Health Advisory
FIRST CONFIRMED INFLUENZA CASES FOR 2007 - 2008

Delaware

The Delaware Division of Public Health (DPH) is reporting the state's first laboratory confirmed cases of influenza. The cases are three and five year-old sisters from Kent County. The five year-old child was hospitalized; the three year-old was evaluated in the emergency department and released to home. Both cases were Type B influenza and were confirmed by the DPH laboratory by both PCR (polymerase chain reaction) and culture.

In addition to laboratory testing, DPH conducts surveillance for influenza by monitoring the occurrence of influenza like illness (ILI) in all hospitals and selected long term care facilities, large corporations and stand alone medical clinics. Reports are provided to DPH weekly. (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). ILI activity has not increased so far this year. Nor have reports of respiratory symptoms among patients seen in Delaware's emergency rooms, also reported to DPH weekly.

National

During week 44 (October 28 – November 3, 2007), a low level of influenza activity was reported in the United States. Fifty (2.5%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories were positive for influenza. The proportion of deaths attributed to pneumonia and influenza was below the epidemic threshold. The proportion of outpatient visits for influenza-like illness (ILI) and acute respiratory illness was below national baseline levels. National information can be found at: http://www.cdc.gov/flu/weekly/index.htm

Vaccine Availability

A DPH clinic schedule can be found here: http://www.dhss.delaware.gov/dhss/dph/fluclinics.html. People in any of the following groups can be vaccinated at DPH clinics (6 months to 18 years require appointment).

• Children age 6-59 months;
• Adults 50 years and older;
• People ages 2-49 with chronic medical conditions;
• Adults or children with spinal cord injuries, seizure disorders, or other muscle and nerve conditions that lead to breathing and swallowing problems.
• Women who will be pregnant during flu season. Vaccination can occur in any trimester;
• Household contacts of out-of-home caregivers of children less than six months old.
• Residents of long-term care facilities;
• Healthcare workers involved in direct patient care; and
• Out-of-home caregivers and household contacts of people in the other high-risk categories.

A comprehensive schedule can be found at this website: http://www.flucliniclocator.org/

Testing

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 assist with surveillance. Culture and subtype testing by the DPH Laboratory is done free of charge and 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.

For more information

• DPH Laboratory: (302) 223-1520
• DPH Immunization Hotline: 1-800-282-8672
• DPH Epidemiology: 1-888-295-5156
• DPH Website: http://www.dhss.delaware.gov/dhss/dph
• CDC Influenza Website:  http://www.cdc.gov/flu/about/disease.htm
• Vaccination Resources for Health Care Professionals: http://www.cdc.gov/flu/professionals/vaccination/
• Antiviral Medications for Influenza: http://www.cdc.gov/flu/professionals/treatment/
• Patient and Provider Education: http://www.cdc.gov/flu/professionals/patiented.htm
• Clinical Description and Diagnosis: http://www.cdc.gov/flu/professionals/diagnosis/
• Lab Diagnosis: http://www.cdc.gov/flu/professionals/diagnosis/
• Influenza Information for Health care Professionals: http://www.cdc.gov/ncidod/dhqp/id_influenza_vaccine.html
• Control of Influenza in Acute Care facilities: http://www.cdc.gov/flu/professionals/infectioncontrol/healthcarefacilities.htm