DC Department of Health

1. H1N1 Flu Update DC Department of Health September 29, 2009

2. Surveillance • Case Definitions • Influenza-like Illness (ILI) • Temperature > 1000 AND • Cough and/or sore throat • Reporting • Cluster (2 or more) or Unusual Occurrance • Division of Epidemiology Disease Surveillance and Investigation – Department of Health • Robin Diggs 202-442-5859 daytime • Chevelle Glymph 202-821-9671 after hours

3. Algorithm for School Responses to Student Illness Does the student have a fever or chills AND Cough and/or sore throat? Unlikely to be influenza. Treat per normal school policy and procedure for student’s symptoms. NO YES • Implement appropriate infection control measures. • Send the student to a room separate from others until he or she can be sent home. • Provide the student with a surgical mask. • School personnel are to wear a surgical mask when providing care within 6 feet of the ill individual. Does the ill student have siblings/ family members in school? Continue heightened alert for student illness. NO YES Screen ill student’s siblings/family members who are in school for fever and respiratory infection symptoms for the next 5 days. • A fever is a temperature taken with a thermometer that is equal to or greater than 100 degrees Fahrenheit (38 degrees Celsius). If you are not able to measure a temperature, the sick person might have a fever if he or she • feels warm • has a flushed appearance, or • is sweating or shivering. • Those with flu-like illness should stay home for at least 24 hours after they no longer have a fever, or signs of a fever, without the use of fever-reducing medicines (acetaminophen and ibuprofen). They should stay home even if they are using antiviral drugs. • Students may return to school without a note from a physician. A note from a parent or guardian is sufficient.

4. Testing & Treatment Testing • Physician’s Offices • May test for Influenza A vs. B • H1N1 Confirmation testing • Hospitalized patients only • Public Health Laboratory only Treatment • Anti-virals • Recommended for high risk patients only • Symptomatic Relief • Fever-reducing medicines (acetaminophen and ibuprofen) • Drink clear fluids to prevent dehydration • Plenty of rest

5. Mitigation • Promotion of • Wash hands • Cover cough • Stay home if sick • Until 24 hours after last fever • School closure • Only when absolutely necessary • High teacher absenteeism and/or student absenteeism • Call your local health department for consultation • DC Department of Health will report to CDC

6. www.flu.dc.gov

7. Medical Interventions • Vaccine • Most effective preventive measure • Anti-virals • Only recommended for high risk populations

8. Vaccine • The priority groups established by CDC • Pregnant women • Health care workers and emergency medical responders • People caring for infants under 6 months of age • Children and young adults from 6 months to 24 years • People aged 25 to 64 years with underlying medical conditions (e.g. asthma, diabetes) • DC has added the following groups • First responders and Essential District Personnel • Homeless persons • Incarcerated persons

9. Vaccine Delivery Schools • Phase I (In school program) • DCPS Schools with School Nurses • weeks 3 – 4 Phase II (School Mass Vaccination Clinics) • DCPS Schools with > 600 students • Charter and Private Schools • hosted by Department of Health • weeks 5-6 • Clustered around the following schools: • Coolidge Senior High School • Wilson Senior High School • Cardoza Senior High School • Dunbar Senior High School • Eastern Senior High School • H.D Woodson Senior High School • Ballou Senior High School

10. Vaccine Delivery • Obstetricians • Pregnant Women • Pediatricians • Care givers or children less than 6 months of age • Children age 6 months to 21 years • Primary Care Physicians • Care givers of children less than 6 months of age • Rheumatologists • Immuno-compromised • HIV Providers • Immuno-compromised • Hospitals • Healthcare workers • All categories through Emergency Department • Community Health Centers • Healthcare workers • Care givers of children less than 6 months of age • Children age 6 months to 24 years • Persons with underlying health conditions • Immuno-compromised • Pharmacies • All categories

11. Vaccine Delivery Sherwood Recreation Center • Mass Vaccination Sites First week • Riggs LaSalle Community Center - Ward 4 • Kennedy Recreation Center - Ward 2 • Sherwood Recreation Center – Ward 6 • Kelly Miller - Ward 7 Second Week • Emery Recreation Center - Ward 4 • Kenilworth Parkside - Ward 7 • Bald Eagle - Ward 8 Subsequent • Convention Center - Ward 1 & Downtown • RFK Stadium – Drive through

12. Vaccine Delivery Mass Vaccinations 12,000 doses at 4 Parks and Recreation Sites first week of mass vax                 Riggs LaSalle Community Center                 Kennedy Recreation Center                 Sherwood Recreation Center                 Kelly – Miller Recreation Center 9,500 doses at Parks and Recreation Sites second week of mass vax Emery Recreation Center                 Kenilworth Parkside Recreation Center                 Bald Eagle Recreation Center 4000 doses at drive-thru model at RFK Stadium the third or fourth week 3000 doses at Convention Center Site during the third or fourth week 28,500 Total doses administered

13. Questions • Beverly Pritchett • Beverly.pritchett@dc.gov • 202-671-4222