H1N1 Maine CDC Responds

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                        Maine CDC Responds

                     Summary of Events & Future Outlook

                                         Western DCC meeting
                                            June 12, 2009

MaryAnn Amrich
Western District Public Health Liaison
Office of Local Public Health
Maine Center for Disease Control & Prevention
Department of Health &Human Services
              Summary of Events

• Thursday, April 23, 2009
   • US CDC- conference call on a novel virus detected in southern
     California, southern Texas, and in Mexico.
   • Maine CDC operationalizes Pandemic Flu Plan

• Friday, April 24, 2009
   • Maine CDC posted H1N1 (Swine Flu) Information on Web Site

• Saturday, April 25, 2009
   • Maine CDC issued a Health Advisory
   • Maine CDC mobilized staff – opened phone banks

                        Maine CDC - OLPH 6/12/09
               Summary of Events

• Monday, April 27, 2009
   • Implemented incident command system to minimize H1N1 impact

• Wednesday, April 29, 2009
   • Health and Environmental Testing Laboratory identified the first cases of
     H1N1 in Maine
   • Maine CDC Web Site received 10,000 hits on this one day

• Saturday, May 2, 2009
   • 25% of Maine’s share of the federal strategic national stockpile arrived
   • Governor Baldacci made it possible for us to purchase a state antiviral
     stockpile. About 27,000 doses arrived, and more is expected.

                           Maine CDC - OLPH 6/12/09
  Maine Responds: Surveillance

• Surveillance:
  • Using existing seasonal flu surveillance system (ex.
    hospital ED visits, hospitalizations, sentinel
    providers, etc.) and enhanced systems, monitored data
    that could indicate disease transmission trends.

  • Laboratory: Tested over 1400 samples

  • Case Investigation/Case Finding: Investigated H1N1
    cases to determine severity of disease, possible modes
    of transmission, and recommend prevention strategies.

                    Maine CDC - OLPH 6/12/09
    Maine Responds: Communication

•   Conference calls with EMA, health care providers, public health partners, labs, etc.
     •   At times over 250 people participated on the health care provider calls.

•   Health Care Provider Consultation Line: close to 1000 calls

•   General Information Public Hotline: close to 2400 calls

•   Daily Updates on Web Site, HANS, press releases, and other information

•   Assuring vulnerable pops have access to H1NI materials in terms of language, culture

•   Health Alerts

•   Press Releases

                                     Maine CDC - OLPH 6/12/09
             Maine Responds

• Strategic National Stockpile: Coordinated receipt
  of strategic national stockpile and allocation to
  appropriate sites.

• Recommendations: Reviewed constantly
  changing federal recommendations, modified to
  meet state needs as appropriate and communicated
  to providers and partners.

                  Maine CDC - OLPH 6/12/09
                           H1N1 Update

•   Maine has identified and confirmed 30 Maine residents with H1N1.

•   In addition to Maine residents, 7 people were diagnosed with H1N1 while visiting the

•   4 cases of H1N1 were recently confirmed at the Cumberland County jail. 2 other
    inmates are being treated for influenza, presumably H1N1.

•   As the infection spreads and re-circulates, the numbers of cases and specific locations
    become less meaningful. The number of identified cases simply indicates the presence
    of H1N1 in Maine.

•   As the infection spreads we expect to see some increase in severity, as has been seen

•   There appears to be a high spread among children and young adults.

                                 Maine CDC - OLPH 6/12/09
                                 H1N1 Update
Current case counts (Maine residents)            Age Distribution of Swine – Origin Influenza A H1N1 in Maine
 County List         New Cases    Total Cases
 Androscoggin                                                                                             4

                                                      Number of Cases
                                                                                   3      3       3
 Cumberland                             17
                                                                            2                                        2              2       2      2
                                                                                                                          1                                            1
                                                                                                                                                                               0      0
 Kennebec                                                                   <5   5 to 10 11 to   16 to   21 to   26 to   31 to    36 to   41 to   46 to       51 to   56 to   61 to   >65
                                                                                          15      20      25      30      35       40      45      50          55      60      65
 Knox                                                                                                                         Age

 Lincoln                 1              1
 Oxford                                 1       Hospitalizations of Swine-Origin Influenza A H1N1 in Maine
 Penobscot                              1
 Piscataquis                                                                                                                     Hospitalized
 Sagadahoc               2              2
 York                    1              8                                                         Not Hospitalized

 Total                   4              30
    H1N1 in Neighboring States

• Massachusetts: 1,010 confirmed cases of H1N1
   • 95% are people < 50 years old
   • 7 schools remain closed; 31 schools have reopened

• New York: 1,100 confirmed cases of H1N1
   • 694 in New York City
   • 406 outside of NYC

• Vermont: 31 confirmed cases – none hospitalized

• New Hampshire: 101 confirmed cases

                        Maine CDC - OLPH 6/12/09
H1N1 around the world

      Maine CDC - OLPH 6/12/09
 Maine CDC Preliminary Summer Plans
          to Address H1N1

• After action reviews
   • survey & stakeholder discussions

• Pandemic Influenza Plan
   • Review & revise state plan as needed

• Large scale vaccinations
   • Updating and activating plans
   • Working with DOE to offer seasonal influenza vaccines for
     school-aged children this fall

                        Maine CDC - OLPH 6/12/09
Maine CDC Preliminary Summer Plans
         to Address H1N1

• Communication
  •   Review/ revise crisis communication protocols
  •   Activating social media communication channels
  •   Evaluate/ revise outreach to vulnerable populations
  •   Prepare media outreach
  •   Review internal/ external roles & communication

• Epidemiology
  • Continue intensive influenza tracking

                      Maine CDC - OLPH 6/12/09
Maine CDC Preliminary Summer Plans
         to Address H1N1

• Antiviral medications
   • Finalize plans for use of & distribution of state-
     purchased stockpile

• Laboratory surveillance
   • HETL (Maine CDC’s Health & Environmental Testing
     Laboratory) received certification 5/28/09 to do H1N1
   • Updating plans for future influenza testing surges

                      Maine CDC - OLPH 6/12/09
           Minimize H1N1’s Impact

•   Maintain vigilant respiratory etiquette: covering coughs and sneezes with sleeves or a
    tissue; washing hands frequently; and staying home if ill, especially with a fever.

•   Stay informed since this event is changing and so is the resulting guidance.

•   Make preparations. If one does not have a pandemic influenza plan, then preparation
    check lists for a variety of settings can be found at:

•   Follow public health advice regarding school closures, avoiding crowds and other
    social distancing measures.

•   Find healthy ways to deal with stress and anxiety.

                                 Maine CDC - OLPH 6/12/09
Maine CDC - OLPH 6/12/09
   Additional Information Links

Maine CDC


               Maine CDC - OLPH 6/12/09

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