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H1N1 Update

05/06/09
As expected, the number of A(H1N1) cases in Maine and across the US will continue to increase as both the virus spreads and the labs get caught up with the diagnostic testing. However, the changes are modest and include: 1 more "probable" case in Maine, 1 more fatality in TX.

With the change in guidelines yesterday regarding school closure, the message seems to be getting out that A(H1N1) should be handled like the regular seasonal flu in terms of precautions and PPE. As such, there was little additional information provided today.

The state antivirual cache (Relenza) will be sent to all hospitals based upon population density. Guidelines for its use are still being finalized by Maine CDC.

There has been confusion about N95s because apparently the FDA issued an Emergency Use Authorization (EUA) that did not include fit testing. However, the EUA is not automatically binding upon other agencies and OSHA has not changed their position on fit testing (and the medical screening), nor has the state Bureau of Labor Standards.
The daily conference calls with MEMA, ME CDC, and the ERT are being terminated for now. If there are significant developments or new information, we will be notified and pass that along.

05/04/09

- there are 7 "probable" cases in Maine. The news today reported an 8th case in Scarborough; however, apparently that information came from an individual physician and not through Maine CDC. It remains to be seen if this latest case will be identified as such by Maine CDC.

- It is likely that Maine will appear on the US CDC confirmed sites in the next day or so. It was emphasized that US CDC will not be testing every sample that is sent to them. Their goal is to get an idea as to where/how the virus is spreading and not to have an exact count of every case. As such, it is likely that there will continue to be differences between the state and federal figures.

- the federal SNS stockpile has been received in Maine and distributed to the 9 hospitals indentified in the Chempak plan.

- Maine CDC staff has personally contacted each of these hospitals this morning to discuss these supplies and talk about the development of guidelines for the use of the supplies. The federal supplies are strictly limited to in-hospital patients, but the state supplies (which are on the way) will likely have different guidelines. Details TBD.

- Primary contact in the hospitals has been the hospital pharmacy and the emergency departments. General questions from health care practitioners should be directed to the 24/7 Disease Reporting Line at ME CDC.

- Hospitals who need to obtain supplies from another site should contact Maine Poison Control.

- Those going into hospitals, nursing homes, etc. should use same precautions as they would use for the seasonal flu. PPE only needs to be used for those in immediate contact with known flu cases or with those who are exhibiting significant s/s.

If you have questions or concerns being brought to your attention, please forward them to me and I will obtain a response through the JIC.

04/30/09

Swine Flu Cases in Maine

AUGUSTA – Governor John E. Baldacci and Maine Center for Disease Control Director Dr. Dora Anne Mills discussed the steps that are being taken to minimize the impact of the H1N1 (swine) flu in Maine at a State House Press Conference today. On Wednesday morning, three cases of H1N1 (swine flu) were confirmed in Maine . All three people are adults and a recovering in their homes. Two are from Kennebec County and one resides in York County.
“It is important for the citizens of Maine to prepare for this as they would any other emergency situation,’’ the Governor said. “We have weathered storms before, whether it be an ice storm, or a blizzard. There are important steps we can all take to minimize the impact of this virus.”

Governor Baldacci urged Mainers to become familiar with the information made available by the State and Federal Centers for Disease Control. Personal checklists are available at http://www.cdc.gov/flu/protect/habits.htm?s_cid=swineFlu_outbreak_003

Antiviral medication is arriving from a federal stockpile later this week. In addition, the Governor has authorized the purchased of $2.175 million of antivirals, which will provide Maine with the maximum amount of coverage if H1NI spreads.

Dr. Mills re-iterated the need for citizens to practice proper respiratory hygiene, including the following steps:

Cover your coughs and sneezes with a tissue or sleeve.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.

Try to avoid close contact with sick people.

If you get sick, stay home from work or school and limit contact with others to avoid infecting them.

“If you become sick with the symptoms of swine flu during this period, you should call your health care provider with the information about your symptoms and where you traveled,” Mills said.

The Governor has planned a meeting later today with the Emergency Response Team and members of the Cabinet to discuss the latest information available.

For facts about influenza, and more information about H1N1 flu, please visit the Maine CDC and U.S. CDC Web sites. Some specific resources:

Maine CDC Web site on Swine Flu: www.mainepublichealth.gov; or http://www.maine.gov/dhhs/boh/swine-flu-2009.shtml

U.S. CDC Web site on Swine Flu: http://www.cdc.gov/swineflu/

Preventing the Flu: http://www.cdc.gov/flu/protect/habits.htm

04/28/09

Maine Update: While Maine has not yet identified any people confirmed with swine influenza A (H1N1), there are several people being tested, and a large number of Mainers have recently returned from traveling in areas where swine influenza is found. The most important strategies to minimize swine flu's impact in Maine are those of respiratory hygiene: covering coughs and sneezes with sleeves or elbows; washing hands frequently; and staying home if ill, especially with a fever. Additionally, everyone should stay informed since this event is rapidly changing and resulting guidance is as well. The U.S. CDC's website has updated national information and guidance at: http://www.cdc.gov/swineflu/. Maine CDC's website has updated Maine-specific information, including daily updates starting later today, as well as links to federal information. It can be located at: www.mainepublichealth.gov. Importantly, everyone should also make preparations. These preparations include activating a pandemic influenza plan. If one does not exist, then preparation check lists for a variety of settings including homes, businesses, and schools can be found at: http://www.pandemicflu.gov/plan/checklists.html. This health advisory contains an update from U.S. CDC including new interim guidance on community mitigation strategies, such as isolation, quarantine, school and day care closures, and the social distancing strategies of cancelling mass gatherings. People and organizations in Maine need to prepare now for those possible strategies to be implemented. To download a Microsoft Word or Adobe PDF version of this advisory please click on the second link at the bottom of this message.

Rick Petrie, EMT-P
Regional EMS Coordinator