Transcript Slide 1
H1N1 Update
Tina Kitchin
Department of Human Services, SPD
9/24/09
Goals
Understand
the flu
Current status of the pandemic
Understand the steps you can take to
protect yourself and your clients
Know where to turn with questions
Influenza
Symptoms:
Respiratory Illness, fever,
headache, myalgia, cough
Transmission
Droplet (3–6 feet)
Incubation:
1–3 days
Impact of Influenza: Typical Year
10%–20%
ill
U.S.
~225,000 hospitalizations
~36,000 deaths
Oregon
~2,750 hospitalizations
~450 deaths
Influenza Virus Changes
“Antigenic drift”
Minor changes to
strains each year,
need new vaccine
Antigenic shift”
Major reassortment,
nobody has immunity
Widespread pandemic
Generation of New Influenza A Virus
Subtypes with Pandemic Potential
Gerberding, J. L. et al. N Engl J Med 2004;350:1236-1247
Why worry about
pandemic H1N1?
Pandemic H1N1 worldwide
• Pandemic H1N1 is widespread:
•confirmed in more than 170 countries
• Cases =296,471; Deaths = at least 3,486*
• WHO / CDC have stopped tracking individual cases
•Focus on impact (deaths)
•Circulating virus types
Oregon status
• Oregon no longer counting every case
•Disease widespread
• Hospitalizations = 139*
(about 11 counties)
• Deaths = 13*
(about 11 counties)
• Cases occur sporadically and in clusters
* PHD data as of 9/18
What makes Pandemic
H1N1 different?
/15
/8
-9/5
-8/29
-8/22
8/30
8/23
8/16
8/9-8
8/2-8
-8/1
-7/25
7/26
7/19
-7/18
/11
-7/4
-6/27
7/5-7
7/12
/13
-6/20
6/28
6/21
6/14
6/7-6
-6/6
-5/30
-5/23
-5/16
5/31
5/24
5/17
5/10
/9
-5/2
5/3-5
4/26
Hospitalizations
Hospitalizations over the summer,
Oregon, 2009*
18
16
14
12
10
8
6
4
2
0
Specimen Collection Date
*as of 11 Sep 2009
Different age distribution of
Hospitalizations *
*as of 31 Jul 2009
Pandemic H1N1 deaths in younger
people, US
140
120
100
80
deaths
60
40
20
0
0-4
5-24
25-49
50-64
Age Group
>65
130
120
110
100
90
80
70
60
50
40
30
20
10
0
Oct
Nov
Dec
Jan
Feb Mar
Apr
May
Jun
30
27
24
21
18
15
12
9
6
3
52
49
46
A (H1)
A (H3)
A (Unk)
B
Novel H1N1
43
40
Isolates
Pandemic H1N1 Influenza strain
Predominates*
Jul
*through 08/01/2009
# of flu-like illnesses as of 9/12
Influenza
Symptoms:
Respiratory Illness, fever,
headache, myalgia, cough
Transmission
Droplet (3–6 feet)
Incubation:
1–3 days
Only You Can Stop the Flu
Stay
home if you are sick
Try to stay 3 ft away from sick people
Wash your hands or use alcohol-based
hand sanitizer
Disinfect contaminated and high-touch
surfaces (door knobs, microwaves,
remotes, phones, etc.)
If you wake up and look like this,
do not go to work.
Vaccination
Seasonal
Protects against 3 other strains for flu.
Recommended for everyone!
Distributed in same way as every year
H1N1
Vaccine –
Vaccine
Protects only against the new H1N1 strain
Targeted for priority groups
Distributed only through Public Health
Vaccination target populations
Pregnant women
60,127
Persons between six months and 24 years of age
1,222,286
People who live with or care for children younger than six
months of age
60,006
Health care and emergency service personnel
155,467
People age 25 through 64 years who are at high risk for
complications
381,141
Total Population
Total Doses
1, 879, 027
3, 758, 054
H1N1 Vaccination Priority Groups
High
Risk people, age 25 – 64
chronic pulmonary (including asthma),
cardiovascular (except hypertension), renal,
hepatic, cognitive, neurologic/ neuromuscular,
hematologic, or metabolic disorders (including
diabetes mellitus) or immunosuppression
(including immunosuppression caused by
medications or by human immunodeficiency
virus)
H1N1 Vaccination Priority Groups
Health
Care Worker
nursing homes, skilled nursing facilities,
physicians’ offices, urgent care centers, and
outpatient clinics, and to persons who provide
home health care
Clarification from PH:
This includes ALFs/RCFs, CCRCs, AFHs, and
HCWs. It does not include any day programs,
senior centers, etc.
Is the vaccine safe??????
This
is the same vaccine that is made
every year for flu, made in the same way.
Every year it include 3 different, new
strains. This vaccine will just include a 4th
strain. There just wasn’t time to get it into
the seasonal vaccine.
There have been no significant side
effects in the current trials.
Office Implications
Asked
to plan for 40% absenteeism
In your office
In facilities/homes, Home Care Workers, etc.
Possibly some interruption in supply chains,
needed services, etc.
Take
Seriously the need for Business
Continuity Plans
Consider cross training now
Protect yourself and others
Make
it easy for folks to wash their hands
or use hand sanitizer – purchase the
sanitizer for common areas and staff who
go into facilities and home
Encourage people who are sick to stay
home
Get immunized for the flu as soon as it is
available for you
Keep In Touch
http://www.flu.oregon.gov/
http://www.oregon.gov/DAS/HR/flu.shtml
http://www.dhs.state.or.us/admin/hr/h1n1/
Look
for the development of a SPD
website for information that has been sent
out, FAQs, policies, etc.
SS-IM-09-048 on SNAP and H1N1
What we need from you
A heads-up
if and when there are
significant impacts in your office, with your
providers, etc.
Policy/Rules that you think may need to be
relaxed if this has a significant impact
Your ideas about how to get providers
vaccinated
A heads-up of rumors that you are hearing
Don’t Get Crazy
Key points
• Pandemic H1N1 flu is here; few people have immunity
• We will likely see more illness, more hospitalizations
• Vaccine is our best weapon:
•Challenge: vaccinate ~2,000,000 Oregonians
• Community Mitigation:
•Stay home when sick, cover cough, wash hands
•Schools, business, health care systems need plan
for business continuity
Tina Kitchin, MD, FAAP
[email protected]