Today, the Centers for Disease Control and Prevention (CDC) reported 21,449 confirmed and probable novel H1N1 influenza cases in the U.S., about 1,600 hospitalizations and 87 deaths. There continues to be a disproportionate amount of illness and hospitalization among younger people, with 57% of the cases between the ages of 5 and 24. There have been 6 pediatric deaths due to the H1N1 influenza virus.
Since the influenza virus is unpredictable, there is no clear sense of what will happen during the summer and the upcoming flu season. The CDC thinks it is likely that localized outbreaks will continue to occur over the summer and that there will be pandemic H1N1 virus, illness and death during the upcoming flu season in the fall and winter.
N95 Respirators
AHCA is in contact with CDC regarding its recommendation for N95 respirators in nursing homes. According to a CDC staff person, the recommendation was made before CDC had much knowledge about transmission of the novel H1N1 Influenza A virus and now that more is known, CDC is revisiting this recommendation. A decision is anticipated in about 2 weeks.
The Society for Healthcare Epidemiology of America (SHEA) released a position paper opposing the use of N95s for respiratory protection from H1N1 influenza during routine patient care activities. SHEA notes that the inappropriate and widespread use of N95 respirators for all novel H1N1 patient care activities does not provide increased protection against the virus and may have an adverse impact on patient and health care worker safety. This position is endorsed by the Infectious Diseases Society of America and the Association for Professionals in Infection Control and Epidemiology. The SHEA position paper may be accessed at http://www.shea-online.org/Assets/files/policy/061209_H1N1_Statement.pdf.
AHCA is communicating also with the Centers for Medicare and Medicaid Services regarding its surveyor guidance relating to a plan for N95 respirators.
Morbidity and Mortality Weekly Report (MMWR) Article: “Novel Influenza A (H1N1) Virus Infections Among Health-Care Personnel – United States, April-May, 2009
Today, the MMWR published a report on H1N1 and health care workers. As of May 13, CDC had information on 48 confirmed or probable H1N1 influenza infections reported to have occurred in healthcare workers, with detailed information on 26 of the cases.
Of the 26 cases, CDC found that 13 (50%) were acquired it in a health care setting. None of the health care personnel infected by ill patients reported fully adhering to CDC’s recommendations on infection control for care of patients with novel H1N1 virus infection in health care settings. According to CDC, the findings cannot definitely establish whether these instances of transmission were related to non-adherence to certain parts of personal protection equipment. According to the CDC, whatever the risk of infection to health care personnel, this report suggests that much of it exists in the outpatient setting, such as outpatient clinics and emergency rooms. The article may be accessed at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5823a2.htm?s_cid=mm5823a2_e.
Influenza Vaccine
The CDC has isolated the new H1N1 virus, successfully produced a candidate vaccine virus, and provided the virus to manufacturers. On June 12, one pharmaceutical company announced that it has produced a first batch of the vaccine. Clinical trials will begin in July.
Production of the seasonal flu vaccine for the 2009-2010 influenza season is nearly complete. Based on serology data, CDC does not believe that the seasonal influenza vaccine will provide any meaningful protection against novel H1N1 influenza virus. However, seasonal vaccine is still strongly recommended as it is a very important protection against the seasonal influenza virus, which causes about 36,000 flu-related deaths and 200,000 flu-related hospitalizations in the U.S. each year.