Maine Department of Health and Human Services

Maine Center for Disease Control and Prevention (Maine CDC)
 (Formerly Bureau of Health)
11 State House Station
Augusta, Maine 04333-0011

Phone 1-800-821-5821 / Fax 207-287-7443

**ADVISORY – Important Information**

 

2006PHADV018

 

TO:                 Border Medical Officers, Emergency Medical Services, Hospitals Lists, Infection Control Practitioners, ME Correctional Facilities, ME Lab facilities, ME Primary Care, MEMA, Public Health Nurses, Public Health, Regional Resource Centers, School Nurses      

 

FROM:           Dora Anne Mills, M.D., M.P.H., Public Health Director           

 

SUBJECT:     Influenza B in Maine

 

DATE:            December 22, 2006    

 

TIME:            11:00 PM

 

PAGES:          3

 

PRIORITY:    Review

 

Confidentiality Notice:  This fax message is intended for the exclusive use of the individual or entity identified above.  It may contain information, which is privileged and/or confidential under both state and federal law.  If you are not notified otherwise, any further dissemination, copying, or disclosure of the communication is strictly prohibited.  If you have received this   transmittal in error, please immediately notify us at 287-3252 and return the original transmission to us by mail at Key Bank Plaza, 6^th Floor-286 Water Street. Augusta, ME  04333, without making a copy.  Your cooperation in protecting confidential information is greatly appreciated.    

INFLUENZA B  IN MAINE

December 22, 2006 

Summary: Laboratory-confirmed influenza B has been reported in Maine for the first time this season. Medical providers should continue to promote influenza immunization, especially for persons at risk of complications. Rapid influenza diagnostic tests may be useful as clinicians begin to see individuals with influenza-like illnesses in their practices. Providers should review updated guidelines for the use of antiviral drugs for prevention and chemoprophylaxis of influenza.  Links to detailed CDC recommendations on vaccination, testing, and antivirals are provided below.

Background:  On December 22nd, laboratory-confirmed influenza B infection was identified in testing of post-mortem specimens from a young adult visiting Maine from out-of-state. The individual, who had died on December 21^{st ,}  was visiting from an area of the country where the incidence of influenza B has been increasing over the past month. Nationally, both influenza A and influenza B activity has increased steadily in recent weeks (For national activity map, see: http://www.cdc.gov/flu/weekly/usmap.htm)

Influenza B is very rarely fatal. It is important to note that the cause of death in this case has not been determined by the Office of the Medical Examiner, and that testing for influenza and other infections is done routinely in cases of unexplained death. Influenza B is not related to avian influenza virus.

Recommendations:

Influenza Vaccine: Influenza vaccination is the primary approach to preventing influenza and its potentially severe complications, and continued active promotion of vaccination is particularly important now that influenza has arrived in Maine. No shortages of influenza vaccine are currently being reported. For information on vaccine availability in Maine, contact the Maine Immunization Program at (207) 287-3746. For detailed CDC recommendations on vaccination go to:   http://www.cdc.gov/flu/professionals/vaccination/recommendations.htm

Antiviral Medications:  Two antiviral agents (oseltamivir and zanamivir) may be useful for treatment and prevention of influenza A and influenza B in selected circumstances. Treatment of influenza within 2 days of onset, can reduce the duration of uncomplicated illness by one day, and may reduce the incidence of some complications. Chemoprophylaxis can be a critical adjunct to immunization in the prevention of influenza in some settings.  Federal CDC guidelines for influenza antiviral use are available at www.cdc.gov/flu/professionals/treatment/

Laboratory Testing for Influenza:  Diagnostic testing should be considered when an institutional outbreak of influenza is suspected or if tests results would affect clinical decision-making. Rapid diagnostic tests have been increasingly used because they can yield results in a clinically relevant time frame (i.e., approximately 30 minutes); however, the reference standard for diagnosis of influenza remains viral culture.  Testing of persons with influenza-like illnesses is especially useful early in the season when the nature and extent of influenza activity is not yet clear.  A clinical diagnosis can be made for patients with signs and symptoms consistent with influenza during periods of peak influenza activity in the community.  Clinicians should consider influenza testing for patients who develop signs and symptoms of influenza while they are in a health-care facility, including long-term care and skilled nursing facilities.  Nasopharyngeal and nasal specimens (swab, aspirate, wash) are preferred over other upper respiratory samples for diagnostic testing because of higher quantities of detectable virus.  The Maine CDC Health and Environmental Testing Laboratory (HETL) offers viral culture and polymerase chain reaction (PCR) testing for influenza; for information on submitting specimens, call (207) 287-2727. For more information on diagnostic testing, see: http://www.cdc.gov/flu/professionals/labdiagnosis.htm

 

For more information: Maine CDC conducts surveillance to track influenza and influenza-like illness across the state; weekly surveillance reports published can be viewed at www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.htm. To report an outbreak of influenza or for consultation on influenza-related emergencies, contact the 24-hour disease reporting line at 1-800-821-5821.