Pandemic Influenza Plan - Questar III

More documents

Recommendations

Info

Section 7: Antiviral Medication Procurement, Distribution, and Use the activities necessary for pandemic planning by the NYSDOH, LHDs, and health care partners are outlined. The recommendations for the use of antivirals during the Pandemic Phase are divided into three situations: 1) when no or sporadic pandemic influenza has been detected in the United States, 2) when there is limited transmission of pandemic influenza in the United States, and 3) when there is widespread transmission in the United States. Treatment strategies for optimizing the use of limited stocks of antiviral drugs will vary depending on the phase of the pandemic. Recommendations for optimal use of limited stocks of antivirals will be updated throughout the course of an influenza pandemic to reflect new epidemiologic and laboratory data. II. Objectives • Describe available strategies for using antiviral medications, the timing of their use, and facilities or settings in which they may be used; • Outline the method by which the NYSDOH will make decisions regarding prioritization of antiviral use during an influenza pandemic; • Plan for the acquisition and distribution of antiviral medications, including the creation and maintenance of antiviral stockpiles; • Monitor antiviral medication use and safety during a pandemic to assure that the benefits outweigh the risks; and • Collect appropriate data on antiviral procurement, distribution, use, safety, effectiveness, and resistance. III. Strategies for the Use of Antiviral Medications During a Pandemic A. Methods for the Use of Antiviral Medications: Treatment, Prophylaxis, and Post-Exposure The option of whether to treat or prophylax with antiviral medications depends on the pandemic phase and the type of group being considered. Treatment is more efficient than prophylaxis in preventing adverse health outcomes. Treatment uses less medication and focuses on those who are ill and will directly benefit from the intervention. However, it may be hard to maintain essential services with this approach. Prophylaxis requires a greater amount of medication because it requires administration over a long period of time. Prophylaxis may be more effective than therapy in maintaining quality health care and public safety. It may prevent absenteeism due to fear of acquiring illness and prevent time lost from work while ill. February 7, 2006 7-3
Section 7: Antiviral Medication Procurement, Distribution, and Use • Treatment (For clinical guidelines regarding the use of antiviral medications to treat patients ill with influenza, see Section 5.) Planning Considerations o The effectiveness of antivirals against a new pandemic influenza strain cannot be predicted. o Early treatment is a more efficient use of antivirals than prophylaxis, because prophylaxis requires 6 or more weeks of daily use, instead of a 5- day treatment course. o The choice of antiviral medication used will depend on what is known about the viral resistance pattern and the availability of a particular drug. o For more information, see Appendix 7-A: Characteristics of Anti- Influenza Antiviral Medications, and Appendix 7-B: Recommended Daily Dosage of Antiviral Medications for Treatment and Prophylaxis. Treatment of Influenza Disease The clinical effectiveness of antiviral medications for treatment of novel influenza is unknown, but it is likely that the earlier treatment is initiated, the greater likelihood of benefit. Treatment strategies for optimizing the use of limited stocks of antiviral drugs will vary depending on the phase of the pandemic. As infection with the pandemic strain becomes more common, laboratory confirmation will be less necessary to initiate treatment. Strategies include: At all stages of a pandemic: o Targeting treatment to influenza patients admitted to the hospital within 48 hours of symptom onset. Treatment after 48 hours of onset may have no benefit. Note: there are no data on the effectiveness of treatment at hospitalization. If stockpiled antiviral drug supplies are very limited, the priority of this group could be reconsidered based on the epidemiology of the pandemic and any additional data on effectiveness in this population. o Implementing mechanisms to detect the emergence of drug-resistant variants by obtaining specimens from persons who develop influenza while on prophylaxis or who progress in severity despite treatment. When pandemic influenza is reported abroad, or sporadic pandemic influenza cases are reported in the United States, without evidence of spread: o Treatment decisions should be based on laboratory confirmation of disease caused by the pandemic strain by viral isolation, real-time polymerase chain reaction (RT-PCR), or other means recommended by CDC. Treatment may be initiated with a positive rapid antigen test for influenza A, though a confirmatory test should be performed and treatment discontinued if influenza is not confirmed (see Sections 2 and 5). o Negative test results would permit cessation of treatment, given the overall low rate of infection in a particular location. February 7, 2006 7-4
Page 1 and 2:
February206 Pandemic Plan NewYorkSt
Page 3 and 4:
Introduction Pandemic influenza occ
Page 5 and 6:
example, at this time, it is realis
Page 7 and 8:
Acronyms (cont.) IND IHANS IRB ISHS
Page 9 and 10:
Section 1: Command and Control I. O
Page 11 and 12:
Section 1: Command and Control pers
Page 13 and 14:
February 7, 2006 Appendix 1-A
Page 15 and 16:
Appendix 1-B The Public Health Law
Page 17 and 18:
Appendix 1-B communicable diseases
Page 19 and 20:
Appendix 1-C Management Office or t
Page 21 and 22:
Appendix 1-E Suspension of Public M
Page 23 and 24:
Appendix 1-G A Guide to New York St
Page 25 and 26:
Appendix 1-G health commissioner. P
Page 27 and 28:
Appendix 1-G 8. State Institutions
Page 29 and 30:
Appendix 1-G b. Governor May Invoke
Page 31 and 32:
Appendix 1-G may direct, pursuant t
Page 33 and 34:
Appendix 1-G c. Commissioner of Gen
Page 35 and 36:
Appendix 1-G Designation of emergen
Page 37 and 38:
Appendix 1-G physician’s assistan
Page 39 and 40:
Appendix 1-H Summary of Public Offi
Page 41 and 42:
Section 2: Surveillance and Laborat
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Appendix 2-A • Surveillance Crite
Page 65 and 66:
Appendix 2-A • In New York City,
Page 67 and 68:
NYSDOH Novel Influenza Case Report
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Appendix 2-C to health care provide
Page 75 and 76:
Virus Detection History NYS Lab Num
Page 77 and 78:
Section 3: Healthcare Planning and
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Section 4: Infection Control I. Ove
Page 127 and 128:
Section 4: Infection Control I. Ove
Page 129 and 130:
Section 4: Infection Control A. Bas
Page 131 and 132:
Section 4: Infection Control Drople
Page 133 and 134:
Section 4: Infection Control • Pe
Page 135 and 136:
Section 4: Infection Control o Noti
Page 137 and 138:
Section 4: Infection Control E. Coh
Page 139 and 140:
Section 4: Infection Control If wid
Page 141 and 142:
Section 4: Infection Control • En
Page 143 and 144:
Section 4: Infection Control should
Page 145 and 146:
Section 4: Infection Control Policy
Page 147 and 148:
Section 4: Infection Control o Staf
Page 149 and 150:
Section 4: Infection Control • De
Page 151 and 152:
Section 4: Infection Control • Pr
Page 153 and 154:
Section 4: Infection Control The ma
Page 155 and 156:
Section 4: Infection Control • Up
Page 157 and 158:
Section 4: Infection Control Health
Page 159 and 160:
Appendix 4-A Soiled linen and laund
Page 161 and 162:
Appendix 4-B Respiratory Hygiene/Co
Page 163 and 164:
Section 5: Clinical Guidelines I. O
Page 165 and 166:
Section 5: Clinical Guidelines incu
Page 167 and 168:
Section 5: Clinical Guidelines 1) N
Page 169 and 170:
Section 5: Clinical Guidelines infe
Page 171 and 172:
Section 5: Clinical Guidelines Alth
Page 173 and 174:
Section 5: Clinical Guidelines Infe
Page 175 and 176:
Section 5: Clinical Guidelines •
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
Page 191 and 192: February 7, 2006 2 Appendix 5-I
Page 193 and 194: Appendix 5-J Clinical Presentation
Page 195 and 196: Appendix 5-J diabetes mellitus), re
Page 197 and 198: Appendix 5-J resistant S. aureus (M
Page 199 and 200: Appendix 5-K eight patients—all o
Page 201 and 202: Appendix 5-L Guidelines for Managem
Page 203 and 204: Appendix 5-L testing should be perf
Page 205 and 206: Appendix 5-L February 7, 2006 5
Page 207 and 208: Section 6: Vaccine Procurement, Dis
Page 219 and 220: Appendix 6-A Vaccine Priority Group
Page 221 and 222: Appendix 6-B Mass Clinic Planning O
Page 223 and 224: Appendix 6-C Vaccine and Antiviral
Page 225 and 226: Appendix 6-C 1. Request Phase The r
Page 227 and 228: Appendix 6-C 3. Receipt and Sign-of
Page 229 and 230: Appendix 6-C • Work with local he
Page 231: Section 7: Antiviral Medication Pro
Page 235 and 236: Section 7: Antiviral Medication Pro
Page 249 and 250: Appendix 7-A Characteristics of Ant
Page 251 and 252: Appendix 7-B a The drug package ins
Page 253 and 254: Appendix 7-C 7 HCWs in emergency de
Page 255 and 256: Section 8: Travel-Related Disease C
Page 267 and 268: Appendix 8-A Home or Community-Base
Page 269 and 270: Appendix 8-B Contact Identification
Page 271 and 272: Appendix 8-B • Determine the time
Page 273 and 274: Appendix 8-C Administrative Data: S
Page 275 and 276: Appendix 8-D CONTACT DAILY TEMPERAT
Page 277 and 278: Appendix 8-F Definitions: Intervent
Page 279 and 280: Appendix 8-F facility. No specific
Page 281 and 282: Appendix 8-F • Resources Required
Page 283 and 284:
Appendix 8-G Business Pandemic Infl
Page 285 and 286:
Appendix 8-G 4. Allocate resources
Page 287 and 288:
Appendix 8-H CDC guidelines suggest
Page 289 and 290:
Appendix 8-H If I am not masked I
Page 291 and 292:
Appendix 8-H NYSDOH Model Influenza
Page 293 and 294:
Appendix 8-H I understand that if
Page 295 and 296:
Section 9: Communications I. Overvi
Page 297 and 298:
Section 9: Communications and commu
Page 299 and 300:
Section 9: Communications web pages
Page 301 and 302:
Section 9: Communications Local Hea
Page 303 and 304:
Section 9: Communications • A JIC
Page 305 and 306:
Section 9: Communications backup to
Page 307 and 308:
Section 9: Communications • In th
Page 309 and 310:
Appendix 9-A Public Health Risk Com
Page 311 and 312:
Appendix 9-C New York State Departm
Page 313 and 314:
Appendix 9-C PRE-EVENT MESSAGE MAP:
Page 315 and 316:
Appendix 9-C PROTECTIVE MESSAGE MAP
Page 317 and 318:
Appendix 9-C TREATMENT MESSAGE MAP:
Page 319 and 320:
Appendix 9-C BUSINESS CONTINUITY PR
Page 321 and 322:
Section 10: Training and Education
Page 323 and 324:
Page 325 and 326:
Page 327 and 328:
Appendix 10-A NYSDOH STAFF PRIVATE
Page 329 and 330:
Page 331 and 332:
Page 333 and 334:
Page 335 and 336:
FACILITY- BASED RNs FACILITY- BASED
Page 337 and 338:
Page 339 and 340:
Page 341 and 342:
Section 11: Workforce Support I. Ov
Page 343 and 344:
Section 11: Workforce Support Pande
Page 345 and 346:
Section 12: Highly Pathogenic H5N1
Page 347 and 348:
Section 12: H5N1 in Non-Human Anima
Page 349 and 350:
Page 351 and 352:
Page 353 and 354:
Page 355 and 356:
Section 13: Public Health Preparedn
Page 357 and 358:
Page 359 and 360:
Page 361 and 362:
Page 363 and 364:
Page 365 and 366:
Page 367 and 368:
Page 369 and 370:
Page 371 and 372:
Page 373 and 374:
Page 375 and 376:
Page 377 and 378:
Page 379 and 380:
Page 381 and 382:
Page 383 and 384:
Page 385 and 386:
Page 387 and 388:
Page 389 and 390:
Appendix 13-A NYSDOH Roles Notified
Page 391 and 392:
Appendix 13-B Notifications sent by
Page 393 and 394:
Appendix 13-B HAN posting is used a
Page 395 and 396:
Appendix 13-B notification system t
Page 397 and 398:
Appendix 13-C Overview of the Healt
Page 399 and 400:
Appendix 13-C • Ongoing surveilla
Page 401 and 402:
Table 1. Summary of HERDS Use To da
Page 403 and 404:
Appendix 13-D Commerce Access and A
Page 405 and 406:
Appendix 13-D Table 3. Organization
show all

Pandemic Influenza Plan - Questar III

Create successful ePaper yourself

Delete template?

Save as template?