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2009-H1N1 Flu - Congressional Update

Centers for Disease Control and Prevention

May 12, Novel Influenza A (H1N1) - Congressional Update

We are providing this document to help inform Congress and congressional staff about the current status of the novel Influenza A (H1N1) events. Any questions should be directed to CDC/Washington at 202-245-0600.

Note: Green text indicates new information. Black text indicates background and other information also included in previous updates.

U.S. Update

As of May 12, 2009 11:00 AM ET, a total of 3009 confirmed human cases of novel Influenza A (H1N1) have been identified in the United States in 44 states and the District of Columbia. One hundred and sixteen cases have been hospitalized. The median age is 15 and range from 1 to 87 years. Six percent hospitalized. There are approximately 643 additional probable cases currently being analyzed. There have been three deaths from novel Influenza A (H1N1), 2 in Texas and 1 in Washington. The total number of cases reported likely represents an underestimation of the actual total number of cases because in order for a case to be confirmed and reported infected individuals must visit a healthcare provider with flu-like symptoms and be tested for novel Influenza A (H1N1).

A summary of the cases is provided below. All questions related to specific cases should be directed to the state health department in the state in which the case occurred. A full list of state health departments and their contact information is available at http://www.astho.org/Programs/Infectious-Disease/H1N1/ under State H1N1 Information.

U.S. Human Cases of Novel Influenza A (H1N1) Infection
(As of May 12, 2009 11:00 AM ET)
State
# of laboratory confirmed cases
# deaths reported among laboratory confirmed cases
Alabama
9
-
Arizona
187
-
California
193
-
Colorado
44
-
Connecticut
28
-
Delaware
45
-
Florida
55
-
Georgia
4
-
Hawaii
6
-
Idaho
2
-
Illinois
554
-
Indiana
61
-
Iowa
55
-
Kansas
22
-
Kentucky**
10
-
Louisiana
20
-
Maine
6
-
Maryland
23
-
Massachusetts
107
-
Michigan
133
-
Minnesota
24
-
Missouri
14
-
Nebraska
19
-
Nevada
12
-
New Hampshire
16
-
New Jersey
7
-
New Mexico
30
-
New York
192
-
North Carolina
11
-
Ohio
7
-
Oklahoma
14
-
Oregon
74
-
Pennsylvania
17
-
Rhode Island
7
-
South Carolina
32
-
South Dakota
3
-
Tennessee
54
-
Texas
206
2
Utah
67
-
Vermont
1
-
Virginia
17
-
Washington
176
1
Washington D.C.
7
-
Wisconsin
437
-
Total Count
3009 cases
3 deaths
Source: CDC (http://www.cdc.gov/h1n1flu/update.htm#statetable)
** Case is a resident of Kentucky but currently hospitalized in Georgia.

NOTE: Because of daily reporting deadlines, the state totals reported by CDC may not always be consistent with those reported by state health departments. If there is a discrepancy between these two counts, data from the state health departments should be used as the most accurate number.

International Update

The World Health Organization (WHO) is providing information on international Novel 2009 H1N1 flu outbreaks at: http://www.who.int/csr/disease/swineflu/en/index.html.

On April 29, 2009 WHO raised the level of influenza pandemic alert from phase 4 to phase 5. Information on WHO′s pandemic influenza phases is available at: http://www.who.int/csr/disease/avian_influenza/phase/en/index.html.

As of May 12, 2009 4:00 PM GMT, the Government of Mexico has reported 2059 laboratory confirmed cases, including 56deaths, of novel Influenza A (H1N1). The higher number of cases in Mexico reflects ongoing testing of previously collected specimens.


International Human Cases of Novel Influenza A (H1N1) Infection
(As of May 11, 2009 4:00 PM GMT)
Country
# of laboratory confirmed cases reported by country with cases
# of deaths reported among laboratory confirmed cases
Argentina
1
-
Australia
1
-
Austria
1
-
Brazil
8
-
Canada
330
1
China, Hong Kong, Special Administrative Region
2
-
Columbia
3
-
Costa Rica
8
1
Denmark
1
-
El Salvador
4
-
France
13
-
Germany
12
-
Guatemala
1
-
Ireland
1
-
Israel
7
-
Italy
9
-
Japan
4
-
Mexico
2059
56
Netherlands
3
-
New Zealand
7
-
Norway
2
-
Panama
16
-
Poland
1
-
Portugal
1
-
Republic of Korea
3
-
Spain
95
-
Sweden
2
-
Switzerland
1
-
United Kingdom
55
-
Total Count
2651 cases
58 deaths
Source: World Health Organization http://www.who.int/csr/don/2009_05_08a/en/index.html

Background Information About Novel Influenza A (H1N1)

What is CDC′s recommendation regarding “swine flu parties?”
“Swine flu parties” are gatherings during which people have close contact with a person who has novel Influenza A (H1N1) in order to become infected with the virus. The intent of these parties is to become infected with what for many people has been a mild disease, in the hope of having natural immunity to the novel Influenza A (H1N1) virus that might circulate later and cause more severe disease.

“Swine flu parties” are not a safe or effective way to protect against novel Influenza A (H1N1) in the future. While the disease seen in the current novel Influenza A (H1N1) outbreak has been mild for many people, it has been severe and even fatal for others. There is no way to predict with certainty what the outcome will be for an individual or, equally important, for others to whom the intentionally infected person may spread the virus.

CDC recommends that people with novel Influenza A (H1N1) avoid contact with others as much as possible. They should stay home from work or school for 7 days after the onset of illness or until at least 24 hours after symptoms have resolved, whichever is longer.

New Materials to Assist Tribal Nations
CDC released a brochure, Preparing Tribal Nations to Receive Strategic National Stockpile Assets targeting American Indian and Alaska Native government leaders. The brochure is available at: http://www.cdc.gov/h1n1flu/pdf/preparing_tribal_national_stockpile.pdf.

Resources for Businesses and Employers
CDC has developed a Web site with resources for businesses and employers. The Web site includes guidance documents, podcasts and other resources developed by CDC to help prevent the further spread of this new virus available at: http://www.cdc.gov/h1n1flu/business/.

Guidance Documents

CDC has and continues to develop a number of guidance documents related to Novel 2009 H1N1 flu. The documents target a variety of clinical, professional, and individual audiences. The guidance documents are regularly updated as CDC continues to learn more about Novel 2009 H1N1 flu. All current guidance documents are available at: Novel 2009 H1N1 Flu Guidance. Guidance documents include:

These recommendations are based on current information and are subject to change based on ongoing surveillance and risk assessment. This document provides interim guidance for state, local, territorial, and tribal officials to use in developing recommendations for large public gatherings in their communities. As used in this document, a large public gathering refers to an assembly or grouping of many people in one place. Such gatherings can include college and university commencement exercises, church services, sporting events, concerts, social and cultural celebrations, weddings, conferences, and other similar activities attended by relatively large groups of people. This interim guidance does not attempt to define such events in terms of numbers of people in attendance; rather, the focus is on community situations in which crowding is likely to occur. Further, these recommendations do not distinguish between public gatherings held indoors and those held outdoors, because differences in novel influenza A (H1N1) virus transmission patterns in these two settings are not known.

Identification and Confirmation of Infections

What is CDC′s role in evaluating possible novel Influenza A (H1N1) infections?

CDC is collaborating with clinicians and state and local health departments to identify and confirm novel Influenza A (H1N1) virus infections. CDC has also provided guidance for clinicians with patients presenting with possible novel Influenza A (H1N1) infection. Clinicians are asked to obtain a respiratory swab for novel Influenza A (H1N1) testing. Once collected, the clinician should contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory. CDC has distributed diagnostic test kits to states to enable state laboratories to confirm cases directly. A growing number of states are able to confirm cases in their states. CDC is working with additional states to ensure testing kits are functioning properly before they begin confirming cases independently and reporting information back to CDC, as is generally done for seasonal flu. Once states begin employing independent confirmation testing, the number of samples being tested will increase and may result in a rapid increase in case count. Some of this will likely be due to more widespread infection, but some of it may result from an increase in testing capacity and laboratory results.

Major investments in state laboratory capacity over the last five years have enhanced capabilities such that the confirmation testing can be conducted at the state level with distribution of testing kits.

CDC is also assisting with the confirmation of cases of novel Influenza A (H1N1) worldwide through the distribution of testing kits. Requests for testing kits have been received from 131 countries and kits have been provided to 78 countries thus far. CDC continues to work to provide kits to additional countries to increase their capacity to conduct laboratory confirmation of novel Influenza A (H1N1) cases.

HHS and CDC Roles

CDC is actively responding to and investigating the current outbreak of novel Influenza A (H1N1). CDC has fully activated its Emergency Operations Center. In addition to response and laboratory activities described above, 116 staff have been deployed and 34 pending deployment in the U.S., Mexico, and Guatemala to assist with the public health investigation. Staff are currently in California, Delaware, Illinois, New York City, Texas, Washington DC, and at U.S. quarantine stations. On April 21st CDC described the first two cases in a Morbidity and Mortality Weekly Report (MMWR), Swine Influenza A (H1N1) Infection in Two Children --- Southern California, March--April 2009 (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0421a1.htm). An MMWR describing additional cases was published on April 24th and is available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0424a1.htm?s_cid=mm58d0424a1_e. An MMWR Dispatch describing the effects of seasonal influenza epidemics and previous pandemics, pregnant women have been at increased risk for complications related to influenza infection and cases concerning the Novel Influenza A (H1N1). Novel Influenza A (H1N1) Virus Infections in Three Pregnant Women --- United States, April--May 2009 is available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0512a1.htm?s_cid=mm58d0512a1_e

An example of CDC′s response is the use of new communications modes to inform the public. Through its National Center for Health Marketing, CDC is using social media (www.cdc.gov/socialmedia) to provide H1N1 flu-related information when, where and how Americans want it. Ongoing social media activities include: posting information to CDC Facebook, MySpace, and DailyStrength social networking profiles; posting videos and podcasts to the CDC YouTube Channel; reaching out to blog writers to ensure credible information is being shared in blogs; sending email updates to users who have subscribed to receive information about the flu; developing widgets so that CDC flu information can be posted on other Web sites and blogs; and providing updated information to mobile phones. Congressional offices can point constituents to these interactive tools to get information, including:

For more information regarding CDC′s novel Influenza A (H1N1) activities, go to: http://www.cdc.gov/h1n1flu/.

Pandemic Planning Investments at Work

In recent years, CDC has received congressional appropriations pandemic influenza activities.


CDC′s Pandemic Influenza Appropriations
Fiscal Year
Amount
2007
$70,000,000
2008
$154,632,000
2009
$156,046,000
Total Appropriations
$380,678,000

These recent investments have enhanced many areas critical to pandemic influenza preparedness and response, including health monitoring, epidemiology, laboratory capabilities, response, and recovery. The appropriated resources have allowed CDC to work with states and territories to test national infrastructure and develop operational plans, strengthen crisis communication plans and tools, expand the Strategic National Stockpile, improve surveillance systems, and work with international partners to prepare for a pandemic. All of these activities have increased both CDC′s and our partners′ capacity and capabilities for dealing with the current Novel 2009 H1N1 flu outbreak.

For more information about CDC′s pandemic influenza activities and appropriations, please contact CDC/Washington, at (202) 245-0600.

Where to Find Updates

CDC is committed to ensuring Congress, public health partners, the media, and the public are able to obtain up-to-date and accurate information regarding the human Novel 2009 H1N1 flu cases and CDC′s related activities. CDC is providing daily updates on our Web site. Information is available at: http://www.cdc.gov/h1n1flu/index.htm.

In addition, the World Health Organization (WHO) has additional information on the global situation at: http://www.who.int/csr/disease/swineflu/en/index.html. Many state health departments are adding or updating information on Novel 2009 H1N1 flu on their Web sites. A full list of state health departments and their contact information is available at http://www.astho.org/Programs/Infectious-Disease/H1N1/ under State H1N1 Information.

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