State of Rhode Island Influenza Update December 2009

Influenza Virus Spread –Aerosolized droplets from coughing or sneezing up to a 6-foot radius –Hand to face contact (nose, eyes, or mouth) after touching infected areas –Virus infectious only up to 2-3 hrs on surfaces H1N1 Incubation period –1 to 7 days (avg 3-4 days) H1N1 symptom duration – 3 to 7 days but up to 14 days (avg 3-5 days) H1N1 contagious –1 day before symptoms to 10 days after symptoms – peak period while febrile

Coughing & Sneezing Cause Aerosolized Spread

Influenza-Like Illness Must-have symptoms –Fever plus sore throat or –Fever plus cough Other symptoms –Shortness of breath –Fatigue –Headache –Muscle & joint aches –Nausea, vomiting, or diarrhea

Main High-Risk Groups for H1N1 Complications Respiratory illnesses (Asthma, COPD) Cardiovascular Disease Diabetes Pregnancy Immuno-compromised individuals Cerebral Palsy & Muscular Dystrophy

Monitoring the Pandemic Monitor ILI cases –Severity, hospitalizations & deaths –Track impact on schools & healthcare providers Monitor the community presence of H1N1 –School absenteeism reported to HEALTH daily –Physician office and university clinics –Emergency room visits and hospitalizations Revise recommendations –If disease severity changes –Healthcare providers are overwhelmed –As H1N1 pandemic evolves

Public Health Strategies Prevention –Wash hands, cover cough –Use alcohol-based hand gels –Get vaccinated Communication –Briefings, media, website, information line Vaccination priorities –Pregnant women and children first –Access to all Reporting

Goal of Prevention

HEALTH Report Seasonal Vaccine: –Last season HEALTH ordered 245,000 doses and administered 230,000 doses –This season we ordered 318,000 doses –Of the 318,000 doses ordered, HEALTH received only 263,000 doses –33,000 more doses distributed this year –237,000 doses were injectable –26,000 doses were nasal spray

HEALTH Report RI received final shipment: 5,000 doses of injectable and 20,000 of the nasal spray Vaccines are on their way to primary-care doctors to complete their orders Providers urged to save injectable for those 65 and older Protection for nursing home patients –Some nursing home patients have been vaccinated –The high uptake of seasonal flu vaccine among healthcare workers will help protect patients

HEALTH Report H1N1 Vaccine: –HEALTH orders weekly –Expect over 500,000 doses by March 2010 Vaccine plans and uptake –Pregnant and post-partum women 60%+ uptake –Vaccine available for 6 months to 5 years of age – all distributed to providers

HEALTH Report Vaccine plans and uptake –Grades K–12 achieving 75% uptake –18 through 24 – starting with colleges in December –Healthcare workers & 1 st responders starting in December –Adults with chronic illness – starting in January –General public – starting by late January

Influenza Vaccine Programs Work with many local partners including Healthcare Providers, Medical Reserve Corps, Wellness Company, Hospitals, Insurers, RIEMA, local EMAs, Media, Community Agencies, Schools, Colleges/Universities and state agencies Report weekly to CDC Reports posted on

H1N1 is like seasonal influenza but impacts kids/young adults at higher rates Follow flu prevention recommendations Support H1N1 vaccine campaign Stay at home until fever-free for 24 hours without fever-reducing medicine Stay home if you are sick Be flexible and practical Stay informed by visiting or Main Messages

Information Resources HEALTH - -Twitter: RIDEPTOFHEALTH -For general questions RI Relay :30 AM - 4:30 PM -Answered in English and Spanish - Report RI Relay 711 Federal Sources -

David R. Gifford, MD, MPH, Director of Health RI Relay 711 H1N1 Information RI Relay 711