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Delaware Division of Public Health (DPH) would like to share the following new and updated guidance from the Centers for Disease Control and Prevention (CDC) related to H1N1 influenza with the Delaware community.
As of May 27, 2009 there are 112 laboratory-confirmed cases of H1N1 in Delaware. Of the 112 cases, 95 are in New Castle County, 12 in Kent County and 4 in Sussex County. There have been two short hospitalizations related to H1N1 but all cases have recovered, or are recovering, without complications. The ages of the laboratory-confirmed cases ranges from 1 to 41 years.
Influenza illness, including illness associated with the novel influenza A H1N1 virus is ongoing in the United States. The May 22 FluView Report shows that influenza activity is decreasing in the United States; however, levels of influenza-like illness are higher than normal for this time of year. At this time, the majority of influenza viruses isolated in the United States are now novel H1N1 viruses.
It’s uncertain at this time how severe this novel H1N1 outbreak will be in terms of how many people infected have severe complications or death related to novel H1N1 infection. While nation-wide influenza-like-illness surveillance is trending downward, localized outbreaks are ongoing and it’s likely that such outbreaks will continue over the summer. It’s uncertain how the novel H1N1 virus will affect the upcoming 2009-2010 influenza season.
The Centers for Disease Control and Prevention continues its response to the novel H1N1 Flu outbreak. CDC's goals continue to be to reduce the spread and severity of illness and to provide information to assist health care providers, public health officials, and the public address the challenges posed by this emergency. To this end, CDC continues to develop and update guidance documents and provide other information.
As a reminder to clinicians, CDC recommends that influenza antiviral treatment be given to all hospitalized patients with confirmed, probable, or suspected novel influenza A (H1N1) and any patient with confirmed, probable or suspected novel influenza A (H1N1) who is at higher risk for seasonal influenza complications. All hospitalized patients should be carefully monitored and treated with antiviral medications as soon as possible after admission, including patients who seek treatment more than 48 hours after onset of symptoms. The drugs recommended for treatment are either oseltamivir or zanamivir. The novel H1N1 viruses are resistant to amantadine and rimantadine.
Not all people with suspected novel influenza (H1N1) infection need to have the diagnosis confirmed, especially if the person resides in an affected area or if the illness is mild, such as in Delaware.
Clinicians should test persons who have an acute febrile respiratory illness or sepsis-like syndrome and 1) require hospitalization or 2) are at high-risk for severe disease (as listed below). As always, clinicians should use their clinical judgment, in addition to this guidance when deciding when to test for novel influenza A (H1N1). The full CDC recommendation can be found here: http://www.cdc.gov/h1n1flu/identifyingpatients.htm.
Specimen storage and transportation information can be found here: http://www.dhss.delaware.gov/dhss/dph/php/alerts/dhan177.html
Groups at higher risk for seasonal influenza complications include:
For more information please contact the Bureau of Epidemiology at: 1-888-295-5156 or 302-744-4541
CDC specific information regarding H1N1 Flu can be found here: http://www.cdc.gov/h1n1flu/
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