Novel H1N1 Influenza Virus

1
Novel H1N1 Influenza Virus

• City of HoustonPrepares

Stephen L. Williams, M.Ed., M.P.A. Director,
Houston Department of Health and Human Services
September 2009
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History of nH1N1 Outbreak

• April 17 CDC confirms first novel H1N1 virus
  case in California
• April 23 DSHS confirms novel H1N1 virus in 2
  teenagers in same school in Guadalupe County
• April 24 Confirmation of Influenza Like Illness
  in Mexico , DSHS activates Emergency Operations
  Center
• April 25 HDHHS activates Department Emergency
  Operations Center and implements COH Pandemic
  Influenza Plan
• April 26 Begin dissemination of CDC Guidance,
  and other flu related information on HDHHS
  website
• April 29 Confirmation of 1st H1N1 related death
  in Houston/Texas/US
• May 1 activate Catastrophic Medical Operations
  Center (CMOC) to aid in distribution of
  anti-virals and testing supplies

• May 2 Dr. David Persse begins daily conference
  call with area hospitals, and daily H1N1
  information video on HDHHS website, HISD closes
  Lyons and Harvard ES, and Hamilton MS
• May 5 HISD closes Wilson ES and Stevenson MS,
  CDC issues new school closure guidelines
• May 14 HDHHS laboratory approved by CDC to do
  H1N1 confirmatory testing
• May 15 HISD closes Travis ES due to numerous
  absences
• May 16 HDHHS requests CDC epidemiological
  response team to assist in Travis investigation
• May 22 HISD closes Travis ES for remainder of
  school year
• As of 24 July
• US - 43,771 cases / 302 deaths
• Texas 5152 cases / 33 deaths
• Houston Region 278 cases
• City of Houston 799 cases

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Current Assumptions

• Transmission will be rapid and widespread
• Case fatality rate is low
• Vaccine will be available mid to late October
• Not all vaccine needed to immunize community will
  be available at first
• Target populations and priorities for
  immunization have been established by CDC
• Demand for vaccination will mirror that of
  seasonal flu

4
Current Assumptions, contd

• Non-pharmaceutical interventions will help
  prevent or limit spread of disease
• Declared national health emergency remains in
  effect

5
HDHHS Mission Objectives

• Protect the publics health
• Serve as immunization safety net
• Operate regional laboratory to track trends and
  localized outbreaks
• Provide accurate and timely information on
  severity and spread of disease and guidance to
  stakeholders

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Mission Objectives, contd

• Develop and distribute educational materials
• Actively engage media in dissemination of
  critical news regarding spread and severity of
  disease
• Coordinate policy making efforts with partners in
  Harris and Ft. Bend counties, other regional
  partners, DSHS, TEA, TDEM, and CDC

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ReminderSeasonal Flu Impact

• Texas
• Between 1 and 5 million ill
• 16,000 hospitalized
• 3,000 deaths
• Houston
• Between 92,600 and 462,500 ill
• 1,900 hospitalized
• 300 deaths

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Potential nH1N1 Impact on Houston

• 30 - 40 absence rates
• Disruption in normal activities
• Pregnant women and school age children most
  affected
• gt2000 hospitalizations
• gt600 deaths
• Confusing or inaccurate messages from media

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Current Planning

• Immunizations
• Epidemiological Surveillance
• Laboratory Surveillance Testing

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Current Planning, contd

• Stakeholder Meetings
• Non-pharmaceutical Interventions

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Non-pharmaceutical Interventions

• Hand hygiene
• Cough etiquette
• Use hand sanitizer
• Stay home when you are ill
• Keep children home when they are ill
• Disinfect surfaces

• Tele-commute to work
• Use facemask when appropriate
• 6 feet from others
• Isolate ill
• Cancel public events

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Current Planning, contd

• Communications and Education Plan
• Keep public informed
• Maintain calm
• Immunization campaign
• Education re disease prevention
• Education re non-pharmaceutical interventions
• HoustonH1N1.org

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Schools

• CDC guidance does not recommend closure as means
  of containment
• Closures due to lack of staff or significant
  student absences per district policy
• Breakfast and lunch program policies developed by
  TX Dept. of Ag.
• Influenza-like Illness (ILI) surveillance
• Decrease number of social contacts
• Alter school schedules
• Postpone athletic and other school events

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Questions and Discussion