As of 11am ET, a total of 141 human infections with the novel influenza A (H1N1) virus have been confirmed at this time in 19 states by the Centers for Disease Control and Prevention (CDC). Yesterday 109 cases were reported.
Nineteen states have confirmed cases of the H1N1 influenza virus.
New Jersey currently has five confirmed cases.
The complete list of states with current number of confirmed cases may be accessed online at the CDC’s website: www.cdc.gov/h1n1(note change in URL from swine flu to H1N1) and is updated daily at 11am.
To date, one death has been reported in a 22 month-old-child in Texas.
CDC is also investigating other reports of critically ill and hospitalized patients and their work in this area will go on.
There will now be less focus on the number of cases, knowing that CDC expects to see more cases, more hospitalizations, and more deaths from this outbreak over the coming days and weeks.
Influenza is always serious. Each year in the United States, seasonal influenza results in an estimated 36,000 deaths from flu-related causes.
This outbreak certainly poses the threat to be at least as serious as seasonal flu if not more so.
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.
Internationally, more countries are reporting cases of infection with this new virus.
The Director-General of the World Health Organization (WHO) raised the level of influenza alert from phase 4 to phase 5
A Phase 5 alert is a “strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.”
The decision was based primarily on epidemiological data which identified human-to-human transmission and the ability of the virus to cause community-level outbreaks.
It is important to keep in mind that there are things we can do.
Epidemiological investigations, including tracing contacts of all laboratory confirmed patients is ongoing to determine the extent of human-to-human spread.
The CDC has activated its Emergency Operations Center to coordinate the agency’s response to this emerging health threat and ensure an immediate and appropriate response to emerging developments.
The goal of the public health response is to reduce transmission and illness severity and provide information to assist health care providers and public health officials and the public in addressing the challenges posed by this new flu virus.
The CDC continues to update guidance, including a recent posting for concerned parents and other caregivers of children on how to identify symptoms; how to prevent infection; and what to do if your child gets sick. Children are at high risk for serious complications from seasonal flu and it would not be surprising to find a pattern where they also are at higher risk of serious complications from this new virus.
The CDC is taking steps to protect people who might be more vulnerable to serious illness and complications from this virus by pushing out our recommendations through partners to get the word out to these parents that they should take precautions; be aware of warning signs; and seek medical care sooner rather than later.
This morning, the CDC issued interim guidance on school closures. The guidance includes recommendations on school dismissal for K-12 schools and closure of child care programs and facilities.
School dismissal and childcare closures are an important part of a comprehensive approach at reducing the spread of disease
The CDC has developed additional diagnostic laboratory detection tools to assist state public health laboratories with their capacity for testing.
Nationwide distribution of this diagnostic test begins today.
The CDC also issued two MMWR reports that are available on their website:
The first report describes the initial outbreak of H1N1 in Mexico. Findings indicated that transmission in Mexico involves person-to-person spread.
The second report surrounded an outbreak of H1N1 infections in a school in New York City, so far the largest reported cluster of H1N1 cases in the United States.
Everyday we learn more about this virus and what we learn will continue to inform the actions that we take in response.
TRAVEL
The CDC issued a travel health warning recommending that travelers postpone all non-essential travel to Mexico until further notice.
The concern is that continued travel by U.S. travelers to Mexico presents a serious risk for further outbreaks of swine flu in the United States and travel to Mexico poses significant risk to those travelers.
If you must travel to Mexico, there are steps you should take to reduce your risk of infection:
Prepare for your trip before you leave by monitoring the international situation; checking with your health care provider about prescription antiviral medications; packing a travel health kit; reviewing your health insurance plan; and finding where you can get health care services while traveling.
Practice healthy habits to help stop the spread of germs including washing your hands often with soap and water, covering your coughs and sneezes and following all local health advice. This may include wearing a surgical mask to protect others.
You should get a seasonal flu vaccination. It is not expected to protect against swine flu, but it will protect you against seasonal flu. Flu season runs through May in the northern hemisphere, and is just beginning in tropical and southern hemisphere countries.
After you return from Mexico, play close attention to your health for 10 days. If you become sick with a fever PLUS a cough and sore throat, or if you have trouble breathing during the 10 days after your return, see a doctor.
When you make your appointment tell the doctor about your symptoms, where you traveled, and if you had close contact with a sick person or farm animals. This way the doctor is aware you traveled to an area reporting swine flu.
STRATEGIC NATIONAL STOCKPILE (SNS)
The CDC’s Division of the Strategic National Stockpile (SNS) is releasing antiviral drugs, personal protective equipment and respiratory protective devices to help with the public health response.
Twenty states/cities have already received SNS deliveries. SNS estimates completion of deliveries by May 3
New Jersey has 800,000 doses of antiviral medications in its state stockpile. Through the CDC National Stockpile, the state will get another 300,000 courses so we will have a total of 1.1 million doses.
Antivirals are one method in the arsenal of fighting viruses.
Influenza antiviral drugs are prescription medicines (pills, liquid or inhaler) that are prescribed by a healthcare professional and do not cure the flu but help reduce the symptoms and shorten the number of days a person is sick with the flu.
Antiviral drugs work best when started soon after illness onset (within 2 days), but treatment with antiviral drugs should still be considered after 48 hours of symptom onset, particularly for hospitalized patients or people at high risk for influenza-related complications.
PREVENTION and TREATMENT
There is no vaccine available at this time to protect against swine flu. However the CDC is taking aggressive early steps in the process to produce a vaccine has started.
There are actions that you can take to help prevent the spread of germs that cause respiratory illnesses, like influenza:
Cover your nose and mouth when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands with soap and water, especially after you cough or sneeze.
Avoid touching your eyes, nose or mouth.
Avoid close contact with sick people.
Stay home if you are sick.
Social distancing is a way to “keep our distance” form each other reduce the spread of flu.
Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak.
Clinicians should continue to consider swine flu infection in the differential diagnosis of patients with respiratory illness who have either been in contact with persons with confirmed swine flu, or who were in one of the U.S. states that have reported swine flu cases or in Mexico during the 7 days preceding their illness onset.
Patients who meet these criteria should be tested for influenza.
It is important to know that everyone who becomes ill with flu-like symptoms will not be tested or receive antiviral medication.
CDC recommends the use of oseltamivir (trade name Tamiflu®) or zanamivir (trade name Relenza®) for the treatment and/or prevention of infection with swine influenza viruses.
Laboratory testing on swine influenza A (H1N1) viruses that have been detected in humans in the United States and Mexico indicate that they are resistant to amantadine and rimantadine. These drugs will not work against the swine flu.
Anyone who is experiencing flu-like symptoms such as, fever, cough, sore throat, muscle aches, or more serious symptoms like difficulty breathing should call their health care provider.
VACCINE
Aggressive steps are being taken to develop a H1N1 vaccine.
CDC has isolated the new H1N1 virus and is working to make a vaccine.
There are many steps involved with producing a vaccine.
Manufacturing and testing take time.
While the making a vaccine is a priority, it will be several months before one is available.
But there are things that you can do to stay healthy: wash hands, cover coughs and sneezes and stay home if you are sick.
LABORATORY TESTING
Influenza viruses have the ability to undergo constant and dramatic change.
Many different animals and humans get infected with influenza viruses, but the viruses generally stick with one species. 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 is what happened and resulted in this new H1N1 virus. H1N1 is an unusual virus, as the genetic combination has not been recognized before in the United States or elsewhere.
Testing a number of virus samples show that this H1N1 virus does not have similar characteristics to the 1918 pandemic virus.
Additionally, this new H1N1 virus does not have markers that have caused human infections and deaths in other countries with the avian influenza (H5N1) virus.
For NEW JERSEY:
New Jersey has reported 5 confirmed cases of swine flu. We are awaiting laboratory confirmation on two additional cases; confirmation should be available soon.
Four of the five individuals had a travel history.
All of the individuals have mild forms of the flu and are recovering at home.
Samples for two additional probable cases have been sent to the CDC laboratory for confirmatory testing.
NJ has received a shipment of materials from the Strategic National Stockpile.
We understand that people may be concerned about this outbreak of swine flu in parts of the U.S.
New Jersey health officials continue to investigate reports of illness, investigate reports of suspicious illness and monitor the situation in other states.
The NJDHSS opened a toll-free, 24-hour hotline to answer questions from the general public and New Jersey health care providers. The hotline number is 1-866-321-9571.
As per guidance from the CDC, New Jersey’s Public Health and Environmental Laboratories will continue to test for influenza strains. All influenza strains that cannot be typed will be sent to the CDC for further testing.
Families and individuals should also take this opportunity to review and update their family emergency plans.
