AZ Health Alerts
Wednesday July 21, 2010
West Nile Virus – Health Advisory Portions of Maricopa and Pinal counties known as the East Valley (includes Gilbert, Chandler, Mesa, Queen Creek, Higley) are experiencing intense West Nile virus (WNV) activity as is evident by mosquito surveillance efforts and the occurrence of human cases. Twelve human cases of WNV have been reported to date from that area, and over 100 mosquito samples have tested positive. Most of the human cases have had neuroinvasive infections (meningitis and/or encephalitis). One case was fatal. With the arrival of monsoon rains, WNV activity is likely to increase and show-up in new locations around the state.
WNV is a reportable condition in Arizona by both physicians and laboratories. Ordering appropriate diagnostic tests and reporting cases is a vital part of the surveillance program. Surveillance data helps health officials to identify areas/communities at higher risk for disease and helps them to prioritize and target vector control efforts. Suspected cases should be reported to local health department officials. Laboratory testing is available through commercial laboratories. Or, it can also be done at the Arizona State Health Laboratory (ASHL). The ASHL currently performs an IgM capture ELISA for WNV and St. Louis encephalitis (SLE). Testing can be performed on serum or CSF. Specimens can be sent to: Arizona State Health Laboratory
Attn: Virology
250 North 17th Avenue
Phoenix, Arizona 85007
The following information must accompany specimens: patient name, age or date of birth, onset of symptoms, specimen collection date, primary symptoms/clinical picture and contact information for submitting physician.
Clinical Features of WNV infections
- Approximately 70-80% of WNV infections are clinically inapparent.
- Approximately 20% of those infected develop West Nile fever. West Nile fever can range from mild to severe. West Nile fever can be characterized by sudden onset of fever often accompanied by one or more of the following: malaise, headache, anorexia, nausea, vomiting, eye pain, myalgia, maculopapular rash or lymphadenopathy. Some symptoms may persist from days to months.
- Approximately 1 percent of infections with WNV or SLE will result in neurological disease such as meningitis and/or encephalitis. Cases can also present with acute flaccid paralysis (usually asymmetric) with or without preceding fever.
- The incubation period is thought to range from 3 to 14 days in immunocompetent individuals, and up to 21 days after organ transplantation.
- The most significant risk factors for developing severe neurological disease are advanced age and/or history of diabetes.
- In recent WNV outbreaks, symptoms occurring among patients hospitalized with severe disease included fever, weakness, gastrointestinal symptoms and change in mental status; also reported were severe muscle weakness and flaccid paralysis (spastic paralysis can occur with SLE infection), maculopapular or morbilliform rash involving neck, trunk, arms or legs, ataxia and extrapyramidal signs, cranial nerve abnormalities, myelitis, optic neuritis, polyradiculitis and seizures.
Laboratory Findings Among Patients in Recent Outbreaks
- Total leukocyte counts in peripheral blood were mostly normal or elevated, with lymphocytopenia and anemia also occurring.
- Examination of the cerebrospinal fluid (CSF) showed pleocytosis, usually with a predominance of lymphocytes.
Tuesday June 22, 2010
Click here to read the latest vaccine update from the AZ Department of Health Services
Monday March 22, 2010
Click here to read the latest Arizona Vaccine Update from the AZ Department of Health Services
Tuesday November 24, 2009
H1N1 Vaccine Provider Registration is Opening!
The Arizona Department of Health Services has been assigned approximately 1200 additional H1N1 vaccine shipping sites. We are opening registration for NEW providers who wish to administer H1N1 vaccine. Registrants will need their practice information, medical license number, and will need to agree to the terms on the provider agreement.
Registration materials can be accessed at: http://www.azdhs.gov/flu/h1n1/vaccine.htm
Important: Please do not register again if you have previously registered, even if you have not been allocated vaccine.
If you have further questions, please call (602) 364-3642 or e-mail to immunizations@siren.az.gov.
Friday October 23, 2009
On Friday, October 23, 2009, the US Food and Drug Administration (FDA) issued an intravenous (IV) in certain adult and pediatric patients with confirmed or suspected 2009 H1N1 influenza infection who are admitted to a hospital. Clinicians considering use of Peramivir IV under EUA must read and understand the content of the FDA-issued Emergency Use Authorization of Peramivir IV: Fact Sheet For Health Care Providers (<a href=”>click here) prior to initiating a request and must agree to comply with terms and conditions of authorized use of Peramivir per the FDA-issued EUA. Clinicians who, after reading the Fact Sheet for Health Care Providers, wish to obtain Peramivir IV for a patient can download the request form (or access an electronic request portal) click here.
To request Peramivir IV (licensed clinicians with prescribing privileges ONLY), please click here. For any questions, call 1-800-CDC-INFO (1-800-232-4636).
More back up materials on this topic: 1.) EUA Peramivir Letter
Tuesday October 26, 2009
Key Points – 2009 H1N1 & Seasonal Influenza - Oct 23- None of the seasonal or 2009 H1N1 influenza vaccines currently licensed and distributed by the U.S. government contains adjuvants. This means that none of these influenza vaccines contains squalene or aluminum.
- The currently licensed seasonal and 2009 H1N1 influenza vaccines do not contain latex. If healthcare providers do not use the vaccine administration products provided by the vaccine manufacturers which do not contain latex, there may be a risk of latex allergy. - Each year, approximately 6,000 to 9,100 people in the United States get GBS whether or not they receive a vaccination. This means that about 140 people get GBS every week.
During the 2009-2010 influenza season, CDC and FDA will be closely monitoring reports of serious problems following the 2009 H1N1 influenza vaccines and the regular seasonal influenza vaccines including GBS.- Since GBS is a serious disorder that people do get every year, CDC has developed several GBS surveillance systems. These are tracking systems to identify whether some GBS cases are linked to influenza vaccinations.
These surveillance systems include some existing vaccination safety systems, such as the Vaccine Adverse Event Reporting System (VAERS), and new systems, such as the CDC Emerging Infections Program and a partnership with the American Academy of Neurology, which includes doctors (neurologists) who are most likely to see persons with GBS. None of these systems existed in 1976.
Through these systems, CDC and FDA will be able to find any possible link between GBS and seasonal or 2009 H1N1 flu vaccines early in the vaccination campaign if it occurs and take appropriate action.
2009 H1N1 Flu Situation Update - CDC – Oct 23
This page also includes current information on the US Seasonal Influenza Weekly Report (FluView) and the Weekly US Map.
click here
2009 H1N1 Influenza Resources - HHS – Oct 24
The proclamation enhances the ability of our Nation’s medical treatment facilities to handle a surge in H1N1 patients by allowing, as needed, the waiver of certain standard federal requirements on a case-by-case basis
click here
President Obama Signs Emergency Declaration for H1N1 Flu
Antiviral Treatment Options, including Intravenous Peramivir, for Treatment of Influenza in Hospitalized Patients for the 2009-2010 Season - CDC – Oct 24
The US Food and Drug Administration (FDA) has authorized the use of peramivir under an Emergency Use Authorization (EUA). Peramivir is a neuraminidase inhibitor (NAI) that is administered intravenously to treat certain patients with suspected or confirmed 2009 H1N1 influenza virus infection.
click here
Clinicians Considering the Use of Intravenous Peramivir
- CDC – Oct 26
Clinicians considering Peramivir must read and understand the content of the FDA-issued EUA prior to initiating a request and must agree to comply with terms and conditions of authorized use of Peramivir. Emergency Use Authorization of Peramivir IV: Fact Sheet For Health Care Providers and Peramivir Online Ordering System are accessible through this link.
click here
CDC Launches H1N1 Flu Mobile Texting Pilot - CDC – Oct 22
Sign up now to have important CDC information about H1N1 flu and other topics delivered directly to your mobile phone! In September 2009, CDC launched a three-month text messaging campaign pilot to share important, timely health information directly to users.
click here
Updated Interim Recommendations—HIV-Infected Adults and Adolescents: Considerations for Clinicians Regarding 2009 H1N1 Influenza - CDC – Oct 21
This update provides new information about vaccination and treatment of HIV-infected adults and adolescents affected by 2009 H1N1 influenza.
click here
New Antiviral Safety Information Web Page - CDC – Oct 19
This page will be updated periodically with new antiviral safety-related information as it becomes available. Includes: information on new warnings regarding administration of Relenza (zanamivir) Inhalation Solution by nebulizer.
click here
2009 H1N1 Influenza: Resources for Clinicians - CDC – Oct 23
This page is designed to give clinicians access to the latest guidelines and information on the evolving novel H1N1 influenza investigation.
click here
2009 H1N1 Influenza Patient Educational Material - CDC – Oct 21
This update provides new information about vaccination and treatment of HIV-infected adults affected by the 2009 H1N1 flu.
click here
- CDC – Oct 21
Top 10 frequently asked questions on the use of the 2009 H1N1 vaccines: Practical considerations for immunization programs and providers.
click here
10 FAQs for immunization programs and providers
Questions and Answers: Opening and Mixing Tamiflu® Capsules with Liquids if Child Cannot Swallow Capsules - CDC – Oct 20
Opening and Mixing Tamiflu Capsules with Liquids if Child Cannot Swallow Capsules This document contains questions and answers about how to open and mix Tamiflu capsules if a child cannot swallow capsules. Tamiflu capsules may be opened and mixed with sweetened liquids, such as regular or sugar-free chocolate syrup and given that way. click here
New H1N1 & You Question and Answer – CDC – Oct 20
Q & As on general H1N1 topics in the news including CDC reports on 2009 H1N1-related deaths and hospitalizations by age group in the United States from August 30, 2009 through October 10, 2009.
click here
Emerging Infectious Disease (EID) Journal
The Emerging Infectious Diseases (EID) journal provides recognition of new and re-emerging infections and understanding of factors involved in disease emergence, prevention, and elimination. It also represents the scientific communications component of CDC’s efforts against the threat of emerging infections. See the September 2009 issue of the EID journal at the following link:
click here
Emergency Preparedness and Response
FREE CDC Webcast – Blast Injuries - CDC – Nov 17
Register for a FREE Webcast presented by Dr. Scott Sasser, MD, FACEP, of the Centers for Disease Control and Prevention’s (CDC), Division of Injury Response to learn about the unique triage, diagnostic, and management challenges of injuries caused by explosions. Participants will receive a FREE continuing education opportunity through CDC.
click here
HHS Awards $17 Million in a New National Initiative to Fight Health Care-Associated Infections - HHS – Oct 23
HHS Secretary Kathleen Sebelius announced the award of $17 million to fund projects to fight costly and dangerous health care-associated infections, or HAIs.
click here
Travelers’ Health
Health Requirements and Recommendations for Travel to Saudi Arabia during the 2009 Hajj: Information for U.S. Travelers - CDC – Oct 20
To protect the health and safety of pilgrims, Saudi Arabia has established health requirements for all visitors.
click here
ACIP Revised Recommendations for Booster Doses of Meningococcal Vaccine - CDC – Oct 22
The Advisory Committee on Immunization Practices (ACIP) has revised its recommendations for booster doses of meningococcal conjugated vaccine (MCV4, Menactra, sanofi pasteur) for persons ages 2 through 55 years.
click here
Monday October 19
Dealing with Influenza during the 2009-2010 school year
Information for educational institutions