Special Edition

Stay Informed and Prepared for H1N1 Influenza A

Mid-October is the projected date for shipment of vaccine that was specifically developed to target H1N1 Influenza A (formerly referred to as swine flu). Clinical trials recently got underway for the vaccine, with the results determining how soon the vaccine could be available.

The federal government is expected to ship the majority of the vaccine to states, which will then disburse it to local communities. Here in Bexar County, Metro Health will coordinate a great deal of the local distribution (excluding military installations).

Per recommendations from the CDC’s Advisory Committee on Immunization Practices (ACIP), the following population groups are the most vulnerable and should receive the novel H1N1 vaccine as soon as it becomes available:

• Pregnant women
• Persons between the ages of 6 months and 24 years old
• People who live with or care for children younger than 6 months of age
• Healthcare and emergency medical services personnel
• People ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems

As the summer has progressed and more has been learned about this novel virus, the CDC has consistently revised its recommendations and guidelines. One of the recommendations that will have a great impact on persons who are ill, as well as schools and businesses, affects the amount of time an individual with an influenza-like illness should stay home. The recommendations are as follows:

CDC recommends that people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8°C]), or signs of a fever without the use of fever-reducing medications.

This is a change from the previous recommendation that ill persons stay home for seven (7) days after illness onset or until 24 hours after the resolution of symptoms, whichever was longer. The new recommendation applies to camps, schools, businesses, mass gatherings, and other community settings where the majority of people are not at increased risk for influenza complications. This guidance does not apply to health care settings where the exclusion period should be continued for (seven) 7 days from symptom onset or until the resolution of symptoms, whichever is longer.

Meanwhile, Metro Health continues to prepare for the "second wave" of H1N1 Influenza A. The department is officially in planning mode and has developed or coordinated these action steps:

• Expanded surveillance systems to monitor and track the H1N1 virus in our community.

• Purchase of a county-wide Antiviral Cache consisting of 80% Tamiflu, and 20% Relenza of approximately 15,000 courses for first responders and outbreak management.

• Hosted a conference call with hospital CEOs to present the Fall H1N1 Plan and inform them of the hospital specific roles regarding vaccination, antivirals, and employee safety.

• Coordinating a meeting with Educational Service Center Region 20 to outline community-wide vaccination plans and the role of schools in H1N1 surveillance and mitigation activities.

• Met with members of the Bexar County Medical Society to request assistance in accessing family practice, pediatrician, internal medicine, and OB/GYN physicians for a high-efficiency vaccination plan of the CDC identified target populations.

• Working with the South Texas Regional Area Command (STRAC) to review infection control and prophylaxis plans with the hospital infection control practitioners, infectious disease physicians, and CMOs.

Other steps continue to be taken to keep the local community informed and protected. San Antonio's Public Health Team needs all families, businesses, schools, organizations, health care facilities, and others to also take an active role in preventing the spread of H1N1. We all can begin with these basic prevention methods:

If you are sick, stay home.

Wash your hands often (with soap and water).

Cover your cough or sneeze (with tissue or inside of elbow).

Avoid touching your eyes, nose or mouth (allows germs to enter your body or spread germs to others).

Avoid close contact with sick people.

Stay informed – www.sanantonio.gov/health; www.cdc.gov; www.texasflu.org

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