Vaccine Orders: Maine CDC is now processing orders for H1N1 vaccine the same day the request comes in from a health care provider, with about a four-day turnaround between order and receipt of vaccine.
Vaccinate: Maine CDC strongly encourages health care providers to offer H1N1 vaccine to every patient at every visit, so long as there are no contraindications for receiving vaccine.
Early Diagnosis and Treatment: We are finding an increasing number of hospitalized patients who have neither been vaccinated nor received early treatment with antiviral medicines. Vaccination against influenza and early detection of infection with prompt treatment are still important, especially for people at risk of complications.
Treatment Guidelines: Early treatment for influenza may prevent secondary bacterial infections. Maine CDC issued a health alert on Jan. 11 to reinforce recommendations for early treatment of patients with increased risk of complications from influenza.
Vaccine Order form (Online
Order form) (Word*
| PDF*) – a
health care provider must have completed the H1N1 Provider Agreement and received an H1N1
PIN from the Maine Immunization Program before submitting an order
Submit a specimen for influenza testing for patients with ILI who are hospitalized, who have died, or for whom a diagnosis of influenza would affect clinical care, infection control, or management of contacts.
When testing is indicated, rapid diagnostic tests that are negative should be followed by PCR testing.
When a cluster of ILI is identified among patients or residents of an institutional setting, submit specimens to confirm the cause of the outbreak. Once infection has been confirmed as influenza, further testing is not usually indicated.
Specimens submitted to HETL for influenza testing require a supplemental form, called the Influenza Virus Specimen Submission form (Word* | PDF*), to be submitted in addition to HETL’s requisition form (PDF*).
All PCR confirmed influenza A H1N1 cases that are confirmed by a laboratory other than HETL should be reported to Maine CDC. Faxed reports are preferable: 1-800-293-7534. use the Notifiable conditions form Microsoft Word or Adobe PDF*
Rapid antigen test results among outpatients are not reportable. There is no need to phone or fax individual reports of outpatients with influenza by rapid antigen.
Hospital inpatients with laboratory-confirmed influenza by any method or patients who have died and the death is suspected or confirmed by lab test to be influenza-associated should be reported immediately to Maine CDC by phone (1-800-821-5821) or fax (1-800-293-7534). Please clearly indicate that the patient is hospitalized or has died. This immediate notification allows us to act promptly on these cases.
Management
Updated Clinical Testing and Management Guidance for ILI - October 9, 2009 -(Word*
| PDF*
)
Successfully Preventing transmission of influenza in th health care setting requires a comprehensive approach, beginning with plans that are flexible and adaptable should changes occur in the severity of illness or other aspects of 2009 H1N1 and seasonal influenza. Facilities should use a hierarchy of controls approach to prevent exposure of healthcare personnel and patients and prevent influenza transmission within healthcare settings.
Additional MaineCare questions should be directed to MaineCare’s Billing & Information line at 1-800-321-5557 Option #8.
1135 Waivers
The Secretary of Health and Human Services has invoked her waiver authority under Section 1135 of the Social Security Act. This allows for the waiver or modification of certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Social Security Act programs in the emergency area and for the time periods covered by the 1135 authority.
Requests by providers to operate under the flexibilities afforded by the waiver should be sent to the state survey agency or CMS regional office. Please visit the CMS website for a detailed paper outlining the 1135 waiver process (http://www.cms.hhs.gov/H1N1/Downloads/RequestingAWaiver101.pdf).
Many have asked about the ability of Emergency Medical Services professional
(EMS) to administer vaccine. Those EMS professionals who have an Intermediate, Critical Care, or Paramedic
EMS license are able to administer vaccine, so long as they comply with the training and other requirements
in a recently-issued protocol by Maine EMS. These categories represent about 2,000 EMS professionals
across Maine. Those in the First Responder or Basic EMT license categories are not able to administer
vaccine, but are qualified to assist in clinic logistics. See the Maine EMS protocol (PDF*)
