CARROLL COUNTY HEALTH DEPARTMENT

H1N1 FLU UPDATE

4 August 2009

 

NATIONAL: CDC discontinued its practice of reporting state by state individual confirmed and probable cases of novel H1N1 infection on 24 July 2009.  As of 31 July 2009 there have been 5,514 hospitalizations and 353 deaths reported to CDC:

·       7 deaths in individuals 0-4 years

·       56 deaths 5-24 years

·       142 deaths 25-49 years

·       96 deaths 50-64 years

·       29 deaths age 65+

·       23 deaths of unknown age

 

During the week of 19-25 July 2009, H1N1 influenza activity decreased in the U. S; however, there were still higher levels of influenza-like illness than is normal for this time of year.

 

On 29 July the Advisory Committee on Immunization Practice made an official determination as to the top priority groups to be vaccinated first.

If substantial amounts of vaccine are initially available, the following groups are top priority:

·       pregnant women

·       people who live with or care for children younger than 6 months of age

·       health care and emergency services personnel

·       persons between the ages of 6 months through 24 years of age

·       people from age 25 through 64 years who are at higher risk because of chronic health disorders or compromised immune systems. 

 

These groups represent 159 million people nationally and 2.8 million people in Maryland.

 

If availability of vaccine is initially low, CDC recommends the following groups be vaccinated first:

·       pregnant women

·       people who live with or care for children younger than 6 months of age

·       health care and emergency services personnel with direct patient contact

·       children 6 months through 4 years of age

·       children 5 through 18 years of age who have chronic medical conditions

 

These groups represent about 42 million people nationally and about 700,000 Marylanders.

 

MARYLAND: 766 cases of laboratory confirmed and probable H1N1 influenza.  On 24 July 2009, Maryland registered its fourth death associated with the novel H1N1 influenza virus.  This death was an adult from the Eastern Shore with no immediately apparent underlying medical conditions or risk factors. 

 

Maryland is classified as “Local” on CDC’s surveillance report, which indicates influenza activity.  (Classifications used are No Activity, Sporadic, Local, Regional, Widespread).

 

CARROLL COUNTY:  Other than the two confirmed cases reported on 10 June 2009, nothing new to report.

 

OTHER NOTES:

·       WHO’s Global Pandemic Phase remains at SIX (The highest – full pandemic).  Measures spread, not severity

·       WHO reports 134,503 worldwide cases of H1N1 flu and 816 deaths (as of 27 July 2009)

·       H1N1 vaccine clinical trials underway to assess the safety and effectiveness of the vaccine.  Results should be available at end of August or beginning of September.

·       Only the Secretary of Health and Mental Hygiene can close a school.  He will do this after consulting with the State Superintendent of Schools.  This has to do with the Secretary’s legal ability to waive the annual requirement for 180 days of school.

·       To “clear the decks” for H1N1, so to speak, CCHD will conduct its seasonal influenza campaign largely in September this year.

 

CURRENT PUBLIC HEALTH RECOMMENDATIONS FOR A CARROLL COUNTY RESPONSE:

·       The County’s Emergency Medical System needs to establish the “optional protocol” as set out in the Education Article of the Annotated Code, Section 13-516(g), if it has not already done so.  This permits EMT-Ps (paramedics) to administer influenza vaccine to all public safety personnel within the County.  An agreement must be executed with the provider’s jurisdictional EMS operational program medical director and the County Health Officer.

·       Carroll Hospital Center needs to make arrangements to vaccinate all its own medical care providers within that institution, if possible.

·       Carroll County “front line physicians,” (obstetricians, pediatricians, primary care, family practice, internists, etc.) need to be ready to accept H1N1 vaccine to vaccinate their priority group patients, if possible. (CCHD is sending letters to these physicians/practices to gauge their willingness to participate in the mass vaccination effort).

·       The Vulnerable Populations Workgroup of the Disaster Planning Group needs to identify nursing homes, assisted living facilities, Developmentally Disabled group homes, etc. for vaccination of those medical providers.