{"id":10162,"date":"2025-03-01T14:02:58","date_gmt":"2025-03-01T19:02:58","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan201\/"},"modified":"2025-03-02T00:48:52","modified_gmt":"2025-03-02T05:48:52","slug":"dhan201","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan201\/","title":{"rendered":"php\/alerts\/dhan201 ~  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\/dhan201.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\"]-->201 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->October 19, 2009 12:29 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; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; 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; Conditions<\/a><\/li>\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\n        <li><a href=\"\/dph\/links.html\">Links &#038; Resources<\/a><\/li>\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n      <ul id=\"SocialMenu\">\n        <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" target=\"_blank\" title=\"Division of Public Health Facebook Page\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n              <\/div>\n\n            <\/div>\n\n          <\/div>\n\n        <\/div><br>\n\n      <\/div>\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n  \n\n<h2 class=\"center\">Health\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n   Alert<!--[END]-->\n\n<br>\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\nRECOMMENDATIONS FOR EARLY EMPIRIC ANTIVIRAL TREATMENT IN PERSONS WITH SUSPECTED INFLUENZA WHO ARE\n\n\n  AT INCREASED RISK OF DEVELOPING SEVERE DISEASE<!--[END]-->\n\n<\/h2>\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n<p>\n\n\n  <strong>The following Health Alert is from the Centers for Disease Control and Prevention issued on September 19, 2009<\/strong>\n\n\n<\/p>\n\n\n<p>\n\n\n  <em><strong>Summary Recommendations:<\/strong> When treatment of influenza is indicated in a patient with suspected\n\n\n  influenza<strong>,<\/strong> <strong>health care providers should initiate empiric antiviral treatment as soon as possible. Waiting for\n\n\n  laboratory confirmation of influenza to begin treatment with antiviral drugs is not necessary.\u00a0Patients with a negative rapid\n\n\n  influenza diagnostic test should be considered for treatment if clinically indicated because a negative rapid influenza test result does\n\n\n  not rule out influenza virus infection.<\/strong> The sensitivity of rapid influenza diagnostic tests for 2009 H1N1 virus can range from\n\n\n  10% to 70%, indicating that false negative results occur frequently.<\/em>\n\n\n<\/p>\n\n\n<h3>\n\n\n  Situation\n\n\n<\/h3>\n\n\n<p>\n\n\n  The 2009 pandemic H1N1 influenza virus continues to be the dominant influenza virus in circulation in the U.S. The benefit of antiviral\n\n\n  treatment is greatest when it is initiated as early as possible in the clinical course. Several recent reports have indicated two\n\n\n  problems related to antiviral treatment: (1) some patients with suspected influenza who are at higher risk of developing severe\n\n\n  complications, including hospitalized patients, were not treated at all with antiviral medications because of a negative rapid influenza\n\n\n  diagnostic test result and (2) initiation of treatment was delayed for some patients with suspected influenza who are at higher risk of\n\n\n  developing severe complications, including hospitalized patients, because clinicians were waiting for results of real-time reverse\n\n\n  transcriptase-polymerase chain reaction (rRT-PCR) assay.\n\n\n<\/p>\n\n\n<h4>\n\n\n  Who is prioritized for treatment with influenza antiviral drugs?\n\n\n<\/h4>\n\n\n<p>\n\n\n  Most healthy persons (i.e., those without a condition which puts them at higher risk for complications) who develop an illness consistent\n\n\n  with uncomplicated influenza do not need to be treated with antiviral medications and will recover without complications. However,\n\n\n  clinical judgment should be the ultimate guide in making antiviral treatment decisions for ill persons who are not at higher risk for\n\n\n  complications from influenza.\n\n\n<\/p>\n\n\n<p>\n\n\n  Early empiric treatment with oseltamivir or zanamivir is recommended for all persons with suspected or confirmed influenza requiring\n\n\n  hospitalization. Prompt empiric outpatient antiviral therapy is also recommended for persons with suspected influenza who have symptoms\n\n\n  of lower respiratory tract illness or clinical deterioration regardless of previous health or age.\n\n\n<\/p>\n\n\n<p>\n\n\n  Early empiric treatment should be considered for persons with suspected or confirmed influenza who are at higher risk for complications,\n\n\n  even if not hospitalized, including:\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>Children younger than 2 years old\n\n\n  <\/li>\n\n\n  <li>Adults 65 years and older\n\n\n  <\/li>\n\n\n  <li>Pregnant women\n\n\n  <\/li>\n\n\n  <li>Persons with the following conditions:\n\n\n    <ul>\n\n\n      <li>Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell\n\n\n      disease), or metabolic disorders (including diabetes mellitus);\n\n\n      <\/li>\n\n\n      <li>Disorders that that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk\n\n\n      for aspiration (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders)\n\n\n      <\/li>\n\n\n      <li>Immunosuppression, including that caused by medications or by HIV;\n\n\n      <\/li>\n\n\n      <li>Persons younger than 19 years of age who are receiving long-term aspirin therapy, because of an increased risk for Reye syndrome.\n\n\n      <\/li>\n\n\n    <\/ul>\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<h4>\n\n\n  When should health care providers start treatment with antiviral drugs?\n\n\n<\/h4>\n\n\n<p>\n\n\n  Once the decision to administer antiviral treatment is made, oseltamivir or zanamivir should be initiated as soon as possible. Evidence\n\n\n  for benefit from antiviral treatment in studies of seasonal influenza is strongest when treatment is started within 48 hours of illness\n\n\n  onset. However, some studies of oseltamivir treatment of hospitalized patients with seasonal influenza have indicated benefit, including\n\n\n  reductions in mortality or duration of hospitalization, even for patients whose treatment was started more than 48 hours after illness\n\n\n  onset.\n\n\n<\/p>\n\n\n<p>\n\n\n  When treatment is indicated<strong>, health care providers should not wait for laboratory confirmation of influenza to begin oseltamivir\n\n\n  or zanamivir treatment of patients with suspected 2009 pandemic H1N1 influenza virus infection. <em>Patients with a negative rapid\n\n\n  influenza diagnostic test should be considered for treatment if clinically indicated<\/em> because a negative result does not rule out\n\n\n  influenza virus infection.<\/strong> The sensitivity of rapid influenza diagnostic tests to detect 2009 H1N1 virus in respiratory\n\n\n  specimens ranges from 10% to 70%, and therefore false negative results occur frequently. Similarly, false negative results can also occur\n\n\n  with immunoflorescence assays.\n\n\n<\/p>\n\n\n<h4>\n\n\n  What actions should health care providers take when waiting for influenza test results?\n\n\n<\/h4>\n\n\n<p>\n\n\n  Health care providers should empirically treat persons with suspected influenza illness who are at increased risk for complications if\n\n\n  clinically indicated while influenza test results are pending. Antiviral treatment is most effective when administered as early as\n\n\n  possible in the course of illness. The rRT-PCR tests are the most sensitive and specific influenza diagnostic tests, but they may not be\n\n\n  readily available, obtaining test results may take one to several days, and test performance depends on the individual rRT-PCR assay.\n\n\n  Antiviral treatment should not be delayed until rRT-PCR test results are available.\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>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>Interim Recommendations for Clinical Use of Influenza Diagnostic Tests During the 2009-10 Influenza Season: <a href=\"http:\/\/www.cdc.gov\/h1n1flu\/guidance\/diagnostic_tests.htm\">http:\/\/www.cdc.gov\/h1n1flu\/guidance\/diagnostic_tests.htm<\/a>\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<h4>\n\n\n  Questions &#038; Answers:\n\n\n<\/h4>\n\n\n<ul>\n\n\n  <li>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>Influenza Diagnostic Testing: <a href=\"http:\/\/www.cdc.gov\/h1n1flu\/diagnostic_testing_clinicians_qa.htm\">http:\/\/www.cdc.gov\/h1n1flu\/diagnostic_testing_clinicians_qa.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>General information for the public on antiviral drugs is available in \u201c2009 H1N1 and Seasonal Flu: What You Should Know About\n\n\n  Flu Antiviral Drugs\u201d at <a href=\"http:\/\/www.cdc.gov\/H1N1flu\/antivirals\/geninfo.htm\">http:\/\/www.cdc.gov\/H1N1flu\/antivirals\/geninfo.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>Downloadable brochures and informational flyers, including one on antiviral drugs, are available at <a href=\"http:\/\/www.cdc.gov\/h1n1flu\/flyers.htm\">http:\/\/www.cdc.gov\/h1n1flu\/flyers.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>For the FDA page on antiviral influenza drugs: <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 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><!--[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 #201 October 19, 2009 12:29 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-10162","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10162","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=10162"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10162\/revisions"}],"predecessor-version":[{"id":11338,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10162\/revisions\/11338"}],"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=10162"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}