For Health Providers

H1N1 Update

Posted: June 19, 2009
To: Healthcare Providers
From: Mary Maddux-González, MD, MPH, Health Officer, 565-4567

Sonoma County Situation Report

Over the last week, Sonoma County Public Health has identified an increase in H1N1 activity in Sonoma County. We anticipate that we will continue to see more cases over the next several weeks and months now that the H1N1 virus has become well established in California. As of today, there have been a total of 14 cases of novel influenza A (H1N1) cases reported in Sonoma County, including 5 confirmed and 9 probable cases. Fortunately, most cases have been mild to moderate. However, an elderly man with probable H1N1 influenza and multiple underlying chronic medical conditions was recently hospitalized and died today. Several of the recent cases of H1N1 influenza have occurred in cluster settings, such as Sonoma Developmental Center, a local summer camp, and a skilled nursing facility. Public Health Disease Control and Surveillance staff continue to monitor and investigate reports of current cases and new probable cases.

Health facilities that notice any unusual activity of respiratory or influenza-like illness should call the Sonoma County Public Health Disease Control and Surveillance provider line at 565-4567.

Testing Guidance for Sonoma County

Sonoma County has discontinued enhanced surveillance testing for A/H1N1. Testing services at the Public Health lab remain available for diagnostic purposes. Because we are no longer doing enhanced surveillance, normal lab fees for real time PCR respiratory specimens will apply.

Current recommendations from the California Department of Public Health limit testing to persons with influenza-like illness who:

require hospitalization or
are pregnant or
are direct care health care providers or
have died from influenza-like illness

For more information, please contact the Public Health lab at 565-4711.

To test for novel influenza A (H1N1) virus, upper respiratory specimens, such as a nasopharyngeal swab or aspirate, nasal swab plus a throat swab or nasal wash, or tracheal aspirate, should be collected. Rapid tests for influenza are not recommended due to a high number of false negative rapid tests in A/H1N1 specimens. Instructions for the proper collection, storage and transport of specimens can be found on our website: http://www.sonoma-county.org/health/ph/phpreparedness/pdf/h1n1flu_testing.pdf (pdf).

Treatment and Prophylaxis Guidance for Sonoma County

Severe cases, persons at high risk for complications, and certain high-risk contacts of cases may be candidates for antiviral medication. Please refer to the most recent (May 8, 2009) guidance from the California Department of Health on the use of antiviral medication for treatment and prophylaxis of cases and contacts. This document can be found at: http://www.cdph.ca.gov/HealthInfo/discond/Documents/CDPH-Updated-Interim-Guidance-on-Antivirals-for-H1N1-050809.pdf

Key Guidance Documents for Novel Influenza A (H1N1) Management

Infection Control Recommendations for H1N1 Influenza (Swine Influenza) for Hospitalized Patients (May 19, 2009) (pdf)
Source: California Department of Public Health.

Infection Control Recommendations for H1N1 Influenza (Swine Influenza) in Outpatient Settings (May 19, 2009) (pdf)
Source: California Department of Public Health.

Infection Control Recommendations for H1N1 Influenza (Swine Influenza) in Long-term Healthcare Settings (May 19, 2009) (pdf)
Source: California Department of Public Health.

For further information please refer to:

Sonoma County Public Health: H1N1 (Swine) Flu website

California Department of Public Health: Novel Influenza A (H1N1) Virus website

The Centers for Disease Control and Prevnetion: H1N1 Flu (Swine Flu) website

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