Wednesday, August 19, 2009

Weekly Update on H1N1 in Maine 8/19/09

Tracking Updates

Maine has identified 354 cases of H1N1, which include 19 individuals requiring hospitalization and one individual who has died. Of Maine residents with H1N1, 60 percent have been under 25 years of age. The number of cases is only a barometer of community transmission, not of actual case counts, because not all people with infection are tested.

Good Health Habits Can Help Stop Germs

Prevention of H1N1 is most important, especially now that the virus is widespread in many parts of Maine. Covering coughs and sneezes with a sleeve or tissue, washing hands frequently, and staying home if ill with a fever are shared responsibilities of everyone in Maine, especially to protect people who are at higher risk for complications from H1N1 (http://www.cdc.gov/h1n1flu/vaccination/acip.htm).

New Guidance for Businesses, Employers, and the Workplace

Today, CDC released new guidance (http://www.flu.gov/plan/workplaceplanning/guidance.html) that recommends actions that non-healthcare employers should take now to decrease the spread of seasonal flu and H1N1 in the workplace and to help maintain business during the flu season. The guidance includes additional strategies to use if flu conditions become more severe, and some new recommendations regarding when a sick worker may return to work. The guidance in this document may change as additional information about the severity of the flu season and the impact of H1N1 become known. A toolkit, including fact sheets and Q&As, is available at: http://www.flu.gov/plan/workplaceplanning/toolkit.html

H1N1 Summit August 20

The H1N1 Influenza Preparedness Summit co-sponsored by Maine CDC/DHHS, Maine Emergency Management Agency, Maine Department of Education, and Maine EMS will be held this from 8 a.m. to 4 p.m. this Thursday, Aug. 20, at the Augusta Civic Center. Registration is now closed, with more than 1,350 registered. Stakeholders will gather to prepare for a possible escalation of H1N1 in the fall, especially as schools reconvene and transmission is then expected to pick up. Materials such as presentations and a video of the plenary session from the Summit will be available on Maine CDC’s H1N1 web site (http://www.maineflu.gov/) shortly.

Vaccination

Maine CDC continues to work with a number of statewide partners to plan for large scale vaccine campaigns this fall. A conference call for health care providers related to both seasonal flu vaccine and H1N1 vaccine was held on Monday, Aug. 17.

Seasonal Flu Vaccine:
US CDC recommends that all children ages 6 months to 18 years be vaccinated against the regular seasonal flu this year as well as others in high-risk groups for seasonal flu. , and that vaccination for seasonal flu should begin in September, or as soon as seasonal flu vaccine is available, and continue through the flu season. (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr58e0724a1.htm?s_cid=rr58e0724a1_e)

The seasonal flu vaccine is not expected to specifically protect against H1N1. However, with H1N1 and seasonal flu viruses both expected to be circulating, getting a seasonal flu vaccine early will help a person’s overall protection against the flu. Maine CDC expects H1N1 vaccine to arrive in the state in mid-October at the earliest.

H1N1 Vaccine:
The federal government has contracted with five vaccine manufacturers to produce H1N1 vaccine. This vaccine production is being funded by the federal government and will be provided to state health departments as a free federal resource. The goal of the vaccine production effort is to provide enough vaccine to be available for everyone in the United States. Vaccine will only be available through state health departments (Maine CDC/DHHS in Maine), and will not be available for private purchase from manufacturers.

On Tuesday, the Maine Bureau of Insurance announced that the Anthem, Aetna, CIGNA and Harvard Pilgrim insurance companies have voluntarily agreed to cover H1N1 vaccinations for their policyholders.

The actual number of doses of vaccine to be distributed to Maine CDC is not currently known. A supply of vaccine sufficient to vaccinate the entire population in Maine will not be available all at once. Therefore, US CDC has made recommendations about the groups that should be considered the highest priority to receive the first available doses of vaccine. They are:
Pregnant women, because they are at higher risk of complications – especially in the second and third trimesters – and can potentially provide protection to infants who cannot be vaccinated;
Household members and caregivers for children under 6 months old, because younger infants are at higher risk of complications and cannot be vaccinated;
Health care and emergency medical services personnel, because infections among health care workers have been reported and this can be a potential source of infection for patients;
All people ages 6 months through 24 years of age:
Children ages 6 months to 18 years, because there have been many cases of H1N1 in children and they are in close contact with each other in school and day care settings, which increases the chances of spreading disease;
Young adults ages 19 through 24, because there have been many cases of H1N1 in healthy young adults, and they often live, work, and study in close proximity, and they are a frequently mobile population;
People ages 25 through 64 who have health conditions associated with a higher risk of medical complications from the flu, including those with asthma, COPD, diabetes, chronic cardiovascular disease, and people with compromised immune systems.

The H1N1 vaccine is not intended to replace the seasonal flu vaccine – it is intended to be used in addition to seasonal flu vaccine to protect people. At this point in time, there is no evidence that vaccinations will be mandatory. For more information about H1N1 vaccine, visit US CDC’s Q&A: http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm.

Vaccine Distribution:
The large amount of H1N1 vaccine to be distributed and the newly established priority populations require a new approach to vaccine distribution. This approach will be built on extensive vaccine distribution experience within Maine CDC, established emergency preparedness infrastructure and partnerships, and a spirit of shared responsibility between public health, health care providers, and the private sector.

H1N1 vaccine will be distributed to states through a nationwide distributor that now handles the distribution of pediatric vaccine for Maine CDC’s Vaccines for Children Program. This company will directly ship vaccine and associated supplies as designated by Maine CDC to sites in Maine. Some of these sites will include public health sites throughout Maine (including Public Health Nursing sites and city health departments) and through the private sector routes that are traditional providers of seasonal flu vaccine. There will be a significant need for vaccination in non-traditional settings to minimize the impact on the health care system.

Vaccine Distribution and Administration Planning:
Maine CDC field staff located in each DHHS District will serve as District Vaccine Coordinators, who will identify those populations prioritized to receive H1N1 Influenza vaccine who often do not have easy access to vaccine through the health care system. They will work with district and local partners to determine the most efficient and effective means for offering the vaccine to these priority groups.

Vaccine Coordinators will be one component of district leadership teams, which also include staff from the three Regional Resource Centers for Public Health Emergency Preparedness, and Emergency Management Agencies.

Vaccine Coordinators will be participating in the afternoon planning sessions at the Statewide H1N1 Summit on Aug. 20. They are:

District 1 – York: Sharon Leahy-Lind, 490-4625

District 2 – Cumberland: Meredith Tipton, 592-5631

District 3 – Western Maine: MaryAnn Amrich, 753-9103
(Franklin, Oxford, and Androscoggin counties)

District 4 – Mid Coast: Jen Gunderman-King, 596-4278
(Waldo, Knox, Lincoln, and Sagadahoc counties)

District 5 – Central Maine: Sue Lee, 592-5644
(Somerset and Kennebec counties)

District 6 – Penquis: Debra Roy, 592-5633
(Penobscot and Piscataquis counties)

District 7 – Downeast: Jen Gunderman-King/Cindy Look, 596-4278
(Washington and Hancock counties)

District 8 – Aroostook: Sharon Ramey, 592-5632

Tribal Vaccine Coordinator: Jerolyn Ireland, 532-2240, Ext. 15

Other New or Recently Updated US CDC H1N1 Guidance or News

This US CDC MMWR report describes Tamiflu®-resistent H1N1 infection in two immunosuppressed patients in Seattle, Washington. Both patients were successfully treated with Relenza®. The public health risk from these cases appears to be very low. There is no evidence that other contacts became infected with a drug-resistant virus. At this time, there is no evidence of ongoing transmission of drug-resistant H1N1 in the U.S. or worldwide.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0814a1.htm

How to Stay Updated

Weekly Updates: Check the Wednesday late afternoon updates on H1N1 in Maine on Maine CDC’s H1N1 website: http://www.maineflu.gov//

Health Alert Network: Sign up to receive urgent updates from Maine CDC’s Health Alert Network (HAN). The easiest and quickest way is to sign up is through the HAN Alert RSS feed at http://www.mainepublichealth.gov/ (midway down the center of the homepage).

Follow Maine CDC’s Updates:
Facebook (search for “Maine CDC”)
Twitter (http://twitter.com/MEPublicHealth)
MySpace (www.myspace.com/mainepublichealth)
Maine CDC’s Blog (http://mainepublichealth.blogspot.com/)

H1N1 Conference Calls: Maine CDC will be holding conference calls on a variety of topics related to H1N1 over the coming weeks. Conference calls will resume after Labor Day. Check Wednesday Weekly Updates for schedule of topics and call-in information.

Consider Calling or Emailing Us:
For clinical consultation, outbreak management guidance, and reporting of an outbreak of H1N1 call Maine CDC’s toll free 24-hour phone line at: 1-800-821-5821.
General Public Call-in Number for Questions: 1-888-257-0990
NextTalk (deaf/hard of hearing) - (207) 629-5751
Monday - Friday 9 a.m. – 5 p.m.

Email your questions to: Sue.Dowdy@maine.gov

U.S. CDC H1N1 Recommendations and Guidance:
http://www.cdc.gov/h1n1flu/ and http://www.flu.gov/

Maine CDC H1N1 Website and Related Links:
http://www.maineflu.gov/

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