H1N1 Influenza (Swine Flu)Provider Frequently Asked Questions (FAQ)

Last Updated April 29, 2009

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Communication:

What is the telephone number for health care provider disease reporting and information?

The Health care provider line number is 1-800-821-5821.

How can I be placed on the Health Alert Network (HAN)?

Go to the Maine CDC home page at http://www.maine.gov/dhhs/boh/index.shtml and see Health Alert Network for RSS feed. You can then receive the information via email or thru the RSS feed. You can see them on the website earlier than you would receive them by email.

How does one access the most recent information from the State CDC?

The State has a format for a daily report that is posted on our H1N1 Influenza website:  http://www.maine.gov/dhhs/boh/swine-flu-2009.shtml. As messages and information are expected to change frequently, it is important to check the website for updates.

Clinical Information:

Is there any benefit for people who did not get a flu vaccine this year to get one now?

There is no vaccine to protect humans from H1N1 influenza. The seasonal influenza vaccine will only provide protection against strains of influenza still circulating in the state.

Is there any idea of how long this outbreak of H1N1 influenza will be in effect?

Currently, there is no information or data on how long the outbreak will last.

How long does the illness tend to last?

Because this is a new strain of influenza, there is no information or data on how long a person is ill.

After exposure to current US strain will people have immunity to secondary outbreaks of H1N1 strains? Is it better to get virus now than later?

Infection with influenza viruses tends to provide short term immunity, but it is better to avoid infection in the first place.

Testing:

What is the recommended testing kit?

It is recommended that you use a respiratory swab for viral testing using a dacron tipped swab with an aluminum or plastic shaft and inoculate into viral transport medium, label with patient information and refrigerate. Send to the Maine Health and Environmental Testing Laboratory (HETL) for testing. DO NOT send to a referral laboratory instead of the HETL. Check with your lab if you are unsure of the appropriate swab for viral testing. You can call the public health lab for supplies and they will ship them out. Instructions for collecting and submitting laboratory diagnostic specimens for H1N1 influenza testing are available at http://www.maine.gov/dhhs/etl/micro/submitting_samples.htm.

Are the recommended sources only nasopharyngeal or nasal washes?

Nasopharyngeal swabs are the preferred specimens for influenza testing for H1N1 influenza. By preference, recommended sources include: 1) Nasopharyngeal swab, 2) Throat swab, 3) Nasal wash. (HETL Swine Flu Laboratory Submission Information Sheet)

Should the swabs be refrigerated?

Store specimens at 2-8°C until ready for shipping. Specimens should be submitted to lab as soon as possible. For faster turn around time to obtain results, consider hand delivery to HETL. Use wet ice or cold packs to maintain 2-8°C during delivery. Freezing specimens for direct detection (PCR) is not optimal. For shipping purposes, clinical specimens are category B. (HETL Swine Flu Laboratory Submission Information Sheet)

The Health Environmental Testing Lab (HETL) has told us they will supply us with 20 PCR collection media for influenza testing. Do you have guidelines about who and when to test, and how to prioritize?

Maine CDC requests that providers report and test patients with acute febrile respiratory illness who traveled to an affected area 7 days prior to their illness or who have been in contact with confirmed cases of H1N1 influenza. ; Health care providers may choose to perform a rapid antigen test in-house; however, a separate specimen is recommended for testing at the State Health and Environmental Testing Laboratory (HETL) (Maine HAN 4/27/09)

Do you know when additional collection media will be released or available?

If you need additional supplies, please contact the Maine CDC.

Do you have details about updated arrangements for courier services to transport flu tests to HETL?

As much as possible existing courier services services should be used. Emergency courier services can be arranged by contacting the Maine CDC.

Can clinics send dry swabs to the lab to be placed in VTM when they arrive?

This is not recommended. When possible, swabs should be placed directly in VTM.

Is there discussion about using other labs or a mobile lab?

No. The only place for influenza subtyping is Maine Health and Environmental Testing Laboratory (HETL).

Personal Protection Equipment (PPE):

Are facial masks “the way to go” for H1N1 influenza?

Until additional specific information is available regarding the behavior of H1N1 influenza (H1N1), the guidance in the October 2006 “Interim Guidance for the use of Surgical Masks and Respirators in Healthcare Settings during an Influenza Pandemic” http://www.flu.gov/planning-preparedness/community/commaskguidance.pdf (PDF*) should be used. These interim recommendations will be updated as additional information becomes available.

Interim Recommendations:

  • Personnel engaged in aerosol generating activities for suspected or confirmed H1N1 influenza cases should wear a fit-tested disposable N95 respirator.*
  • Pending clarification of transmission patterns for this virus, personnel providing direct patient care for suspected or confirmed swine H1N1 influenza cases should wear a fit-tested disposable N95 respirator when entering the patient room.

* Respirator use should be in the context of a complete respiratory protection program in accordance with Occupational Safety and Health Administration (OSHA) regulations. Information on respiratory protection programs and fit test procedures can be assessed at www.osha.gov/SLTC/etools/respiratory. Staff should be medically cleared, fit-tested, and trained for respirator use, including: proper fit-testing and use of respirators, safe removal and disposal, and medical contraindications to respirator use.

Is it recommended to ramp up on N95 respirators? If so, is there a calculation or volume? What will be released to us from the resource centers?

The number of N95 respirators that Maine will receive from the federal stockpile is currently unknown.

Treatment:

What are the objective facts to support or refute the use of anti-influenza treatment?

At this time, CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with H1N1 influenza viruses. For more detailed information on treatment, please see the recent MMWR report released on April 28, 2009 at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0428a1.htm?s_cid=mm58d0428a1_e

Information for this document comes from:
Center for Disease Control (CDC) websites on H1N1 influenza
http://www.cdc.gov/swineflu/

Maine Center for Disease Control and Prevention
http://www.maine.gov/dhhs/boh/swine-flu-2009.shtml