Health Alert
DELAWARE DIVISION OF PUBLIC HEALTH
2005-2006 INFLUENZA INFORMATION

The following is information about the Delaware Division of Public Health's influenza vaccination and surveillance activities for the 2005-2006 season.

Vaccine Availability

• In addition to vaccine being shipped directly to private providers in Delaware, the Division of Public Health (DPH) ordered 24,000 doses of adult vaccine manufactured by Sanofi Pastur and 10,000 doses of Sanofi Pasteur vaccine for children eligible for the Vaccines For Children (VFC) Program. VFC is the program which provides free vaccine to all Medicaid, un-insured, under-insured, and American Indian children up to age 18.
• DPH vaccine began arriving the week of Sept.12. The VFC vaccine is arriving in allotments of 1,100 per week. Adult vaccine is arriving in allotments of 4,800 every few weeks.

Vaccine Distribution

• Notices of VFC vaccine availability were sent to providers on September 30 and the first shipments went out October 5.
• DPH clinics will begin on October 11. The current schedule runs through the end of November. Information about sites and schedule can be obtained by calling the DPH Immunization Hotline (800-282-8672) or checking the DPH website (http://www.dhss.delaware.gov/dhss/dph/fluclinicschedule2005.html).
• At the present time, DPH clinics will be restricted to people in the high risk groups (see below):

High risk groups

• Individuals 50 years of age and older;
• Long term care facility (nursing homes and other such institutions) patients or residents;
• Individuals above the age of 24 months with chronic medical conditions (these include diabetes, heart or kidney disease, neurological illness, pulmonary disease, etc.); Also includes children on long term aspirin therapy and anyone with a compromised immune system;
• Children from 6 to 23 months;
• Women who are or will be pregnant before the end of flu season;
• Health care workers in direct patient care;
• Individuals who reside in a household with at-risk individuals.

Influenza Surveillance

DPH conducts surveillance for influenza activity in Delaware. Surveillance is used to:

• Advise the medical community when influenza activity begins so they can treat patients accordingly;
• Determine the subtype of circulating influenza virus. The subtype is clinically important to determine susceptibility to antiviral medications;
• Detect any unusual influenza activity, such as a sudden increase;
• Contribute to national monitoring of influenza activity. Subtype information is shared with CDC. In addition, DPH provides an assessment of influenza activity (widespread, regional, local, sporadic or no activity).

Surveillance methods use for the 2005-2006 season are as follows:

• All hospitals report culture confirmed cases of influenza and rapid test positive cases directly to DPH through the Delaware Electronic Reporting and Surveillance System (DERSS).
• All hospitals and selected long term care facilities, school wellness centers, large corporations and stand alone medical clinics also report weekly, the number of Influenza-like Illness (ILI) cases (The CDC definition of ILI is fever equal to or greater than 100 degrees F, oral or equivalent, and cough and/or sore throat, in the absence of a known cause).
• The DPH Laboratory is working with hospital laboratories to obtain specimens from patients who have a rapid positive test or positive culture. Such specimens will be cultured and subtyped. Culture also has the advantage of identifying respiratory disease due to non-influenza viruses (e.g. parainfluenza, respiratory syncytial, adenovirus).
• DPH strongly encourages other providers (for example, school wellness centers, long term care facilities, physicians, etc.) to submit influenza specimens to the DPH Laboratory for culture confirmation and subtyping (throat/NP/nasal wash) to help with surveillance. Culture and subtype testing by the DPH Laboratory is done free of charge & results are sent back to the requesting physician or hospital as soon as test results are available. To submit a specimen for culture contact the DPH laboratory (302-223-1520) to request influenza virus isolation kits and obtain information about specimen transport to the laboratory.

Other DPH Laboratory Information

The DPH Laboratory will be performing real-time PCR (polymerase chain reaction) testing in special circumstances only after discussion with laboratory administration. RT-PCR has the advantages of a quick turn around time and the ability to detect non-viable particles. It can also be used to distinguish the common human strains of influenza virus (H1, H3) from those strains carried by birds (H5).

For More Information

• CDC Influenza Website: www.cdc.gov/flu
• DPH Website: http://www.dhss.delaware.gov/dhss/dph/fluclinicschedule2005.html
• DPH Laboratory: (302) 223-1520
• DPH Immunization Hotline: 800-282-8672
• DPH Epidemiology: 888-295-5156