For Health Providers
Situation Update on H1N1 in Sonoma County
Posted: August 19, 2009
To: Healthcare Providers
From: Mark Netherda, MD, Deputy Health Officer, 565-4567
Public Health staff continues to monitor the local H1N1 2009 virus in Sonoma County with increased focus on preparing for a fall vaccination campaign. This week, information on ways to reduce the spread of the flu was sent to Sonoma County schools as part of our Back to School Campaign. To date, there have been 32 hospitalizations and five fatalities related to H1N1 in Sonoma County. The virus continues to circulate in the county, but the actual number of individuals affected is not available because testing guidelines focus on hospitalized patients, some high-risk individuals or fatalities.
New Clinical Guidance from California Department of Public Health (CDPH)
CDPH issued a Health Alert on August 13th (pdf) containing important new information and guidance on the Pandemic (H1N1) 2009 Influenza situation. Information covered in the document includes:
- Updated guidance on how long persons with influenza-like illness should be away from others.
- Guidance for school (K-12) responses to influenza in the 2009-2010 school year.
- Recommendations for the use of alcohol-based hand sanitizers in schools.
- Testing of bacterial isolates from H1N1 2009 patients with secondary bacterial infections.
- Changes in the reporting of H1N1 2009 hospitalized patients by local health departments.
- CDPH H1N1 2009 testing priorities (see below).
Important Changes in Influenza Testing at the Sonoma County Public Health Laboratory
The Sonoma County Public Health Laboratory is changing the way specimens submitted for influenza testing are processed and reported. Because virtually all positive influenza specimens in California are currently proving to be the Pandemic (H1N1) 2009 strain, the California Department of Public Health has determined that any test by RT-PCR that is positive for Influenza A should be considered highly suspect for H1N1 and testing need not go further.
Influenza tests submitted to the Sonoma County Public Health Laboratory will be tested for influenza type A, and those specimens testing positive for type A will not proceed further, with the exceptions of specimens from patients who are hospitalized in an ICU setting or cases which result in a fatality. Tests for hospitalized patients or fatalities will be sent on to the State Public Health Laboratory for further testing and confirmation. This change in the H1N1 testing protocol will result in tremendous savings of time and resources and should result in faster reporting of results. The State Public Health Laboratory will continue to monitor for other types of influenza and when numbers of seasonal flu are increasing, further sub-typing of influenza A specimens will be reinstated at the Sonoma County Public Health Laboratory. Specimens are run on set days during the week and are never available as a STAT result. Testing results should not delay the initiation of antiviral medications when clinically indicated. Priority testing of specimens continues, as outlined below.
Current recommendations from the Sonoma County Department of Health Services limit testing to persons with influenza-like illness who:
- require hospitalization, or
- are pregnant, or
- are direct-care health care providers, or
- have died from influenza-like illness, or
- may be an index case in an institutional/outbreak setting.
Specimens from persons outside these categories will not be prioritized at the Sonoma County Public Health Laboratory.
IMPORTANT: Specimens submitted to the Sonoma County Public Health Laboratory must be received with the proper, fully completed Novel Influenza a (H1N1) Specimen Submittal requisition form (pdf) issued by the California Department of Public Health Viral and Rickettsial Disease Laboratory. The form is available from the laboratory. Submissions must include the demographic information requested at the bottom of the form, indicating if the patient is pregnant, hospitalized, in the ICU, a Healthcare worker, etc. Failure to complete submittal forms properly will delay processing of specimens and may result in specimens being rejected for testing. For more information, please contact the Public Health Laboratory at 565-4711.
For further information about (H1N1) Flu 2009 please refer to:
Sonoma County H1N1 (Swine) Flu Information
California Novel Influenza A (H1N1) Virus (Swine Flu) Information
CDC Novel H1N1 Flu (Swine Flu)
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