Wednesday, May 22, 2013

Alabama Health Alert Message On Respiratory Cluster


Dothan, Ala Perry-Castañeda Library Map Collection


UPDATED 14:45 hrs:  Lisa Schnirring at CIDRAP NEWS has just posted a report that summarizes what we know till now about this cluster.


Alabama officials probe respiratory illness cluster



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My thanks to the reader who sent me the link to the following Alert Message from the Alabama Department of Health on the unidentified respiratory cluster in and around Dothan, Alabama (see Updating The Dothan, Alabama Respiratory Cluster Story).




Alabama Department of Public Health ALERT Message 5/21/13

On 5/16/13, a pulmonologist in Southeast Alabama reported to the Alabama Department of Public Health (ADPH) that three patients had been hospitalized with cough, shortness of breath, and pneumonia, were on ventilators, and had no known cause for their illness.


The ADPH and the Houston County Health Department began an epidemiology investigation to interview the families about travel and exposure. 
Specimens were requested  and submitted to the ADPH Bureau of Clinical Laboratories (BCL) in

On 5/17/13, BCL reported one of the three patients tested positive for 2009 H1N1.  On 5/18/13, this
patient died.  On 5/19/13, the same hospital reported that a transferred patient on a ventilator with respiratory symptoms had died.  On 5/19/13, this hospital had nine additional patients present to the emergency department with influenza-like illness and three of those patients were admitted.  Specimens have been collected on all patients.  The BCL has tested all specimens on a PCR flu panel and one tested positive for AH3.  The specimens were also forwarded to CDC for additional testing.  

At this time, there is no epidemiological link between these patients.  While two patients have tested positive for influenza, the exact role of influenza in this cluster is unknown.  On 5/21/13, ADPH sent a News Release regarding the situation.

ADPH has reiterated that healthcare providers should use standard precautions when dealing with
patients with respiratory illness.  Physicians should use clinical judgment in determining the best
treatment for their patients since the etiology of the outbreak is unknown at this time.  


Please report all patients currently hospitalized with pneumonia, with unknown cause (regardless of quick
flu test results), to, Respiratory Illness REPORT Card.


For patients who present  with fever (>100.4F) and cough or shortness of breath with unknown cause
(regardless of quick flu test results), please submit an upper tract specimen, ie, oropharyngeal (OP) swab or nasopharyngeal (NP) swab, to the Bureau of Clinical Laboratories as part of ADPH's year-round
influenza surveillance program. 

For more information about collecting, packing, and submitting lab specimens, please go to or call BCL 334-260-3429, Microbiology Division.

For patients who present with pneumonia with unknown cause (regardless of quick flu test results),
please collect and submit  a lower tract specimen, ie, bronchoalveolar lavage, tracheal aspirate, or
sputum, to the BCL.

For patients admitted to the hospital with cough or shortness of breath, and pneumonia (regardless of
quick flu test results), with unknown cause, please send both upper and lower tract specimens.  Multiple respiratory specimen types with ample volume are preferred. 

If you have any questions, please contact the Epidemiology Division at 1-800-338-8374 and ask to
speak with staff involved in the Respiratory Illness Outbreak.


Anonymous said...

whats AH3 Michael?

Michael Coston said...

AH3 would be influenza A, H3, but with no NA identified.

Could be seasonal H3N2, or even a variant H3 virus I susppose.

Anonymous said...

No updates on Alabama cluster since the 22nd?

Michael Coston said...

The `All Clear' was sounded on Thursday - Only Flu, Rhinovirus, and bacterial pneumonia detected.

Here's the link