Influenza Update - November 22

Novel Influenza H1N1 Update Dr. Stuart B. Weiss INFLUENZA UPDATE Nov 22, 2009 SUBSCRIBE: Click button at bottom or send email to: sweiss@MedPrepGroup.com Okay, it seems official. The U.S. novel H1N1 has peaked for the moment but all the news is still not rosey. While the situations seems to be improving in the U.S., the number of influenza cases is still way up and in other parts of the world, there is no sign of a peak yet. Current Situation: The CDC reports that 43 states now report widespread flu activity, this is down from 46 states last week. The number of people visiting physicians in the US for influenza-like illness has decreased for the third straight week although the overall number is still very high. The WHO reports that while there is some slowing of new cases in the U.S., Canada continue to show intensifying disease. In other areas of the world: Europe: Transmission is widespread and increasing across Europe especially in north, east and southeast Europe with some dramatic recent spikes in eastern Europe. A peak seems to have occurred in some western Europe countries especially Iceland, Ireland, UK and Belgium. Central/Western Asia: Increased disease in Kazakhstan, Uzbekistan and parts of Afghanistan. this is affecting troops and Afghan security forces. East Asia: Japan's numbers of new cases is slightly decreased. Some experts suspect large numbers of cases in China. There is also seasonal H1N1 and H3N2 circulating in China Southern Hemisphere: Temperate zones showing little to no activity, tropical zones have variable activity Vaccine Update: Supply shortages of H1N1 vaccine continue as 11 million doses of vaccine were released last week. This brings the total to 54.1 million doses. CDC reported 21 additional pediatric deaths this week due to flu related complications. 2/3 of the children had underlying medical problems such as asthma, cerebral palsy or muscular dystrophy. There were two clusters of patients in hospitals with Tamiflu resistant novel H1N1 viral infections. One cluster was in the UK and another was in the U.S.. At a news conference late last week, the CDC mentioned a mutation in the novel H1N1 virus was found in Norway. This mutation may make the virus live easier deep in lung tissue. Researchers at the USDA found that the novel H1N1 virus has changed enough that it doesn't infect birds well or spread between them easily. Egypt reported another H5N1 (Bird flu) case in a 21 year old male who was involved with slaughtering chickens. HOUSEKEEPING ITEM: If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sweiss@MedPrepGroup.com ANALYSIS: Its now been three weeks in a row that the number of cases of people visiting their physicians for influenza like illness has decreased and in fact, several television network news stories last week interviewed hospital folks who reported less emergency department and clinic visits. It does indeed appear that we have peaked and are on the downswing of this wave. I say wave because there are some reports of a second wave starting in some countries already. As indicated by the virus mutation, the clusters of resistance and the virus's adaptation to humans, this is far from over. In fact, in many parts of the world, the numbers are still markedly increasing. This decrease in the U.S. gives us a chance to take a deep breath but I can't stress strongly enough that planning efforts should continue. It is not time to let down your guard as there is no evidence to support that position this early in the flu season. The highest travel time of the year is approaching and people from different parts of our country and the world will be coming together. We will have to watch to see if this changes the viral patterns. I have done several webinars and talks this past week in different parts of the country and had many questions about the novel H1N1 vaccine. My advice remains the same. It is an extremely safe vaccine and I recommend it to everyone who is eligible. Use this lull in public attention to have eligible people vaccinated. Go on the Goggle flu site and find where vaccine is available. ADVICE: In the U.S. this past week, there were congressional hearings on making sick time mandatory as a way to fight H1N1. Don't wait for congress to act, review your H.R. plans and make some decisions on how you will handle employees who are out sick with the flu or those that stay home with sick family members. Review the American With Disabilities act and decide what screening questions you can ask. It may be challenging to keep interest in this topic as your C-suite executives have seen the news stories about flu having peaked. Remind them that even though we have peaked, this is one of three expected waves and we still have markedly increase flu cases across the U.S. even thought the numbers of new cases seem to have peaked three weeks ago. Lastly, don't take your eye completely off H5N1 as Egypt reported yet another case this week. TOOLS: Pandemic QuickStart - If you need to quickly bring your company up to speed with its pandemic planing efforts, we can help with our quickstart resources. Virtual Medical Director - If you don't have a corporate medical director, our Virtual Medical Director program may be a good solution for you. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. We have affordable decision support plans that you can enroll in. Pandemic Planning Assistance - We have a policy matrix, policy toolkits, FAQ's, posters, employee educational materials, a trigger based action plan template . We can help you jumpstart your planning or take a look at your current plans with a fresh set of eyes. Not preparing now would be a serious mistake. If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program. Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC