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News: H1N1 Influenza Virus Update for Tennessee

For more information about the current flu outbreak, visit the Department of Health Web site at http://health.state.tn.us/swineflu.htm.
Additional information is also available at the CDC’s Web site at http://www.cdc.gov/h1n1flu/.

H1N1 Vaccine Distribution in Tennessee and Challenges to the Medical Home

November 12, 2009: In Tennessee we finally have sufficient quantities of the H1N1 mist but the media misinformation has caused widespread fear that that formulation is somehow dangerous. As a result, most parents want the inactivated vaccine and we can’t keep enough of that on hand for the infants and at risk kids who really need it.

The second issue here is that the schools are giving the vaccine out in some counties. Since some parents assume that it is free there and that we charge in our offices, they are opting to get the vaccine at school or not at all.

Lastly, when schools and employers provide the vaccine to parents and children, we do not get any written notification so our medical records are incomplete or we run the risk of giving excessive doses. Obviously this is not in keeping with the medical home model that we continue to stress.

State Public Health Lab Approved to Confirm H1N1 Flu Cases

MAY 7, 2009; CONTACT: Andrea Ewin Turner, The Tennessee Department of Health; 615.741.3111 (office); 615.708.9384 (cell)

NASHVILLE, Tenn. - The Tennessee Department of Health state laboratory is now confirming cases of the H1N1 influenza virus and will no longer submit all samples to the Centers for Disease Control and Prevention (CDC) for confirmation. Now that confirmations can be made by the state lab, Tennessee will begin reporting only confirmed cases of this new strain of flu virus.

“This demonstrates the quality of work and expertise among our state lab professionals,” said state Health Commissioner Susan R. Cooper, MSN, RN. ”Residents and their health care providers will receive reports of confirmed cases of the H1N1 virus as soon as testing is complete.”

Tennessee cases previously listed as probable are now reported as confirmed. Cooper reiterated statements made Wednesday that the increase in confirmed cases comes with this change in procedure, and does not necessarily reflect a surge in cases of the virus.

The Tennessee Department of Health continues to conduct active surveillance to determine how widespread the virus is in the state, and has confirmed additional cases since the most recent update. As of today, 36 cases have been confirmed statewide. The county breakdown of cases is as follows:

County	Confirmed Cases
Davidson	18
Knox	8
Maury	1
Shelby	1
Williamson	8
Total	36

All patients are recovering from the illness and have a good prognosis. The Tennessee Department of Health is working with local public health officials to identify and provide antiviral medication to the patients’ family and close contacts. Anyone identified as a close contact of a patient will be notified by the Department.

Tennessee’s public health lab system includes the central location in Nashville, regional labs in Knoxville and Jackson, and a partnership agreement with the Memphis-Shelby County Health Department Laboratory. The central lab has been able to maintain and stay current with all Tennessee demands for H1N1 specimen testing, in addition to other routine activities. To date, 568 specimens submitted from Tennessee residents have been tested.

“Specimens will be processed as quickly as possible to assist health care professionals in providing the best possible care to their patients and help state epidemiologists monitor the progression the H1N1 flu outbreak,” said David L. Smalley, Ph.D., MSS, BCLD, Tennessee public health laboratory director.

It was also announced today that the state lab is assisting Texas public health authorities with testing of samples from their patients who may be infected with the new H1N1 flu virus. Tennessee’s public health labs have already begun testing an initial submission of 400 samples from Texas. The regional labs in Knoxville and Memphis are providing support to Texas. Both Tennessee and Texas samples are tested using the same procedures, so Texas results from Tennessee’s labs are also final.

In order to be certified, state labs must submit five samples to the CDC, which are then verified. CDC also allows for state to state arrangements for one "certified" lab to do confirmatory testing for another. Additionally, one state certified lab can do the verification tests for another and inform CDC accordingly.

State Receives Second CDC Confirmation of H1N1 Virus Case

MAY 5, 2009; CONTACT: Andrea Ewin Turner, The Tennessee Department of Health; 615.741.3111 (office); 615.804.9972 (cell)

NASHVILLE, Tenn. - The Tennessee Department of Health has received notification from the Centers for Disease Control and Prevention (CDC) that another case of the novel H1N1 virus identified in the state has been confirmed positive. This confirms a case from Davidson County. Starting this week, the state public health lab will be able to confirm cases of the virus for the state with the use of flu kits provided by federal officials.

“This confirms what we already know. The flu virus is circulating in Tennessee, so we must remain vigilant and practice good hand washing and respiratory etiquette skills,” said State Health Commissioner Susan R. Cooper, MSN, RN. “Make sure the young and the elderly are washing their hands at every opportunity and staying home if they have flu symptoms like a fever, headache or a sore throat.”

To date, a total of 15 cases of this strain of flu have been identified through state lab testing. The breakdown is as follows:

County	CDC Confirmed Cases	Probable Cases
Davidson	1	9
Knox	0	2
Shelby	0	1
Williamson	1	1
Total	2	13

Human cases of the H1N1 virus infection are being identified both in the U.S. and internationally. The Tennessee Department of Health is conducting active surveillance to determine how widespread the virus is in Tennessee. The Department is also collaborating with U.S. Health and Human Services to ensure the state has adequate medical supplies and necessary medications on hand should they be needed.

As of today, CDC has confirmed 279 human cases of this strain of flu infection in the U.S. and one related death. The most current information, as well as a state-by-state breakdown, can be found on the CDC Web site at http://www.cdc.gov/h1n1flu/.

Tennessee residents who think they may be ill with the flu or flu-like illness should contact their health care provider. Symptoms of the illness are as follows: fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea. Your health care provider will determine whether influenza testing or treatment is needed. If you become ill and experience any warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing
Bluish skin color
Not drinking enough fluids
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough
Fever with a rash

In adults, emergency warning signs that need urgent medical attention include:

Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting

The Department of Health recommends frequent hand washing with warm soapy water, keeping hands away from your face, eyes and mouth, and covering coughs and sneezes with a sleeve or tissue. These precautions can also help prevent the spread of other illnesses including the common cold.

TN Receives CDC Confirmation of First Novel H1N1 Virus Case

MAY 3, 2009; CONTACT: Shelley Walker, The Tennessee Department of Health; 615.804.9972 (cell); Shelley.Walker@tn.gov

NASHVILLE, Tenn. - The Tennessee Department of Health has received notification from the Centers for Disease Control and Prevention (CDC) that the initial case of the novel H1N1 virus identified in the state has been confirmed positive. The initial case was identified by the department in Williamson County on April 29.

Starting this week, the state public health lab will be able to confirm cases of the virus for the state with the use of flu kits provided by federal officials.

“The state of Tennessee is taking the necessary level of precaution as directed by the CDC to slow the spread of this new flu virus in these identified communities,” said State Health Commissioner Susan R. Cooper, MSN, RN. “This allows federal officials time to learn more about the virus, its severity and its impact on those affected.”

To date, a total of 9 cases of this strain of flu have been identified through state lab testing. The breakdown is as follows:

County	CDC Confirmed Cases	Probable Cases
Davidson	0	6
Knox	0	1
Shelby	0	1
Williamson	1	0
Total	1	8

“This CDC confirmation does not change any of the recommendations or interventions already in place. We will continue to see more cases identified in these communities because of expanded testing and surveillance,” said State Epidemiologist Tim F. Jones, MD. “It is important that people continue to wash their hands at every opportunity, cover coughs and sneezes with a sleeve or tissue, and stay home if you have any cold or flu symptoms.”

As of today, CDC has confirmed 226 human cases of this strain of flu infection in the U.S. and one related death. The most current information, as well as a state-by-state breakdown, can be found on the CDC Web site at http://www.cdc.gov/h1n1flu/.

Tennessee Identifies First Probable Case of Novel H1N1 Virus

APRIL 29, 2009; CONTACT: Andrea Ewin Turner, The Tennessee Department of Health; 615.741.3111 (office); 615.708.9384 (cell)

NASHVILLE, Tenn. - The Tennessee Department of Health lab has identified the first probable case of the novel H1N1 virus in the state. The specimen will be sent to the Centers for Disease Control and Prevention to confirm preliminary results.

“The Tennessee Department of Health is taking all necessary precautions in responding to this public health emergency,” said Governor Phil Bredesen. “As diagnosis of the illness continues, we must following the guidance of the state and federal health officials by staying home when we are sick and practicing good hygiene by washing our hands frequently. These small steps will help slow the spread of this illness.”

The patient is a Williamson County resident, who is receiving treatment for symptoms at home, is recovering from the illness, and has a good prognosis. The Tennessee Department of Health is working with local officials to identify and provide antiviral medication to the patient’s family and close contacts. Anyone identified as a close contact of the patient will be notified by the Department.

“It’s important to note that more human cases of swine flu will be detected in Tennessee because of expanded testing and surveillance,” said State Health Commissioner Susan R. Cooper, MSN, RN. “People should be alert to developing news and information about this virus, but should not panic based on this probable case. The more you know, the more you can do to ensure your family’s health.”

Human cases of the H1N1 virus infection have been identified both in the U.S. and internationally. While this is the first probable case in Tennessee, new cases are being identified daily in other states and counties.

The Tennessee Department of Health is conducting active surveillance to determine if any individuals in Tennessee have this strain of the influenza virus. The Department is also collaborating with U.S. Health and Human Services to ensure the state has adequate medical supplies and necessary medications on hand should they be needed.

As of today, the Centers for Disease Control and Prevention (CDC) has confirmed 91 human cases of this strain of flu infection in the U.S. The most current information, as well as a state-by-state breakdown, can be found on the CDC Web site at http://www.cdc.gov/swineflu/.