Wednesday, May 27, 2009

Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission

Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission

As per the CDC - This document provides updated interim guidance on the use of facemasks and respirators for decreasing the exposure to novel influenza A (H1N1) virus. This guidance replaces other CDC guidance on mask and/or respirator use that may be included in other CDC documents in regards to the outbreak of novel H1N1 virus. No change has been made to guidance on the use of facemasks and respirators for health care settings. This document includes guidance on facemask and respirator use for a wider range of settings than was included in previous documents and includes recommendations for those who are at increased risk of severe illness from infection with the novel H1N1 virus compared with those who are at lower risk of severe illness from influenza infection. For more information about human infection with novel influenza A (H1N1) virus, visit the CDC H1N1 Flu website. Other CDC novel H1N1 guidance will be updated with the information contained in this document as soon as possible.

For complete article go to

Guidelines on Assessment and Remediation of Fungi in Indoor Environments

Guidelines on Assessment and Remediation of Fungi in Indoor Environments

As per NYC Dept of Health and Mental Hygiene - This 2008 document revises existing guidelines and supersedes all prior editions. It is based both on a review of the current literature regarding fungi (mold) and on comments from a review panel consisting of experts in the fields of mycology/microbiology, environmental health sciences, environmental/occupational medicine, industrial hygiene, and environmental remediation.

To see the entire guidelines go to

Saturday, May 23, 2009

Mold Prevention and Control Tips

Moisture control is the key to mold control. When water leaks or spills occur indoors - act promptly. Any initial water infiltration should be stopped and cleaned promptly. A prompt response (within 24-48 hours) and thorough clean- up, drying, and/or removal of water-damaged materials will prevent or limit mold growth.

Mold prevention tips include:

  • Repairing plumbing leaks and leaks in the building structure as soon as possible.
  • Looking for condensation and wet spots. Fix source(s) of moisture incursion problem(s) as soon as possible.
  • Preventing moisture from condensing by increasing surface temperature or reducing the moisture level in the air (humidity). To increase surface temperature, insulate or increase air circulation. To reduce the moisture level in the air, repair leaks, increase ventilation (if outside air is cold and dry), or dehumidify (if outdoor air is warm and humid).
  • Keeping HVAC drip pans clean, flowing properly, and unobstructed.
  • Performing regularly scheduled building/ HVAC inspections and maintenance, including filter changes.
  • Maintaining indoor relative humidity below 70% (25 - 60%, if possible).
  • Venting moisture-generating appliances, such as dryers, to the outside where possible.
  • Venting kitchens (cooking areas) and bathrooms according to local code requirements.
  • Cleaning and drying wet or damp spots as soon as possible, but no more than 48 hours after discovery.
  • Providing adequate drainage around buildings and sloping the ground away from building foundations. Follow all local building codes.
  • Pinpointing areas where leaks have occurred, identifying the causes, and taking preventive action to ensure that they do not reoccur.


Friday, May 22, 2009

Mold Remediation in Schools and Commercial Buildings

Mold Remediation in Schools and Commercial Buildings per the USEPA

Table 1: Water Damage - Cleanup and Mold Prevention

Books and papers- For non-valuable items, discard books and papers.
Photocopy valuable/important items, discard originals.
Freeze (in frost-free freezer or meat locker) or freeze-dry.

Carpet and backing - dry within 24-48 hours§ Remove water with water extraction vacuum.
Reduce ambient humidity levels with dehumidifier.
Accelerate drying process with fans.

Ceiling tiles - Discard and replace.

Cellulose insulation -Discard and replace.

Concrete or cinder block surfaces-Remove water with water extraction vacuum.
Accelerate drying process with dehumidifiers, fans, and/or heaters.

Fiberglass insulation - Discard and replace.

Non-porous, hard surfaces (Plastics, metals) - Vacuum or damp wipe with water and mild detergent and allow to dry; scrub if necessary.

Upholstered furniture - Remove water with water extraction vacuum.
Accelerate drying process with dehumidifiers, fans, and/or heaters.
May be difficult to completely dry within 48 hours. If the piece is valuable, you may wish to consult a restoration/water damage professional who specializes in furniture.

Wallboard (Drywall and gypsum board) - May be dried in place if there is no obvious swelling and the seams are intact. If not, remove, discard, and replace. Ventilate the wall cavity, if possible.

Window drapes - Follow laundering or cleaning instructions recommended by the manufacturer.

Wood surfaces Remove moisture immediately and use dehumidifiers, gentle heat, and fans for drying. (Use caution when applying heat to hardwood floors.)
Treated or finished wood surfaces may be cleaned with mild detergent and clean water and allowed to dry.

Wet paneling should be pried away from wall for drying.


Thursday, May 21, 2009

Determining Eligibility of Mold Remediation Costs For Grant from FEMA

This is part II in the series about FEMA grants for mold remediation costs - The cost of mold sampling, both pre-and post-remediation, may be eligible for reimbursement, provided there is evidence prior to remediation to indicate the existence of disaster-related mold.
  • The cost of mold sampling which reveals no presence of disaster-related mold is not eligible for reimbursement.
  • Costs to perform eligible remediation - either through force account or a contractor - may be eligible for reimbursement. Contractor costs are subject to the contract procurement requirements in 44 CFR 13.36.
  • The following remediation activities may be eligible under Category B:
    * Wet vacuuming, damp wiping or HEPA vacuuming of the interior space.
    * Removal of contaminated gypsum board, plaster (or similar wall finishes), carpet or floor finishes, and ceilings or permanent light fixtures.
    * Cleaning of contaminated heating and ventilation (including ductwork), plumbing, and air conditioning systems, or other mechanical equipment.
  • If an applicant fails to take reasonable measures to prevent the spread of mold contamination to a facility, the rehabilitation and repair of the additional contaminated area will not be eligible for federal assistance
  • If an applicant can document and justify why reasonable measures were not taken to prevent further contamination to a facility from mold, or why reasonable measures taken were insufficient to prevent further damage, remediation activities may be eligible for reimbursement. Examples of extenuating circumstances may include:
    * Disruption of power.
    * Facility remained underwater.
    * Inability to access the facility due to the disaster, i.e. debris blocking access routes and facility.
    * Facility HVAC equipment damaged due to the disaster.
    * Insufficient resources to remediate the entire facility.


Wednesday, May 20, 2009

Obtaining Grant Money for Mold Remediation Through FEMA Part I

As per FEMA website - Extensive disaster-related damages may result in public facilities becoming inundated or exposed to wet and humid weather conditions for extended periods of time. The limited availability of repair and restoration contractors may delay clean-up activities. In addition, the disruption of electrical power can inhibit the use of water extraction, pumping and drying electric equipment. As such, the damaged structures and their contents may remain waterlogged until power is restored and remediation can begin. Such water saturation may cause growth and propagation of mold on structures and interior contents, causing health-related problems and increasing the cost of repairs. The following guidance is provided to assist Public Assistance staff and applicants (entities that meet the requirements of 44 CFR 206.222 - State, local governments, Indian tribes or authorized tribal organizations, and certain private non-profits) with the remediation and/or repair of their damaged facilities.


Tuesday, May 19, 2009

A Practical Approach to Mold Remediation

Here is a good article / paper on a practical approach to mold remediation - Mold Remediation: A Practical Approach

Mold Can Be A Problem Long After Floodwaters Recede

MONTGOMERY, Ala. -- Mold can be a growing problem.

Five to six weeks after a flood, mold can become a problem in homes and businesses that have not been thoroughly cleaned.

The Federal Emergency Management Agency (FEMA) offers steps that can be taken to combat the musty, microscopic organism's growth and its potential to cause serious health problems. Mold can also cause structural damage to homes, according to state and federal officials.
"Removing flood contaminated materials and household goods, and thoroughly cleaning up after a flood are essential steps in combating mold," said Federal Coordinating Officer Albie Lewis.
Floodwaters affect household fixtures in different ways.

Porous materials are nearly impossible to clean. Soaked carpets, carpet pads, linoleum, fabric covered furniture, wet insulation and ceiling tiles should be thrown out. There is no way to clean them. For heirloom rugs and furniture, contact a professional cleaner.
Appliances such as refrigerators, freezers, cooking stoves, dishwashers, hot water heaters, washers and driers contain insulation which may harbor mold spores without visible evidence and should be discarded.

Surfaces such as wallboard, sheetrock, chipboard and particle board may have to be replaced. Water can wick up higher than the visible water line. The best practice is to remove the wall board at least a foot above the water line.

Non-porous surfaces, including glass, ceramic, metal and plastic, can be cleaned. A combination of water, household bleach and soap or detergent can be used to wash down walls, floors and other mold-contaminated areas. Follow directions on containers and take particular note of warnings.

Here are some cleaning tips to rid damaged properties of, and prevent mold.
  • Do not mix chlorine liquids and ammonia. Wear rubber gloves, protective clothing and a
    tight-fitting face mask when working around mold.
  • Remove heating and cooling registers and ducts, and then hose the ducts to prevent contamination from flowing through the ducts when the unit is turned on.
  • Heating and air conditioning filters should be changed and the system ductwork cleaned by a professional so that mold spores don't circulate in the dwelling or business.
  • After hosing ductwork, wash with a disinfectant. If ducts are in slab or otherwise inaccessible, have them cleaned professionally.
  • When rebuilding, property owners living in flood-prone areas should consider using water-resistant materials.

Excerpted from press release from FEMA

Monday, May 18, 2009

Mold Prevention Tips From the CDC


  • Keep the humidity level in your home between 40% and 60%. Use an air conditioner or a dehumidifier during humid months and in damp spaces, like basements.
  • Be sure your home has enough ventilation. Use exhaust fans which vent outside your home in the kitchen and bathroom. Make sure your clothes dryer vents outside your home.
  • Fix any leaks in your home’s roof, walls, or plumbing so mold does not have moisture to grow.
  • Clean up and dry out your home thoroughly and quickly (within 24–48 hours) after flooding.
  • Add mold inhibitors to paints before painting.
  • Clean bathrooms with mold-killing products.
  • Remove or replace carpets and upholstery that have been soaked and cannot be dried promptly. Consider not using carpet in rooms or areas like bathrooms or basements that may have a lot of moisture.


Saturday, May 16, 2009

CDC Travel Health Warning for Novel H1N1 Flu in Mexico Removed

CDC’s Travel Health Warning recommending against non-essential travel to Mexico, in effect since April 27, 2009, has now been downgraded to a Travel Health Precaution for Mexico.

Current Situation

CDC has been monitoring the ongoing outbreak of novel H1N1 flu in Mexico and, with the assistance of the Mexican authorities, has obtained a more complete picture of the outbreak. There is evidence that the Mexican outbreak is slowing down in many cities though not all. In addition, the United States and other countries are now seeing increasing numbers of cases not associated with travel to Mexico. Finally, the risk of severe disease from novel H1N1 virus infection now appears to be less than originally thought.

CDC Recommendations

At this time, CDC has removed its recommendation that U.S. travelers avoid travel to Mexico.
CDC continues to recommend that travelers visiting Mexico take steps to protect themselves from getting novel H1N1 flu.

CDC recommends that travelers at high risk for complications from any form of influenza discuss with their physicians the risks and benefits of travel in the context of their planned itinerary to Mexico, and may want to consider postponing travel. Travelers at high risk for complications include:

  • Children less than 5 years old
  • Persons aged 65 years or older
  • Children and adolescents (less than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection
  • Pregnant women
  • Adults and children who have chronic pulmonary, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders
  • Adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV)
  • Residents of nursing homes and other chronic-care facilities

If you travel to an area that has reported cases of novel H1N1 flu:
Stay Informed

Be aware that Mexico is checking all exiting airline passengers for signs of novel H1N1 flu. Exit screening may cause significant delays at airports.


Thursday, May 14, 2009

Mold Remediation Tasks

Tasks Involved In Remediation as Per the CDC

Responding to mold problems requires a series of actions. The order in which actions take place is sometimes important. Typically, the following actions are implemented to some extent regardless of whether a problem is small and simple or large and complex:
  • Take emergency actions to stop water intrusion if needed.
    Identify vulnerable populations, extent of contamination, and moisture dynamic.
  • Plan and implement remediation activities.
  • Establish appropriate containment and worker and occupant protection.
  • Eliminate or limit moisture sources and dry the materials.
  • Decontaminate or remove damaged materials as appropriate.
  • Evaluate whether space has been successfully remediated.
  • Reassemble the space to prevent or limit possibility of recurrence by controlling sources of moisture and nutrients.
  • For small, simple problems, the entire list may be implemented by one person. For larger, more complex problems, the actions in the list may be accomplished by a series of people in different professions and trades. For circumstances that fall between those extremes, some combination of occupant action and professional intervention will be appropriate. In general, no single discipline brings together all the required knowledge for successful assessment and remediation.


What You Can Do To Stay Healthy Per CDC

What You Can Do to Stay Healthy

As per the CDC:
  • Stay informed. This website will be updated regularly as information becomes available.
    Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
  • Take everyday actions 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.
  • Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
  • Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
  • Find healthy ways to deal with stress and anxiety.
  • Call 1-800-CDC-INFO for more information.

Wednesday, May 13, 2009

Flood Cleanup and the Air in Your Home

As per the USEPA, for basic information on how to clean up after a flood and how to prevent indoor air problems go to This 28 page booklet prints in landscape as a 15 page printout. The booklet discusses how to prevent and cleanup your home after a flood.

CDC Increases Testing for Swine Flu

CDC has developed a PCR diagnostic test kit to detect this novel H1N1 virus and has now distributed test kits to all states in the U.S. and the District of Columbia and Puerto Rico. The test kits are being shipped internationally as well. This will allow states and other countries to test for this new virus. This increase in testing will likely result in an increase in the number of confirmed cases of illness reported. This, combined with ongoing monitoring through Flu View should provide a fuller picture of the burden of disease in the United States over time.

Tuesday, May 12, 2009

CDC Public Guidance on Swine Flu H1N1 Virus

Public Guidance

In addition, CDC has provided guidance for the public on what to do if they become sick with flu-like symptoms, including infection with novel H1N1. CDC also has issued instructions on taking care of a sick person at home. Novel H1N1 infection has been reported to cause a wide range of symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. In addition, a significant number of people also have reported nausea, vomiting or diarrhea. Everyone should take everyday preventive actions to stop the spread of germs, including frequent hand washing and people who are sick should stay home and avoid contact with others in order to limit further spread of the disease.

Swine Flu CDC Update - New Virus Emerges

A New Virus Emerges

Novel influenza A (H1N1) is a new flu virus of swine origin that was first detected in April, 2009. The virus is infecting people and is spreading from person-to-person, and has sparked a growing outbreak of illness in the United States with an increasing number of cases being reported internationally as well.

CDC anticipates that there will be more cases, more hospitalizations and more deaths associated with this new virus in the coming days and weeks because the population has little to no immunity against it. Novel influenza A (H1N1) activity is now being detected in two of CDC’s routine influenza surveillance systems as reported in the May 8, 2009 FluView. FluView is a weekly report that tracks U.S. influenza activity through multiple systems across five categories.

The May 8 FluView found that the number of people visiting their doctors with influenza-like-illness is higher than expected in the United States for this time of year. Second, laboratory data shows that regular seasonal influenza A (H1N1), (H3N2) and influenza B viruses are still circulating in the United States, but novel influenza A (H1N1) and “unsubtypable”* viruses now account for a significant number of the viruses detected in the United States.

It’s thought that novel influenza A (H1N1) flu spreads in the same way that regular seasonal influenza viruses spread; mainly through the coughs and sneezes of people who are sick with the virus.

CDC continues to take aggressive action to respond to the outbreak. CDC’s response goals are to reduce the spread and severity of illness, and to provide information to help health care providers, public health officials and the public address the challenges posed by this new public health threat.


Monday, May 11, 2009

CDC Issues School Guidance

This includes updated interim guidance for schools and childcare facilities on preventing the spread of novel influenza A (H1N1) virus. At this time, CDC recommends the primary means to reduce spread of influenza in schools focus on early identification of ill students and staff, staying home when sick, and good cough etiquette and frequent hand washing. Decisions about school closure should be at the discretion of local authorities based on local considerations.


Sunday, May 10, 2009

CDC Develops PCR Diagnostic Test Kit

As per the CDC website - CDC Has Increased Testing

CDC has developed a PCR diagnostic test kit to detect this novel H1N1 virus and has now distributed test kits to all states in the U.S. and Puerto Rico. The test kits are being shipped internationally as well. This will allow states and other countries to test for this new virus. This increase in testing capacity is likely to result in an increase in the number of reported confirmed cases in this country, which should provide a more accurate picture of the burden of disease in the United States.


Thursday, May 7, 2009

Antimicrobial Products for Use Against Swine Flu and Other Influenza Viruses

Antimicrobial Products Registered for Use Against the H1N1 Flu (Swine Flu) and Other Influenza A Viruses on Hard Surfaces - As Per USEPA

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) are currently tracking an H1N1 flu outbreak that has caused infections in humans in the United States, Mexico, Canada and other countries. Information on this Web page will help you identify antimicrobial products that are registered by EPA to disinfect hard, non-porous surfaces that may be contaminated with the 2009-H1N1 flu.

EPA registers pesticide products, including disinfectants. As part of the registration process, EPA evaluates the product efficacy to make sure the public health label claims are accurate. Currently, over 500 disinfectant products are registered for use on hard, non-porous surfaces against influenza A viruses. EPA believes, based on available scientific information, that the currently registered influenza A virus products will be effective against the 2009-H1N1 flu strain and other influenza A virus strains on hard, non-porous surfaces. For safe and effective use of these products, always follow label instructions for these products, paying special attention to the product’s dilution rate (if applicable) and contact time.

Choose a product whose label states that it is effective against "Influenza A virus" and lists your specific site of concern, such as: farm premises, hospitals and other healthcare facilities, schools, offices or homes. These products are widely available and can be purchased at drugstores, supermarkets, and home maintenance/repair stores, among others.

As the CDC stresses, your first line of defense is to wash your hands frequently with soap and water or use an alcohol-based cleaner. These registered disinfectant products are for use on hard, non-porous surfaces, such as door knobs, handles, tables, floors, etc. EPA emphasizes that these products are not to be used on the skin or to be taken orally.

More than 500 antimicrobial products (20 pp, 62 K PDF) are registered by EPA specifically for use against influenza A virues. This is not a complete list since some products may have different distributor or product names and may not be referenced. We will continue to update this list as more information becomes available. Approved products specifically have label information which states they provide effectiveness against “Influenza A virues.”

Up-to-date information about the 2009-H1N1 flu is available on CDC’s Web site


Wednesday, May 6, 2009

Influenza A(H1N1) Swine Flu - update May 6 2009

As per WHO - May 6 2009, 22 countries have officially reported 1516 cases of influenza A (H1N1) infection.

Mexico has reported 822 laboratory confirmed human cases of infection, including 29 deaths. The United States has reported 403 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (165), China, Hong Kong Special Administrative Region (1), Colombia (1), Costa Rica (1), Denmark (1), El Salvador (2), France (4), Germany (9), Guatemala (1), Ireland (1), Israel (4), Italy (5), Netherlands (1), New Zealand (6), Portugal (1), Republic of Korea (2), Spain (57), Switzerland (1) and the United Kingdom (27).

It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

WHO advises no restriction of regular travel or closure of borders.

There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

Further information on the situation will be available on the WHO website on a regular basis.

EPA ensures students and faculty protected from asbestos at 5 Arizona charter schools

SAN FRANCISCO -- The U.S. Environmental Protection Agency recently fined five Arizona charter school operators a combined total of $ 35,700 for Asbestos Hazard Emergency Response Act violations.

The U.S. Environmental Protection Agency recently fined five Arizona charter school operators a combined total of $ 35,700 for Asbestos Hazard Emergency Response Act violations.

In April 2007, EPA inspectors discovered the school operators failed to conduct inspections to determine if asbestos-containing material was present in school buildings, and all had failed to develop asbestos management plans. The schools have since completed inspections and have developed asbestos management plans.

“All schools, including charter schools, need to conduct asbestos inspections and have asbestos management plans,” said Katherine Taylor, associate director for the Communities and Ecosystems Division in EPA’s Pacific Southwest region. “We are pleased that these schools have now conducted inspections and put asbestos management plans into place, as asbestos in schools has the potential for endangering the health of students, teachers, and others, including maintenance workers.”

The schools are:

* Phoenix Advantage Charter School: The operator, Phoenix Advantage Charter School, Inc. was fined $12,600. The school’s first management plan documented over 10,000 square feet of assumed asbestos-containing materials. The revised management plan shows after more testing and abatement actions, the school building still contains 3,200 square feet of actual or assumed asbestos-containing materials.

* The Arts Academy at Estrella Mountain and South Mountain: The operator, PCL Charter Schools, was fined $10,200. The Estrella Mountain location was found to not have any asbestos containing materials, while the South Mountain location’s management plan shows that the school contains 2,059 square feet of asbestos-containing materials.

* The Hearn Academy: The operator, Ball Hearn, was fined $8,800 and the school was found to contain 1,230 square feet of asbestos-containing materials.

* Tucson Preparatory School: The operator, Tucson Preparatory Partnership, Inc., was fined $200 for not having a management plan at its former location on North Oracle Road. An asbestos inspection conducted by the new tenants of the North Oracle building identified no asbestos-containing materials.

* AAEC at Paradise Valley, South Mountain, and Red Mountain: The operator, Arizona Agribusiness & Equine Center, Inc. was fined $3,900 for failing to conduct an inspection of Paradise Valley school, and for not having management plans at its Paradise Valley, South Mountain, and Red Mountain schools. No asbestos-containing materials were identified at these schools.

Federal law requires schools to conduct an initial inspection using accredited inspectors to determine if asbestos-containing building material is present and develop a management plan to address the asbestos materials found in the school buildings. In certain circumstances, an inspection is not required if the school has a signed statement from the architect or builder stating that a new building was constructed with no asbestos-containing materials.

Schools that do not contain asbestos-containing material must still develop a management plan that identifies a designated person and includes the architect’s statement or building inspection and the annual notification to parents, teachers, and employees regarding the availability of the plan.

The EPA’s rules also require the school to appoint a designated person who is trained to oversee asbestos activities and ensure compliance with federal regulations. Finally, schools must conduct periodic surveillance and re-inspections, properly train the maintenance and custodial staff, and maintain records in the management plan.

Local education agencies must keep an updated copy of the management plan in their administrative office and at the school, which must be made available for inspection by parents, teachers, and the general public. Asbestos is a known environmental carcinogen. Individuals exposed to airborne asbestos fibers could contract illnesses such as mesothelioma and lung cancer.

For more information on asbestos in schools visit:

Tuesday, May 5, 2009

Infections With a Swine-Origin Influenza A (H1N1) Virus

On April 28, this report was posted as an MMWR Dispatch on the MMWR website ( ).

Since April 21, 2009, CDC has reported cases of respiratory infection with a swine-origin influenza A (H1N1) virus (S-OIV) transmitted through human-to-human contact (1,2). This report updates cases identified in U.S. states and highlights certain control measures taken by CDC. As of April 28, the total number of confirmed cases of S-OIV infection in the United States had increased to 64, with cases in California (10 cases), Kansas (two), New York (45), Ohio (one), and Texas (six). CDC and state and local health departments are investigating all reported U.S. cases to ascertain the clinical features and epidemiologic characteristics. On April 27, CDC distributed an updated case definition for infection with S-OIV (Box).

Of the 47 patients reported to CDC with known ages, the median age was 16 years (range: 3--81 years), and 38 (81%) were aged <18 years; 51% of cases were in males. Of the 25 cases with known dates of illness onset, onset ranged from March 28 to April 25 (Figure). To date, no deaths have been reported among U.S. cases, but five patients are known to have been hospitalized. Of 14 patients with known travel histories, three had traveled to Mexico; 40 of 47 patients (85%) have not been linked to travel or to another confirmed case. Information is being compiled regarding vaccination status of infected patients, but is not yet available. According to the World Health Organization (WHO), as of April 27, a total of 26 confirmed cases of S-OIV infection had been reported by Mexican authorities. Canada has reported six cases and Spain has reported one case.*

Compete releae can be found at

Monday, May 4, 2009

H1N1 Flu (Swine Flu) Update May 4 2009

CDC continues to take aggressive action to respond to an expanding outbreak caused by novel H1N1 flu.

CDC’s response goals are to:

1.Reduce transmission and illness severity, and
2.Provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.

CDC continues to issue and update interim guidance daily in response to the rapidly evolving situation. CDC will issue updated interim guidance for clinicians on how to identify and care for people who are sick with novel H1N1 flu illness. This guidance will provide priorities for testing and treatment for novel H1N1 flu infection. The priority use for influenza antiviral drugs during this outbreak will be to treat people with severe flu illness.

On May 3, CDC is scheduled to complete deployment of 25 percent of the supplies in the Strategic National Stockpile (SNS) to all states in the continental United States. These supplies and medicines will help states and U.S. territories respond to the outbreak. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against the novel H1N1 flu virus.

Response actions are aggressive, but they may vary across states and communities depending on local circumstances. Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak. People who are sick are urged to stay home from work or school and to avoid contact with others, except to seek medical care. This action can avoid spreading illness further.


Sunday, May 3, 2009

Maryland Dept of Heath and Hygiene Swine Flu Preparedness Guide

Maryland's Department of Health and Metal Hygiene has developed a Swine Flu Preparedness Guide which can be found at Swine Flu Preparedness Guide. It includes Common Sense Precautions Including:
•Wash your hands often, especially after coughing, sneezing, and wiping or blowing the nose.
•Cover your mouth when coughing or sneezing.
•Use paper tissues when wiping or blowing your nose; throw tissues away after use.
•Stay away from crowded living and sleeping spaces, if possible.
•Stay home and avoid contact with other people to protect them from catching your illness.

Saturday, May 2, 2009

Antiviral Drugs and H1N1 Flu (Swine Flu)

As per the CDC ( )

Antiviral Drugs

Antiviral drugs are prescription medicines (pills, liquid or an inhaler) with activity against influenza viruses, including swine influenza viruses. Antiviral drugs can be used to treat swine flu or to prevent infection with swine flu viruses. These medications must be prescribed by a health care professional. Influenza antiviral drugs only work against influenza viruses -- they will not help treat or prevent symptoms caused by infection from other viruses that can cause symptoms similar to the flu.

There are four influenza antiviral drugs approved for use in the United States (oseltamivir, zanamivir, amantadine and rimantadine). The swine influenza A (H1N1) viruses that have been detected in humans in the United States and Mexico are resistant to amantadine and rimantadine so these drugs will not work against these swine influenza viruses. Laboratory testing on these swine influenza A (H1N1) viruses so far indicate that they are susceptible (sensitive) to oseltamivir and zanamivir.

Benefits of Antiviral Drugs
Treatment: If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious influenza complications. Influenza antiviral drugs work best when started soon after illness onset (within two 2 days), but treatment with antiviral drugs should still be considered after 48 hours of symptom onset, particularly for hospitalized patients or people at high risk for influenza-related complications.

Prevention: Influenza antiviral drugs also can be used to prevent influenza when they are given to a person who is not ill, but who has been or may be near a person with swine influenza. When used to prevent the flu, antiviral drugs are about 70% to 90% effective. When used for prevention, the number of days that they should be used will vary depending on a person’s particular situation.

CDC Recommendation

CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine influenza viruses.

•Oseltamivir (brand name Tamiflu ®) is approved to both treat and prevent influenza A and B virus infection in people one year of age and older.
•Zanamivir (brand name Relenza ®) is approved to treat influenza A and B virus infection in people 7 years and older and to prevent influenza A and B virus infection in people 5 years and older.

Recommendations for using antiviral drugs for treatment or prevention of swine influenza will change as we learn more about this new virus.

Friday, May 1, 2009

CDC H1N1 Flu Update (Swine Flu)

CDC continues to take aggressive action to respond to an expanding outbreak caused by H1N1 (swine flu). CDC’s response goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.

CDC continues to issue and update interim guidance daily in response to the rapidly evolving situation. Early this morning, CDC provided interim guidance on school closures. Supplies from CDC’s Division of the Strategic National Stockpile (SNS) are being sent to all 50 states and U.S. territories to help them respond to the outbreak. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against this new virus.

Response actions are aggressive, but they may vary across states and communities depending on local circumstances. Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak. People who are sick are urged to stay home from work or school and to avoid contact with others, except to seek medical care. This action can avoid spreading illness further.