{"id":10198,"date":"2025-03-01T14:03:05","date_gmt":"2025-03-01T19:03:05","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan234\/"},"modified":"2025-03-02T00:49:55","modified_gmt":"2025-03-02T05:49:55","slug":"dhan234","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan234\/","title":{"rendered":"php\/alerts\/dhan234 ~  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\/dhan234.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\"]-->234 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->August 5, 2010 1:45 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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To\n\n\n  contact the DPH Immunization Program, call 1-800-282-8672.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Summary\n\n\n<\/h3>\n\n\n<p>\n\n\n  Influenza A (H3N2) virus infections have been recently detected in people in a number of states across the U.S., including two small\n\n\n  localized outbreaks. Sporadic cases of influenza and localized summer outbreaks from seasonal influenza viruses are detected each summer.\n\n\n  Clinicians are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses,\n\n\n  including pneumonia, even during the summer months. Treatment decisions should not be made on the basis of a negative rapid influenza\n\n\n  diagnostic test result since the test has only moderate sensitivity. False positive results also can occur, particularly at times when\n\n\n  overall influenza prevalence is low. For patients for whom laboratory confirmation is desired, or to confirm initial influenza cases in a\n\n\n  community in which cases have been tested by rapid influenza diagnostic tests, it is recommended that reverse transcriptase -polymerase\n\n\n  chain reaction (RT-PCR), and\/or viral culture is utilized. Clinicians should use empirical treatment with influenza antiviral medications\n\n\n  for persons hospitalized with suspected influenza, and for suspected influenza infection of any severity in high-risk individuals,\n\n\n  regardless of influenza immunization status. Early initiation of treatment provides more optimal clinical responses, although treatment\n\n\n  of moderate, severe, or progressive disease begun after 48 hours of symptoms can still provide benefit.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Background\n\n\n<\/h3>\n\n\n<p>\n\n\n  During late June and July, 2010, the number of seasonal influenza A (H3) viruses reported to CDC increased slightly compared with\n\n\n  previous months. In the first part of July, two small RT-PCR-confirmed outbreaks were detected in two non-bordering eastern counties in\n\n\n  Iowa. The first included four of 13 members of a college sports team who became ill. Three of the four tested positive for influenza A by\n\n\n  rapid tests and two of the three were further tested and found to be positive for influenza A (H3) by RT-PCR. The second outbreak\n\n\n  involved nine of 12 children in a child care setting and one parent reporting influenza-like illness; two were rapid test positive for\n\n\n  influenza A and one was PCR positive for influenza A (H3). Specimens and isolates have been sent to CDC for further characterization.\n\n\n  None of the patients had a history of recent travel and no epidemiological links were identified between the two outbreaks.\n\n\n<\/p>\n\n\n<p>\n\n\n  Between June 20 and July 23, 2010, CDC also received additional influenza A (H3) positive specimens from 11 other states along with a\n\n\n  smaller number of sporadic samples positive for 2009 H1N1 influenza A and B viruses. Localized summer outbreaks in the United States from\n\n\n  seasonal influenza viruses and sporadic cases of influenza are detected each summer.\n\n\n<\/p>\n\n\n<p>\n\n\n  Antigenic characterization of the influenza A (H3) viruses received at CDC are pending. However, based on hemagglutinin gene sequencing\n\n\n  data from four viruses isolated from July specimens, these viruses are expected to be antigenically similar to A\/Perth\/16\/2009-like H3N2\n\n\n  viruses. AnA\/Perth\/16\/2009-like H3N2 virus is included in the 2010-11 seasonal influenza vaccine. Perth-like H3N2 viruses were first\n\n\n  identified in early 2009, but have not yet circulated widely in the United States. Past influenza vaccines did not contain this strain,\n\n\n  so vaccination with last year\u2019s seasonal vaccine would not be expected to provide substantial protection against this H3N2\n\n\n  Perth-like strain.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Recommendations\n\n\n<\/h3>\n\n\n<p>\n\n\n  Health care providers are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory\n\n\n  illnesses, including pneumonia, even during the summer months. The neuraminidase inhibitors oseltamivir (Tamiflu\u00ae) and zanamivir\n\n\n  (Relenza\u00ae) are currently recommended for use against circulating influenza viruses. The adamantanes (amantadine and rimantadine) are\n\n\n  not recommended because of high levels of resistance to these drugs among recently circulating influenza A (H3) and 2009 H1N1 pandemic\n\n\n  viruses.\n\n\n<\/p>\n\n\n<p>\n\n\n  Clinical judgment is an important factor in treatment decisions for patients presenting with influenza-like illness. Prompt empiric\n\n\n  antiviral treatment with influenza antiviral medications is recommended while results of definitive diagnostic tests are pending, or if\n\n\n  diagnostic testing is not possible, for patients with clinically suspected influenza illness who have:\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>Illness requiring hospitalization,\n\n\n  <\/li>\n\n\n  <li>Progressive, severe, or complicated illness, regardless of previous health status, and\/or\n\n\n  <\/li>\n\n\n  <li>Patients at increased risk for severe disease.\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p>\n\n\n  Persons at high risk of influenza complications include people aged 65 years and older, young children, pregnant women, people with\n\n\n  long-term health conditions like asthma, diabetes, neurologic and neuro-developmental disorders, heart disease, and people with\n\n\n  immunosuppressive conditions or medications.\n\n\n<\/p>\n\n\n<p>\n\n\n  Antiviral treatment, when clinically indicated, should <strong>not be delayed pending definitive laboratory confirmation of\n\n\n  influenza.<\/strong> Influenza antiviral medications are most effective when initiated within the first 2 days of illness, but these\n\n\n  medications may also provide benefits for severely ill patients when initiated even after 2 days. Point of care rapid tests capable of\n\n\n  detecting influenza A and B virus infections are available, but health care providers and public health personnel should be aware that\n\n\n  rapid influenza diagnostic tests have limited sensitivity and false negative results are common. Thus, negative results from rapid\n\n\n  influenza diagnostic test should not be used to guide decisions regarding treating patients with influenza antiviral medications. In\n\n\n  addition, false positive tests can occur and are more likely when influenza is rare in the community. When laboratory confirmation is\n\n\n  desired, testing by RT-PCR and\/or viral culture is recommended.\n\n\n<\/p>\n\n\n<p>\n\n\n  Providers are asked to report unusual increases in febrile respiratory disease outbreaks to their local and state health departments and\n\n\n  to confirm positive rapid test results with PCR or culture when community circulation of influenza viruses is low.\n\n\n<\/p>\n\n\n<h3>\n\n\n  For More Information\n\n\n<\/h3>\n\n\n<p>\n\n\n  More information on influenza prevention, diagnosis and treatment can be found at <a href=\"http:\/\/www.cdc.gov\/flu\" title=\"http:\/\/www.cdc.gov\/flu\">www.cdc.gov\/flu<\/a>. Beginning this influenza season, the Advisory Committee on Immunization Practices (ACIP)\n\n\n  recommends influenza vaccination of all persons 6 months of age and older. These updated recommendations can be found at <a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/rr59e0729.pdf\" title=\"http:\/\/www.cdc.gov\/mmwr\/pdf\/rr\/rr59e0729.pdf\">http:\/\/www.cdc.gov\/mmwr\/pdf\/rr\/rr59e0729.pdf<\/a>.\n\n\n<\/p>\n\n\n<p>\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. If you are not a member and would\n\n\n  like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a>\n\n\n<\/p><br>\n\n\n<br>\n\n\n<p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> 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 Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p>\n\n\n\n<!--[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 #234 August 5, 2010 1:45 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-10198","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10198","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=10198"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10198\/revisions"}],"predecessor-version":[{"id":11374,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10198\/revisions\/11374"}],"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=10198"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}