Pandemic Influenza Plan - Questar III

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Appendix 5-J bacterial involvement. Similarly, bacterial sinusitis can develop in older children and adults with influenza. Seasonal influenza can cause a range of cardiovascular complications, most commonly as an exacerbation of an underlying condition such as congestive heart failure. Pregnant women and children with congenital heart defects can also experience worsening cardiac function during an influenza illness. Cardiac inflammation, such as myocarditis and pericarditis, can be found occasionally, although clinical manifestations are rare. Available reports suggest that myocarditis might have occurred more frequently during pandemic years. Influenza virus is not typically identified in heart tissue, suggesting that the host inflammatory response might play a role. Although influenza has been associated in rare instances with sudden death possibly due to cardiac arrhythmia, this outcome has been difficult to investigate. Gastrointestinal involvement is uncommon with seasonal influenza, although more commonly reported in children. Manifestations can include vomiting and diarrhea, sometimes leading to significant dehydration. Transient hepatic inflammation can occur in rare circumstances. Myositis related to influenza is another complication more commonly found in children, although more frequently associated with influenza B. Involvement may be limited to pain and weakness of the lower extremities but can progress to rhabdomyolysis and renal failure in some cases. Among the neurologic complications associated with seasonal influenza, uncomplicated self-limited febrile seizures are the most common, usually occurring in younger children with high fever. Influenza-associated encephalopathy, characterized by an acute alteration in mental status within the first few days of fever onset, is a recently recognized complication of influenza in children. Most reports of influenza-associated encephalopathy have been in Japanese children, but the condition has been reported sporadically in other countries, including the United States. The syndrome can include seizures, neurologic deficits, obtundation, and coma. While most children recover completely, some cases can result in permanent sequelae or death. This condition might be due to an abnormal host inflammatory response without viral infection of the central nervous system. Guillain-Barre syndrome and transverse myelitis have been reported to occur in very rare instances after influenza, but no definite etiologic relationship has been established. Reye syndrome is another serious neurologic complication associated with influenza. It is characterized by an acute encephalopathy combined with hepatic failure in the absence of inflammation in either the brain or the liver. Hepatic involvement includes fatty infiltration, hypoglycemia, and hyperammonemia, whereas neurologic manifestations include cerebral edema, delirium, coma, and respiratory arrest. Reye syndrome was found to be associated with the use of aspirin in children; its incidence has decreased dramatically since the 1980s after aspirin use was discouraged in children. Seasonal influenza can be associated with systemic complications, such as sepsis and shock. Sepsis caused by invasive co-infection with Staphylococcus aureus, including methicillin- February 7, 2006 4
Appendix 5-J resistant S. aureus (MRSA), or other bacteria, such as Neisseria meningitidis has been reported. Toxic shock syndrome without bacterial co-infection has also been reported. 2 Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2005;54:1-40 www.cdc.gov/mmwr/pdf/rr/rr54e713.pdf. Source: U.S. Department of Health and Human Services. HHS Pandemic Plan. November 2005 February 7, 2006 5
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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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Section 4: Infection Control should
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Page 177 and 178: Appendix 5-B Clinical Evaluation of
Page 179 and 180: Appendix 5-C Special Situations and
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Page 183 and 184: DRAFT Appendix 5-E Footnotes to App
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Page 187 and 188: Appendix 5-F 7. Guidance on the eva
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Page 193 and 194: Appendix 5-J Clinical Presentation
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Page 207 and 208: Section 6: Vaccine Procurement, Dis
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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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