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HomeMy WebLinkAboutAgenda - 06-16-2009 - Info Item 2S,~-Forma-l~ i on z+ 2m G°J~ty 1•lea7f~ o, A R D ~ ~ 0 3 0 North Coroli~w Public Haahh ORANGE COUNTY HEALTH DEPARTMENT Rosemary L. Summers, MPH, DrPH Health Director Richard E. Whiffed Human Services Center 300 West Tryon Street Post Office Box 8181 Hillsborough, NC 27278 Phone: (919)245-2411 Fax: (919)644-3007 www, co. orange. nc. us/health Central Administrative Services Dental Health Services Environmental Health Services Health Promotion and Education Services Personal Health Services 300 West Tryon Street Hillsborough, NC 27278 To: Orange County Board of Commissioners From: Rosemary L. Summers, Health Director Re: Novel HIN1 Influenza Virus Response Date: June 10, 2009 Attached is a report summarizing the County's response to the ongoing novel H IN 1 influenza virus (swine flu) that has been of international concern for more than two months. The Orange County response is truly a community wide effort that involves many partner organizations and agencies. Emergency Services and the Sheriff's Office provide valuable support in any response effort and this one is no exception. UNC Health Care, UNC Campus Health, Chapel Hill Carrboro City Schools and Orange County Schools continue to contribute to the response effort in significant ways that assist in the protection of all Orange County residents. If you have any questions about the report or the ongoing response please do not hesitate to contact me. Cc: Board of Health PH: (919)245-2411 FAX: (919)644-3007 Orange County Health Department Report on H1 N1 Response April 23 -May 30, 2009 Orange County has had 7 cases of novel H1N1 influenza as of June 9, 2009. The first case was laboratory confirmed on May 22. One formal isolation order was issued on April 29 for a suspected case that later tested negative. Generally, individuals who get this virus experience relatively mild disease, however, unlike seasonal flu, there was no vaccine that could be protective for people with underlying health conditions. The pattern of the disease emerged after several incubation periods passed, providing a greater predictability to guide the response. This virus is now considered to be in general circulation and will remain so throughout the summer. Testing is no longer being authorized except for suspected cases in certain settings (health care) or among hospitalized individuals. This virus spreads in the same way as the seasonal flu, through contact with respiratory droplets or by contact with surfaces that have been touched by an infected person with virus on their hands. First Notification The Orange County Health Department (OCHD) received alerts from the NC Health Alert Network and the Centers for Disease Control Health Alert Network during the evening of April 23, 2009, detailing the first case report of a novel influenza virus in Texas. OCHD activated the Epidemiology Response Team (Epi Team) the next morning to monitor the national situation and began communicating with community partners and county staff. The core Epi Team consists of the communicable disease program coordinator, the community services supervisor, the OCHD public information officer, the environmental health director, the personal health services director, the preparedness coordinator, and the health director. It expands by adding other staff with specific skill sets, depending on the outbreak or investigation in progress. A typical outbreak response begins with determining the factors surrounding the infected persons that will prevent further spread of the disease. The novel H1 N1 influenza outbreak differs because Orange County had no laboratory confirmed cases until May 22, 2009, nearly a month after the original notification. Activities for the period April 23 through May 22 included surveillance and communicating with partner agencies and, the public. This response involved county and community agencies beyond the health department's response. Emergency Services, the Sheriffs Office and Information Technology were key supporting county agencies.. Both school districts, UNC Hospital, and UNC Campus Health were all an important part of the overall community surveillance and response. Community medical providers saw patients and consulted with health department staff to determine whether a patient met the case definition for testing. OCHD Response Activities (A Sample • Daily health alerts to medical providers for a week; then as new guidance emerged • Daily conference calls with community partners through May 11 • Daily conference calls with the State of North Carolina through May 15 • Collected daily attendance data from both school systems • Collected daily pharmacy reports on current stocks of antivirals • Called and interviewed all suspected cases and their close contacts • Community education and prevention messages distributed through churches, daycares, schools, and county website; Spanish available • Protocols developed for the receipt and distribution of the assets sent through the Strategic National Stockpile • Arranged weekend transport for laboratory cultures to the state public health laboratory • Trained nurses to collect swab samples • Conducted respiratory fit testing with Emergency Services for community partners, health department, and ES staff • Received 25% of the Orange County allocation of the Strategic National Stockpile • Distributed antivirals to health care agencies requesting supplies to treat uninsured that were ill with suspected H1 N1 • Health director met via teleconference with representatives from all of the UNC campuses • Core group of health department staff were trained on Web EOC • Refreshed the public call-in information only line (no messages) Time and Costs CHD Staff members reported a total of 332.5 hours in April and 569.75 hours in May for this response. Operational costs were also estimated for a total staff and operational cost of $54,543 for April and May. These costs were not in addition to current budgets; however activities normally done by these staff members were cancelled or curtailed, including school-based Tdap vaccinations, rescheduled clinical appointments, cancelled meetings for on-going projects, and cancelled community presentations. For the most part, exempt staff worked very long hours and into the weekends to continue to do what was required. Volunteers from the Orange County Reserve Corps assisted in distributing community education materials. These figures do not include time or costs borne by Emergency Services or the Sheriffs Department. The Future OCHD plans to continue prevention messaging throughout the summer and into next year's typical flu season. Orders have already been placed for seasonal influenza vaccine and as usual we will vaccinate high risk individuals before making vaccine available to the general public. It is unknown at this time whether there will be a suitable vaccine available for the H1 N1 swine influenza. The CDC and researchers are alert for any indications that the virus may shift or change to an alternate form.