Pandemic Influenza Plan - Questar III

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Section 5: Clinical Guidelines I. Overview II. III. IV. Objectives Clinical Guidelines for the Interpandemic and Pandemic Alert Periods Clinical Guidelines for the Pandemic Period V. Activities by Pandemic Period Appendices: 5-A: Risk of Novel Influenza in Persons with Severe Respiratory Disease or Influenza-Like Illness during the Interpandemic and Pandemic Alert Periods 5-B: Clinical Evaluation of Patients with Influenza-Like Illness during the Interpandemic and Pandemic Alert Periods 5-C: Special Situations and Exceptions to the Clinical Criteria 5-D: Home Care Infection Control Guidance for Pandemic Influenza Patients and Household Members 5-E: Case Detection and Clinical Management during the Interpandemic and Pandemic Alert Periods 5-F: Case Detection and Clinical Management during the Pandemic Period 5-G: Management of Community-Acquired Pneumonia during an Influenza Pandemic: Adults 5-H: Management of Community-Acquired Pneumonia during an Influenza Pandemic: Children 5-I: Pandemic Influenza Infection Control Guidance for Healthcare Providers 5-J: Clinical Presentation and Complications of Seasonal Influenza 5-K: Clinical Presentation and Complications of Illnesses Associated with Avian Influenza A (H5N1) and Previous Pandemic Influenza Viruses 5-L: Guidelines for Management of Community-Acquired Pneumonia, Including Post-Influenza Community- Acquired Pneumonia February 7, 2006 5-1
Section 5: Clinical Guidelines I. Overview * This section provides clinical procedures for the initial screening, assessment, and management of patients with suspected novel influenza during the Interpandemic and Pandemic Alert Periods, and for patients with suspected pandemic influenza during the Pandemic Period. The appendices include information on the clinical presentation and complications of seasonal influenza, the clinical features of infection due to avian influenza A (H5N1) virus and previous pandemic influenza viruses, and the management of patients with community-acquired pneumonia or secondary bacterial pneumonia during a pandemic. The guidance is current as of October 2005, and is subject to change as experience is gained. Updates will be provided, as needed, on the NYSDOH HPN (https://commerce.health.state.ny.us/hpn/) and on the CDC website (www.cdc.gov/flu/). During the Interpandemic and Pandemic Alert Periods, early recognition of illness caused by a novel influenza A virus strain will rely on a combination of clinical and epidemiologic features. During the Pandemic Period (in a setting of high community prevalence), diagnosis will likely be more clinically oriented because the likelihood will be high that any severe febrile respiratory illness is pandemic influenza. During periods in which no human infections with a novel influenza A virus strain have occurred anywhere in the world (Interpandemic Period: Phases 1, 2; see Appendix 5-A), or when sporadic cases of animal-to-human transmission or rare instances of limited human-to-human transmission of a novel influenza A virus strain have occurred in the world (Pandemic Alert Period: Phases 3, 4), the likelihood of novel influenza A virus infection is very low in a returned traveler from an affected area who has severe respiratory disease or influenza-like illness. Since human influenza A and B viruses circulate worldwide among humans year-round, the possibility of infection with human influenza viruses is much higher and should be considered. Once local person-to-person transmission of a novel influenza A virus strain has been confirmed (Pandemic Alert Period: Phase 5), the potential for novel influenza A virus infection will be higher in an ill person who has a strong epidemiologic link to the affected area (Appendix 5-A). This section is designed to serve as a guide for clinicians, with the understanding that the management of influenza is based primarily on sound clinical judgment regarding the individual patient as well as an assessment of locally available resources, such as rapid diagnostics, antiviral drugs, and hospital beds. Early antiviral therapy shortens the duration of illness due to seasonal influenza and would be expected to have similar effects on illness due to novel or pandemic influenza viruses (see Section 7: Antiviral Medication Procurement, Distribution and Use). Clinical management must also address supportive care and management of influenza-related complications. * This section closely adapted from the U.S. Department of Health and Human Services. HHS Pandemic Plan, Supplement 5. November 2005 February 7, 2006 5-2
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February206 Pandemic Plan NewYorkSt
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Introduction Pandemic influenza occ
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example, at this time, it is realis
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Acronyms (cont.) IND IHANS IRB ISHS
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Section 1: Command and Control I. O
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Section 1: Command and Control pers
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February 7, 2006 Appendix 1-A
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Appendix 1-B The Public Health Law
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Appendix 1-B communicable diseases
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Appendix 1-C Management Office or t
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Appendix 1-E Suspension of Public M
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Appendix 1-G A Guide to New York St
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Appendix 1-G health commissioner. P
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Appendix 1-G 8. State Institutions
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Appendix 1-G b. Governor May Invoke
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Appendix 1-G may direct, pursuant t
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Appendix 1-G Designation of emergen
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Appendix 1-H Summary of Public Offi
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Section 2: Surveillance and Laborat
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Appendix 2-A • Surveillance Crite
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Appendix 2-A • In New York City,
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NYSDOH Novel Influenza Case Report
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Appendix 2-C to health care provide
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Virus Detection History NYS Lab Num
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Section 3: Healthcare Planning and
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Section 6: Vaccine Procurement, Dis
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Appendix 6-A Vaccine Priority Group
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Appendix 6-B Mass Clinic Planning O
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Appendix 6-C Vaccine and Antiviral
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Appendix 6-C 1. Request Phase The r
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Appendix 6-C 3. Receipt and Sign-of
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Appendix 6-C • Work with local he
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Section 7: Antiviral Medication Pro
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Appendix 7-A Characteristics of Ant
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Appendix 7-B a The drug package ins
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Appendix 7-C 7 HCWs in emergency de
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Section 8: Travel-Related Disease C
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Appendix 8-A Home or Community-Base
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Appendix 8-B Contact Identification
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Appendix 8-B • Determine the time
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Appendix 8-C Administrative Data: S
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Appendix 8-D CONTACT DAILY TEMPERAT
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Appendix 8-F Definitions: Intervent
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Appendix 8-F facility. No specific
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Appendix 8-F • Resources Required
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Appendix 8-G Business Pandemic Infl
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Appendix 8-G 4. Allocate resources
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Appendix 8-H CDC guidelines suggest
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Appendix 8-H If I am not masked I
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Appendix 8-H NYSDOH Model Influenza
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Appendix 8-H I understand that if
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Section 9: Communications I. Overvi
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Section 9: Communications and commu
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Section 9: Communications web pages
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Section 9: Communications backup to
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Appendix 9-A Public Health Risk Com
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Appendix 9-C New York State Departm
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Appendix 9-C PRE-EVENT MESSAGE MAP:
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Appendix 9-C PROTECTIVE MESSAGE MAP
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Appendix 9-C TREATMENT MESSAGE MAP:
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Appendix 9-C BUSINESS CONTINUITY PR
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Section 10: Training and Education
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Appendix 10-A NYSDOH STAFF PRIVATE
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FACILITY- BASED RNs FACILITY- BASED
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Section 11: Workforce Support I. Ov
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Section 11: Workforce Support Pande
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Section 12: Highly Pathogenic H5N1
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Section 12: H5N1 in Non-Human Anima
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Section 13: Public Health Preparedn
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Appendix 13-A NYSDOH Roles Notified
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Appendix 13-B Notifications sent by
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Appendix 13-B HAN posting is used a
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Appendix 13-C Overview of the Healt
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Appendix 13-C • Ongoing surveilla
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Table 1. Summary of HERDS Use To da
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Appendix 13-D Commerce Access and A
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Appendix 13-D Table 3. Organization
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