vax: taking charge of your health [by Jason Eberhart-Phillips MD, Kansas State Health Officer and Director of Health, KDHE]

     

    1029 King County Flood Warning Center opens as Snoqualmie, Tolt rivers rise on heavy rains [Washington]

     

    1028 The CHU Saint-Justine and the Montreal Children's Hospital reminds parents that ERs are for urgent care [Quebec]

     

    1028 More than 38,000 vaccinated against H1N1 this week [Manitoba]

     

    1028 Flu assessment clinic opening in Charlottetown [Prince Edward Island]

     

    1028 First H1N1 flu-related hospitalization confirmed [Yukon]

     

    1028 Statement from chief medical officer of health: H1N1 flu clinics update [New Brunswick]

     

    1028 Govt of Canada providing H1N1 travel guidance [Ottawa ON]

     

    1028 First death linked to H1N1 reported as flu is widespread [Vermont]

     

    1028 City officials launch school-based H1N1 vax program [New York City]

     

    1028 Flu activity widespread as H1N1 vax delays continue [New Jersey]

     

    1028 H1N1-related death in an 80-year-old woman [Delaware]

     

    1028 Rumor control: H1N1 vax and prisons [Texas]

     

    1028 Two more H1N1 deaths confirmed [Minnesota]

     

    1028 H1N1 mass vax clinics update [Arkansas]

     

    1028 Child death linked to pertussis [Iowa]

     

    1028 State recommends prioritization of H1N1 vax [Wisconsin]

     

    1028 Strategy for H1N1 vax response [Oklahoma]

     

    1028 Indications flu activity has peaked in Denver-Boulder metro area [Colorado]

     

    1027 Fifth Calgary H1N1 vaccination clinic opens Wednesday, October 28 [Alberta]

     

    1027 Adjuvanted H1N1 vax now available for some pregnant women [Prince Edward Island]

     

    1027 Province has 80 new cases of H1N1 flu [Nova Scotia]

     

    1027 Almost 90 new severe cases of H1N1 flu since Oct 20 [British Columbia]

     

    1027 DHS proposes guidance for anthrax responders [Washington DC]

     

    1027 Clarification on H1N1 priority groups - in English and Spanish [Massachusetts]

     

    1027 DHHS announces activation of H1N1 flu public inquiry line [New Hampshire]

     

    1027 E.coli 0157:H7 found in beef patties after more than 20 children became ill [Massachusetts]

     

    1027 DoH expands list of priority groups served at free H1N1 vax clinics [Washington DC]

     

    1027 High-risk individuals offered H1N1 influenza vaccine [Alabama]

     

    1027 Flu helpline surpasses 5,000 calls [Marion County, Indiana]

     

    1027 State Public Health director urges patience as H1N1 vax supply limited [Illinois]

     

    1027 H1N1 vax continues to trickle into state [Oregon]

     

    1027 Two more flu-related deaths reported [Wyoming]

     

    1026 Estimates indicate 115,000 residents have or have had H1N1 flu [Louisiana]

     

    1026 State announces toll-free H1N1 flu vax hotline [South Dakota]

     

    1026 H1N1 update - activity in province beginning to increase [New Brunswick]

     

    1026 Overall flu activity increased for fifth consecutive week [Canada]

     

    1026 Canada works with Australia to secure additional H1N1 vax for pregnant women [Ottawa ON]

     

    1026 Cautionary note on provincial Tamiflu supply [Vancouver, BC]

     

    1026 H1N1 vax clinics now open [Alberta]

     

    1026 Statement on Declaration of Emergency [Massachusetts]

     

    1024 State has received only 5 percent of requested H1N1 vax - officials ask for patience [Alaska]

     

    1023 Four more H1N1-related deaths reported [Nebraska]

     

    1023 Dept for Public Health urges patience on H1N1 while reporting two additional H1N1-related deaths [Frankfort KY]

     

    1023 Children ages 5-18 with underlying medical conditions will receive H1N1 vax as supplies permit [Little Rock, Arkansas]

     

    1023 Mayor Menino urges patience in light of delays in vax delivery [Boston, Massachusetts]

     

    1023 Many school H1N1 vax clinics postponed due to limited vaccine supply [Vermont]

     

    1023 DoH continues statewide distribution of H1N1 vax [Pennsylvania]

     

    1023 Gov Paterson issues disaster declaration for Essex County and area impacted by Lake Champlain bridge closure [Albany NY]

     

    1023 New Castle County death of 15-year-old boy examined for H1N1 [Delaware]

     

    1023 SOGC recommends that all pregnant women over 20 weeks gestation receive the H1N1 vax immediately [Ottawa ON]

     

    1023 Début de la campagne de vaccination volontaire contre le virus de la grippe A(H1N1) dans la région de l'Outaouais [Gatineau QC]

     

    1023 Students continue to learn about H1N1 prevention at schools [Saskatchewan]

     

    1023 Everyone encouraged to get vax'd [Prince Edward Island]

     

    1023 Tamiflu to be available free of charge with prescription [New Brunswick]

     

    1023 Plans for H1N1 flu clinics being finalized with launch next week [Manitoba]

     

    1023 Province sends first shipment of 700,000 doses of H1N1 vax to health units [Ontario]

     

    1023 Persons at risk for complications and healthcare workers - H1N1 vax to be offered beginning Oct 26 [Quebec]

     

    1023 KDHE announces additional H1N1-related death [Kansas]

     

    1022 Limited availability of flu vax - Focus on the highest priority groups immediately [Maine]

     

    1022 Flu activity widespread - H1N1 confirmed in all regions [Vermont]

     

    1022 DHHS takes steps to limit H1N1 spread at state facilities [North Carolina]

     

    1022 Rumor control: Letter concerning H1N1 vax and prison inmates [Massachusetts]

     

    1022 State reports first H1N1-related death [Delaware]

     

    1022 National H1N1 vax supply not adequate enough to meet public demand [Texas]

     

    1022 Culebra Meat Market recalling certain beef products for E.coli 0157:H7 [San Antonio, Texas]

     

    1022 Response to new FluLine service is “very heavy” - efforts underway to expand system [Minnesota]

     

    1022 State records three more deaths associated with H1N1 novel influenza [Minnesota]

     

    1022 FluLine to offer support and treatment options for people with possible symptoms of influenza [Minnesota]

     

    1022 Anticipated supplies of H1N1 vax slow to arrive [Arkansas]

     

    1022 Public health director warns of potentially contaminated baby food - Plum Organics recalling Apple & Carrot Portable Pouch baby food [Illinois]

     

    1022 State's 211 'clinic finder' connects public to flu shot clinics statewide [Wisconsin]

     

    1022 Another death linked to H1N1 flu [Wyoming]

     

    1022 State releases cache of N95 respirators from emergency stockpile to combat spread of H1N1 in healthcare settings [California]

     

    1021 Flu pandemic requires national plan, say Atlantic mayors [Charlottetown, PEI]

     

    1021 H1N1 outbreak on turkey farm confirmed [Kitchener ON]

     

    1021 Province announces rollout of H1N1 vax campaign [Prince Edward Island]

     

    1021 Province to start H1N1 vax program next week [Newfoundland and Labrador]

     

    1021 Province completes test of tsunami notification system [Victoria, BC]

     

    1021 Province to begin H1N1 immunization campaign [Halifax, NS]

     

    1021 Vax will be available in province starting Oct 26 [Edmonton, AB]

     

    1021 H1N1 vax approved and timing confirmed [Victoria, BC]

     

    1021 Pharmacists to give H1N1 vax [Victoria, BC]

     

    1021 H1N1 vax to begin on Oct 26 [Whitehorse, Yukon]

     

    1021 Guidelines for H1N1 and sporting events [Northwest Territories]

     

    1020 Thirty-three new severe cases of H1N1 since Oct 13 [British Columbia]

     

    1020 Seasonal flu vax manufacturers notify DoH of delay and reduction in shipments [Rhode Island]

     

    1020 Bloomberg launches Flu Fighters initiative to bolster flu prevention efforts [New York City]

     

    1020 School-based H1N1 vax efforts ready for launch [New York City]

     

    1020 State officials understand and share frustration associated with H1N1 vax shortages [Massachusetts]

     

    1020 Finding flu shots in the face of increased demand for H1N1 vax [Delaware]

     

    1020 At-risk group will be focus of first public H1N1 vax clinic [Marion County, Indiana]

     

    1020 DSHS officials expect weekly availability of H1N1 vax to be low for next few weeks [Texas]

     

    1020 DoH recommends revax of some individuals against H1N1 [North Dakota]

     

    1020 DNR and City of St Louis warn of high methane levels near demolition landfill [Missouri]

     

    1020 DHH updates states of Fight The Flu campaign [Louisiana]

     

    1020 H1N1 vax coming more slowly than expected [Oregon]

     

    1020 H1N1 vax available for people with no health insurance and significant health problems [King County, Washington]

     

    1017 H1N1 flu is widespread [Northwest Territories]

     

    1017 Province issues updated guidance H1N1 documents to healthcare providers [Ontario]

     

    1017 H1N1 flu update - vax may be available earlier than November [New Brunswick]

     

    1017 Clinical features of severe cases of pandemic influenza [Global]

     

    1017 States advised of production delays for the new H1N1 vax [Vermont]

     

    1017 H1N1 flu vax clinics getting underway [Connecticut]

     

    1017 Bureau of Insurance announces progress and positive actions to cover H1N1 flu vax [Maine]

     

    1017 Free H1N1 vax clinics for youth, pregnant women [Washington DC]

     

    1017 Additional H1N1 flu vax coming to state [Oklahoma]

     

    1017 State receives fewer than anticipated H1N1 vax doses this week [Colorado]

     

    1017 H1N1 flu vax distribution underway - flu activity high [Wyoming]

     

    1017 First local H1N1 flu death this fall [King County, Washington]

     

    1017 State response to H1N1 continues, Joint Info Center opens [Arizona]

     

    1015 FDA warns of unapproved and illegal H1N1 drug products purchased over the internet [USA]

     

    1015 Dept of Health announces AmbuBus evacuation program [Mississippi]

     

    1015 Dept of Health to launch public health hotline [North Dakota]

     

    1015 New toll-free number to provide 24/7 H1N1 flu and vax info [Missouri]

     

    1015 Flu activity increases in state - 56 schools reporting more than 10 percent absenteeism due to illness [Iowa]

     

    1015 WNv - Tests confirm state's first death from disease [Washington]

     

    1015 H1N1/ILI status report - Level of flu activity very unusual for this time of year and increasing [Utah]

     

    1015 With pandemic H1N1 on the rise, Public Health stresses importance of prevention and vaccination [Utah]

     

    1015 First H1N1 flu death of patient with no serious prior medical problems [Kansas]

     

    1014 Central Region health directors encouraging parents to complete H1N1 vax permission forms [Virginia]

     

    1014 State University of New York launches H1N1 pandemic flu strategy [Albany]

     

    1014 Indianapolis area hospitals modify visitation policies in response to flu season [Indiana]

     

    1014 Seasonal flu shots now available at county health depts [Mississippi]

     

    1014 Schools providing free flu shots to state's children beginning today [Arkansas]

     

    1014 Two additional deaths related to H1N1 [Arkansas]

     

    1014 Cherokee County death linked to H1N1 flu [Alabama]

     

    1014 Stop flu at school vax clinics begin [Hawai'i]

     

    1014 H1N1: Tips for when to seek medical advice [Oregon]

     

    1014 Dept of Health completes critical resource shortages planning guide and implementation toolkit [Virginia]

     

    1014 H1N1 vax to be more widely available over next few weeks [Delaware]

     

    1013 Province hosts 2009 Atlantic 911 conference [Prince Edward Island]

     

    1013 Fire and emergency services training school to be hosted in Stephenville [Newfoundland and Labrador]

     

    1013 New directory for persons with disabilities launched [New Brunswick]

     

    1013 Province supports doctors to treat more H1N1 patients [British Columbia]

     

    1013 H1N1 flu under surveillance [British Columbia]

     

    1013 Town hall meeting in Iqaluit tackles H1N1 vax myths [Canada]

     

    1013 Govt of Canada launches H1N1 preparedness guide [Canada]

     

    1009 FluWatch reports slightly higher flu activity [Canada]

     

    1009 Seasonal flu vax now available for those over 65 [Prince Edward Island]

     

    1009 Delays in shipments of and high demand for season flu vax cause confusion [New Hampshire]

     

    1009 H1N1 State changing the way it reports flu hospitalizations and deaths [North Carolina]

     

    1009 Salmonella Typhimurium outbreak linked to consumption of raw alfalfa sprouts [Michigan]

     

    1009 Seasonal flu vaccine is in short supply for now [Vermont]

     

    1009 H1N1 DPH reports two additional flu-related deaths [Kentucky]

     

    1009 H1N1 DPH launches new public toll free hotline [Kentucky]

     

    1009 H1N1 Fourth flu death reported [Iowa]

     

    1009 H1N1 Mobile death linked to flu [Alabama]

     

    1009 H1N1 State Health dept activates hotline [Oklahoma]

     

    1009 H1N1 DHH confirms arrival of limited doses of vax [Louisiana]

     

    1009 H1N1 DHH confirms three deaths from flu [Louisiana]

     

    1009 H1N1 Additional doses of vax expected to arrive next week [North Dakota]

     

    1009 H1N1 DSHS provides vax update [Texas]

     

    1009 H1N1 DoH provides recommendations for people sick with flu symptoms [New Mexico]

     

    1009 Health improves in some but not all realms for King County residents, as shown by new Community Health Indicators [King County]

     

    1009 H1N1 Flu infection contributes to death of Bannock County teen [Idaho]

     

    1009 H1N1 Second death reported as flu is widespread in state [Wyoming]

     

    1009 H1N1 Both seasonal flu and H1N1 vax to be available [Colorado]

     

    1009 ER staff can help detect and prevent domestic violence [Utah]

     

    1009 H1N1 Flu vax is safe and important during pregnancy [Utah]

     

    1009 H1N1 DoH confirms additional death related to flu [Hawai'i]

     

    1009 H1N1 Get vax'd - state public health director [California]

     

    1009 Lights, camera, save lives! Video contest deadline approaching [California]

     

    1009 CDPH publishes study on autism and maternal and paternal age [California]

     

    1003 H1N1 : State records three new deaths associated with H1N1 flu [Minnesota]

     

    1003 H1N1 : First supply of H1N1 vaccine will go to healthcare and emergency medical workers [Minnesota]

     

    1003 H1N1 : State expecting first doses of H1N1 vax to arrive next week [North Dakota]

     

    1003 H1N1 : DHH and LHSAA team up to beat H1N1 [Louisiana]

     

    1003 ILI : Seasonal flu vax to be available for high-risk groups at parish health units [Louisiana]

     

    1003 H1N1 : State reports first H1N1 death [South Dakota]

     

    1003 H1N1 : State places order for first shipment of H1N1 vax [South Dakota]

     

    1003 H1N1 : Fifteen deaths now linked to H1N1 flu [Alabama]

     

    1003 H1N1 : Three additional deaths linked to H1N1 flu [Alabama]

     

    1003 H1N1 : DOH places first order for H1N1 flu vax and launches new info website [Hawaii]

     

    1002 Health warning on certain imported dried plums containing elevated levels of lead [Colorado]

     

    1002 H1N1 : State expects small amount of 2009 H1N1 vax next week [Colorado]

     

    1002 H1N1 : Community readies for arrival of H1N1 flu vax [Washington]

     

    1002 H1N1 : Dept of Health announces two deaths in children related to H1N1 flu [New Mexico]

     

    1001 American Samoa tsunami response [Washington DC]

     

     

     

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