{"id":10315,"date":"2025-03-01T14:07:36","date_gmt":"2025-03-01T19:07:36","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan342\/"},"modified":"2025-03-02T00:52:51","modified_gmt":"2025-03-02T05:52:51","slug":"dhan342","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan342\/","title":{"rendered":"php\/alerts\/dhan342 ~  Division of Public Health  &#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\/dhan342.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\"]-->342 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->December 4, 2014 10:34 am <!--[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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This season, influenza A (H3N2) viruses have been reported most frequently and have been\n\n\n\n\n\n\n\n\n\n\n\n\n\ndetected in almost all states.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>During past seasons when influenza A (H3N2) viruses have predominated, higher overall and age-specific\n\n\n\n\n\n\n\n\n\n\n\n\n\nhospitalization rates and more mortality have been observed, especially among older people, very young\n\n\n\n\n\n\n\n\n\n\n\n\n\nchildren, and persons with certain chronic medical conditions compared with seasons during which influenza\n\n\n\n\n\n\n\n\n\n\n\n\n\nA (H1N1) or influenza B viruses have predominated.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Influenza viral characterization data indicates that 48% of the influenza A (H3N2) viruses collected\n\n\n\n\n\n\n\n\n\n\n\n\n\nand analyzed in the United States from October 1 through November 22, 2014 were antigenically &#8220;like&#8221;\n\n\n\n\n\n\n\n\n\n\n\n\n\nthe 2014-2015 influenza A (H3N2) vaccine component, but that 52% were antigenically different (drifted)\n\n\n\n\n\n\n\n\n\n\n\n\n\nfrom the H3N2 vaccine virus. In past seasons during which predominant circulating influenza viruses have\n\n\n\n\n\n\n\n\n\n\n\n\n\nbeen antigenically drifted, decreased vaccine effectiveness has been observed. However, vaccination has\n\n\n\n\n\n\n\n\n\n\n\n\n\nbeen found to provide some protection against drifted viruses. Though reduced, this cross-protection might\n\n\n\n\n\n\n\n\n\n\n\n\n\nreduce the likelihood of severe outcomes such as hospitalization and death. In addition, vaccination will\n\n\n\n\n\n\n\n\n\n\n\n\n\noffer protection against circulating influenza strains that have not undergone significant antigenic drift\n\n\n\n\n\n\n\n\n\n\n\n\n\nfrom the vaccine viruses (such as influenza A (H1N1) and B viruses).<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p><strong>Because of the detection of these drifted influenza A (H3N2) <\/strong><strong>viruses<\/strong><strong>,\n\n\n\n\n\n\n\n\n\n\n\n\n\nthis CDC Health Advisory is <\/strong><strong>being issued <\/strong><strong>to re-emphasize the importance\n\n\n\n\n\n\n\n\n\n\n\n\n\nof<\/strong><strong> the use of <\/strong><strong>neuraminidase inhibitor <\/strong><strong>antiviral medications\n\n\n\n\n\n\n\n\n\n\n\n\n\nwhen indicated for treatment and prevention of influenza, as an adjunct to vaccination.<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>The two prescription antiviral medications recommended for treatment or prevention of influenza are\n\n\n\n\n\n\n\n\n\n\n\n\n\noseltamivir (Tamiflu\u00ae) and zanamivir (Relenza\u00ae). Evidence from past influenza seasons and the\n\n\n\n\n\n\n\n\n\n\n\n\n\n2009 H1N1 pandemic has shown that treatment with neuraminidase inhibitors has clinical and public health\n\n\n\n\n\n\n\n\n\n\n\n\n\nbenefit in reducing severe outcomes of influenza and, when indicated, should be initiated as soon as possible\n\n\n\n\n\n\n\n\n\n\n\n\n\nafter illness onset. Clinical trials and observational data show that early antiviral treatment can:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>shorten the duration of fever and illness symptoms;<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>reduce the risk of complications from influenza (e.g., otitis media in young children and pneumonia\n\n\n\n\n\n\n\n\n\n\n\n\n\nrequiring antibiotics in adults); and<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>reduce the risk of death among hospitalized patients.<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h2>Background<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>As of November 22, influenza activity has increased slightly in most parts of the United States. Surveillance\n\n\n\n\n\n\n\n\n\n\n\n\n\ndata indicate that influenza A (H3N2) viruses have predominated so far, with lower levels of detection\n\n\n\n\n\n\n\n\n\n\n\n\n\nof influenza B viruses and even less detection of H1N1 viruses. During the week ending November 22, 1,123\n\n\n\n\n\n\n\n\n\n\n\n\n\n(91.4%) of the 1,228 influenza-positive tests reported to CDC were influenza A viruses and 105 (8.6%)\n\n\n\n\n\n\n\n\n\n\n\n\n\nwere influenza B viruses. Of the 85 influenza A (H3N2) viruses collected by U.S. laboratories and antigenically\n\n\n\n\n\n\n\n\n\n\n\n\n\nor genetically characterized at CDC since October 1, 2014, 44 (52%) are significantly different (drifted)\n\n\n\n\n\n\n\n\n\n\n\n\n\nfrom A\/Texas\/50\/2012, the U.S. H3N2 vaccine virus. Drifted H3N2 viruses were first detected in late March\n\n\n\n\n\n\n\n\n\n\n\n\n\n2014, after World Health Organization (WHO) recommendations for the 2014-2015 Northern Hemisphere vaccine\n\n\n\n\n\n\n\n\n\n\n\n\n\nhad been made in mid-February. At that time, a very small number of these viruses had been found among\n\n\n\n\n\n\n\n\n\n\n\n\n\nthe thousands of specimens that had been collected and tested, but these viruses have become more predominant\n\n\n\n\n\n\n\n\n\n\n\n\n\nover time. Most of the drifted H3N2 viruses are A\/Switzerland\/9715293\/2013 viruses, which is the H3N2\n\n\n\n\n\n\n\n\n\n\n\n\n\nvirus selected for the 2015 Southern Hemisphere influenza vaccine. These drifted viruses will likely continue\n\n\n\n\n\n\n\n\n\n\n\n\n\nto circulate in the United States throughout the season. All influenza viruses tested for resistance to\n\n\n\n\n\n\n\n\n\n\n\n\n\nneuraminidase inhibitors this season have shown susceptibility to both oseltamivir and zanamivir. Given\n\n\n\n\n\n\n\n\n\n\n\n\n\nthe likelihood that the drifted influenza A (H3N2) viruses will continue to circulate this season, CDC\n\n\n\n\n\n\n\n\n\n\n\n\n\nis issuing the following recommendations to remind clinicians of CDC\u2019s guidance for the use of influenza\n\n\n\n\n\n\n\n\n\n\n\n\n\nantiviral medications.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h2>Recommendations for Health Care Providers<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>Clinicians should encourage all patients 6 months and older who have not yet received an influenza\n\n\n\n\n\n\n\n\n\n\n\n\n\nvaccine this season to be vaccinated against influenza. There are several influenza vaccine options for\n\n\n\n\n\n\n\n\n\n\n\n\n\nthe 2014-15 influenza season (see <a href=\"http:\/\/www.cdc.gov\/flu\/protect\/vaccine\/vaccines.htm\" target=\"_blank\">http:\/\/www.cdc.gov\/flu\/protect\/vaccine\/vaccines.htm<\/a>).<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>Clinicians should encourage all persons with influenza-like illness who are at high risk for influenza\n\n\n\n\n\n\n\n\n\n\n\n\n\ncomplications (see list below) to seek care promptly to determine if treatment with influenza antiviral\n\n\n\n\n\n\n\n\n\n\n\n\n\nmedications is warranted.<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h2>Summary of CDC Recommendations for Influenza Antiviral Medications for the 2014-2015 Season:<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h3>Influenza Vaccination<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Clinicians should continue to vaccinate patients who have not yet received influenza vaccine this season.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h3>Antiviral Use<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Clinical benefit is greatest when antiviral treatment is administered early. When indicated, antiviral\n\n\n\n\n\n\n\n\n\n\n\n\n\ntreatment should be started as soon as possible after illness onset, ideally within 48 hours of symptom\n\n\n\n\n\n\n\n\n\n\n\n\n\nonset. However, antiviral treatment might still have some benefits in patients with severe, complicated,\n\n\n\n\n\n\n\n\n\n\n\n\n\nor progressive illness and in hospitalized patients when started after 48 hours of illness onset.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for any patient\n\n\n\n\n\n\n\n\n\n\n\n\n\nwith confirmed or suspected influenza who:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>is hospitalized;<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>has severe, complicated, or progressive illness; or<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>is at higher risk for influenza complications. This list includes:\n\n\n\n\n\n\n\n\n\n\n\n\n\n <ol style=\"list-style-type: lower-alpha\">\n\n\n\n\n\n\n\n\n\n\n\n\n\n  <li>children aged younger than 2 years;<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n  <li>adults aged 65 years and older;<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n  <li>persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal,\n\n\n\n\n\n\n\n\n\n\n\n\n\nhepatic, hematological (including sickle cell disease), and metabolic disorders (including diabetes mellitus),\n\n\n\n\n\n\n\n\n\n\n\n\n\nor neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral\n\n\n\n\n\n\n\n\n\n\n\n\n\nnerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability\n\n\n\n\n\n\n\n\n\n\n\n\n\n[mental retardation], moderate to severe developmental delay, muscular dystrophy, or spinal cord injury);<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n  <li>persons with immunosuppression, including that caused by medications or by HIV infection;<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n  <li>women who are pregnant or postpartum (within 2 weeks after delivery);<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n  <li>persons aged younger than 19 years who are receiving long-term aspirin therapy;<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n  <li>American Indians\/Alaska Natives;<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n  <li>persons who are morbidly obese (i.e., body-mass index is equal to or greater than 40); and<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n  <li>residents of nursing homes and other chronic-care facilities.<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <\/ol>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Clinical judgment, on the basis of the patient\u2019s disease severity and progression, age, underlying\n\n\n\n\n\n\n\n\n\n\n\n\n\nmedical conditions, likelihood of influenza, and time since onset of symptoms, is important when making\n\n\n\n\n\n\n\n\n\n\n\n\n\nantiviral treatment decisions for high-risk outpatients. <strong>Decisions about starting antiviral treatment\n\n\n\n\n\n\n\n\n\n\n\n\n\nshould not wait for laboratory confirmation of influenza.<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Oseltamivir is approved for treatment of influenza in persons aged two weeks and older, and for chemoprophylaxis\n\n\n\n\n\n\n\n\n\n\n\n\n\nto prevent influenza in people one year of age and older, while zanamivir is approved for treatment of\n\n\n\n\n\n\n\n\n\n\n\n\n\npersons seven years and older and for prevention of influenza in persons five years and older. Because\n\n\n\n\n\n\n\n\n\n\n\n\n\nhigh levels of resistance to adamantane antiviral medications continue to be observed among circulating\n\n\n\n\n\n\n\n\n\n\n\n\n\ninfluenza A viruses, adamantanes (rimantadine and amantadine) are not recommended for treatment or prevention\n\n\n\n\n\n\n\n\n\n\n\n\n\nof influenza.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Antiviral treatment also can be considered on the basis of clinical judgment for any previously healthy,\n\n\n\n\n\n\n\n\n\n\n\n\n\nsymptomatic outpatient who is not considered \u201chigh risk\u201d with confirmed or suspected influenza,\n\n\n\n\n\n\n\n\n\n\n\n\n\nif treatment can be initiated within 48 hours of illness onset.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h3>Special Considerations for Institutional Settings<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Use of antiviral chemoprophylaxis to control outbreaks among high risk persons in institutional settings\n\n\n\n\n\n\n\n\n\n\n\n\n\nis recommended. An influenza outbreak is likely when at least two residents are ill within 72 hours, and\n\n\n\n\n\n\n\n\n\n\n\n\n\nat least one has laboratory confirmed influenza. When influenza is identified as a cause of a respiratory\n\n\n\n\n\n\n\n\n\n\n\n\n\ndisease outbreak among nursing home residents, use of antiviral medications for chemoprophylaxis is recommended\n\n\n\n\n\n\n\n\n\n\n\n\n\nfor residents (regardless of whether they have received influenza vaccination) and for unvaccinated health\n\n\n\n\n\n\n\n\n\n\n\n\n\ncare personnel. For newly-vaccinated staff, antiviral chemoprophylaxis can be administered up to two weeks\n\n\n\n\n\n\n\n\n\n\n\n\n\n(the time needed for antibody development) following influenza vaccination. Chemoprophylaxis may also\n\n\n\n\n\n\n\n\n\n\n\n\n\nbe considered for all employees, regardless of their influenza vaccination status, if the outbreak is\n\n\n\n\n\n\n\n\n\n\n\n\n\ncaused by a strain of influenza virus that is not well matched by the vaccine. Antiviral chemoprophylaxis\n\n\n\n\n\n\n\n\n\n\n\n\n\nshould be administered for a minimum of two weeks, and continue for at least seven days after the last\n\n\n\n\n\n\n\n\n\n\n\n\n\nknown case was identified.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>To reduce the substantial burden of influenza in the United States, <strong>CDC continues to recommend\n\n\n\n\n\n\n\n\n\n\n\n\n\na three-pronged approach: <\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<ol>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li><strong>influenza vaccination<\/strong>. The influenza vaccine contains three or four influenza\n\n\n\n\n\n\n\n\n\n\n\n\n\nviruses depending on the influenza vaccine\u2014an influenza A (H1N1) virus, an influenza A (H3N2) virus,\n\n\n\n\n\n\n\n\n\n\n\n\n\nand one or two influenza B viruses. Therefore, even if vaccine effectiveness is reduced against drifted\n\n\n\n\n\n\n\n\n\n\n\n\n\ncirculating viruses, the vaccine will protect against non-drifted circulating vaccine viruses. Further,\n\n\n\n\n\n\n\n\n\n\n\n\n\nthere is evidence to suggest that vaccination may make illness milder and prevent influenza-related complications.\n\n\n\n\n\n\n\n\n\n\n\n\n\nSuch protection is possible because antibodies created through vaccination with one strain of influenza\n\n\n\n\n\n\n\n\n\n\n\n\n\nviruses will often \u201ccross-protect\u201d against different but related strains of influenza viruses;<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li><strong>use of neuraminidase inhibitor medications when indicated for treatment or prevention<\/strong>.\n\n\n\n\n\n\n\n\n\n\n\n\n\nAntiviral treatment with oseltamivir or zanamivir is recommended as early as possible for any patient\n\n\n\n\n\n\n\n\n\n\n\n\n\nwith confirmed or suspected influenza who: is hospitalized; has severe, complicated, or progressive illness;\n\n\n\n\n\n\n\n\n\n\n\n\n\nor is at higher risk for influenza complications. Antiviral chemoprophylaxis should be used for prevention\n\n\n\n\n\n\n\n\n\n\n\n\n\nof influenza when indicated for institutional influenza outbreaks, and may be considered for those who\n\n\n\n\n\n\n\n\n\n\n\n\n\nhave contraindications to influenza vaccination. <strong>CDC recommends antiviral chemoprophylaxis for\n\n\n\n\n\n\n\n\n\n\n\n\n\na minimum of two weeks, and continuing for at least seven days after the last known case was identified.<\/strong><\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li><strong>use of other preventive health practices that may help decrease the spread of influenza<\/strong>,\n\n\n\n\n\n\n\n\n\n\n\n\n\nincluding respiratory hygiene, cough etiquette, social distancing (e.g., staying home from work and school\n\n\n\n\n\n\n\n\n\n\n\n\n\nwhen ill, staying away from people who are sick) and hand washing.<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<\/ol>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h2>For More Information:<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>Influenza Vaccines Available in United States, 2014\u201315 Influenza Season: <a href=\"http:\/\/www.cdc.gov\/flu\/protect\/vaccine\/vaccines.htm\" target=\"_blank\">http:\/\/www.cdc.gov\/flu\/protect\/vaccine\/vaccines.htm<\/a><\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>Information for healthcare professionals on the use of influenza antiviral medications: <a href=\"http:\/\/www.cdc.gov\/flu\/professionals\/antivirals\/\" target=\"_blank\">http:\/\/www.cdc.gov\/flu\/professionals\/antivirals\/<\/a><\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>Summary of Influenza Antiviral Treatment Recommendations for clinicians: <a href=\"http:\/\/www.cdc.gov\/flu\/professionals\/antivirals\/summary-clinicians.htm#summary\" target=\"_blank\">http:\/\/www.cdc.gov\/flu\/professionals\/antivirals\/summary-clinicians.htm#summary<\/a><\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>Diagnostic Testing for Influenza: <a href=\"http:\/\/www.cdc.gov\/flu\/professionals\/antivirals\/summary-clinicians.htm#diagnostic\" target=\"_blank\">http:\/\/www.cdc.gov\/flu\/professionals\/antivirals\/summary-clinicians.htm#diagnostic<\/a><\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities: <a href=\"http:\/\/www.cdc.gov\/flu\/professionals\/infectioncontrol\/ltc-facility-guidance.htm\" target=\"_blank\">http:\/\/www.cdc.gov\/flu\/professionals\/infectioncontrol\/ltc-facility-guidance.htm<\/a><\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n <li>Call the Delaware Division of Public Health, Office of Infectious Disease Epidemiology at 302-744-4990<\/li>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p class=\"center\"><em>The Centers for Disease Control and Prevention (CDC) protects people&#8217;s health\n\n\n\n\n\n\n\n\n\n\n\n\n\nand safety by preventing and controlling diseases and injuries; enhances health decisions by providing\n\n\n\n\n\n\n\n\n\n\n\n\n\ncredible information on critical health issues; and promotes healthy living through strong partnerships\n\n\n\n\n\n\n\n\n\n\n\n\n\nwith local, national, and international organizations.<\/em><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>************************************<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n\n\n\n\n\n\n\n\n\n\n\nIf you are not a member and would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a><\/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 #342 December 4, 2014 10:34 am 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-10315","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10315","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=10315"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10315\/revisions"}],"predecessor-version":[{"id":11491,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10315\/revisions\/11491"}],"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=10315"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}