Pandemic Influenza Plan - Questar III

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Appendix 5-J such as chills, rigors, diaphoresis, and myalgias, are also suggestive. The positive predictive value of any clinical definition is strongly dependent on the level of influenza activity and the presence of other respiratory pathogens in the community. Routine laboratory findings No routine laboratory test results are specific for influenza. Leukocyte counts are variable, although thrombocytopenia and severe leukopenia have been described in fulminant cases. Leukocytosis of >15,000 cells/ml should raise suspicion for a secondary bacterial process. Comprehensive laboratory testing might reveal other influenza-related complications (see below). Differential diagnosis The fever and respiratory manifestations of seasonal influenza are not specific and can occur with several other pathogens, including respiratory syncytial virus (RSV), parainfluenza viruses, adenoviruses, human metapneumovirus, rhinoviruses, coronaviruses, and Mycoplasma pneumoniae. In contrast to influenza viruses, most of these pathogens do not usually cause severe disease, particularly in previously healthy adults. RSV and parainfluenza viruses can, however, lead to severe respiratory illness in young children and the elderly and should be considered in the differential diagnosis if circulating in the community. Even if an alternate etiology is determined, viral or bacterial co-infections can still be a possibility. The tendency for influenza to occur in community epidemics and to affect persons of all ages can sometimes allow the clinician to diagnose seasonal influenza with reasonable certainty in the absence of laboratory testing. Nevertheless, a definitive diagnosis requires laboratory testing. Rapid influenza diagnostic tests and immunofluorescence testing using a panel of respiratory pathogens have become increasingly available for aiding clinical management of patients with suspected influenza. Further information on diagnostic testing for influenza can be found at http://www.cdc.gov/flu/professionals/ labdiagnosis.htm. Complications Groups at risk for complications of influenza The following groups are currently recognized by the Advisory Committee on Immunization Practices (ACIP) to be at higher risk for complications of seasonal influenza (e.g., hospitalization; death) compared to healthy older children and younger adults: 2 • Persons aged 65 years • Residents of nursing homes and other chronic-care facilities that house persons of any age who have chronic medical conditions • Adults and children who have chronic disorders of the pulmonary or cardiovascular systems, including asthma • Adults and children who required regular medical follow-up or hospitalization during the previous year because of chronic metabolic diseases (including February 7, 2006 2
Appendix 5-J diabetes mellitus), renal dysfunction, hemoglobinopathies, or immunosuppression (including immunosuppression caused by medications or by infection with human immunodeficiency virus [HIV]) • Children and adolescents (aged 6 months–18 years) who are receiving long-term aspirin therapy (and are therefore at risk for Reye syndrome) • Pregnant women • All children aged
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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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Section 4: Infection Control I. Ove
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Section 4: Infection Control I. Ove
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Section 4: Infection Control A. Bas
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Section 4: Infection Control Drople
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Section 4: Infection Control • Pe
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Section 4: Infection Control o Noti
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Section 4: Infection Control E. Coh
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Section 4: Infection Control If wid
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Section 4: Infection Control • En
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Page 177 and 178: Appendix 5-B Clinical Evaluation of
Page 179 and 180: Appendix 5-C Special Situations and
Page 181 and 182: Appendix 5-D handling soiled laundr
Page 183 and 184: DRAFT Appendix 5-E Footnotes to App
Page 185 and 186: Appendix 5-F February 7, 2006 1
Page 187 and 188: Appendix 5-F 7. Guidance on the eva
Page 189 and 190: Appendix 5-H Source: U.S. Departmen
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Page 193: Appendix 5-J Clinical Presentation
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Page 201 and 202: Appendix 5-L Guidelines for Managem
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Page 207 and 208: Section 6: Vaccine Procurement, Dis
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Page 223 and 224: Appendix 6-C Vaccine and Antiviral
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Page 229 and 230: Appendix 6-C • Work with local he
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Section 7: Antiviral Medication Pro
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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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