# 8218
Given that it is winter, bird flu is active in some parts of the world, and Canada recently saw their first imported case of H5N1, it is not surprising that the CDC continues to expand, and update, their guidance documents on dealing with novel influenza infections in the United States.
Last week, the CDC issued a HAN Advisory On Canadian H5N1 Case, while two days ago they released Updated Interim Infection Control Guidance For Novel Flu In Healthcare Settings.
Last night the CDC published a pair of guidance documents on testing recommendations for person suspected of having either the H5N1 or H7N9 virus.
Testing Recommendations for Persons with possible infection with Avian Influenza A (H7N9) virus in the United States Friday, January 24, 2014 5:11:00 PM Testing Recommendations for Persons with possible infection with Highly Pathogenic Avian Influenza A (H5N1) virus in the United States Friday, January 24, 2014 5:10:00 PM
Both sets of recommendations are quite similar, differing primarily in the sections detailing the parts of the world where each virus has been reported in the previous 24 months. I’ve excerpted portions of the H7N9 guidance below:
Patients who meet both the clinical and exposure criteria described below should be tested for avian influenza A (H7N9) virus infection by reverse-transcription polymerase chain reaction (RT-PCR) assay using H7-specific primers and probes. Decisions on diagnostic testing for influenza using RT-PCR should be made using available clinical and epidemiologic information, and additional persons in whom clinicians suspect avian influenza A (H7N9) virus infection also should be tested. For more information on laboratory testing of persons under investigation for avian influenza A (H7N9) virus infection, please see Information for Health Professionals and Laboratorians. Guidance on testing, treatment, and infection control will be updated by CDC as more information becomes available.
Clinical Illness Criteria
- Patients with new-onset severe acute respiratory illness requiring hospitalization (i.e., illness of suspected infectious etiology that is severe enough to require inpatient medical care in the judgment of the treating clinician).
AND- Patients for whom no alternative infectious etiology is identified.
Exposure Criteria
- Patients with recent travel (within 10 days of illness onset) to areas where human cases of avian influenza A (H7N9) virus infection have recently become infected1 or where avian influenza A (H7N9) viruses are known to be circulating in animals2.
OR- Patients who have had recent close contact (within 10 days of illness onset) with suspected3 or confirmed cases of human infection with avian influenza A (H7N9) virus. Close contact may be regarded as coming within about 6 feet (2 meters) or within the room or care area of a person with a suspected or confirmed case while the person was ill (beginning 1 day prior to illness onset and continuing until resolution of illness). Close contacts include healthcare personnel providing care for a person with a suspected or confirmed case, family members of a person with a suspected or confirmed case, persons who lived with or stayed overnight with a person with a suspected or confirmed case, and others who have had similar close physical contact, especially without the use of respiratory protection.
OR- Persons with an unprotected exposure to avian influenza A (H7N9) virus in a laboratory setting.
1As of January 23, 2014, mainland China is the only country where human cases of avian influenza A (H7N9) virus infection have recently (within the past 24 months) become infected.
2As of January 23, 2014, mainland China is the only country where avian influenza A (H7N9) viruses are known to be circulating in animals.
3Patients suspected of having infection with avian influenza A (H7N9) virus can include probable cases, cases under investigation for infection with avian influenza A (H7N9) virus, and other patients for whom available clinical and epidemiologic information support a diagnosis of infection with avian influenza A (H7N9) virus.State health departments are encouraged to investigate potential human cases of avian influenza A (H5N1) virus infection and should notify CDC within 24 hours of identifying a probable or confirmed case of novel influenza A virus infection, including avian influenza A (H5N1) virus infection, and avian influenza A (H7N9) virus.
Last October the CDC also released the following treatment guidelines for the H7N9 virus:
H7N9: CDC Guidance On Antiviral Chemoprophylaxis – Oct 2013
H7N9: Updated CDC Guidance For Antiviral Treatment – Oct 2013
While some may view the recent release of these updated guidance documents as `alarming’, I view them as simply prudent preparedness measures on the part of the CDC. We’ve known for years that novel influenza viruses are just an airplane ride away from North America, and the events earlier this month in Canada simply reinforced that reality.
The only thing `alarming’ would be if they were ignoring the avian flu situation, which clearly they are not.
While we may go years or even decades without seeing another pandemic, the reality is one could also start next week. Which is why everyone – not just government agencies, and healthcare facilities – should give some thought as to how they would deal with a large scale epidemic or even a pandemic.
Credit CDC
Last October, in Pandemic Preparedness: Taking Our Cue From The Experts, I wrote about personal and business pandemic preparedness, which included numerous links to governmental guidance documents, and an excellent 20 minute video produced by Public Health - Seattle & King County - called Business Not As Usual .
If you’ve not seen this movie, or haven’t seen it recently, it is well worth taking the time to watch it.
You’ll also find a long list of preparedness resources available on this page as well:
Pandemic preparedness is admittedly just one facet of overall disaster preparedness, something we should all be taking seriously.
Last September was National Preparedness Month (NPM2013), and I, along with many other coalition members, devoted a good deal of time towards spreading the preparedness message.
The goal of NPM2013 is to foster a culture of national preparedness, and to encourage everyone to plan and be prepared to deal with any disaster where they can go at least 72 hours without electricity, running water, local services, or access to a supermarket.
These are, of course, minimum goals.
Whether is is a pandemic, an earthquake, a hurricane, wild fire, or a tornado outbreak - we know that major disasters happen every year, and can affect millions of people.
And those who are better prepared to deal with them, are more apt to get through them with the least amount of loss.
