{"id":10156,"date":"2025-03-01T14:02:56","date_gmt":"2025-03-01T19:02:56","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan196\/"},"modified":"2025-03-02T00:48:51","modified_gmt":"2025-03-02T05:48:51","slug":"dhan196","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan196\/","title":{"rendered":"php\/alerts\/dhan196 ~  Division of Public Health &#8211; &#8211; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan196.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->196 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->September 28, 2009 2:11 pm <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; 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Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; 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So\n\n\n  far, ninety-nine percent of all subtyped influenza viruses being submitted to CDC are 2009 influenza A (H1N1) viruses.\n\n\n<\/p>\n\n\n<p>\n\n\n  The current situation will likely affect pharmacies as a greater number of people than usual seek to fill prescriptions for influenza\n\n\n  antiviral drugs or antibiotics to treat secondary bacterial infections, in addition to seeking advice on over-the-counter flu\n\n\n  medications. This may affect supplies and availability of antiviral medications and other materials that may be needed to fill\n\n\n  prescriptions.\n\n\n<\/p>\n\n\n<p>\n\n\n  Pharmacists and physicians who care for pediatric patients should be aware of two issues: (1) the possible need to compound Tamiflu\u00ae\n\n\n  on site if commercially manufactured pediatric oral suspension formulation is not available, and (2) the need to ensure that the units of\n\n\n  measure on the dosing dispenser and the dosing instructions match.\n\n\n<\/p>\n\n\n<p>\n\n\n  These situations are addressed in the updated interim recommendations issued by CDC on September 22, 2009 for the use of antivirals in\n\n\n  the treatment and prevention of influenza which can be found at <a href=\"http:\/\/www.cdc.gov\/H1N1flu\/recommendations.htm\">http:\/\/www.cdc.gov\/H1N1flu\/recommendations.htm<\/a> and in the 2009-2010 Influenza\n\n\n  Season: Information for Pharmacists available at <a href=\"http:\/\/www.cdc.gov\/H1N1flu\/pharmacist\/pharmacist_info.htm\">http:\/\/www.cdc.gov\/H1N1flu\/pharmacist\/pharmacist_info.htm<\/a>.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Alternatives to Tamiflu\u00ae Oral Suspension for Pediatric Patients\n\n\n<\/h3>\n\n\n<p>\n\n\n  If pediatric formulations of Tamiflu are not available, pharmacists may compound Tamiflu\u00ae 75 mg capsules into an oral suspension\n\n\n  onsite. For the FDA -approved instructions for the emergency compounding of an oral suspension from Tamiflu\u00ae 75mg capsules, see the\n\n\n  FDA approved manufacturer package insert for oseltamivir (Tamiflu), available on the FDA Web site at <a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/UCM147992.pdf\">http:\/\/www.fda.gov\/downloads\/Drugs\/DrugSafety\/InformationbyDrugClass\/UCM147992.pdf<\/a>\n\n\n<\/p>\n\n\n<p>\n\n\n  Compounding an oral suspension from Tamiflu\u00ae 75mg capsules provides an alternative when commercially manufactured oral suspension\n\n\n  formulation is not readily available. Tamiflu\u00ae capsules 75 mg may be compounded using either of two vehicles: Cherry Syrup\n\n\n  (Humco\u00ae) or Ora-Sweet\u00ae SF (sugar-free) (Paddock Laboratories). Other supplies needed to compound include mortar and pestle and\n\n\n  amber glass or amber polyethyleneterephthalate (PET) bottle.\n\n\n<\/p>\n\n\n<p>\n\n\n  In addition, for children who may not be able to swallow capsules, Tamiflu\u00ae (30mg, 45mg and 75mg)capsules may be opened and mixed\n\n\n  with sweetened liquids, such as regular or sugar-free chocolate syrup, if oral suspension is not available.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Note on Tamiflu Oral Suspension Syringe\n\n\n<\/h3>\n\n\n<p>\n\n\n  The second issue that pharmacists and physicians may face is the need to ensure that the units of measure on the dosing dispenser and the\n\n\n  dosing instructions match. An oral dosing dispenser with 30 mg, 45 mg, and 60 mg graduations of Tamilfu\u00ae is provided in the packaging\n\n\n  for the manufacturer\u2019s product rather than graduations in milliliters (mL) or teaspoons (tsp).This can lead to patient or caregiver\n\n\n  confusion and dosing errors. When dispensing commercially manufactured Tamiflu\u00ae oral suspension, pharmacists should ensure the units\n\n\n  of measure on the dosing instructions match the dosing device provided. If prescription instructions specify administration using mL or\n\n\n  tsp, then the device included in the Tamiflu\u00ae product package should be removed and replaced with an appropriate measuring device,\n\n\n  such as an oral syringe if the prescribed dose is in milliliters (mL). When dispensing Tamiflu\u00ae oral suspension for children younger\n\n\n  than 1 year of age, the oral dosing dispenser that is included in the product package should always be removed. Pharmacists and health\n\n\n  care providers should provide an oral syringe that is capable of accurately measuring the prescribed milliliter (mL) dose, and counsel\n\n\n  the caregiver how to administer the prescribed dose. Oseltamivir is authorized for emergency use in children younger than 1 year of age\n\n\n  under an Emergency Use Authorization (EUA) issued by FDA. For the EUA, see <a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/tamiflu-hcp.pdf\">http:\/\/www.cdc.gov\/h1n1flu\/eua\/pdf\/tamiflu-hcp.pdf<\/a>.\n\n\n<\/p>\n\n\n<h3>\n\n\n  For More Information:\n\n\n<\/h3>\n\n\n<ul>\n\n\n  <li>2009-2010 Influenza Season: Information for Pharmacists: <a href=\"http:\/\/www.cdc.gov\/H1N1flu\/pharmacist\/pharmacist_info.htm\">http:\/\/www.cdc.gov\/H1N1flu\/pharmacist\/pharmacist_info.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010\n\n\n  Season: <a href=\"http:\/\/www.cdc.gov\/H1N1flu\/recommendations.htm\">http:\/\/www.cdc.gov\/H1N1flu\/recommendations.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>Questions &#038; Answers: Antiviral Drugs, 2009-2010 Flu Season: <a href=\"http:\/\/www.cdc.gov\/h1n1flu\/antiviral.htm\">http:\/\/www.cdc.gov\/h1n1flu\/antiviral.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>Updated Interim Recommendations for Obstetric Health Care Providers Related to Use of Antiviral Medications in the Treatment and\n\n\n  Prevention of Influenza for the 2009-2010 Season: <a href=\"http:\/\/www.cdc.gov\/H1N1flu\/pregnancy\/antiviral_messages.htm\">http:\/\/www.cdc.gov\/H1N1flu\/pregnancy\/antiviral_messages.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>Antiviral Drugs: Summary of Side Effects: <a href=\"http:\/\/www.cdc.gov\/flu\/protect\/antiviral\/sideeffects.htm\">http:\/\/www.cdc.gov\/flu\/protect\/antiviral\/sideeffects.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>For the FDA page on antiviral influenza drugs:<br>\n\n\n    <a href=\"http:\/\/www.fda.gov\/Drugs\/DrugSafety\/InformationbyDrugClass\/ucm100228.htm\">http:\/\/www.fda.gov\/Drugs\/DrugSafety\/InformationbyDrugClass\/ucm100228.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>For the FDA-approved package insert with instructions for the emergency compounding of an oral suspension from Tamiflu\u00ae 75mg\n\n\n  capsules see <a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/UCM147992.pdf\">http:\/\/www.fda.gov\/downloads\/Drugs\/DrugSafety\/InformationbyDrugClass\/UCM147992.pdf<\/a>\n\n\n  <\/li>\n\n\n  <li>For the FDA public health alert regarding Tamiflu (oseltamivir) for Oral Suspension: Potential Medication Errors see <a href=\"http:\/\/www.fda.gov\/Safety\/MedWatch\/SafetyInformation\/SafetyAlertsforHumanMedicalProducts\/ucm183714.htm\">http:\/\/www.fda.gov\/Safety\/MedWatch\/SafetyInformation\/SafetyAlertsforHumanMedicalProducts\/ucm183714.htm<\/a>.\n\n\n  <\/li>\n\n\n  <li>For additional information, you can also call CDC\u2019s toll-free hotline, 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348, which\n\n\n  is available 24 hours a day, every day.\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p class=\"text-center\">\n\n\n  ****\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n<\/p>\n\n\n<p>\n\n\n  If you are not a member and would like to subscribe, please complete the form found online at:\u00a0 <a href=\"\/main\/mailforms\/dph_hanform.aspx\">http:\/\/dhss.delaware.gov\/main\/mailforms\/dph_hanform.aspx<\/a>\n\n\n<\/p><br>\n\n\n<br>\n\n\n<p>\n\n\n  Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader. A free copy of Adobe\n\n\n  Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe<\/a> . If you are\n\n\n  using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit\n\n\n  Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.\n\n\n<\/p><!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #196 September 28, 2009 2:11 pm Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10156","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10156","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10156"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10156\/revisions"}],"predecessor-version":[{"id":11332,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10156\/revisions\/11332"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10156"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}