Pandemic Influenza Plan - Questar III

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Section 2: Surveillance and Laboratory Testing • Safety precautions to be taken while handling specimens in the laboratory o Guidance for handling respiratory secretions from patients who are suspected of being infected with influenza virus but who do not have a history of travel to an area where a novel influenza virus, such as the Asian HPAI H5N1 avian influenza virus, is circulating and not suspected to be infected with a novel influenza virus: The following should be performed in BSL-2 facilities with standard BSL-2 practices. • Pathological examination and processing of formalin-fixed or otherwise inactivated tissues. • Molecular analysis of extracted nucleic acid preparations. • Electron microscopic studies with glutaraldehyde-fixed grids. • Routine staining and microscopic analysis of fixed smears. • Final packaging of specimens for transport to diagnostic laboratories for additional testing. Specimens should already be in a sealed, decontaminated primary container. The following activities involving untreated specimens should be performed in a BSL-2 facility AND in a Class II biological safety cabinet. • Aliquoting and /or diluting specimens. • For the appropriate strains, inoculation of cell cultures with the original diagnostic specimen or the culture amplified isolate. • Nucleic acid extraction procedures involving untreated specimens. • Based on CDC guidance, rapid EIA commercial influenza antigen detection assays. Laboratory workers should wear protective equipment, including disposable gloves and solid front gowns with cuffed sleeves. Work surfaces should be decontaminated upon completion of work with appropriate disinfectants and all disposable waste autoclaved. Any procedure or process that cannot be conducted within a biological safety cabinet requires the use of the appropriate combinations of personal protective equipment (e.g., respirators and face shields) and physical containment devices (centrifuge safety cups or sealed rotors). Centrifugation should always be carried out using aerosol-sealed centrifuge cups and rotors that are loaded and unloaded in a biological safety cabinet. o Guidance for handling respiratory secretions from patients who have history of travel to an area where a novel influenza virus, such as the highly pathogenic Asian HPAI H5N1 avian influenza virus, is circulating OR are suspected to be infected with a novel influenza virus: February 7, 2006 2-19
Section 2: Surveillance and Laboratory Testing • These specimens must NOT be inoculated into cell culture. • If the laboratory has the capability of performing molecular detection by RT- PCR, nucleic acid to be used in the assay may be extracted in a BSL-2 facility using a Class II biological safety cabinet and appropriate personal protective equipment. It should be noted that for molecular analysis of potential influenza A/H5 (Asian lineage) strains, the CDC recommends that procedures should be performed using BSL-2 facilities and BSL-3 practices. • After consultation with the Regional Epidemiologist, the original specimen should be forwarded to the Wadsworth Center for analysis. • An occupational health plan should be in place such that laboratory workers are regularly monitored for symptoms of respiratory infection. Detailed information about occupational health protection from avian influenza viruses in the laboratory can be found at the following Wadsworth Center web site: http://www.wadsworth.org/events/sars/SARS_Protocol.pdf • Surge capacity Should an increased demand for diagnostic testing arise that requires additional laboratory staff, the Laboratory Chief of the Zoonotic Diseases and Clinical Virology Laboratory will work with the Wadsworth Center senior administration to bring in appropriately trained and vaccinated personnel. • Contacts for additional information Dr. Kirsten St. George 518-869-4520, kxs16@health.state.ny.us Dr. Amy Dean 518-862-4322, abd01@health.state.ny.us Mr. Ryan Bennett 518-869-4551, rtc03@health.state.ny.us V. Epidemiologic Surge Capacity During the inter-pandemic phase, epidemiologic investigation of any suspect and confirmed human novel influenza virus infections will be extensive to attempt to limit transmission. If a novel strain of influenza strain that is capable of person-to-person transmission is suspected in New York State, staff may need to be mobilized in a short time frame to conduct surveillance activities, outbreak investigations, contact tracing, and to implement control measures. As a supplement to local health department staff, NYSDOH Regional and Central Office staff, including but not limited to those in the Bureaus of Communicable Disease Control (BCDC), Sexually Transmitted Disease Control (BSTDC), Tuberculosis Control (BTBC), and AIDS Epidemiology (BHAE) may be utilized. Many local health department epidemiologists and case investigators are nurses and may also be needed to assist with vaccination and/or antiviral therapy delivery. Given that public health medical staff may also be engaged in vaccine/antiviral initiatives, other local and state public health staff as noted above, may need to be mobilized and receive just in time training to assist with case investigations, contact tracing, and ensuring control measures are being implemented. February 7, 2006 2-20
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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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Page 15 and 16: Appendix 1-B The Public Health Law
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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 • De
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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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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 diabetes mellitus), re
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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-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 backup to
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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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