Agenda - 06-16-2009 - Info Item 2

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Orange County Health Department Report on H1 N1 Response April 23 -May 30, 2009 Orange County has had 7 cases of novel H1N1 influenza as of June 9, 2009. The first case was laboratory confirmed on May 22. One formal isolation order was issued on April 29 for a suspected case that later tested negative. Generally, individuals who get this virus experience relatively mild disease, however, unlike seasonal flu, there was no vaccine that could be protective for people with underlying health conditions. The pattern of the disease emerged after several incubation periods passed, providing a greater predictability to guide the response. This virus is now considered to be in general circulation and will remain so throughout the summer. Testing is no longer being authorized except for suspected cases in certain settings (health care) or among hospitalized individuals. This virus spreads in the same way as the seasonal flu, through contact with respiratory droplets or by contact with surfaces that have been touched by an infected person with virus on their hands. First Notification The Orange County Health Department (OCHD) received alerts from the NC Health Alert Network and the Centers for Disease Control Health Alert Network during the evening of April 23, 2009, detailing the first case report of a novel influenza virus in Texas. OCHD activated the Epidemiology Response Team (Epi Team) the next morning to monitor the national situation and began communicating with community partners and county staff. The core Epi Team consists of the communicable disease program coordinator, the community services supervisor, the OCHD public information officer, the environmental health director, the personal health services director, the preparedness coordinator, and the health director. It expands by adding other staff with specific skill sets, depending on the outbreak or investigation in progress. A typical outbreak response begins with determining the factors surrounding the infected persons that will prevent further spread of the disease. The novel H1 N1 influenza outbreak differs because Orange County had no laboratory confirmed cases until May 22, 2009, nearly a month after the original notification. Activities for the period April 23 through May 22 included surveillance and communicating with partner agencies and, the public. This response involved county and community agencies beyond the health department's response. Emergency Services, the Sheriffs Office and Information Technology were key supporting county agencies.. Both school districts, UNC Hospital, and UNC Campus Health were all an important part of the overall community surveillance and response. Community medical providers saw patients and consulted with health department staff to determine whether a patient met the case definition for testing.