FLU NEWS SCAN: Pandemic planning, hospital flu markers, health worker flu vaccination, H5N1 test

Jun 13, 2011

Survey: Home health agencies lacking somewhat in pandemic preparedness
Almost a third of US home health agencies reported having trouble obtaining supplies during the 2009 H1N1 flu pandemic, according to a survey administered last spring, well after the peak of the outbreak. Among 526 respondents (25% response rate), 30.4% reported trouble obtaining supplies and 33.5% reported having no surge capacity, with smaller agencies (200 or fewer employees) more likely to experience those situations. Regarding preparedness, 87.3% reported having a pandemic flu plan, while 72.3% reported having updated it in the previous year. (The survey did not ask who had plans in place prior to the 2009 pandemic.) About 80% reported stockpiling personal protective equipment, and 71.3% reported fit-testing staff for respirators. Only 49.2%, however, had conducted disaster drills, and only 11.2% said their employers had stockpiled oseltamivir (Tamiflu) for employees. The authors recommend these steps: developing more surge capacity, better coordinating home health agency plans with regional plans to gain access to resources, and increasing drills and exercises.
Jun 13 Am J Infect Control abstract

Hospital labs and pharmacies provide early flu warning
Monitoring patterns in hospital labs and pharmacies is a useful and timely way to gauge local flu activity, according to an observational study. Researchers from the Detroit Medical Center, which has eight hospitals in three counties, used such a system during the 2009 H1N1 flu pandemic. The system analyzed the results of rapid flu tests and osteltamivir (Tamiflu) prescriptions. They compared the trends with surveillance data from the Michigan Department of Community Health and found that flu-like illness tracked closely with the percentage of positive lab tests and oseltamivir prescriptions. A novel system using the data can notify health systems about an uptick in flu activity about a week earlier than conventional surveillance systems, allowing hospitals to take earlier infection-control precautions, the group wrote.
July Infect Control Hosp Epidemiol abstract

Modified flu vaccination policy showed good results in health workers
A healthcare worker flu vaccination policy that stopped short of mandatory immunization but put in place a facemask requirement for unvaccinated employees boosted uptake during the 2009-10 pandemic flu season and kept rates up the following season. Researchers from Geisinger Medical System, which includes more than 12,000 healthcare employees in Pennsylvania, said the policy required unvaccinated workers to wear a mask when within 6 feet of a patient between Nov 1 and Mar 31. It also took several approaches to making it easier for workers to be vaccinated, such as giving departmental "flu team captains" kits for delivering flu vaccine whenever employees had time to be vaccinated. During the 2009-10 season, employees were required to receive both the pandemic and seasonal flu vaccines. In 2007 and 2008 immunization rates were 47% and 61%, respectively, but coverage rose to 95% during 2009-10. For the past flu season, the system maintained a comperable coverage rate, which as of December 2010 was 92%. The researchers said the policy achieved good compliance in a short time and may do more to create team spirit and a culture of safety than mandated vaccination.
July Infect Control Hosp Epidemiol abstract

Researchers develop simple test for detecting H5N1
Researchers have reported developing a low-cost test to detect H5N1 avian flu in humans and animals based on a region of the virus that varies little among different strains, according to a new study. The Singaporean researchers, who previously identified an epitope that is conserved 100% in human H5N1 isolates and 97% in avian isolates, designed a peptide enzyme-linked immunosorbent assay (ELISA) around that epitope. They evaluated the sensitivity and specificity of the assay using chicken antisera to H5N1 viruses from divergent clades and other flu viruses, as well as human sera from patients infected with H5N1 or seasonal flu. The peptide ELISA detected antibodies to H5N1 more accurately than hemagglutinin inhibition, immunofluorescence assay, and immunodot blot tests. In addition, antibodies to other influenza subtypes accurately tested negative with the new assay. The authors say the test is "robust, simple, and cost effective and is particularly beneficial for developing countries and rural areas."
Jun 10 PLoS ONE study

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