The World Health Organization said Tuesday that the number of deaths globally from the H1N1 virus has doubled in the past three weeks, rising to over 700 from about 330 at the start of July.
Browsing Posts tagged virus
A. Context
Identification and investigation of hospitalized cases of influenza is needed to assess the effect of
Swine-origin influenza A/H1N1 virus (S-OIV) in BC. The BC College of Physicians also sent an email on
July 2, 2009 to all physicians from the Provincial Health Officer that included this request to test for
influenza. S-OIV continues to circulate in BC and in recent weeks, provinces have noted increasing
numbers of hospitalization due to S-OIV
B. Guidelines for testing
• TEST all patients admitted overnight (or longer) to hospital with a history of recent acute
respiratory illness (i.e., history of fever and new or worse cough/breathing difficulty, with or
without other flu-like symptoms such as sore throat, rhinorrhea, sneezing, myalgia, arthralgia,
headache, fatigue, etc.);
• Test as soon as possible on admission to increase likelihood of virus detection;
• Test even if the etiology appears to be bacterial;
• Specimen collection for influenza testing may include a nasopharyngeal (NP) swab or
bronchoalveolar lavage (BAL). If patient presents with a rapidly progressive acute respiratory
illness that is negative by NP swab for influenza A/H1N1, additional testing should be performed
on tracheal or other pulmonary samples, if clinicians suspect influenza pneumonia diagnosis.
NP samples should be collected on viral swabs (ideally, COPAN flocked swabs);
• Specimens should be submitted to BCCDC Public Health Microbiology & Reference Laboratory,
with “hospitalized” written in large letters on the requisition;
• The requisition form, along with detailed instructions, can be found online at
http://www.phsa.ca/bccdcpublichealthlab (click on “Forms & Requisitions” on the left-hand panel,
then choose “H1N1 Flu Virus: Virus Culture Form”);
• Start antivirals according to clinical judgment without waiting for test results. Antivirals
are most effective when administered within 48 hours of illness onset.
C. Reporting of Cases
Lab-confirmed S-OIV cases who are admitted to hospital must be reported to the Public Health
Unit in the area where the patient lives. Public health staff will follow-up with detailed investigation of
hospitalized, lab-confirmed S-OIV cases.
Abbotsford HU
Tel: 604-864-3400 Agassiz HU
Tel: 604-793-7160 Burnaby HU
Tel: 604-918-7605 Chilliwack HU
Tel: 604-702-4900 Cloverdale HU, Surrey
Tel: 604-575-5100 Guildford HU, Surrey
Tel: 604-587-4750
Hope HU
Tel: 604-860-7630 Langley HU
Tel: 604-539-2900 Maple Ridge HU
Tel: 604-476-7000 Mission HU
Tel: 604-814-5500 New Westminster HU
Tel: 604-777-6740 Newport HU, Port Moody
Tel: 604-949-7200
Newton HU, Surrey
Tel: 604-592-2000 North Delta HU
Tel: 604-507
-5400 North Surrey HU
Tel: 604-587-7900 Port Coquitlam HU
Tel: 604-777-8700 South Delta HU
Tel: 604-952-3550 White Rock HU
Tel: 604-542-4000
After Hours Public Health Emergency Pager: 604-527-4806. Ask for the Medical Health Officer On-Call
Research Scientists Discover How Flu Damages Lung Tissue: “A protein in influenza virus that helps it multiply also damages lung epithelial cells, causing fluid buildup in the lungs, according to new research from the University of Alabama at Birmingham (UAB) and Southern Research Institute . Publishing online this week in the journal of the Federation of American Societies for Experimental Biology, the researchers say the findings give new insight into how flu attacks the lungs and provides targets for new treatments.”
The World Health Organization is convening a meeting of its emergency committee on pandemic influenza today to seek its advice on whether to move the current outbreak of swine influenza to Phase 6, which describes a full-scale pandemic.
Phase 6 by definition implies that a new strain of influenza to which most or all people are susceptible is spreading freely in at least two regions of the world. If WHO moves to Phase 6, it will be acknowledging what has been clear for several weeks — that there is “community transmission” of the novel strain of influenza A (H1N1) in places other than Mexico, the United States and Canada.
Clinical information on this SRI from Mexico remains the same:
- Initial symptoms: high fever, headache, eye pain, shortness of breath, extreme fatigue
- Rapid progression to severe respiratory distress within about 5 days, many needing mechanical ventilation
- Most cases are previously healthy young adults (age 25-44), including some health care workers
- The outbreak virus is resistant to amantadine but sensitive to oseltamivir. The current seasonal influenza
- vaccine is not expected to provide much if any protection against this new swine flu virus.
Severe Respiratory Illness (SRI) in Mexico another example of need to take care with SRI
Recent media reports on serious respiratory illness (SRI) in Mexico are a good reminder that unusual SRI’s can occur anywhere in the world. It is important to take care to protect yourself, your patients, and other health care workers against infectious SRI.
BCCDC has advised that two clusters of about 100+ patients with SRI have been identified in various parts of
south and central Mexico. Nine of the patients died. The situation is still under investigation and it has not yet been determined if these cases of SRI are unusual or not. Here is what has been reported at this point:
- The cases developed influenza-like illness (ILI) (ILI is typically defined as fever + cough + other symptoms.)
- Rapid progression to severe respiratory distress within about 5 days
- A high proportion of cases required mechanical ventilation
- The case-fatality rate was relatively high among hospitalized patients (5% in one cluster and 20% in the other)
- Most cases were among previously healthy young adults
- Some health care workers were affected
View Swine Map
Wiley InterScience: Reference Work: The Cochrane Library 2009, Issue 2:
“There are several Cochrane reviews of the evidence relevant to different aspects of the prevention and treatment of influenza. These are listed below, organised into ways to reduce the spread of the virus, vaccination and interventions that have been assessed for its treatment.
Interventions to prevent the spread of the influenza viru
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(Via interscience.)
