FW: Centers for Disease Control and Prevention (CDC) novel H1N1 flu key points

[Guest guest]

Dear

Colleagues,

We

are obviously not out of the woods yet!  Reading this mailing, it is clear that

the 5764 reported and probably cases of H1N1 virus is an under report for the

reasons discussed below.

It

would be helpful to hear from you if this information is still helpful or if it

is a duplication of information that you are receiving from other sources. 

Please let me know at Ryder@....

Thanks,

Bobbi

Bobbi Ryder

President & CEO

National Center for Farmworker Health, Inc.

1770 FM 967

Buda, TX

(512) 312-5453 direct line

(512) 312-5451 Mendoza , Assistant

(512) 312-2600

www.ncfh.org

From: Centers for Disease

Control & Prevention [mailto:cdc@...]

Sent: Thursday, May 21, 2009 11:00 AM

ryder@...

Subject: Centers for Disease Control and Prevention (CDC) novel H1N1 flu

key points

You are

subscribed to novel influenza A H1N1 Updates from Centers for Disease

Control and Prevention (CDC). This information has recently been updated.

H1N1 Update

·

Influenza

illness, including illness associated with the novel influenza A H1N1 virus is

ongoing in the United States.

·

There are

localized outbreaks of novel H1N1 activity ongoing in several states.

·

The states that

have reported the most novel H1N1 activity are Arizona, California, Illinois,

New York, Texas, Washington state and Wisconsin.

·

On May 21, 2009

CDC reported a total of 5,764 probable and confirmed cases of novel H1N1

infection with 9 deaths.

·

The most recent

reported death occurred in a 22-year-old in Utah.

·

This number is

thought to represent a small proportion of the total number of people

who have been infected with the novel H1N1 virus.

o This is an underestimate

because

§

Many people ill

with influenza-like symptoms do not seek medical care

§

Many who do

seek medical care are not tested for influenza

·

It’s uncertain

at this time how severe this novel H1N1 outbreak will be in terms of how many

people infected have severe complications or death related to novel H1N1

infection.

·

We are still

learning about the severity and other epidemiological characteristics of the

novel H1N1 virus.

So far, the

largest number of novel H1N1 confirmed and probable cases (more than 60%

of cases) have been in people between the ages of 5 years and 24 years

old.

However,

nearly 40% of hospitalizations have occurred in people between the ages of

19 and 49 years of age. And about 18% of hospitalized patients have been

between the ages of 10 and 18 years old. Only 13% of hospitalizations have

occurred in people 50 years and older.

Pregnancy and other previously

recognized medical conditions from seasonal influenza appear to be associated

with increased risk of complications from this novel H1N1 as well. 

Seventy-one

percent (71%) of hospitalized patients have had underlying chronic medical

conditions.

Reported

deaths have occurred in people ranging in age from 22 months old to 57

years old.

There are few cases and no

deaths in people older than 65 years, which is unusual when compared with

seasonal flu.

There is not enough information

at this time to predict how severe this novel H1N1 outbreak will be in

terms of illness and death or how it will compare with seasonal influenza.

MMWR

The May 22 issue of the MMWR

will contain an article entitled “Cross-reactive Serum Antibody Response

to the Novel Influenza A (H1N1) Virus After Vaccination with Seasonal

Influenza Vaccine.”

This MMWR article

provides details of a serology study of samples from children, younger

adults and older adults vaccinated with recent seasonal influenza vaccines

to try to determine whether seasonal vaccines offered any immune benefits

against novel H1N1 virus.

“Serology” is

the study of blood serum to

identify antibodies in the serum. Serum is what is left when red and white

blood cells are removed from blood. The presence of antibodies in serum

can indicate immune protection against a certain infectious agent.

CDC conducted this study using

stored sera collected from children in age groups ranging from 6 months

to 9 years of age and adults 18 to 64 years old or adults older than 60

years vaccinated with the seasonal influenza vaccines developed for

influenza seasons from 2005 to 2008.

The results presented in this

study found that the seasonal influenza vaccine provides little or no

immune benefit against the novel H1N1 flu virus.

Specifically, the study found

that:

o

Children

have no existing antibody immunity to the novel H1N1 flu virus and did not

develop antibody after vaccination with seasonal vaccine.

o

Some

younger adults had a low level of cross-reactive antibody against the novel

H1N1 flu virus prior to vaccination with seasonal vaccine. There was a small

increase in the level of cross-reactive antibodies after vaccination with

seasonal influenza vaccine.

o

About

one-third of adults older than 60 years of age had cross-reactive antibody

against this novel H1N1 virus prior to vaccination with seasonal vaccine. There

was no increase in the level of these cross-reactive antibodies in older people

after vaccination with seasonal influenza vaccine.

These results suggest that some

adults may have some degree of preexisting cross-reactive antibody to the

novel H1N1 flu virus, especially adults older than 60.

It is unknown how much, if any,

protection may be afforded against the novel influenza A (H1N1) by

existing antibody.

A possible explanation to this

preexisting antibody in adults is that they may have had previous

exposure, either through infection or vaccination to an influenza A H1N1

virus that was more closely related to the novel H1N1 flu virus than are

contemporary seasonal influenza A (H1N1) strains.

CDC believes, based on this

data, that seasonal influenza vaccine is unlikely to provide any

meaningful protection against novel influenza A (H1N1) virus.

Vaccination with seasonal

vaccine is still recommended to protect against the seasonal influenza

viruses in the vaccine.

The MMWR report is available at

http://www.cdc.gov/mmwr/

Vaccine

Vaccines are a very important

tool for the prevention of influenza, including novel influenza that may

become pandemic.

CDC has isolated the novel H1N1

flu virus and is working to make a candidate vaccine virus that can be

provided to industry so that manufacturers can scale up for production of

a vaccine, if necessary.

CDC is hopeful that we will

have vaccine viruses to send to manufacturers by the end of May.

This is within original

timelines sent out by CDC.

There are many steps involved

with producing a vaccine, and we are committed to working with the NIH,

FDA, BARDA, WHO and the manufacturers of influenza vaccines through this

process.

If

things go well, and a decision is made to seek full scale vaccine

production, it will be several months until the vaccine will be available.

So

a vaccine is an important tool for the future.

Seasonal Flu Vaccine.  Production of the seasonal

flu vaccine for next season is nearly complete and will be completed. Seasonal

flu is responsible for causing an estimated 36,000 flu-related deaths and

200,000 flu-related hospitalizations in the U.S. each year. Seasonal flu vaccine

is always a public health priority.

 Stay Home If You Are Sick

Do not travel if you are sick

· To help

control the spread of novel H1N1 flu, those who are sick with flu-like symptoms

should stay at home except to seek medical care or for other necessary reasons.

· The

symptoms of this new H1N1 flu virus in people are similar to the symptoms of

seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body

aches, headache, chills and fatigue. A significant number of people who have

been infected with this virus also have reported diarrhea and vomiting.

· Staying

at home means that you should not leave your home unless you need to go to the

doctor. This means avoiding normal activities, including work, school, travel,

shopping, social events, and public gatherings.

· If you

are sick, CDC recommends that you stay home for 7 days after your symptoms

begin or until you have been symptom-free for 24 hours, whichever is longer.

This is to keep from spreading the virus to other people.

· Resting

at home will also help you feel better sooner.

· Even if

you start to feel better during this period, it is important that you stay home

for the recommended time except to seek medical care or if needed. You should

not travel, go to work or school, or run errands.

· If

people with flu-like illness must leave their home (for example, to seek

medical care or other necessities) they should cover their nose and mouth when

coughing or sneezing. A surgical loose-fitting mask can be helpful for people

who have them, but a tissue or other covering is appropriate as well.

· If you

get sick with flu-like symptoms and have a trip scheduled, you should not

travel until 7 days after your symptoms begin or until you have been

symptom-free for 24 hours, whichever is longer.

· If you

get sick during a trip, you should stay in your hotel room for 7 days after

your symptoms begin or until you have been symptom-free for 24 hours, whichever

is longer (except to seek medical care or other necessities).

· Have you ever

worried that you may become sick because you had to sit close to someone who

was sick on a plane, in the office, or at school? Remember that if you

were healthy, you would want sick people to stay at home instead of traveling

and risking the health of others.

· If you

are sick, think about your fellow passengers before you travel. Do your part --

stay home, recover, and keep others well.

· For

more information about healthy and safe travel visit www.cdc.gov/travel or

call 1-800-CDC-INFO

There is no vaccine yet and antiviral drugs

may be difficult to get when traveling.

· There

is not yet a vaccine for novel H1N1 flu. Scientists are working hard to develop

one.

· Antiviral

drugs are prescription medicines (pills, liquid or an inhaler) that can work

against flu viruses, including novel H1N1 flu.

· Do not

assume that antiviral drugs will be easy to get if you are traveling.

· If you are

sick, take steps to keep from spreading the virus to other people:

· Stay home

for 7 days after your symptoms begin or until you have been symptom-free for 24

hours, whichever is longer.

· If you

get sick during a trip, you should stay in your hotel room for 7 days after

your symptoms begin or until you have been symptom-free for 24 hours, whichever

is longer.

· If

you must leave your home or hotel room (for example, to seek medical care or

other necessities), cover your nose and mouth when coughing or sneezing. A

surgical loose-fitting mask can be helpful for persons who have access to

these, but a tissue or other covering is appropriate as well.

· Cover your

nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the

trash after you use it.

· The

best way to protect yourself from novel H1N1 flu is to take everyday steps to

reduce the spread of the virus. These steps are:

· Wash

your hands often with soap and water, especially after you cough or sneeze.

Alcohol-based hand cleaners are also effective.

· Do not

touch your eyes, nose or mouth. Germs spread this way.

·

Avoid close contact with sick people.

·

For

more information about healthy and safe travel visit www.cdc.gov/travel or call 1-800-CDC-INFO

School

Closures

At

this time, schools across the country continue to close as a result of

novel H1N1 flu activity based on local considerations.

We

know that children are susceptible to novel H1N1 flu, and schools or

childcare facilities may act as a point of spread.

As

we know from seasonal flu, schools are a challenge. Aside from closing

schools for an extended period of time in coordination with other means to

reduce spread in a community, there is no approach that will completely

stop or prevent transmission of flu in a school setting.

There is a need for localized

responses in schools, and when absentee rates are increasing in students

and staff due to novel H1N1 flu illness, it is appropriate to close

schools if they are not able to function.

On

May 5, CDC issued updated guidance for schools impacted by novel H1N1 flu

infections. This guidance attempts to strike a balance between measures

that may have an effect on slowing transmission and those that create

other problems (such as disrupting education and sending kids to malls or

other social gathering spots where they’d still be susceptible.)

In the updated school guidance, CDC

recommends that parents and guardians should monitor their school-aged

children, and faculty and staff should self-monitor every morning for

symptoms of flu-like illness.

CDC

understands that parents are concerned about how to protect their children

from novel H1N1 flu and other infectious diseases.

As

much as we wish there was, there is no approach that will guarantee

protection from infectious diseases spread by flu viruses.

This

is why CDC is working to develop a vaccine for the novel H1N1 flu virus.

Vaccines are not 100 percent effective, but they provide the best

protection against viruses, such as flu.

Antiviral

medications can also be used to treat flu illness, and in some cases, to

prevent flu infection. Use of antiviral medications for prevention may be

particularly important for people at high risk of flu complications who

have had a close exposure to someone with novel H1N1 flu

Even

if a school is closed for an extended period of time, both children and

adults are still susceptible to flu if they have interactions with other

people, some of whom may be shedding flu viruses even though they don’t

have symptoms.

The largest number of novel H1N1

confirmed and probable cases are occurring in people from the ages of 5 to

24, so many of them are school-aged children.

Students,

faculty, and staff who have flu-like illness should stay home for 7 days

after symptoms have started or at least 24 hours after symptoms resolve,

whichever is longer, seeking medical care if symptoms are severe.

Students, faculty and staff who appear

to have flu-like illness or become ill during the school day should be

isolated promptly in a room separate from other students and sent home.

Any

dismissal based on local considerations must be done while working closely

with the local or state health departments.

Schools

and childcare facilities do not need to do extra cleaning (such as washing

walls) before children can return. 

Schools can

help teach students and staff how to reduce the spread of novel H1N1 flu

through hand hygiene and cough etiquette.

Washing hands or use of

alcohol-based gels in schools or at home can offer protection.

People at high risk for flu

associated complications who have had close contact with someone sick with

flu should consider talking to their health care provider about influenza

antiviral medications.

Seasonal Influenza

Context

Flu

seasons vary in timing, duration and severity.

Seasonal

influenza can cause mild to severe illness, and at times can lead to death.

Each year, in the United

States, on average:

5%

to 20% of the population gets the flu;

36,000

people die from flu-related complications.

More

than 200,000 people are hospitalized from flu-related causes.

Ninety

percent of seasonal flu-related deaths occur among people 65 years and

older.

About

60 percent of hospitalizations occur in people 65 years and older.

Illness rates

are highest in school-aged children

Serious

complications from seasonal influenza are rare in school-aged children,

but they do happen.

20,000

children younger than 5 years old are hospitalized each year from

flu-related causes. (In children, the risk of hospitalization and death is

highest in children younger than 2 years old.)

On average,

about 100 children per year die from flu-related causes. (During the

2007-08 flu season, CDC received reports that 86 children died from

influenza-related complications. During the current flu season, CDC has

received 59 reports of deaths in children younger than 18.)

People age 65 years and

older, people of any age with chronic medical conditions (such as asthma,

diabetes, heart disease, and other conditions), pregnant women, and young

children are more likely to get complications from seasonal influenza. The

flu can make chronic health problems worse.

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