Pandemic Influenza Plan - Questar III

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Section 7: Antiviral Medication Procurement, Distribution, and Use I. Overview II. III. IV. Objectives Strategies for the Use of Antiviral Medications During a Pandemic A. Methods for the Use of Antiviral Medications: Treatment, Post-Exposure Prophylaxis, and Prophylaxis B. Timing of the Use of Antiviral Medications Prioritization V. Antiviral Medication Procurement and Distribution VI. VII. VI. Antiviral Medication Safety A. Antiviral Effectiveness B. Antiviral Drug Resistance C. Contraindications D. Antiviral Medication Adverse Event Monitoring and Reporting E. Contingency Planning for Investigational New Drug (IND) Use Data Collection Activities by Pandemic Period Appendices: 7-A: 7-B: 7-C: 7-D: Characteristics of Anti-Influenza Antiviral Medications Recommended Daily Dosage of Antiviral Medications for Treatment and Prophylaxis Antiviral Medication Priority Group Recommendations Pediatric Use of Antiviral Medications February 7, 2006 7-1
Section 7: Antiviral Medication Procurement, Distribution, and Use I. Overview The targeted use of antiviral agents could, as part of a response strategy to susceptible strains, decrease the health impact of an influenza pandemic. Use of antiviral prophylaxis has been up to 70% to 90% effective in preventing symptomatic influenza infection caused by susceptible strains, if prophylaxis is begun before exposure to influenza. Also, treatment with one class of agents, neuraminidase inhibitors, has been shown to decrease severe complications such as pneumonia and bronchitis and to reduce hospitalizations. These interventions may be particularly important before vaccine is available and for those in whom vaccination may be medically contraindicated. Protection afforded by antiviral medications is virtually immediate and does not interfere with the response to inactivated influenza vaccines. It is important to avoid inappropriate use of antiviral medications that may lead to viral resistance. Drugs with activity against influenza viruses (antivirals) include the adamantanes, amantadine and rimantadine, and the neuraminidase inhibitors, oseltamivir and zanamivir. Appropriate use of these agents during an influenza pandemic may reduce morbidity and mortality and diminish the overwhelming demands that will be placed on the healthcare system. Antivirals might also be used during the Pandemic Alert Period in limited attempts to contain small disease clusters and potentially slow the spread of novel influenza viruses. The Department of Health and Human Services (DHHS) and the National Vaccine Advisory Committee (NVAC), in cooperation with the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP), have provided guidance on prioritization of persons to be given antivirals during a pandemic. This guidance will most likely change when epidemiologic data on a specific pandemic virus becomes available. Once this information is known, the NYSDOH, in conjunction with the CDC, health care organizations, and local health departments (LHDs), will determine the prioritization of the population groups to receive influenza antiviral medication. These recommendations will then be distributed as statewide guidelines. It is also important to monitor the use of antiviral medications. These drugs are in frequent use both during the influenza season, and for other indications year round. There is information and data available on the side effects of antiviral medications. However, there are no data available on the large scale use of these medications in a pandemic situation. Monitoring and tracking of antiviral use, compliance, effectiveness, resistance, and adverse events are important aspects of responding to a pandemic. This section of the pandemic influenza plan provides recommendations on the distribution and use of antiviral drugs for treatment and prophylaxis during an influenza pandemic. It discusses the strategies available for the use of antiviral medications, including how they can be used, the timing of their use, and facilities or settings in which they may be offered. This section also reviews the issues surrounding the procurement and distribution of antiviral medications, safety monitoring, and data collection. Finally, February 7, 2006 7-2
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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 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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Section 4: Infection Control Policy
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Section 4: Infection Control o Staf
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Section 4: Infection Control The ma
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Section 4: Infection Control • Up
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Section 4: Infection Control Health
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Appendix 4-A Soiled linen and laund
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Appendix 4-B Respiratory Hygiene/Co
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Section 5: Clinical Guidelines I. O
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Section 5: Clinical Guidelines incu
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Section 5: Clinical Guidelines 1) N
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Section 5: Clinical Guidelines infe
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Section 5: Clinical Guidelines Alth
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Section 5: Clinical Guidelines Infe
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Section 5: Clinical Guidelines •
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Appendix 5-B Clinical Evaluation of
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Page 183 and 184: DRAFT Appendix 5-E Footnotes to App
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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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Page 253 and 254: Appendix 7-C 7 HCWs in emergency de
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Page 277 and 278: Appendix 8-F Definitions: Intervent
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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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