ADPH Makes Recommendations Regarding Novel H1N1 Influenza

Main Category: Swine Flu
Also Included In: Flu / Cold / SARS;  Public Health;  Respiratory / Asthma
Article Date: 24 Aug 2009 - 2:00 PDT

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Novel H1N1 influenza continues circulating in Alabama, and the Alabama Department of Public Health urges the public to consider strategies to best respond to it. The Centers for Disease Control and Prevention recently issued guidance to assist businesses and institutions of higher education plan for the influenza season. Alabama physicians were also notified about changes needed because of the prevalence of the novel H1N1 strain.

While the severity of illness that novel H1N1 influenza will cause is unknown, employers should consider offering vaccine to protect their employees against seasonal flu and encourage employees to be vaccinated for both seasonal and novel H1N1 influenza.

"As we face the renewed challenge of novel H1N1, we ask that businesses encourage their employees who are sick to stay home," Dr. Donald Williamson, state health officer, said. The CDC also recommends that employees who begin to experience flu-like symptoms at work be sent home and perhaps encouraged to seek medical treatment. Flexibility is needed to reduce transmission among staff and to protect those at increased risk.

If influenza incidence conditions are similar to those of the past spring, the CDC recommends that institutions of higher education facilitate the self isolation of residential students with flu-like illness. Students and staff with flu-like illness should stay away from classes and limit interactions with others for at least 24 hours after they no longer have a fever or signs of a fever without the use of fever-reducing medicines.

In addition, nonresidential students, faculty and staff with flu-like illness should be asked to isolate themselves at home, at a friend's home, or at family member's home. High-risk students, faculty and staff should be permitted to stay home when influenza is spreading in the community.

With the increase in influenza, the department also has informed Alabama physicians that the prevalence of H1N1 influenza makes routine confirmatory tests for novel H1N1 influenza no longer necessary. More than 99 percent of all positive influenza samples tested by the Bureau of Clinical Laboratories during the past four weeks were positive for the novel strain. "Public health resources will be directed instead to testing of hospitalized patients, pregnant women and a fixed number of patients seen weekly by a statewide network of designated medical practices," Dr. Williamson stated.

While recommendations from the Centers for Disease Control and Prevention change frequently, guidance for excluding ill persons depends upon their setting. Persons with influenza-like illness should remain at home until at least 24 hours after they are free of fever (100 degrees F) or signs of a fever without the use of fever-reducing medications. This is often three to five days.

This recommendation applies to schools, businesses, mass gatherings, camps, and other community settings where the majority of people are not at increased risk for influenza complications. Convalescent health care workers should be excluded for seven days from the onset of symptoms or until the resolution of symptoms, whichever is longer.

The federal government has advised public health agencies to prepare for the delivery of 45 million doses of the novel H1N1 vaccine nationwide in October. The strategy in Alabama will be to push the vaccine to school-based clinics for kindergarten through 12th grade students. The vaccine will be offered at no charge; insurers will pay the costs to administer the vaccine. By October, 600,000 courses of novel H1N1 vaccine are expected to be shipped to Alabama, followed by an additional 300,000 doses every two weeks. By December, 2 million doses of vaccine are expected. Plans now call for two novel H1N1 shots to be administered. Currently, the novel H1N1 attack rate for children and young adults (ages 5 to 24) is higher than for all other age groups, but the hospitalization rate for children under age 4 is the highest.

Alabama has experienced approximately 1,300 novel H1N1 influenza cases and two deaths. The department will monitor school absenteeism with the State Board of Education, and will work with the Alabama Hospital Association to monitor bed availability and fatalities. Detailed guidance for businesses, employers and institutions of higher education are available at flu.gov.

Source
Alabama Department of Public Health

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