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2009-H1N1 Flu - Congressional Update

Centers for Disease Control and Prevention

2009 H1N1 Influenza Update Banner

October 1, 2009

With this update, CDC Washington will resume regular congressional updates on 2009 H1N1 Influenza and related topics, initially on a weekly basis. HHS’ Assistant Secretary for Legislation will also be hosting periodic telebriefings on 2009 H1N1.

In This Update:

Current Situation Update

Between April 25 and August 30, 2009, CDC maintained nationalsurveillance for laboratory–confirmed 2009 H1N1 hospitalizations and deaths. During that time 9,079 hospitalizations and 593 deaths were reported to CDC. On August 30, 2009 two changes were implemented that affected reporting of hospitalizations and deaths to CDC. The first was that reporting was “re–set” to zero to facilitate reporting for the 2009–10 season. Thus only hospitalizations and deaths that have occurred since August 30 will be reported as the season progresses.

Second, new case definitions for influenza–associated hospitalizations and deaths were implemented to facilitate tracking in the fall. The new definitions allow states to report to CDC hospitalizations and deaths that are either laboratory confirmed or identified through surveillance systems that identify illness “syndromes.” These cases may result from all types of influenza, not just those from 2009 H1N1 flu.

From August 30 through September 19, there were 114 lab confirmed and 822 “syndromic” deaths reported, and 10,082 hospitalizations (1,690 of which are lab confirmed) in the U.S. Because of the new case definitions, however, comparison with numbers of hospitalizations and deaths reported before August 30 is not advised.

Currently, flu activity is increasing in most of the United States with more than half of all states reporting widespread influenza activity.

H1N1 FLU View map

Globally, the 2009 H1N1 influenza virus continues to be the dominant influenza virus in circulation. As of September 20, 2009, the World Health Organization (WHO) regions have reported at least 318,925 laboratory–confirmed cases of 2009 H1N1 with more than 3,917 deaths, which is an increase of at least 22,454 cases and more than 431 deaths since September 13th. The laboratory–confirmed cases represent a substantial underestimation of total cases in the world, as many countries focus surveillance and laboratory testing only on people with severe illness.

More information regarding 2009 H1N1 Influenza activity can be viewed here.

More information about CDC′s 2009 H1N1 influenza surveillance system is available here.

Key Influenza Prevention Messages

All individuals should take these everyday steps to protect themselves from flu:

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol–based hand cleaners are also effective.
  • Avoid touching your eyes, nose or mouth.
  • Try to avoid close contact with sick people.
  • If you are sick with flu–like illness, stay home for at least 24 hours after your fever is gone (without the use of a fever–reducing medicine) except to get medical care or for other necessities. Keep away from others as much as possible to keep from making others sick.

Other important actions include:

  • Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
  • Be prepared in case you get sick and need to stay home. A supply of over–the–counter medicines, alcohol–based hand rubs, tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious.

Vaccination Information

Vaccine Production and Distribution

  • The U.S. has purchased vaccine in sufficient quantity to cover every American that wants to be vaccinated, from five U.S. licensed vaccine manufacturers.
  • Vaccine will begin to be shipped beginning the first week in October and continuing each week into December. 
  • Currently, it is projected that that 45 to 52 million doses are expected to be available by mid October and approximately 20 million doses are expected to be available in each of the following weeks.
  • The number of doses available to each state will be determined by the state′s population.
  • 2009 H1N1 Influenza vaccine distribution will be a state health department managed process similar to the process for the Vaccines for Children (VFC) Program, with state–directed distribution to up to 90,000 public and private health care providers.
  • It is not expected that there will be a shortage of novel H1N1 vaccine, but availability and demand can be unpredictable, and there is some possibility that initially the vaccine will be available in limited quantities. Initial vaccination programs will be targeted to priority groups (see table below).

See questions and answers about 2009 H1N1 Influenza vaccine distribution here.

Vaccine Recommendations

  • It is anticipated that seasonal flu and 2009 H1N1 vaccines may be administered on the same day, however, the seasonal vaccine is already available and individuals are encouraged to get their seasonal flu vaccine as soon as possible.
  • Vaccine will be available in a combination of settings such as vaccination clinics organized by local health departments, healthcare provider offices, schools, and other private settings, such as pharmacies and workplaces.
2009-2010 Influenza Recommendations

Vaccine Safety

  • We expect the 2009 H1N1 influenza vaccine to have a similar safety profile as seasonal flu vaccines, which have a very good safety track record.
  • The CDC and FDA closely monitor the safety of seasonal influenza and other vaccines licensed for use in the United States in cooperation with state and local health departments, healthcare providers, and other partners.
  • Clinical trials on 2009 H1N1 influenza vaccine began in July and are ongoing. Early information from trials indicates the vaccines are safe, and that one dose of vaccine provides protection to most healthy adults and children 10-17 years old. It is likely that children younger than 10 years will need two doses of 2009 H1N1 flu vaccine. The trials are also seeking information on pregnant women and on immune-compromised individuals.
  • CDC and its partners will use several systems to monitor the safety of 2009 H1N1 monovalent influenza vaccine. Two primary systems that will be used are the Vaccine Adverse Event Reporting System (VAERS), which is jointly operated with FDA, and the Vaccine Safety Datalink (VSD) Project.  
  • Read more about the clinical trials here and 2009 H1N1 Influenza vaccine safety here.

Vaccine Financing and Reimbursement

  • Novel H1N1 vaccine will be procured and purchased by the federal government and made available for vaccinators at no cost.
  • Vaccination providers can not charge or bill for the 2009 H1N1 vaccine, though some may charge for administration of the vaccine.
  • Vaccine will be administered free of charge in public clinics and settings, and patients will not be charged for administration of 2009 H1N1 vaccine in such settings.  Most private health insurers are expected to reimburse providers for the cost of administration.

Antivirals and 2009 H1N1 Influenza

Antiviral drugs are prescription medicines that fight against the flu by keeping flu viruses from reproducing in your body. On September 22, 2009 CDC updated its recommendations for the use of influenza antiviral medicines to provide additional guidance for clinicians in prescribing antiviral medicines for treatment and prevention (chemoprophylaxis) of influenza during the 2009-2010 flu season. The priority for use of antiviral medications this season continues to be in people with more severe illness, such as people hospitalized with influenza, and people at increased risk of influenza-related complications, as outlined in earlier antiviral recommendations.

Treatment with influenza antiviral drugs is generally not needed for people who are not at higher risk for complications or do not have severe influenza, such as those requiring hospitalization.

See more information on antiviral drugs and 2009 H1N1 Influenza here.

CDC Guidance on Prevention and Control

CDC has issued (or updated) guidance to help individuals, schools, businesses, and others take steps to avoid the flu and deal with its consequences.  All guidance can be accessed at
http://www.cdc.gov/h1n1flu/guidance/. Below, we have provided direct links to key guidance that may be of interest.

Guidance for Schools
http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm.

Guidance for Institutions of Higher Education
http://www.cdc.gov/h1n1flu/institutions/guidance/

Guidance for Childcare Facilities
http://www.cdc.gov/h1n1flu/childcare/guidance.htm.

Guidance for Business, Employers and Workplaces
http://www.cdc.gov/h1n1flu/business/guidance/.

Vaccination Guidance for State, Local, Tribal and Territorial Health Officials
http://www.cdc.gov/h1n1flu/vaccination/statelocal/.
Accompanying checklist for planning:
http://www.cdc.gov/H1N1flu/vaccination/statelocal/planning_checklist.htm.

Clinician Guidance Regarding Diagnostic Tests
http://www.cdc.gov/h1n1flu/guidance/rapid_testing.htm.

Guidance for Individuals Handling 2009 H1N1 Clinical Specimens or Isolates
http://www.cdc.gov/h1n1flu/guidelines_labworkers.htm.

Guidance for Patients and Caretakers
http://www.cdc.gov/h1n1flu/guidance_homecare_directions.htm and:

http://www.cdc.gov/h1n1flu/guidance_homecare.htm.

Implementation Guidance for Managing Calls and Call Centers during a Large-Scale Influenza Outbreak
http://www.cdc.gov/h1n1flu/callcenters.htm.

Guidance for Community Settings
http://www.cdc.gov/h1n1flu/guidance/exclusion.htm and: http://www.cdc.gov/h1n1flu/masks.htm.

Guidance for Travel and Travel Industry
http://www.cdc.gov/h1n1flu/guidance/cruiseships.htm and: http://www.cdc.gov/h1n1flu/guidance/air-crew-dom-intl.htm.

Guidance for Parents of Patients/Patients with Asthma
http://www.cdc.gov/h1n1flu/asthma.htm.

Interim Guidance for State and Local Health Departments for Reporting Influenza-Associated Hospitalizations and Deaths for the 2009-2010 Season
http://www.cdc.gov/H1N1flu/hospitalreporting.htm

Communication Tools for Members and Constituents

CDC recognizes that H1N1 flu is of significant interest and concern to your constituents.  With this in mind, we offer cutting edge CDC communication tools you can use to effectively communicate information about 2009 H1N1 flu during the upcoming flu season:

  • Short (less than 140 characters) messages that you or your member can post to their Twitter account provide effective messages and shortened links to further information on H1N1
  • CDC and Flu.gov Twitter feeds (@CDCemergency, @CDCFlu, @CDC_ehealth, and @FluGov) that provide regularly updated information (and can be “re-tweeted” by members that use Twitter to disseminate information to constituents)
  • Buttons (in both English and Spanish), widgets, e-cards, and other tools that can be used on websites or in email newsletters
  • CDC′s image library, containing H1N1 flu-related images that can be used in your web materials and newsletters
  • CDC′s dedicated Youtube channel and other videos containing H1N1 and other health information
  • Podcasts of H1N1 and other health information, featuring CDC experts

All of these resources can be found at http://www.cdc.gov/SocialMedia/Campaigns/H1N1/. If you need technical assistance in using these tools, please contact Justin Cormier (jcormier@cdc.gov) or Andi Lipstein (alipstein@cdc.gov) in the CDC Washington Office.

We also have produced a variety of materials that can be printed at a local (or commercial) printer and distributed.  We do not stock these documents, but they can be useful handouts at district events.  Updated 2009-10 Flu Season Print Materials

Please let us know what other tools and information would be of interest to you and your staff as you communicate with your constituents and the public this fall, and we will be glad to work with you to meet your needs.

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  • Historical Document: October 1, 2009
  • Content source: CDC Washington
    Content Management: Office of Enterprise Communication
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