Extra: 2009 H1N1 (Swine) Flu Guidance for Clinicians
Current Clinician Guidance
The State of Georgia has established a flu information hotline specifically designated for health care providers. The clinician hotline is 1-888-H1N1-MED, or 1-888-4161-633. There is also a hotline for the general public, and it can be accessed at 1-888-H1N1-INFO, or 1-888-4161-4636.
Click here for a PDF version of updated interim guidance issued September 17 for obstetric health care providers related to use of antiviral medications in the treatment and prevention of influenza for the 2009-2010 season.
Click here for a PDF version of the following Clinician Guidance
The following information was distributed to providers by the Coastal Health District on August 25, 2009 and offers guidance for novel H1N1 Influenza virus testing:
Laboratory testing for novel H1N1 influenza at the Georgia Public Health Laboratory is used primarily for public health surveillance, not for primary diagnosis of individual patients. At this time, the H1N1 virus seems to be epidemiologically similar to seasonal influenza, so we are focusing our surveillance efforts to gain information about severe outcomes of H1N1 infection (such as hospitalization) and clusters/outbreaks in institutional or social venues.
Patients must meet certain criteria (listed below) to be tested for H1N1 influenza.
Criteria for novel H1N1 influenza testing at the Georgia Public Health Laboratory:
Specimens can be submitted for:
1. Patients hospitalized with influenza-like illness (see definition below).
2. Infants, persons ≥ 65yrs, or persons with a compromised immune system who are hospitalized with a sepsis-like syndrome, if H1N1 influenza is suspected and other causes are less likely.
3. At this time, NO specimens from suspect cases with mild ILI should be sent to the Georgia Public Health Laboratory for testing.
Note: Influenza-like illness (ILI) is defined as an illness with fever (≥ 100° F) AND cough and/or sore throat (in the absence of a known cause other than influenza.
Clinicians MUST contact an epidemiologist at the Coastal Health District at 912-644- 5200 or the Georgia Division of Public Health Acute Disease Epidemiology Section (404-657-2588) to obtain approval to submit specimens for testing, the appropriate submission form, and to coordinate specimen shipping. After business hours, specimens can be collected and held in the refrigerator at 4ºC until Public Health can be consulted.
SAMPLES SUBMITTED DIRECTLY TO THE PUBLIC HEALTH LABORATORY WITHOUT APPROPRIATE PUBLIC HEALTH SCREENING AND THE APPROPRIATE SUBMISSION FORM MAY NOT BE TESTED.
Update: August 5, 2009 CDC Recommendations for the Amount of Time Persons with Influenza-Like Illness Should be Away from Others
CDC recommends that people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8°C]), or signs of a fever without the use of fever-reducing medications.
This is a change from the previous recommendation that ill persons stay home for 7 days after illness onset or until 24 hours after the resolution of symptoms, whichever was longer. The new recommendation applies to camps, schools, businesses, mass gatherings, and other community settings where the majority of people are not at increased risk for influenza complications.
This guidance does not apply to health care settings where the exclusion period should be continued for 7 days from symptom onset or until the resolution of symptoms, whichever is longer. These extended guidelines may also need to be considered fro daycares with children <6 months old attending. See http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm for updates about the health care setting.
This revision for the community setting is based on epidemiologic data about the overall risk of severe illness and death and attempts to balance the risks of severe illness from influenza and the potential benefits of decreasing transmission through the exclusion of ill persons with the goal of minimizing social disruption.
Current guidance for treatment of suspected cases of novel H1N1 influenza infections is available at http://cdc.gov/h1n1flu/guidance/.
Additional information on Novel H1N1 Influenza can be found on the Centers for Disease Control and Prevention website: http://www.cdc.gov/flu/swine/index.htm
If you have any questions, please call the Coastal Health District at 912-644-5200 or the Georgia Division of Public Health (404-657-2588 during normal working hours or 1-866-PUB-HLTH after hours).
Guidance should be considered interim and will be updated frequently.
Click here for general information about swine flu.
WWW Address: http://www.gachd.org/extra/swine_flu_guidance_for_clinici.php