Overview
US CDC reported 1,380 hospitalizations and 196 deaths nationwide between August 30, and September 5, 2009. As of Sept. 6, the World Health Organization reported at least 3,205 deaths from H1N1 and reports of H1N1 from more than 200 countries.
Maine has identified 381 cases of H1N1, which include 19 individuals requiring hospitalization and one individual who has died. There have been no new outbreaks or institutions since the last update. The outbreak at Bowdoin College is ongoing. Of Maine residents with H1N1, 63 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.
H1N1 influenza vaccine: Licensed health care providers may now register to receive H1N1 vaccine. Information can be found at http://www.maineflu.gov/. H1N1 vaccine is expected to arrive in Maine in mid-October, with a possible small shipment in early October. The distribution of the first few shipments of H1N1 vaccine will be focused on settings where pregnant women are cared for, schools, and hospitals. Eventually sufficient vaccine is expected for everyone.
Seasonal influenza vaccine: Maine CDC has distributed about 49,000 seasonal flu vaccine for children and 55,000 for adults. 11 schools have conducted seasonal flu vaccine clinics this week, and about 116 school districts or schools have registered to offer seasonal flu vaccine clinics.
Maine CDC has posted an updated FAQ for the general public at http://www.maine.gov/dhhs/boh/maineflu/swine-flu-public-faq.shtml.
US CDC released several question and answer documents, including the following topics:
Guillain-Barré syndrome: http://www.cdc.gov/h1n1flu/vaccination/gbs_qa.htm
H1N1 vaccine safety: http://www.cdc.gov/h1n1flu/vaccination/vaccine_safety_qa.htm
Thimerosal: http://www.cdc.gov/h1n1flu/vaccination/thimerosal_qa.htm
Updates by Priority Population
The following groups are prioritized to be offered the first available doses of H1N1 vaccine, because they are at higher risk of complications from H1N1 infection or are more likely to pass the flu on to others who may be at higher risk of complications:
Pregnant women;
Household members and caregivers for children under 6 months old;
Health care and emergency medical services personnel;
All people ages 6 months through 24 years of age;
People ages 25 through 64 who have health conditions.
Pregnant Women:
An increased risk during pregnancy – especially in the second and third trimesters – has been consistently well-documented across several countries. Pregnant women are prioritized for H1N1 vaccine because of this risk, and because they can potentially provide protection to infants who cannot be vaccinated.
Maine CDC is working with clinicians who provide health care for pregnant women to assure they have H1N1 vaccine for their patients and themselves as soon as it arrives in Maine. A conference call for clinicians who care for pregnant women washeld from noon to 1 p.m. Thursday, Sept. 17. Q&As from the call will be posted at http://www.maineflu.gov/ soon.
The National Institute of Allergy and Infectious Diseases (NIAID) has begun H1N1 vaccine trials in pregnant women: http://www.nih.gov/news/health/sep2009/niaid-09.htm
Health Care and Emergency Medical Services Personnel:
Maine CDC is working with the Regional Resource Centers at Eastern Maine Medical Center, Central Maine Medical Center, and Maine Medical Center, to assure that all health care providers and Emergency Medical Services personnel (EMS) are offered H1N1 vaccine during the first few weeks of its arrival.
Updated frequently asked questions for health care providers, clinicians, and EMS have been posted at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/provider-faq.shtml
Health care workers and EMS who would like to volunteer to vaccinate children as part of the school-based clinic initiative should register at http://www.maineresponds.org/. Maine Responds will verify the credentials of volunteers, and they will be added to a list at http://www.maine.gov/mema/mema_news_display.shtml?id=79232.
The Institute of Medicine issued its report to US CDC and OSHA with their recommendations for the use of protective personal equipment (PPE) in clinical settings. Their recommendations confirmed the current US CDC guidance issued in May (http://www.cdc.gov/h1n1flu/guidance/) that N95 respirators be used in clinical settings by health care workers in close contact with those with H1N1 or influenza-like illness. (http://www.iom.edu/CMS/3740/71769/72967.aspx) CDC anticipates that their updated recommendations should be available by or in October. Maine CDC is not planning to issue guidance until after US CDC issues their updated recommendations.
Child Care Providers:
Maine CDC will be holding a conference call for child care providers from noon to 1 p.m., Monday, Sept. 21. The call-in number is 1-800-914-3396, pass code is 473623. Maine CDC has mailed information on H1N1 to all 3,000 licensed early childhood programs in Maine.
School-age Children:
Maine CDC is working with Maine Department of Education (DOE) to assure that all Maine children are offered seasonal (regular) and H1N1 vaccine in local schools.
US CDC released school-located vaccination planning materials and templates (http://www.cdc.gov/h1n1flu/vaccination/slv/). Maine-specific information can be found in our school-based vaccine clinic tool kit: http://www.maine.gov/dhhs/boh/maineflu/schools/index.shtml
A conference call for school personnel and health care providers working on this initiative was held Monday, Sept. 14. The questions and answers from this call, as well as other frequently asked questions, can be found at: http://www.maine.gov/dhhs/boh/maineflu/schools/index.shtml#faq
A list of schools and schools units that have signed up with the Maine Immunization Program to offer vaccine to their students (as of Monday, Sept. 14) is posted at http://www.maine.gov/dhhs/boh/maineflu/schools/index.shtml.
People with Health Conditions:
Anyone with asthma is at higher risk for flu-related complications, such as pneumonia. US CDC created a web site with information for people with asthma: http://www.cdc.gov/h1n1flu/asthma.htm?s_tw_flu44
Vaccination
Seasonal Flu Vaccine:
H1N1 has been the focus of attention since the spring, but it is important that we do not forget the risks of the regular seasonal flu. Seasonal flu vaccine has begun to arrive in Maine; US CDC recommends that people at risk for the seasonal flu get vaccinated as soon as it is available:
Children ages 6 months to 18 years
Pregnant women
People 50 years of age and older
People of any age with certain chronic medical conditions
People who live in nursing homes and other long-term care facilities
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
Household contacts and out of home caregivers of children younger than 6 months old
H1N1 Vaccine:
The FDA has approved the H1N1 vaccine. The vaccines will be distributed nationally after the initial lots become available, which is expected within the next four weeks. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm182399.htm.
Early results from clinical trials indicate that adults age 18 and older may need only one dose of H1N1 vaccine. http://www.hhs.gov/news/press/2009pres/09/20090911a.html
Vaccine planning with communities and schools is well underway to ensure that all Maine children, all health care providers and Emergency Medical Services personnel, pregnant women, and others in high-risk groups for H1N1 are offered H1N1 vaccine as soon as it arrives in Maine.
