George A. Ralls M.D.Dave Freeman

Health Services DepartmentSeptember 1st, 2009

INFLUENZA UPDATE

• Brief History

• Current Situation

• Disease Projections

• Mitigation Efforts

• CDC Guidelines

H1N1 INFLUENZA

PRESENTATION OUTLINEH1N1 INFLUENZA

• Brief History

• Current Situation

• Disease Projections

• Mitigation Efforts

• CDC Guidelines

• March & April of 2009– New form (Novel) of

Influenza found to cause disease in Mexico and Southern US

– Spread rapidly across North America

• By May 2009 “Swine Flu” identified in many areas of the world

H1N1 INFLUENZA

• Symptoms of H1N1 are similar to those of seasonal flu:• Fever • Cough • Sore throat • Runny or stuffy nose • Body aches • Headache• Chills • Fatigue

H1N1 INFLUENZA

• On June 11th, 2009 the WHO declared a worldwide pandemic (pandemic level 6)

– Uncontained community level transmission in many areas of the world

H1N1 INFLUENZA

• Symptoms no worse than seasonal flu

• Most patients recovered with no treatment

• Case mortality rate low• Deaths in predisposed

patients

Reassuring early trends

H1N1 INFLUENZA

PRESENTATION OUTLINE

• Brief History

• Current Situation

• Disease Projections

• Mitigation Efforts

• CDC Guidelines

2185 Deaths Worldwide

• Estimated over 1 Million infected in US since outbreak

– 8843 Hospital Admissions

– 556 deaths

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• 605 Hospital Admissions

• 66 Deaths

Florida

H1N1 INFLUENZA

% of Florida ED Visits for ILI

Seasonal Flu –vs- H1N1 Positive Tests

Florida H1N1 Deaths (N=66)

H1N1 INFLUENZA

H1N1 Related Deaths (US)

H1N1 INFLUENZA

PRESENTATION OUTLINE

• Brief History

• Current Situation

• Disease Projections

• Mitigation Efforts

• CDC Guidelines

87.7% of US population is less than 65 years old

H1N1 INFLUENZA

Second Emergence

Deaths attributed to pneumonia and influenza are low and within bounds for what is expected in

the summer

PRESENTATION OUTLINE

• Brief History

• Current Situation

• Disease Projections

• Mitigation Efforts

• CDC Guidelines

MITIGATION

MITIGATION

MITIGATION

• Delivered in October or earlier?• Distributed from FDOH Central

Pharmacy• Coordinated through CHDs• Requires 2 shots – 28 days

apart• Priority groups for vaccinations

H1N1 Vaccine

• Pregnant women• People who live with or care for children

younger than 6 months of age• Healthcare and emergency medical

services personnel• Persons between the ages of 6 months

and 24 years old• People ages of 25 through 64 years of

age who are at higher risk because of chronic health disorders or impaired immune systems

H1N1 Vaccine

Priority Groups

• Brief History

• Current Situation

• Disease Projections

• Mitigation Efforts

• CDC Guidelines

H1N1 INFLUENZA

www.cdc.gov

www.flu.gov

H1N1 INFLUENZA

CDC Guidelines• Parents & caregivers• Pregnant women• Clinicians• Businesses & employers• Schools, colleges & universities• Persons with chronic conditions• Travelers & travel industry

• Sick persons should stay home• Expect sick employees to be out for

about 3 to 5 days in most cases• Ensure that your sick leave policies are

flexible• Do not require a doctor’s note for

workers who are ill with ILI to validate their illness or to return to work

Employer Guidelines

H1N1 INFLUENZA

Employees who are well but who have an ill family member at home

with influenza can go to work

Should monitor their health status closely & stay home if they become ill

H1N1 INFLUENZA

Employer Guidelines

H1N1 INFLUENZA

Employer Guidelines

Influenza widgets and /or links on Intranet

CDC recommends people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F), or signs of a

fever without the use of fever-reducing medications

Persons NOT working in a Healthcare Setting

Exclusion Period

H1N1 INFLUENZA

• Review and revise COOP• Mass Vaccination for Priority

Employees • Employee Workplace Policies

– Hygiene– Social Distancing– Don’t come to work when sick

• Personal Protection Equipment

Work Force Protection

H1N1 INFLUENZA

• Cough or sneeze into tissue and throw it in trash or use upper arm if no tissue available

• Wash hands for 15-20 seconds or use alcohol-based hand gel often

• Keep hands away from eyes and mouth unless hands were washed

• Get a pneumonia shot if in high risk group: prevents secondary infections after the flu

• Avoid others if you are sick or if they are sick

• Develop an Individual/family plan

What Can You Do Now?

• Monitoring CDC and WHO influenza response recommendations and activities

• 25% of the SNS stockpile of antiviral drugs, personal protective equipment, and respiratory protection devices has been recieved – 25% additional coming soon

• State and local public health agencies have been developing, exercising, and revising their mass vaccination plans since 2001

What is Florida Doing?

• Orange County is reviewing and updating its response plan

• Surveillance for influenza is ongoing

• Currently working with local public health and hospital partners to identify gaps in preparedness and response

• Incident Management Team is organized and overseeing planning process

What is Orange County ESF8 Doing?

SUMMARY

• Rapidly developing situation• Develop good habits now• Cover your cough• Wash your hands• Avoid touching your face• Follow advice of public health officials

• Talk to a healthcare provider about “Flu” shots• Stay informed

www.cdc.govwww.flu.gov

Questions?

H1N1 INFLUENZA