Pandemic Influenza Plan - Questar III

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Section 2: Surveillance and Laboratory Testing caused by a novel influenza virus occur in the United States or in another country or if person-to-person spread is slow, limited or widespread. In conjunction with recommendations from other public health partners, such as the Centers for Disease Control and Prevention (CDC) and WHO, NYSDOH will provide updated guidance to medical providers and local health departments on an ongoing basis. Activities outlined below will be contingent on local, national, and international influenza activity at the time. A. Components of Surveillance In addition to surveillance activities conducted by local health departments (LHDs), the NYSDOH has been routinely coordinating a comprehensive statewide influenza surveillance system. These activities collect data from multiple partners throughout the state. Information compiled includes laboratory testing data, nosocomial outbreak reports, influenza-like illness by age group, hospitalizations, and pediatric deaths. These routine systems could be enhanced during an influenza pandemic. • Virologic Surveillance: o WHO and/or National Respiratory and Enteric Virus Surveillance System (NREVSS): There are 13 participating laboratories in New York State that report weekly throughout the influenza season. Data reported are the number of specimens tested and the number positive for influenza by type. Of the 13 labs, three also report subtype. In addition to providing information on when and where influenza activity is occurring, the data also identify which viruses are circulating. The total number of specimens tested is also reported to allow the calculation of the percent of specimens that are positive. o Electronic Clinical Laboratory Reporting System (ECLRS): Individual positive laboratory specimens are reported to NYSDOH via ECLRS. It provides real-time data that allows daily assessment of when and where influenza activity is occurring. • Outpatient Surveillance: o Surveillance for <strong>Influenza</strong>-Like Illness: There are 79 (1/140,000 population) medical providers throughout New York State, excluding New York City, who are currently participating in the U.S. <strong>Influenza</strong> Sentinel Provider Network (SPN). During the influenza season May through October, they voluntarily report weekly the total number of patients seen and the number of patients presenting with influenza-like-illness (ILI) by age group. This data is analyzed weekly to assess influenza-like illness morbidity in the outpatient setting. Each provider is also allowed to submit six specimens throughout the season for viral testing at NYSDOH Wadsworth Center. February 7, 2006 2-3
Section 2: Surveillance and Laboratory Testing o Local Health Department Telephone Emergency Department Contact Surveillance System: This reporting system is available on the NYSDOH Health Information Network (HIN) for local health departments to report findings of daily contact with emergency departments. The data are reviewed seven days a week by NYSDOH staff for any significant findings. Unusual illness reports and clusters are followed-up by state and LHD epidemiologists. A daily summary is distributed Monday through Friday to NYSDOH staff. o Syndromic Surveillance: • Medicaid Prescription Data: Electronic data is received seven days a week. Data includes influenza antiviral prescriptions by zip code. This allows an assessment of antiviral use in the Medicaid outpatient community (it excludes antiviral medications that are administered to inpatients and nursing home residents). Other medications that may be used as an indicator of respiratory illness are also analyzed. • National Retail Data Monitor – Real-Time Outbreak and Disease Surveillance (RODS): Over-the-counter retail pharmaceuticals sales data are reported daily by 20,000 participating pharmacies nationwide. Although influenza-specific medications are not included, other categories can be used as indicators of possible respiratory illness. • Electronic Emergency Department Syndromic Surveillance System: Thirty-six hospitals in 14 counties outside NYC currently submit an electronic file seven days a week with chief complaint for all patients presenting to the emergency department within the past twenty-four hours. Chief complaints are grouped into “syndromes,” including a febrile respiratory syndrome, to categorize clinical presentations of the patients seeking medical attention. Statistical methods are used to determine if there are any short-term or sustained increases in patients presenting with possible respiratory illness. Within NYC, New York City Department of Health and Mental Hygiene (NYCDOHMH) receives data for the previous 24 hours from 48 NYC emergency departments. Visits are also grouped into syndromes, including Respiratory and Fever-flu-like illness. Data is analyzed (citywide temporal trend analysis, spatial cluster analysis, and age-specific analysis) 365 days a year. • BioSense System: Selected ICD-9 coded outpatient visits at Department of Defense ambulatory-care centers and Department of Veterans Affairs outpatient clinics generate Sentinel Infection Alerts. NYSDOH investigates all alerts that may indicate single cases of diseases of public health significance or clusters of disease occurrences. February 7, 2006 2-4
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
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Page 15 and 16: Appendix 1-B The Public Health Law
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Page 23 and 24: Appendix 1-G A Guide to New York St
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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 •
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Appendix 5-B Clinical Evaluation of
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Appendix 5-C Special Situations and
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Appendix 5-D handling soiled laundr
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DRAFT Appendix 5-E Footnotes to App
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Appendix 5-F February 7, 2006 1
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Appendix 5-F 7. Guidance on the eva
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Appendix 5-H Source: U.S. Departmen
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February 7, 2006 2 Appendix 5-I
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Appendix 5-J Clinical Presentation
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Appendix 5-J resistant S. aureus (M
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Appendix 5-K eight patients—all o
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Appendix 5-L Guidelines for Managem
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Appendix 5-L testing should be perf
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Appendix 5-L February 7, 2006 5
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Section 6: Vaccine Procurement, Dis
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Appendix 6-A Vaccine Priority Group
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Appendix 6-B Mass Clinic Planning O
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Appendix 6-C Vaccine and Antiviral
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Appendix 6-C 1. Request Phase The r
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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-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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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 12: Highly Pathogenic H5N1
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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-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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