Past Updates from the Clinician Listserv

Update Sent November 23, 2009

NOTE: This document is provided for historical purposes only and may not provide our most accurate and up-to-date information. The most current Clinician's information can be found on the Clinician Home Page.

The following updates were made to CDC information and guidance from Nov 09 - Nov 16, 2009. If you have any questions on these or other clinical issues, please write to us at coca@cdc.gov.

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Today's topics Include:

Upcoming COCA Conference Calls
2009 H1N1 & Seasonal Influenza
Influenza Key Points and Messages
2009 H1N1 Influenza Vaccine
2009 H1N1 and Seasonal Influenza Resources
Webinars and Webcast
Emergency Preparedness and Response
Food and Drug Safety

Upcoming COCA Conference Calls

2009 H1N1 Influenza: Pregnant Women and Newborns
Speakers: Dr. Sonja Rasmussen and Dr. Wanda Barfield
Date: Tuesday, November 17, 2009
Time: 1:00 - 2:00 PM ET
Call-in number: 888-283-2960
Passcode: 7113863

The PowerPoint Presentation is currently available on the COCA website: http://emergency.cdc.gov/coca/callinfo.asp.
Continuing Education Credits/Contact Hours (CME, CNE, CEU and CHES) will be available for this COCA Conference Call!

Clinical Information Call on Pandemic Influenza A (H1N1) in Critically Ill Patients
Date: Wednesday, November 18, 2009
Time: 3:00 - 4:00 PM ET
Call-in number: 888-283-2960
Passcode: 3768316

The PowerPoint Presentation will be available on the COCA website on November 18th: http://emergency.cdc.gov/coca/callinfo.asp.
There are no Continuing Education Credits/Contact Hours being offered with this call.

2009 H1N1 & Seasonal Influenza

Weekly FluView Map and Surveillance Report - CDC - Nov 13
Updated CDC FluView for 2009-2010 Influenza Season Week 44 ending November 7, 2009. All data are preliminary and may change as more reports are received.
http://www.cdc.gov/flu/weekly/

2009 H1N1 Flu: International Situation Update - CDC - Nov 13
This report provides an update to the international situation as of November 13, 2009. The World Health Organization (WHO) continues to report updated 2009 H1N1 flu-associated laboratory-confirmed cases and deaths on its Web page.
http://www.cdc.gov/h1n1flu/updates/international/

U.S. Influenza and Pneumonia-Associated Hospitalizations and Deaths from August 30 to November 7, 2009 - CDC - Nov 13
During the week of November 1-7, 2009, influenza activity continued to increase in the United States as reported in FluView. Flu activity is now widespread. Nationwide, visits to doctors for influenza-like-illness are increasing steeply and are now higher than what is seen at the peak of many regular flu seasons. In addition, flu-related hospitalizations and deaths continue to go up nation-wide and are above what is expected for this time of year.
http://www.cdc.gov/h1n1flu/updates/us/#totalcases

WHO Updates International H1N1 Flu Situation - WHO - Nov 13
As of 8 November 2009, worldwide more than 206 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 6250 deaths. WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states and through monitoring of multiple sources of data.
http://www.who.int/csr/don/2009_11_13/en/index.html

Influenza Key Points and Messages

(Updated) As of Wednesday, November 11, 2009, there were a total of 36,983,500 doses ordered and a total of 35,445,700 doses shipped.

(Updated) As of Friday, November 13, 2009, a total of 43,009,400 doses were available for ordering. Of those available doses, 31,799,700 doses were injectable (flu shots) and 11,209,700 were LAIV (nasal spray vaccine

(Updated) As of November 6, approximately 93.7 million doses of seasonal influenza vaccine have been distributed (this is about 82% of doses expected this season).

The H1N1 virus activity remains widespread in the U.S., with 46 states reporting widespread activity. Although this is a reduction of two states from last week, the rate of H1N1 cases is higher than normal compared to this time last year. Approximately, 6.7% of doctor’s visits for the current reporting period were H1N1-related (a decline of one percent from last week).

As the supply increases, access and ease of getting vaccinated will improve. It may take longer in some areas than others to get an adequate supply, but as a reminder, all of the states are receiving an amount of vaccines proportionate to their population.

The top priority for available vaccine is reaching people in targeted populations. How people in these groups are reached will vary from state to state, as well as within communities. Some states may do vaccine dissemination through doctors’ offices, schools, workplace clinics, local healthy departments, etc. Putting vaccine where people typically go is most critical.

November is American Diabetes Awareness Month. The CDC recommends that people with diabetes get vaccinated with the H1N1 injectable vaccine, not the nasal spray, as soon as it becomes available in their communities. People with diabetes have an increased risk of severe illness from any flu.

2009 H1N1 Influenza Vaccine

Effectiveness of 2008-09 trivalent influenza vaccine against 2009 pandemic influenza A (H1N1)--United States, May-June 2009 – MMWR - Nov 13
Results from recent serologic studies have suggested that seasonal influenza vaccines are unlikely to provide substantial cross-protection against infection with the pandemic H1N1 virus. To complement the serologic studies and evaluate the effectiveness of 2008--09 trivalent seasonal influenza vaccine against laboratory-confirmed pandemic influenza A (H1N1) illness, CDC used available data to conduct a case-cohort analysis.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5844a5.htm

2009 H1N1 Influenza Vaccine Supply Status - CDC - Nov 13
Every Friday, CDC will post updated 2009 H1N1 vaccine supply and distribution data. 26,248,100 doses have been shipped as of November 11, 2009.
http://www.cdc.gov/h1n1flu/vaccination/vaccinesupply.htm

FDA Expands Approved Use of H1N1 Vaccines to Include Infants and Children - FDA - Nov 12
The U.S. Food and Drug Administration has approved the use of the CSL Limited’s 2009 H1N1 influenza vaccine to include children ages 6 months and older. This vaccine was previously approved only for use in adults, ages 18 years and older.
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm190359.htm

Letter to providers promoting PPSV for Adults - CDC - Nov 10
Pneumococcal infections have been identified as an important complication in severe and fatal cases of 2009 H1N1 influenza virus infection. CDC has written a letter to providers urging them to make sure all their adult patients with indications have received the pneumococcal polysaccharide vaccine.
http://www.cdc.gov/h1n1flu/vaccination/provider/lettertoprovider.htm

FDA Commissioner Addresses Nation's Doctors on H1N1 Vaccine - FDA - Nov 10
Letter to healthcare professionals from Dr. Margaret Hamburg, Commissioner of Food and Drugs, thanking you for your efforts during the 2009 H1N1 influenza outbreak. The letter also addresses questions of vaccine safety and availability and outlines the processes that took the 2009 H1N1 influenza vaccine from creation to manufacture to distribution.
http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm189691.htm

2009 H1N1 and Seasonal Influenza Resources

Update- FDA Questions and Answers for Health Care Providers: Renal Dosing and Administration Recommendations for Peramivir IV - CDC - Nov 13
Questions and answers for renal dosing and administration for peramivir IV.
http://www.cdc.gov/h1n1flu/eua/peramivir.htm

Interim Planning Considerations for Mass Gatherings in the Context of Pandemic (H1N1) 2009 Influenza - WHO - Nov 13
Mass gatherings are highly visible events with the potential for serious public health and political consequences if they are not planned and managed carefully. The purpose of this document is to outline key planning considerations for organizers of mass gatherings in the context of pandemic (H1N1) 2009 influenza.
http://www.who.int/csr/resources/publications/swineflu/cp002_2009-0511_planning_considerations_for_mass_gatherings.pdf

Antiviral Widget - 5 in 5: Clinician Quick Facts for 2009 H1N1- CDC - Nov 12
Add this widget to your Web page to provide 5 quick facts for health care providers and clinicians to consider when evaluating a patient for antiviral treatment in five minutes or less. The clinician widget is live and available online at http://www.cdc.gov/widgets/#5in5

Older age and a reduced likelihood of 2009 H1N1 virus infection - NEJM - Nov 12
Early epidemiologic reports regarding the 2009 pandemic influenza A (H1N1) virus suggest that cases of infection and deaths are concentrated in adults between the ages of 20 and 40 years. This finding could reflect age-related differences in susceptibility or differential testing and diagnosis in this age group. Author examined whether the reported excess of cases in younger persons derives from testing practices or reflects a differential risk of infection in Ontario, Canada.
http://content.nejm.org/cgi/content/full/361/20/2000

Clinical management of human infection with pandemic influenza (H1N1) 2009: Revised Guidance - WHO - Nov 11
In October 2009, WHO convened an international consultation represented by all WHO Regions, in Washington, DC, USA, to revise the guidance on clinical management of patients with pandemic (H1N1) 2009 virus infection. Experts in public health, laboratory science, pathology, and clinical care came together to review the published evidence to date and to share unpublished data. This document incorporates the knowledge made available to WHO and updates previous WHO guidance.
http://www.who.int/csr/resources/publications/swineflu/clinical_management_h1n1.pd

Emergence of oseltamivir-resistant pandemic H1N1 virus during prophylaxis - NEJM - Nov 11
Letter in the New England Journal of Medicine reporting the emergence of an oseltamivir-resistant virus in a familial cluster of infections with the 2009 H1N1 virus.
http://content.nejm.org/cgi/content/full/NEJMc0910060/?rss

Interim Guidance: Considerations Regarding 2009 H1N1 Influenza in Intrapartum and Postpartum Hospital Settings - CDC - Nov 10
This interim guidance has been updated to replace previously posted guidance entitled "Considerations Regarding Novel H1N1 Flu Virus in Obstetric Settings". This document clarifies clinical considerations related to management of suspected or confirmed maternal infection with 2009 H1N1 influenza virus infection within labor and delivery, postpartum, and newborn care settings in hospitals.
http://www.cdc.gov/h1n1flu/guidance/obstetric.htm

CDC Partners with Medscape –Video Series
CDC has teamed up with Medscape to offer a weekly video series designed to provide updated information to Medscape's physicians, nurses, pharmacists, and other healthcare professionals. This series offers video commentaries on the current topics important to all practicing clinicians, including H1N1 and seasonal influenza, infection control, travel medicine, and much more. The first two video commentaries feature CDC's Dr. Sonja Rasmussen discussing "2009 H1N1 Influenza Vaccine in Pregnancy" and Dr. William Atkinson discussing "Seasonal and H1N1 Influenza Vaccines -- Timing of Doses."
View the entire series: http://www.medscape.com/partners/cdc/public/cdc-commentary.

Webinars and Webcast

FREE CDC Webcast - Blast Injuries: What You Need to Know
Date and Time: Tuesday, November 17, 2009 at 10:00 AM (ET)
In an instant, an explosion or blast can wreak havoc; producing numerous casualties with complex, technically challenging injuries not commonly seen after natural disasters such as floods or hurricanes. Register for a FREE Webcast presented by Dr. Scott Sasser, MD, FACEP, of the Centers for Disease Control and Prevention’s (CDC), Division of Injury Response to learn about the unique triage, diagnostic, and management challenges of injuries caused by explosions. Participants will receive a FREE continuing education opportunity through CDC.
http://www.jems.com/webcasts/blast_injuries.html

Know What To Do About The Flu Webcast on Diabetes and H1N1
Date and Time: Wednesday, November 18, 2009 at 1:00 PM (ET)
Top health and medical experts answer questions on diabetes and H1N1. The webcast can be viewed live at http://www.flu.gov. You may submit questions to hhsstudio@hhs.gov.

HHS/CDC Webinar on 2009 H1N1 Flu Vaccine Safety Communication
Date and Time: Thursday, November 19, 2009 at 2:00 PM (ET)
Call-In: 1- 888 -566-6135 and Participant code: 9302444
Presentation: https://www.livemeeting.com/cc/orau1/join?id=34J8NS&role=attend&pw=SK%2Bd4rxcZ
Meeting ID: HT35ZM and Entry Code: gH{"7*M5Q
The purpose of the webinar is to share information with public health and health professionals about the Department of Health and Human Services' efforts to communicate with the public and providers about the safety of the 2009 H1N1 influenza vaccines.‪ This webinar will include a discussion around vaccine safety communication strategies with communication staff from the National Vaccine Program Office, Centers for Disease Control and Prevention and Food and Drug Administration.

Planning for a Pandemic Webcast - Can History Inform Action
Date and Time: Monday, November 30, 2009 at 1:00 PM (ET)
Public Health Reports (PHR) Meet the Author web cast series brings together public health historians and practitioners to connect the U.S. experience of the 1918 flu pandemic to the ongoing practice issues facing influenza preparedness planning. Speakers include: Howard Markel, MD, PhD, Alexandra Stern, PhD,and Marty Cetron, MD
http://www.publichealthreports.org/interactive/webcast.cfm

Emergency Preparedness and Response

Sebelius Announces Release of Recovery Act Funding to Improve Care in Nation's Ambulatory Surgical Centers - HHS - Nov 10
To reduce healthcare-associated infections (HAIs) in stand-alone or same-day surgical centers, the HHS Secretary Kathleen Sebelius today announced the availability of up to $9 million in funding from the American Recovery and Reinvestment Act (ARRA) to state survey agencies in 43 states. HAIs are infections some patients acquire when they are in a health care setting such as a hospital or outpatient clinic.
http://www.hhs.gov/news/press/2009pres/11/20091110a.html

Food and Drug Safety

FDA Issues 2009 FDA Food Code - FDA - Nov 9
The Food and Drug Administration announced the publication of the new FDA Food Code, a model code and reference document that provides a scientifically sound technical and legal basis for regulating the retail and food service segment of the food industry. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm189598.htm

USDA CONSUMER ALERT - Keeping Food Safe During an Emergency - USDA - Nov 9
The U.S. Department of Agriculture is providing recommendations to those affected by tropical storms, flooding or severe weather in the Southeastern United States due to Hurricane Ida. USDA is hopeful that this information will help minimize the potential for foodborne illnesses due to power outages and other problems that are often associated with severe weather events.
http://www.fsis.usda.gov/News_&_Events/NR_110909_01/index.asp

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