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 H1N1 Update from St. Paul from Representative Falk

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PostSubject: H1N1 Update from St. Paul from Representative Falk   Mon Nov 23, 2009 11:55 pm

Itís been a rough fall in Minnesota, with thousands of people contracting H1N1, and sadly, over 20 Minnesotans have died from complications related to H1N1. Although recent reports indicate the number of new cases is decreasing, I would like to take this opportunity to provide an update on Minnesotaís response to the H1N1 outbreak.

Vaccine Supplies

Minnesota has allocated 700,000 doses of H1N1 vaccine, including 515,000 injectable doses to hospitals and clinics. The stateís goal is to vaccinate the estimated 718,000 pregnant women, children and teens and adults with chronic diseases who are at highest risk of H1N1 complications. Still, 2.7 million Minnesotans are in at least one of the priority groups to receive the vaccine.

The state has also received 185,000 nasal spray doses, which are not recommended for pregnant women and others in the high-risk groups.

Reason for Delay in Receiving Vaccine Supplies

Supplies of the vaccine have been delayed due to the challenges of growing the virus in chicken eggs. Vaccine manufacturers say they have had trouble getting a good virus yield.

Vaccine Distribution to Clinics

Minnesota health authorities are first targeting the most vulnerable individuals to receive the vaccine. High risk individuals include:

Pregnant women;

People who live with or care for children younger than 6 months of age;

Health care and emergency medical services personnel;

People between the ages of 6 months and 24 years old;

People 25 through 64 years of age who are at high risk for H1N1 because of chronic health disorders or compromised immune systems.

This approach is different from several other states which are shipping H1N1 to private businesses or are holding flu shot clinics. In some states, citizens have lined up for blocks waiting in line in public hoping to get the shot.

MDH says it prefers the priority-setting approach because medical personnel can identify those most vulnerable to get the shots first, citizens do not expose themselves to the virus by standing in line at public flu clinics (avoiding crowds is a good prevention measure) and it avoids rushes on medical facilities by not announcing where the vaccine is available.

MDH Testing

Health officials arenít testing everyone with H1N1 symptoms. MDH indicates it is time-consuming and expensive to test everyone. In addition, most flu viruses now circulating are H1N1.

MDH FluLine

MDH has set up a phone-based FluLine for people with symptoms. In the first 21 hours of operation, the service received more than 2,100 calls from people wanting to speak with a nurse. There were many more people who couldnít get through.

The hot line opens with a recorded message giving basic flu information. The service then triages people needing health advice and, in some cases, may prescribe medicine over the phone. The phone network has 50 lines staffed by nurses and operates around the clock.

People who call the line are asked several questions about their health and are either transferred to their insurance provider's network or given recommendations for treating themselves. For high-risk individuals or those with severe symptoms, nurses can write prescriptions for antiviral medications and fax them to a pharmacist. Nurses can prescribe the drugs under a standing order from a doctor, an arrangement that's legal in response to a pandemic.

The tollĖfree number for the Minnesota FluLine is 1Ė866Ė259Ė4655.

Vaccine Ingredients

Concerns have been raised about the presence ofadjuvants and Thimerosol in H1N1 vaccines.

MDH reports there are no adjuvants in any of the flu vaccines. Some vaccines do have Thimerosol, but not FluMist or some single-dose vials. It is possible to ask for Thimerosol-free vaccine.

The CDC says the H1N1 vaccine is as safe as the seasonal flu vaccine because it is manufactured in exactly the same way. They only changed the virus strain, which is something they do every year when they make a new seasonal flu vaccine.

Immune Response Time

A good immune response develops within about 10 days of receiving the vaccination. However, children under 10 donít develop a strong immunity with just one dose. They need a second vaccination within a month after the first one.

Why Arenít Facilities Being Shut Down?

Public health officials say they canít contain the virus at this point. It is too widespread. They also worry that shutting down certain public facilities would have a very negative effect on the economy.

Impact of National Emergency Declaration

President Obama declared a national emergency because of H1N1. The declaration gives hospitals flexibility to set up off-site clinics to treat H1N1 patients if they canít handle the volume of patients showing up in the emergency room. Federal rules normally prevent hospitals from setting up an auxiliary clinic if itís more than a couple hundred feet from the hospital, but the declaration means clinics can be placed at other locations.

Hospitals in southern states have set up tents to treat patients with flu symptoms, but cold weather prevents states like Minnesota from setting up tents at this time of year. With permission from the Secretary of Human Services, a hospital in Minnesota can now set up a flu clinic in a building farther away from the hospital if needed.

H1N1-Related Deaths in Minnesota

As of November 13, the Department of Health had confirmed 21 deaths related to the H1N1 strain and two additional flu-related deaths. Most victims had underlying conditions that contributed to their deaths. Those conditions ranged from asthma to obesity to weakened immune systems.

H1N1-Related Closings

School closings Ė As of mid-October, nearly all schools have remained open. There were 230 schools reporting excess absences to the Health Department.

Businesses -- Businesses arenít required to report this data, but anecdotal information indicates that some businesses are experiencing a lot of absences.

Long-term care facilities Ė As of mid-October, long-term care facilities have reported no flu outbreaks. This data fits with reports that older people might have some natural immunity to the N1N1 virus possibly because they may have been exposed to an earlier version of the virus when they were younger.
Clinics have difficulty managing second doses for children

The CDC has told clinics they cannot hold vaccine supplies in reserve. If a clinic has 500 doses, it cannot give those doses to 250 children and save the remaining 250 doses for booster shots a month later.
MDH officials say children will get their vaccines. It will simply be a matter of whether they get the vaccine four weeks or six weeks after the first one.

All Minnesota counties now organizing vaccination clinics

As of Nov. 12, all 87 Minnesota counties have at least some H1N1 vaccine doses and will be organizing vaccination clinics in the coming days. The first clinics will be at daycare facilities and then elementary schools.

The nasal spray contains a live but weakened form of H1N1 influenza and is not recommended for children 2 and younger or for anyone with a chronic condition. It also isn't recommended for children who have received the nasal spray for seasonal influenza in the prior four weeks. Receiving both nasal vaccines within that timeframe makes them less effective.

Counties have received some of each type, but some are saving the injectable vaccine for the youngest children and making it available by appointment.
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