Microsoft Office Outlook Memo Style flu caseload

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					Kent, Dana L (HSS)
From:                       Wayne, Kathleen A (HSS)
Sent:                       Thursday, November 12, 2009 3:28 PM
To:                         HSS DPA WIC Coordinators
Cc:                         Fitzjarrald, Elinor A (HSS); Rich, Elaine M (HSS); Nisonger, Elaine P (HSS); Albrecht, Alice E
                            (HSS); Kent, Dana L (HSS); Hoger, Fatima S (HSS); Carrillo, Rebecca N (HSS); Eriksen,
                            Christina N (HSS); Pietan, James J (HSS); Goode, James B (HSS)
Subject:                    November 13 WIC Update
Attachments:                extra foods client flyer FINAL 10-20-09.pdf

Hi Everyone, 
A big thank‐you goes to Bart for implementing the new USDA policy to increase fruit and vegetable cash‐value‐vouchers 
to $10 for women.  Bart is working on additional AKWIC updates that will be released this Friday night.  Please make 
sure your computers are left on.  
 I will be out of the office on Friday, please contact Becky (465‐8629) or Fatima (269‐3459) if you have questions.  
Here are some other things to share. 

   •    FY 10 5 State Questions—below are the state’s 5 questions to add to your clinics client questionnaire. Please let
        us know if you encounter client responses that need our immediate attention, such as if WIC foods are not
        available at the store. If you have additional questions or concerns, please contact Dana Kent.
   •     1. What change in eating habits or physical activities, if any, has your family made in the past year?
   •    2 . How has the change in the new WIC food items (whole grains, fruits and vegetables, tofu, low fat milk)
        changed how your family eats or shops?
   •    Have you heard about the WIC client online nutrition education? Yes No If yes; have you used this service? Yes
   •    4. Have you had problems this year purchasing the new WIC foods (whole grains, fruits and vegetables, tofu
        and soy) in a WIC approved grocery store? Yes No If you had problems please explain.
   •    5. How helpful has WIC been in assisting you to successfully breastfeed your baby? Please circle; (1 being the
        least helpful, 5 being the most helpful. N/A; does not apply to me.)
        1______2_____3_____4_____5 N/A

   1. New WIC Laptop Deployment and Training-- All the Local Agencies need training on Guardian Edge before the
      Laptops get deployed to their agencies. LAs can contact the trainer, Edwell John to
      sign up for a class in November. There is no charge for classes. Classes last about 1.5 hours.

   2. UHT Package Clarification--- UHT can be issued for cases where there was no refrigeration and after assessment
      with the clinic staff.

   3. Tofu and Bread Food List Additions—see attached.

   4. Caseload Performance--As previously discussed in Caseload Teleconferences we will be monitoring caseload this
      fiscal year more carefully than in the past. We will start implementation of our caseload policies by monitoring
      caseload and sending out letters for those Local Agencies not meeting the 97% standard. We will be requiring
      Action Plans from any agency that continues to have caseload issues overtime. This year we will NOT take
      money away from agencies not meeting the PS but plan to implement this policy during the next fiscal year
      (2011). We WILL allocate additional funding to those agencies >103% standard in January.

    5. LA Self Assessment--Just a reminder that we are no longer requiring the Self Assessment to be done in
       November each year. They will be required at the time of your Management Evaluation.

    6. CDC Health Advisory—See below message from CDC regarding Clinicians Concerning Antiviral Treatments for
       2009 H1N1.

    7.   USDA Team Nutrition Resource—USDA would like to announce the availability of print files for The Two Bite
         Club storybook. Our national office will be sending a copy of the print files to each State agency. State agencies
         can use the files to print their own copies of the storybook if they choose. Demand for the storybook has been
         high and FNS will continue to fill orders for States that do not wish to print their own. A 50-copy limit applies.
         The downloadable PDF of the storybook is available on the Team Nutrition website at:

Have a great weekend,



This is an official
CDC Health Advisory

Distributed via Health Alert Network
November 6, 2009, 13:51 EST (01:51 PM EST)

Key Issues for Clinicians Concerning Antiviral Treatments for 2009 H1N1

Although use of influenza antiviral drugs in the United States has increased during the 2009-2010 flu season, not all people
recommended for antiviral treatment are getting treated. Listed below are important facts to consider when deciding whether a patient
needs to be treated with antiviral medication.

It is critical to remember that it is not too late to treat, even if symptoms began more than 48 hours ago. Although antiviral treatment is
most effective when begun within 48 hours of influenza illness onset, studies have shown that hospitalized patients still benefit when
treatment with oseltamivir is started more than 48 hours after illness onset. Outpatients, particularly those with risk factors for severe
illness who are not improving, might also benefit from treatment initiated more than 48 hours after illness onset.

Recommendations for Clinicians:
Many 2009 H1N1 patients can benefit from antiviral treatment, and all hospitalized patients with suspected or confirmed 2009 H1N1
should receive antiviral treatment with a neuraminidase inhibitor - either oseltamavir or zanamavir - as early as possible after illness
onset. Moderately ill patients, especially those with risk factors for severe illness, and those who appear to be getting worse, can also
benefit from treatment with neuraminidase inhibitors. A full listing of risk factors for severe influenza is available at:
                                                                     2 <>

Although antiviral medications are recommended for treatment of 2009 H1N1 in patients with risk factors for severe disease, some
people without risk factors may also benefit from antivirals. To date, 40% of children and 20% of adults hospitalized with
complications of 2009 H1N1 did not have risk factors. Clinical judgment is always an essential part of treatment decisions.

When treatment of persons with suspected 2009 H1N1 influenza is indicated, it should be started empirically. If a decision is made to
test for influenza, treatment should not be delayed while waiting for laboratory confirmation. The earlier antiviral treatment is given,
the more effective it is for the patient. Also, rapid influenza tests often can give false negative results. If you suspect flu and feel
antiviral treatment is warranted, treat even if the results of a rapid test are negative. Obtaining more accurate testing results can take
more than one day, so treatment should not be delayed while waiting for these test results. For more information on influenza testing,
please see: <> .

Although commercially produced pediatricoseltamivir suspension is in short supply, there are ample supplies of children's
oseltamivircapsules, which can be mixed with syrup at home. In addition, pharmacies can compound adult oseltamivircapsules into a
suspension for treatment of ill infants and children. Additional information on compounding can be found at: <> .
For More Information
Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-
2010 Season: <>

Questions & Answers:
Antiviral Drugs, 2009-2010 Flu Season: <>
Influenza Diagnostic Testing:

Updated Interim Recommendations for Obstetric Health Care Providers Related to Use of Antiviral Medications in the Treatment and
Prevention of Influenza for the 2009-2010 Season:

Antiviral Drugs: Summary of Side Effects:

General information for the public on antiviral drugs is available in "2009 H1N1 and Seasonal Flu: What You Should Know About
Flu Antiviral Drugs" at <> .

Downloadable brochures and informational flyers, including one on antiviral drugs, are available at <> .

For the FDA page on antiviral influenza drugs:

For additional information, you can also call CDC's toll-free hotline, 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348, which is
available 24 hours a day, every day.
Categories of Health Alert messages:
Health Alert      conveys the highest level of importance; warrants immediate action or attention.
Health Advisory provides important information for a specific incident or situation; may not require immediate action.
Health Update provides updated information regarding an incident or situation; unlikely to require immediate action.
To remove your address or a duplicate address from the State of Alaska Division of Public Health electronic public health alert list,
please send an e-mail message to with "REMOVE" or "DUPLICATE" as the SUBJECT of the e-mail.
To correct your address or add a colleague's address, please send an e-mail message to with "CORRECT" or
"ADD" as the SUBJECT of the e-mail.

This message is sent to you as a service of the State of Alaska DHSS, Division of Public Health, through the Section of Epidemiology,
P.O. Box 240249, Anchorage, Alaska 99524-0249, (907) 269-8000. The Section of Epidemiology maintains a 24-hour Emergency
Number, 1-800-478-0084. Internet site:

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