Pandemic Influenza Plan - Questar III

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Appendix 5-A Risk of Novel Influenza in Persons with Severe Respiratory Disease or Influenza- Like Illness during the Interpandemic and Pandemic Alert Periods Clinicians should recognize that human influenza A and B viruses and other respiratory viruses circulate year-round among people throughout the world, including in countries affected by outbreaks of avian influenza A viruses in poultry. Seasonal human influenza A and B community outbreaks occur in temperate climates of the northern and southern hemisphere, and human influenza activity may occur year-round in subtropical and tropical regions. Outbreaks of human influenza can occur among travelers during any time of the year, including periods of low influenza activity in the United States (e.g., summer). Phases 1, 2: Interpandemic Period A novel influenza A virus has been detected in animals but not in humans. During these phases, the risk of human infection with a novel influenza A virus strain is extremely low. The risk of human infection with human influenza viruses or other viruses is much higher in persons living in or traveling to affected areas. Phases 3, 4: Pandemic Alert Period A novel influenza A virus has been detected in humans through sporadic animal-to-human transmission in an affected area (e.g., direct contact with infected poultry), and few cases of limited, local human-to-human transmission have occurred (small clusters of cases). During these phases, the risk of human infection with a novel influenza A virus strain is very low. The risk of human infection with human influenza viruses or other viruses is much higher in persons living in or traveling to affected areas. Phase 5: Pandemic Alert Period A novel influenza A virus has been detected in humans in larger clusters in an affected area, suggesting that the virus is becoming better adapted to spread among people. During this period, the risk of human infection with a novel influenza A virus strain is higher, depending on specific exposures, in persons living in or traveling to affected areas. Human infection with human influenza viruses or other viruses will occur and should still be considered. Source: U.S. Department of Health and Human Services. HHS Pandemic Plan. November 2005 February 7, 2006
Appendix 5-B Clinical Evaluation of Patients with Influenza-Like Illness during the Interpandemic and Pandemic Alert Periods • Patients who require hospitalization for an influenza-like illness for which a definitive alternative diagnosis is not immediately apparent* should be questioned about: 1. travel to an area affected by avian influenza A virus outbreaks in poultry, 2. direct contact with poultry, 3. close contact with persons with suspected or confirmed novel influenza, or 4. occupational exposure to novel influenza viruses (such as through agricultural, health care, or laboratory activities). • Patients may be screened on admission for recent seasonal influenza vaccination and pneumococcal vaccination. Those without a history of immunization should receive these vaccines before discharge, if indicated. • Patients meeting the epidemiologic criteria for possible infection with a novel strain of influenza should undergo a routine diagnostic work-up, guided by clinical indications. Appropriate personal protective equipment should be used when evaluating patients with suspected novel influenza, including during collection of specimens.** • Immediately contact the local and state health departments to report the suspected case and to arrange laboratory testing. • Diagnostic testing for a novel influenza A virus should be initiated as follows: o Collect all of the following specimens: nasopharyngeal swab, nasal swab, wash, or aspirate, throat swab, and tracheal aspirate (if intubated), and place into viral transport media and refrigerate at 4°C until specimens can be transported for testing. See Section 2. o RT-PCR testing is not available in hospital laboratories and must be performed at a qualified laboratory such as the Wadsworth Center laboratory or the CDC Influenza Laboratory. Viral culture should be performed only at biosafety level 3 [BSL-3] with enhancements. • Depending on the clinical presentation and the patient’s underlying health status, other initial diagnostic testing might include: o Pulse oximetry o Chest radiograph o Complete blood count (CBC) with differential o Blood cultures o Sputum (in adults), tracheal aspirate, and pleural effusion aspirate (if an effusion is present) Gram stain and culture o Antibiotic susceptibility testing (encouraged for all bacterial isolates) o Multivalent immunofluorescent antibody testing or PCR of nasopharyngeal aspirates or swabs for common viral respiratory pathogens, such as influenza A and B, adenovirus, parainfluenza viruses, and respiratory syncytial virus, particularly in children o In adults with radiographic evidence of pneumonia, Legionella and pneumococcal urinary antigen testing February 7, 2006 1
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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 c. Commissioner of Gen
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Appendix 1-G Designation of emergen
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Appendix 1-G physician’s assistan
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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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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 Local Hea
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Section 9: Communications • A JIC
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Section 9: Communications backup to
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Section 9: Communications • In th
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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-B notification system t
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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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Pandemic Influenza Plan - Questar III

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