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FLU Update:
Previous Entries
11/20/09 Update: H1N1 (Swine Flu) University Health Center, University of Georgia
10/28/09 Update: H1N1 (Swine Flu) University Health Center, University of Georgia
10/23/09 Update: H1N1 (Swine Flu) University Health Center, University of Georgia
10/21/09 Update: H1N1 (Swine Flu) University Health Center, University of Georgia
10/20/09 Update: H1N1 (Swine Flu) University Health Center, University of Georgia
10/14/09 Update: H1N1 (Swine Flu) University Health Center, University of Georgia
10/5/09 Update: H1N1 (Swine Flu) University Health Center, University of Georgia
9/28/09 Update: H1N1 (Swine Flu) University Health Center, University of Georgia
9/8/09 UGA Officials Address Swine Flu Hearsay -- Read the complete Red and Black article
Update: H1N1 (Swine Flu) University Health Center, University of Georgia
November 20, 2009
As many students leave campus for Thanksgiving holiday, H1N1 vaccine finally arrived at the Health Center on Nov 19th. Despite the significant decrease in the number of new daily cases, the prevalence of disease remains above epidemic levels and influenza is still spreading on campus.
During the first 13 weeks of the semester we saw 5,000 students with respiratory infections, which is twice the usual rate for the fall semester. Of those, 1,754 met the diagnostic criteria for influenza-like illness.
This graph depicts the weekly percentage of visits for ILI (Influenza-Like Illness) January 1 through November 14, 2009. The green dotted line is US national data reported by CDC ILINET. The red line is UGA University Health Center data. The flat dotted line represents the national epidemic baseline level. As you can see, although we are past the highest surge of infections, we are still experiencing epidemic level of influenza and expect this will continue for some time to come.
Many students are still susceptible to this virus and I encourage them to consider getting vaccinated prior to their final exams and the winter holiday break. We have 4,100 doses of H1N1 Vaccine, including both the injectable and the nasal vaccine type. Eligible students, spouses, partners and campus health care workers are strongly encouraged to obtain the vaccine. Those who should not take the vaccine include anyone with a documented allergy to the vaccine, a previous systemic allergic reaction to chicken eggs, and anyone with a prior history of Guillain-Barré Syndrome.
Through government-mandated agreement, we are providing this vaccine to the first priority group including the following individuals:
- Pregnant women
- People who live with or care for infants younger than 6 months
- Healthcare & emergency medical personnel with direct patient contact
- Persons between the ages of 6 months and 24 years
- People ages 25-64 who are at higher risk because of chronic health disorders or compromised immune systems including:
- Asthma
- Neurological and neuro-developmental conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].
- Chronic lung disease (such as chronic obstructive pulmonary disease and cystic fibrosis)
- Heart disease (such as congenital heart or coronary artery disease, congestive heart failure)
- Blood disorders (such as sickle cell disease)
- Endocrine disorders (such as diabetes mellitus)
- Kidney or Liver disorders
- Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
- Weakened immune system due to disease or medication (such as people with HIV or AIDS, cancer, or those on chronic steroids)
- People younger than 19 years of age who are receiving long-term aspirin therapy
Once the demand for vaccine by the prioritized groups has been met we will offer vaccine to others. Nasal (no-needle) vaccine is recommended for those in the priority groups who do not have any chronic or current medical conditions.
Update: H1N1 (Swine Flu) University Health Center, University of Georgia
October 28, 2009
During the past week, we saw a continued decline the number of students with influenza. This is the first week during this semester that our ILI visit count was lower than 113 students. Our total ILI case count exceeds 1,543. The weekly percentage of visits for ILI is now similar to peak prevalence during a typical flu season.
The Provost released a memorandum this week encouraging professors to relax attendance policies. Maybe this will improve self-isolation as we move toward the winter flu season.
This week, 2 ½ months after the disease surge in the southeastern United States, President Obama announced a national medical emergency. I do not anticipate this will have any immediate effect for UGA students.
UHC has administered 1,822 seasonal flu shots, but we are still awaiting our allotment of H1N1 vaccine.
Last week, CDC updated recommendations for antiviral therapy indications:
- Most healthy persons (i.e., those without a condition which puts them at higher risk for complications) who develop an illness consistent with uncomplicated influenza do not need to be treated with antiviral medications and will recover without complications.
- Prompt empiric outpatient antiviral therapy is recommended for persons with suspected influenza who have symptoms of lower respiratory tract illness or clinical deterioration regardless of previous health or age.
- Early empiric treatment should be considered for persons with suspected or confirmed influenza who are at higher risk for complications, even if not hospitalized, including children younger than 2 years old; adults 65 years and older; pregnant women; and persons with the following conditions:
- Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), or metabolic disorders (including diabetes mellitus)
- Disorders that that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders)
- Immunosuppression, including that caused by medications or by HIV
- Persons younger than 19 years of age who are receiving long-term aspirin therapy, because of an increased risk for Reye syndrome
When treatment is indicated, providers should not wait for laboratory confirmation of influenza to begin treatment. A negative rapid influenza diagnostic test result does not rule out influenza infection and patients with a negative should be considered for treatment if clinically indicated.
Additional info:
Flu.gov
Times Topics: Swine Flu (H1N1 virus)
Inactivated 2009 H1N1 Influenza Vaccine (Adobe pdf)
Live, Intranasal 2009 H1N1 Influenza Vaccine (Adobe pdf)
CDC Asthma Information for Patients
Update: H1N1 (Swine Flu) University Health Center, University of Georgia
October 23, 2009
UHC Clinics have now given 1720 seasonal flu vaccines! We expect to be out of vaccine before Thanksgiving, so make sure to schedule your appointment as soon as you can. Students can schedule online, and students, faculty, and staff can schedule by calling their medical clinic team or Allergy Travel Clinic.
Update: H1N1 (Swine Flu) University Health Center, University of Georgia
October 21, 2009
University Health Center Medical Clinics and Allergy Travel Clinic have given over 1400 seasonal flu vaccines since October 1! This means we have given almost half of our order in two weeks. Due to the changeover by the manufacturers to the production of H1N1 influenza vaccine, we are unable to purchase additional seasonal flu vaccine this year, and many other providers are out of vaccine. Call your clinic or Allergy Travel Clinic for an appointment or go on-line in OpenCommunicator to schedule your shot. I got my shot!
H1N1 vaccine will be available for students later this semester. We are planning to provide the H1N1 vaccine to students at the University Health Center and at the Tate Center in walk-in clinics – check back to this webpage for confirmed clinic dates once we receive the vaccine from the state of Georgia.
Update: H1N1 (Swine Flu) University Health Center, University of Georgia
October 20, 2009
The atypical influenza season continues unabated on campus.
During the past week the number of students seeking general medical services increased 37%
over the same week in 2008. 138 students were treated for flu among the 1,578 visits for primary
care last week. The total number of influenza diagnoses at UHC since June hit 1,455 and all
respiratory infections soared 137% above previous year visits, most assuredly related to influenza.
ILINet reports the prevalence is increasing nationally and ranges from 1.8% - 12.9% of
patient visits. At UHC we peaked in August at 18.1% but now it is down to 7.8% of visits. Hopefully, our downward trend will continue.
Vaccination can prevent disease. But, as the extraordinary demand for vaccine has never been
higher, we have already used half of our supply of seasonal vaccine in just two weeks. The majority
of vaccine has been given to students. 71% of UHC staff got their shots, which is well above the
national average for health care facillities. When we run out of seasonal vaccine, we cannot get any
more. Students should make an appointment for the flu shot before we run out.
By now everyone should acknowledge that students attending class or other events while ill
will spread the disease. The Health Center cannot excuse students from class. However, some professors demand ‘hand written’ doctor’s notes or refuse to accept that students will have unusually high absenteeism.
Anyone with respiratory infection, especially with fever, should take precautions not to spread the infection to others. Remain isolated, at least six feet away from others, sneeze or cough into a tissue then discard the tissue into the trash, wash your hands or use alcohol based hand gels.
Students are reminded that the Health Center will close on furlough days. Any sick students
requiring health care should look for care from their doctor, local community doctor offices or
Emergency Rooms.
Current status of the epidemic and useful recommendations can be found at Flu.gov.
If you are looking for an excellent overview of the history of novel H1N1, you might try the New York Times website, Times Topics: Swine Flu (H1N1 virus).
Additional info:
Inactivated 2009 H1N1 Influenza Vaccine (Adobe pdf)
Live, Intranasal 2009 H1N1 Influenza Vaccine (Adobe pdf)
CDC Asthma Information for Patients
Update: H1N1 (Swine Flu) University Health Center, University of Georgia
October 14, 2009
During the past 8 weeks the number of students treated with ILI, URI, and viral syndrome at UHC surpassed every previous winter flu season. The prior downward trend in cases reversed as more students sought treatment last week. In only two other weeks during the epidemic did we see more illness. This upward trend occurred throughout the southeastern United States according to CDC ILINET and reinforces our suspicions that it will be a long fall and winter.
One factor which may be contributing to this uptick could be students are attending class while ill and contributing to the spread of disease. More students complained this week about professors' reluctance to excuse students from class.
Vaccination is the best protection against this disease. Continue to encourage all patients without contraindications, to obtain both seasonal and H1N1 immunizations and if indicated get the pneumococcal vaccine.
Liz Rachun is coordinating a communications plan to spread the word about vaccine, and Martha Davis Gollin will develop an outreach program to deliver vaccines at campus locations.
H1N1 vaccine appears safe. It is produced in the same way and is very similar to the seasonal vaccine used every year. It is manufactured and purified in the same factories. All completed testing indicates it has similar side effects as seasonal vaccine, including sore arms and mild fever. Importantly, the vaccine matches the H1N1 variant that is causing disease globally.
CDC modified advice to people with asthma, encouraging, among other things, to update their written Asthma Action Plan. The AAP includes a list of daily medications, symptoms to monitor and actions to take to manage an asthma ‘attack’ including when to go to the Emergency Room.
Update: H1N1 (Swine Flu) University Health Center, University of Georgia
October 5, 2009
For the 6th consecutive week more than 100 students came to UHC with influenza. This semester 1,113 students were seen with ILI (Influenza-like Illness). The decline from the peak weekly incidence of 293 cases is welcomed and raises many questions about the future.
It seems unlikely that this epidemic is over. More plausible scenario is that we will continue to see cases at a mildly elevated level until the ‘real’ flu season hits this winter. Which virus will we see dominate? How virulent will the winter versions be? No one can tell us.
Two vaccines provide protection for the most likely viral candidates.
Seasonal influenza vaccine arrived Wednesday and already 129 UHC staff members rolled up their sleeve for a shot. Seasonal vaccine will cost fees-paid students $15.00 and non-fees paid recipients $25.00.
UHC requested H1N1 vaccine last month. H1N1 vaccine will be free to all students.
H1N1 vaccine appears safe. It is produced in the same way and is very similar to the seasonal vaccine used every year. It is manufactured and purified in the same factories. All completed testing indicates it has similar side effects as seasonal vaccine, including sore arms and mild fever. Importantly, the vaccine matches the H1N1 variant that is causing disease globally.
Patients with pre-existing asthma account for 32% of hospitalizations with novel H1N1 influenza. In the general population 8% of people have asthma and at UGA our records suggest about it is 9%.
CDC modified advice to people with asthma, encouraging, among other things, to update their written Asthma Action Plan. The AAP includes a list of daily medications, symptoms to monitor and actions to take to manage an asthma ‘attack’ including when to go to the Emergency Room.
CDC also published guidelines this week for physicians to triage ill patients by telephone. I urge everyone to use caution here as we continue to see students with symptoms suggestive of influenza-like illness but caused by bacteria or viruses other than influenza. Some require treatment such as Group A streptococcus, or special precautions as in infectious mononucleosis.
Inactivated 2009 H1N1 Influenza Vaccine (Adobe pdf)
Live, Intranasal 2009 H1N1 Influenza Vaccine (Adobe pdf)
CDC Asthma Information for Patients
Update: H1N1 (Swine Flu) University Health Center, University of Georgia
September 28, 2009
During the past week our cases of ILI (Influenza-like Illness) continued a downward decline. We are seeing about 20 students with ILI per day which is significantly fewer than the peak incidence in late August of >60 ILI per day. Since fall semester began 1,000 students were diagnosed with ILI, 200 with Viral Syndrome and 1,388 with URI. We have treated 1,011 ILI cases since June 17, 2009.
By the end of semester week 6, 18% of our direct care employees reported symptoms consistent with ILI. Some tested positive for H1N1, most have had mild disease, and some had other illnesses.
Also across Georgia this week, cases continued to decline. On September 21st, Children’s Healthcare in Atlanta closed down their Emergency Operations Center for H1N1. Pediatric patients with ILI are now appearing in the usual February flu season numbers.
Warm weather is not typically conducive to the spread of influenza. Nobody knows why this is true, but it is. Since we expect that approximately 80% of students either have already or will become infected within the next 18 months, the winter flu season may bring a significant increase in the number of ill students unless they are immunized.
Immunity can only be achieved by having the disease or getting vaccinated. H1N1 vaccines are FDA approved and shipments begin in mid-October. Our seasonal vaccine should arrive within the next two weeks.
The UHC Asthma Team is drafting a secure message regarding seasonal and H1N1 vaccines. This mass communication campaign targets high-risk individuals with asthma and other chronic diseases. Recommendations for Pneumococcal Vaccine for those with asthma and for smokers are included.
UHC is now working at a normal flu season level. The first wave of disease appears to be settling down. There is more to come. Accurate predictions are elusive, so we prepare for the worst case and hope for the best.
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