FW: Centers for Disease Control and Prevention (CDC) N1N1 Influenza Daily Update

[Guest guest]

Dear

Colleagues, here is your update for today from CDC re H1N1 Influenza. 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: Wednesday, May 13, 2009 9:55 AM

ryder@...

Subject: Centers for Disease Control and Prevention (CDC) N1N1 Influenza

Daily Update

You are

subscribed to H1N1 influenza updates from the Centers for Disease Control and

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

Surveillance & Reporting

·

Note that after today (May 13, 2009) the key points will not

include updated case counts.

·

The list of states with the numbers of people who are confirmed

cases of novel H1N1 infection will be available online and updated Monday -

Friday at approximately 11 a.m. at http://www.cdc.gov/h1n1flu/. (Most states do

not report over the weekend.)

· CDC is

reporting 3,352 laboratory confirmed human infections with novel H1N1 flu in 44

states and the District of Columbia (D.C.) in the United States.

· An

additional 604 probable cases have been reported nationwide. (CDC will not be

reporting probable cases at the state level.)

· This is

a total of 3,956 confirmed and probable cases in 46 states and the District of

Columbia in the United States.

·

Three deaths in

the U.S. have been confirmed from this outbreak to date.

·

Novel influenza

A (H1N1) activity is now being detected in two of CDC’s routine influenza surveillance systems as reported in the May 8,

2009 FluView.

·

FluView is a weekly report that

tracks U.S. influenza activity through multiple systems across five categories.

· CDC will report

individual cases for as long as possible, and then will transition to using the

seasonal surveillance system to track the progress of the novel H1N1 outbreak.

· Routine seasonal

surveillance does not count individual cases, but instead monitors activity

levels and virus characteristics through a nationwide surveillance system.

· The

Epidemiology and Prevention Branch in the Influenza Division at CDC collects,

compiles and analyzes information on influenza activity year round in the

United States and produces a weekly report published each Friday called “FluView”

(normally from October through mid-May).

· In

light of the current outbreak, weekly publication of FluView will

continue over the spring and summer.

· The

U.S. influenza surveillance system is a collaborative effort between CDC and

its many partners in state and local health departments, public health and

clinical laboratories, vital statistics offices, healthcare providers, clinics

and emergency departments.

· Information

in five categories is collected from nine different data sources that allow CDC

to:

o

Find out when and where influenza activity is occurring

o

Track influenza-related illness

o

Determine what influenza viruses are circulating

o

Detect changes in influenza viruses

o

Measure the impact influenza is having on deaths in the United

States

More

information about CDC’ s influenza surveillance systems can be found at http://www.cdc.gov/flu/weekly/fluactivity.htm

Outbreak

Summary

·

Novel influenza

A (H1N1) is a new flu virus of swine origin that was first detected in April,

2009.

·

The virus is

infecting people and is spreading from person-to-person, and has sparked a

growing outbreak of illness in the United States with an increasing number of

cases being reported internationally as well.

·

This virus is

spreading from person-to-person without regard for borders, race or ethnicity.

·

CDC anticipates

that there will be more cases, more hospitalizations and more deaths associated

with this new virus in the coming days and weeks because the population has

little to no immunity against it.

· The

number of countries reporting cases of this virus is growing.

· Refer

to the WHO website at http://www.who.int/en/for updated country counts.

· According

to WHO, there is no evidence of sustained person-to-person transmission beyond

two generations outside of North America.

· This

kind of sustained transmission in other parts of the world would need to occur

in order for WHO to raise the pandemic alert phase to level 6.

· Should

WHO raise the pandemic alert level to phase 6, this would have little impact on

the United States.

· The United

States is already engaged in implementing its pandemic response plan.

· Influenza

is always serious – each year in the United States, seasonal influenza results,

on average, in an estimated 36,000 deaths and more than 200,000

hospitalizations from flu-related causes.

·

It’s uncertain at this time how severe this novel H1N1 outbreak

will be in terms of illness and death compared with other influenza viruses.

· Because

this is a new virus, most people will not have immunity to it, and illness may

be more severe and widespread as a result.

·

In addition, currently there is no vaccine to protect against this

novel H1N1 virus as we have for seasonal influenza.

· This

outbreak certainly poses the potential to be at least as serious as seasonal

flu, if not more so, especially given the fact that there currently is no

vaccine against this virus and there is no immunity against this virus in the

population.

· The Southern

Hemisphere is just going into their flu season and how this virus behaves in

terms of illness severity, high risk groups and overall burden of disease might

give us some clues about what we can expect for the Northern Hemisphere in the

upcoming 2009-2010 flu season.

Response:

The Federal

Government is mounting an aggressive response to this outbreak.

CDC’s goals

during this public health emergency are to reduce illness and death, and

to provide information to assist health care providers, public health

officials and the public in addressing the challenges posed by this newly

identified influenza virus.

CDC

continues to update guidance continuously as more information becomes

available.

For example,

CDC has issued updated interim guidance for clinicians on the use of

influenza antiviral medications. CDC recommends that use of antiviral

medications be prioritized for hospitalized patients and sick patients who

are at high risk of serious seasonal flu-related complications.

·

Visit

http://www.cdc.gov/h1n1flu/guidance/ for the most updated guidance.

·

Deployment

of 25 percent of the SNS supplies has been completed to all 62 states or

project areas.

·

There

are currently 115 CDC staff persons deployed in the field to support the

outbreak response.

CDC is taking early steps in

the vaccine manufacturing process, working closely with manufacturing and

the rest of the government. (More vaccine information below.)

CDC-developed

and is distributing PCR diagnostic test kits to detect this virus

domestically and internationally.

All 50 states,

the District of Columbia and Puerto Rico have received test kits.

· This will increase

testing capacity, which likely will result in a rapid jump in the number of

confirmed cases once states start doing their own testing.

· This will be an

artifact of testing, but will actually present a more accurate picture of the

true scope of novel H1N1 disease in the United States.

Yesterday, May

12, CDC issued an MMWR Report entitled “Novel Influenza A (H1N1)

Infections in Three Pregnant Women – United States, April-May 2009”

As of May 10,

a total of 20 cases of novel influenza A (H1N1) virus have been reported

among pregnant women in the United States from 12 states; 15 of these

cases are confirmed (with one death) and 5 of these cases are “probable.”

This MMWR

report provides preliminary details on three cases of novel influenza A

(H1N1) virus infection in pregnant women. Additional information on these

cases and other pregnant women with this infection is being compiled by

CDC based on reports from state health departments. (More information on

pregnancy and influenza below.)

The MMWR

report is available at

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0512a1.htm?s_cid=mm58d0512a1_e

Much of CDC’s

guidance is informed by studies and past experience with seasonal (human)

influenza and past influenza pandemics.

Like seasonal flu, some people may be at greater risk

of serious complications related to novel H1N1 infection and illness.

People who are at high risk of serious seasonal

flu-related complications include pregnant women, children younger than 5

years old, people with chronic medical conditions, and people 65 years and

older.

CDC believes

this information from seasonal flu applies to the novel H1N1 (swine flu)

viruses as well, but studies on this virus are ongoing to learn more about

its characteristics and to learn what groups are at highest risk.

This is a

rapidly evolving situation and guidance should be considered interim and

will be updated frequently as more information becomes available.

Visit

the CDC website at http://www.cdc.gov/h1n1flu/ for more

information or call 1-800-CDC-INFO.

· Everyday, we learn

more about this virus and what we learn will continue to inform the actions

that we take in response.

Pregnancy

·

Pregnant women

are at high risk for serious complications from seasonal flu and have been

disproportionately affected in influenza pandemics.

·

Pregnancy

weakens a woman’s immune system and places her at increased risk for serious

flu-related complications. The greatest risks for pregnant women can be

pneumonia or dehydration. There can also be risks to their unborn babies

including pre-term labor.

·

For novel

influenza A (H1N1), CDC has determined that the benefits of treatment or chemoprophylaxis

with zanamivir or oseltamivir “likely outweigh the theoretical risks of

antiviral use.”

·

Therefore, CDC

is recommending that if a clinician suspects that a pregnant woman is infected

with this virus, she should receive antiviral treatment without confirmatory

testing.

·

Thus CDC

recommends that antiviral use recommendations be applied to pregnant women as

it is applied to other groups of persons at high risk of influenza-related

complications.

·

This is a more

forward-leaning approach than what is taken with seasonal flu because the

burden of illness on pregnant women of the novel H1N1 virus is unknown and we

know from the past that influenza can be a serious disease in pregnant women.

·

We are taking

steps to protect pregnant women and others who may be at high risk of serious

flu-related complications by pushing out our recommendations on how to

aggressively treat novel H1N1 influenza.

·

On our

website, we have posted:

o

Pregnant

Women and Novel H1N1 Considerations for Clinicians.

o

What

Pregnant Women Should Know

o

Breastfeeding

Your Baby: What Parents Should Know

o

Info

for Pregnant Women in Education, Child Care, and Health Care

·

In addition, we

are reaching out through partners to get the word out to these groups that they

should take precautions; be aware of warning signs; and seek medical care

sooner rather than later.

Novel H1N1 Flu Virus

·

The hallmark of influenza viruses is their ability to undergo

constant and dramatic change.

·

Many different animals and, of course, humans get infected with

influenza viruses, but the viruses generally stick with one species or

another.

·

However, sometimes flu viruses jump from one species to another,

and sometimes, viruses from different species can infect the same host and

result in a new combination of virus genes.

·

This last scenario is what happened and resulted in the novel H1N1

flu virus.

·

This is a very unusual virus. This particular genetic combination

of influenza virus segments has not been recognized before in the U.S. or

elsewhere.

·

Testing of a number of the virus samples submitted to CDC show

that they are very similar, which means that they likely originated from the

same source.

It’s too soon

to predict what will happen or how the virus might change.

Regular

seasonal influenza activity continues in the United States at this time.

There are

seasonal influenza A H1, influenza A H3 and type B viruses circulating and

causing illness in the United States – these are viruses that regularly

circulate among humans – in addition to the novel influenza A H1N1 virus.

There is the

possibility of reassortment (swapping virus genes) between this novel

influenza A (H1N1) virus and circulating seasonal influenza viruses.

Such a

reassortant virus could be resistant to the antiviral drug oseltamivir

because most of currently circulating seasonal H1 viruses are resistant to

oseltamivir. (They are sensitive to zanamivir and the adamantane drugs

amantadine and rimantidine.)

That is one

reason why it’s important to continue to watch the novel H1N1 virus and

human seasonal viruses carefully over the coming weeks and months and to

continue to be prepared and proactive.

In addition,

as always, we must continue to look for emergence of other flu viruses

with pandemic potential.

It is

important that we continue to watch this virus carefully to look for

changes that may occur.

The Southern Hemisphere is just

going into their flu season and how this virus behaves will give us some

clues about what we can expect for the Northern Hemisphere.

Vaccine

Vaccines are a very important

part of a response to 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.

There are many steps involved

with producing a vaccine, and we are committed to going forward with the

NIH, and FDA, BARDA, and the manufacturers of influenza vaccines, to see

about developing full scale vaccine production.

If

things go well, and we achieve full scale 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.

Public/Personal Responsibility:

·

You have a role

in protecting yourself and your family.

Stay informed.

Health officials will provide additional information as it becomes

available. Visit www.cdc.gov

· Everyone

should take everyday steps to protect your health and lessen the spread of this

new virus:

Cover

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

tissue in the trash after you use it.

Wash

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

sneeze. Alcohol-based hand cleaners are also effective.

Avoid

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

Try

to avoid close contact with sick people.

Stay home if you are sick 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 infecting others and

spreading the virus further.

Children, especially younger children,

might potentially be contagious for longer periods. CDC is studying the

virus and its capabilities to try to learn more and will provide more

information as it becomes available.

Follow local public health advice regarding school

closures, avoiding crowds and other social distancing measures based on

illness in specific communities.

We

do have antiviral medications in our arsenal against flu.

The

priority use for influenza antiviral drugs during this outbreak is to treat

severe influenza illness (including those who are hospitalized or ill

people who are considered at high risk of serious influenza-related

complications).

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