Update on A (H1N1) Influenza (Swine Influenza) - May 4, 2009

A (H1N1) influenza continues to dominate the news. While there is some discussion that the rate of spread may be diminishing, it is still too early to predict the end of this wave of spread, and whether or not we will witness another wave(s).

According to the Centers for Disease Control (CDC), as of May 4 at 11 am, there are 279 confirmed cases across 36 states in the US. There is still only one confirmed swine-flu-related death, in Texas. The World Health Organization pandemic alert level is currently at Phase 5 (out of 6), with 21 countries officially reporting a total of 1085 cases.

Here's the breakdown in the U.S. of laboratory confirmed cases:

Alabama 4
Arizona 17
California 30
Colorado 7
Connecticut 2
Delaware 20
Florida 5
Idaho 1
Illinois 8
Indiana 3
Iowa 1
Kansas 2
Kentucky 1
Louisiana 7
Maryland 4
Massachusetts 6
Michigan 2
Minnesota 1
Missouri 1
Nebraska 1
Nevada 1
New Hampshire 1
New Jersey 7
New Mexico 1
New York 73
North Carolina 1
Ohio 3
Oregon 3
Pennsylvania 1
Rhode Island 1
South Carolina 15
Tennessee 1
Texas 41
Utah 1
Virginia 3
Wisconsin 3

Here's some excellent information from the CDC about how best to safeguard pregnant women against exposure to A (H1N1) influenza:

Considerations for pregnant women who are more likely to be exposed to H1N1 flu (swine flu) at work:

This information is for pregnant women who work in jobs where they are more likely to be exposed to people with confirmed, probable, or suspected novel H1N1 virus infection.

Schools and child care workers
Pregnant women working in school settings (e.g. teachers, day care workers) should follow the same guidance as do nonpregnant school workers and the general public.

H1N1 Flu (Swine Flu) and You

Guidance for Schools K-12

Alert for institutions of higher learning

Health care workers

All health care workers in direct patient care, including pregnant women, should follow standard precautions with all patients, regardless of infection status (http://www.osha.gov/Publications/OSHA_pandemic_health.pdf, page 15).

Health care workers treating patients with suspected or known illness easily transmitted by contact, droplet, or airborne transmission (e.g. influenza viruses) should do a risk assessment to determine the type of transmission-based precautions needed. Contact, droplet, or airborne precautions may be indicated (http://www.osha.gov/Publications/OSHA_pandemic_health.pdf, pages 16-17).

Pregnant women who will likely be in direct contact with patients with confirmed, probable, or suspected influenza A (H1N1) (e.g., a nurse, physician, or respiratory therapist caring for hospitalized patients), should consider reassignment to lower-risk activities, such as telephone triage.

If reassignment is not possible, pregnant women should avoid participating in procedures that may generate increased small-particle aerosols of respiratory secretions in patients with known or suspected influenza, including the following procedures:

Endotracheal intubation
Aerosolized or nebulized medication administration
Diagnostic sputum induction
Bronchoscopy
Airway suctioning
Positive pressure ventilation via face mask (e.g., BiPAP and CPAP)
High-frequency oscillatory ventilation
Guidance on pre-exposure and post-exposure chemoprophylaxis with antiviral agents, including for pregnant women can be found at http://www.cdc.gov/h1n1flu/recommendations.htm.

For additional guidance for health care providers please visit http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm.

Tags: A(H1N1) influenza, S-OIV, influenza, swine flu, flu, swine influenza, wilderness medicine, outdoor medicine, healthline