NEWS SCAN: Pandemic guide for nursing homes, antivirals in pregnant women, quarantine messaging, UK flu-vaccine barriers, C difficile in kids

Jan 4, 2011

Pandemic planning guide for nursing homes released
The New Jersey Hospital Association (NJHA) announced yesterday the release of a free guide to help nursing homes prepare for an influenza pandemic. The 225-page guide, Planning Today for a Pandemic Tomorrow: A Toolkit for Nursing Facilities, is a detailed assessment and planning tool with checklists, policies, sample forms, and helpful Web links, the NJHA said. The group received a grant from Roche, maker of Tamiflu, to prepare the guide. "We are very excited about the opportunity to give nursing homes the tools they need to protect their residents and staff members in the event of an influenza outbreak," said Diane Anderson, director of emergency preparedness for NJHA, in a news release. Modules in the guide address topics such as clinical considerations, operational issues, communications, legal issues, psychosocial concerns, and ethical considerations. The resource is modeled after the NJHA's pandemic flu planning document for acute-care hospitals. The group is providing free copies of the toolkit on CD to all New Jersey nursing homes and to state long-term care associations across the country.
Jan 3 NJHA press release

CDC updates guidance on use of flu antivirals in pregnant women
The Centers for Disease Control and Prevention (CDC) recently released updated guidance on the use of influenza antivirals in pregnant and postpartum women during the current flu season. The update reflects a meeting of experts held in August. Because pregnancy increases the risk of severe flu complications, the CDC recommends antiviral treatment in women during pregnancy and up to 2 weeks postpartum if they have suspected or confirmed flu, with oseltamivir (Tamiflu) as the currently preferred drug. The standard course of treatment is 5 days, but women who are hospitalized with severe illness may need a longer course. Prophylactic treatment can be considered for pregnant and postpartum women who have had close contact with flu patients, the CDC said. Data from the last flu season show that pregnant women who received antiviral treatment were less likely to need intensive care and less likely to die, and the available data suggest that oseltamivir and zanamivir (Relenza) do not cause birth defects, the guidance states.
CDC guidance on antivirals for pregnant women, updated Dec 29
CDC's general guidance on antiviral treatment for flu patients

Study finds 90% understood pandemic quarantine guidance
An Australian study released today found that 90% of those voluntarily placed under home quarantine during the 2009 H1N1 flu pandemic understood what they were supposed to do, almost 90% of parents received information from their children's school, and more than half were fully compliant with quarantine recommendations. Using Internet and telephone surveys, researchers analyzed data from 297 of 1,157 potentially eligible households—those that had a case-patient or close contact of a patient—from 33 schools in metropolitan Melbourne. The level of understanding of steps to take during home quarantine varied depending on whether the household had a case or not, 98% to 88%. More than 87% of parents received quarantine information from the school, 63% from a health department, 44% from the media, and 28% from a healthcare provider. About two thirds of respondents rated as useful or extremely useful information that came from health departments (68%), schools (66%), and healthcare providers (63%), compared with only 38% for media sources. Fifty-three percent of households said they were fully compliant with quarantine guidance, and this number increased among those who said they understood what to do (55% versus 35%).
Jan 4 BMC Infect Dis abstract

British parents face flu-vaccine roadblocks
Amid rising numbers of 2009 H1N1 infections, which health officials fear may climb higher as children return to school after the holidays, some British parents are running into roadblocks when trying to get their children immunized, the London-based Daily Mail reported today. During the pandemic the government offered free flu shots for healthy children younger than 5, but this season the National Health Service is offering them only to patients in high-risk groups. Though British policy doesn't bar parents from getting their children vaccinated at pharmacies for a fee, many pharmacies won't vaccinate children younger than 16, and some are refusing to immunize those under 18, according to the Daily Mail. Meanwhile, Irish health officials have ordered 30,000 more doses of flu vaccine to meet rising demand fueled by 2009 H1N1 activity, the Irish Times reported today. Dr Kevin Kelleher, head of health protection for Ireland's Health Service Executive, told the Times that most of the 650,000 doses of seasonal flu vaccine that were delivered in September have been administered.
Jan 4 Daily Mail story
Jan 4 Irish Times story

C difficile infections rising in hospitalized children
The number of hospital-related Clostridium difficile infections in children is rising, according to a 4-year review of an inpatient database. Researchers from the Uniformed Services University of the Health Sciences in Bethesda, Md., presented their findings yesterday in an early online report from Archives of Pediatric and Adolescent Medicine. To identify patterns of C difficile rates in children, they looked at the triennial Healthcare Cost and Utilization Project Kids' Inpatient Database for 1997, 2000, 2003, and 2006. The number of cases rose from 3,565 in 1997 to 7,779 in 2006. Researchers found that children with C difficile infections had an increased risk of death, colectomy, longer hospital stay, and higher hospitalization charges. However, unlike in adults, the group did not find a pattern of increasing disease severity in children. They concluded that C difficile infections are significantly affecting hospitalized children and that patients with underlying conditions or undergoing antibiotic treatment are at greatest risk.
Jan 3 EurkAlert press release
Jan 3 Arch Pediatr Adol Med abstract

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