Health Update
UPDATED GUIDANCE: PATIENT TESTING FOR NOVEL INFLUENZA A (H1N1) VIRUS AS OF MAY 15, 2009

The Division of Public Health (DPH) encourages Delaware clinicians to follow guidance issued by the Centers for Disease Control and Prevention (CDC) that 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.

The following guidance issued by DPH on May 8 is no longer in effect: “for the purposes of disease surveillance only, DPH is seeking specimens from persons other than University of Delaware students with influenza-like symptoms if they present with a fever >100° F and cough, sore throat, or nasal congestion.”

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:

• Children less than 5 years old
• Persons aged 65 years or older
• Children and adolescents (< 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza infection
• Pregnant women
• Adults and children who have chronic pulmonary, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders
• Adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV)
• Residents or nursing homes or other chronic-care facilities

As of May 15, 61 cases of novel H1N1 influenza have been confirmed in Delaware. Four are from Sussex County, 1 from Kent County, and 56 from New Castle County. The median age of the cases is 18 years. One was hospitalized (and discharged). Only 2 reported travel to Mexico.

For more information please call the Bureau of Epidemiology at 1-888-295-5156 or (302) 744-4541

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