A few minutes ago, I participated in a statewide conference call sponsored by the Georgia Department of Education to provide H1N1 updates to educators. The speakers were Dr. Patrick O’Neal, Division Chief for Emergency Preparedness and Response, Georgia Department of Community Health, and Dr. Michelle Conner, Program Director of Infectious Disease and Immunization, Georgia Department of Community Health. I will provide my summary of the information presented in this conference call below:
Dr. O’Neal described Four Pillars of Attention being addressed by public health. The first pillar is the need to continue to monitor the situation with H1N1 paying particular attention to any increases in severity or evidence that the virus is mutating. So far, there has been no evidence of either of these occurring. The CDC is working on a process to more accurately count the number of H1N1 cases in order to be able to put the number of deaths associated with it into some context for comparison. Currently the CDC has characterized the severity of H1N1 as low to moderate. CDC is also monitoring for any evidence that the virus has become resistant to antiviral medications. Less than thirty cases have been reported to have demonstrated some resistance to the antiviral medications but this is extremely minimal.
The second pillar addressed by Dr. O’Neal was the mass vaccination campaign. This campaign is two pronged and includes seasonal flu vaccinations and H1N1 vaccinations. The reason that this is important is because there is a need to not overwhelm the healthcare system’s capacity to help patients who need medical care. Vaccinations should prevent some people from catching the flu or needing healthcare and thus freeing up capacity of health care facilities to serve patients that really need care. The vaccinations campaign is also designed to reduce the potential of people catching both strains of the flu at once. This would be really bad for people with other health complicating conditions. There is an increased chance that the virus may mutate if a person is infested with both seasonal flu and H1N1 at the same time.
The third pillar is community mitigation. Currently the CDC and Georgia Department of Community Health are not recommending the closing of schools to decrease the spread of the flu. Decisions to close schools at this point should remain a local decision based on significantly higher rates of absenteeism or concentrations of high risk medically fragile students. The fourth pillar is communication. It is very important that the message get out that the degree of sickness from H1N1 at this time is generally milder than seasonal flu. The duration is typically 2-3 days for otherwise healthy people. He emphasized the importance of continuing careful hand washing of 20 seconds or more with soap and warm water, covering coughs and sneezes, and staying home when sick. All three of these recommendations should be followed for the best outcome.
Dr. Conner discussed recent news regarding the H1N1 vaccination. The FDA has approved the H1N1 vaccination. It should be available as early as October 5th. It has been researched and created through the same process as regular flu. This process has a very good safety profile. To date, over 2700 have registered to administer the vaccine in Georgia. This should be more than an adequate network of providers. There are no plans for public health to provide immunizations in schools. However, local communities may choose to develop plans to offer voluntary school-based vaccinations on their own. (In Barrow County, we have no current plans to offer voluntary school-based H1N1 vaccinations but we are willing to have a discussion about it). There has not been a final decision made about the number of doses that will be required. It is expected that adults will need 1 dose and children will need 2 doses.
Questions and answers:
1. Recently we have heard reports in the media that people who are sick should remain at home for longer (up to 7 days) before returning to work and school. What is the current recommendation from CDC? Some health care providers believe that a longer time out of work and school is needed. However, Dr. O’Neal recommends sticking to the CDC guidelines of 24 hours after the person has no fever without the use of fever reducing medications.
2. How close together can a person have the seasonal flu vaccine and H1N1 vaccine? If the person receives the injectable (shot form of the vaccine there are no spacing issues. The only recommendation so far is that a person cannot get both vaccinations in the intranasal form on the same day.
3. Can a person get the vaccine while taking antiviral medications? This is not recommended because the antiviral medications will prevent the body from benefitting from the vaccine. It is best to wait a few days after completing an antiviral medication before getting the vaccination.
4. Are vaccinations mandatory? The vaccinations are definitely not mandatory.
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