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Information for Healthcare Professionals UPDATE
Important Health Notice

June 11, 2009
Volume 6, Issue 14

Highlights:

The WHO has raised the global pandemic alert level from Phase 5 to Phase 6, signaling that a global pandemic is underway.
This is based on trends in transmission globally, and does not reflect any change in severity of the circulating virus.
Guidance to health care settings in Ontario remains unchanged.

This Important Health Notice (IHN) is based on current information received to date and provides the following:

Status update
Significance for Ontario of the World Health Organization declaration of Phase 6
Reinforced direction on lab testing

Status Update

On June 11, 2009, the World Health Organization (WHO) raised the pandemic alert level from Phase 5 to Phase 6. Designation of this phase indicates that a pandemic is underway. However, this designation is based on sustained human-to-human transmission in more than one WHO Region, and does not indicate any change in the severity of the circulating virus.

As of June 10, 2009 there were 1,638 lab-confirmed cases of novel H1N1 Influenza A virus in Ontario. Of these cases, 54 reported travel to Mexico prior to symptom onset; 775 cases acquired Influenza A H1N1 in Ontario; 15 cases traveled to locations other than Mexico; in the remaining cases the exposure is unknown. At this time there have been few hospitalized cases, most of whom have recovered and have been discharged.

Significance of the Phase 6 Declaration for Ontario

The clinical guidance for health care providers dealing with the novel H1N1 Influenza A virus in Ontario remains unchanged by this declaration. This includes the guidance related to laboratory testing, as provided in the June 4th Important Health Notice and related guidance documents.

Reminder: Direction on Laboratory Testing

Testing for novel H1N1 Influenza A is not recommended for patients with mild illness. Specimens should only be submitted for testing where lab results are required for clinical management of hospitalized cases of ILI or where patients are at high risk for complications from influenza. Testing carried out to date has confirmed that the novel H1N1 influenza A virus is currently the predominant circulating strain of influenza in many communities. Monitoring for changes to the severity of the virus is ongoing.

Guidance documents continue to be available on the ministry H1N1 Flu Virus website in the section for Health Care Providers under “Emergency Departments” and “Ambulatory Care Settings” at www.health.gov.on.ca

The Ontario Health Plan for an Influenza Pandemic (OHPIP) lays out a range of suggested activities to be undertaken in Phase 6. However, this planning was based on a scenario involving moderate to severe illness. As the novel H1N1 Influenza A virus has to date caused mostly mild illness, decisions regarding these activities will continue to evolve with the situation. The launch of any new ministry initiatives or guidance will be communicated through IHNs and other ministry documents.

The OHPIP can be accessed at
http://www.health.gov.on.ca/english/providers/program/emu/pan_flu/pan_flu_plan.html

Health Care Provider Hotline

If you are a health care worker and have any questions or concerns on the Important Health Notices and related guidance documents, please call the Health Care Provider Hotline toll-free at 1-866-212-2272*.

Hours of Operation**
Monday-Friday 0900hrs to 1600hrs
Saturday-Sunday CLOSED**

*This hotline is intended to provide guidance and support to health care workers only and is not a service to provide general information to the public.
**Hours of Operation are subject to change. Please monitor future Important Health Notices for changes.
**On-call services are available for urgent issues, and can be reached through the Health Care Provider Hotline.

Dr. David Williams
Acting Chief Medical Officer of Health
Phil Graham
Interim Director, Emergency Management Unit

Wellpoint Flu Bulletin Registration

Please complete the form below to receive updates by email

To register by telephone please call 1-866-450-6379


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H1N1 Influenza A Symptoms

People infected with the virus have symptoms that include:

Fever
Cough
Muscle and joint pain
Shortness of breath
Eye Pain
Body aches
Sore Throat
Gastrointestinal symptoms (vomiting and diarrhea) may also be present

Patients with symptoms should self-isolate for 7 days from time of symptom onset. Infectivity starts 24 hours before onset of symptoms.

Source: World Health Organization

What You Can Do to Stay Healthy

There are everyday actions people can take to stay healthy:

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective
Avoid touching your eyes, nose or mouth. Germs spread that way

Try to Avoid Close Contact with Sick People

There are everyday actions people can take to stay healthy:

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people
If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them

Wellpoint clients can contact their Wellpoint physician at 1-888-598-1113. Do not visit your family physician or clinic without telephoning first to notify them of your concern, so that may make proper arrangements. You may be directed to your local emergency department.

Frequently Asked Questions

What should I do if I feel that I may have been exposed by recently visiting Mexico or being in close contact with someone who has?

There is an approximate two to seven day incubation period for this virus. This means that it may take five days after exposure to an infected person to develop a fever, cough and other symptoms.

There are no laboratory tests for asymptomatic people. The present flu shot does not protect against this strain of virus.

If I feel ill, what should I do?

If you feel ill and believe that you may have been exposed to swine flu, call your Wellpoint physician. Wellpoint AdvoCare clients can access their physician directly on a call back basis by calling 1-888-598-1113.

Information Contacts

The Canadian government has set up a hotline and websites for information about the swine flu virus. The number is 1-800-454-8302, and the websites are fightflu.ca, voyage.gc.ca and phac.gc.ca.

You may visit the website for regular updates, or register for Wellpoint situation update by calling 1-866-450-6382. Registered organizations can add their Twitter address to our Wellpoint Twitter account and will automatically be updated as the situation progresses.

Firms and organizations looking to consider how well they would be equipped to manage a more extensive swine flu management program or any conventional occupational health need, should contact the Wellpoint Client Services office at 416-969-3269, or email fluinfo@wellpointhealth.ca.