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Influenza is not a reportable disease in New Hampshire, but surveillance systems are in place to help determine the extent of illness and current circulating virus types. During the traditional influenza season (beginning of October through mid-May), weekly flu reports are published. Data from heath care providers and laboratories, as well as data from other surveillance systems, are analyzed, and NH flu activity is reported weekly to the Centers for Disease Control and Prevention (CDC). New Hampshire participates in the U.S. Influenza Sentinel Provider Surveillance System, a collaborative effort between the CDC, the NH Department of Health and Human Services, and health care providers throughout the State.
Influenza Vaccine
Influenza vaccination is the primary method for preventing influenza and its severe complications. All health care workers who have direct patient contact should receive annual influenza vaccination. All persons in high risk groups outlined in CDC's Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP) should be offered influenza vaccination.
Healthy children aged 24-59 months and their household contacts and out-of-home caregivers have been added, extending the recommendations for vaccination of children so that all children aged 6 to £59 months should receive annual vaccination.
The NH Immunization Program provides vaccines for all NH children.
Antiviral Medications
Although annual vaccination is the primary strategy for preventing complications of influenza virus infections, antiviral medications may be effective for the chemoprophylaxis and treatment of influenza. Four licensed antiviral agents are available in the U.S.: amantadine, rimantadine, zanamivir, and oseltamivir. However, due to high levels of resistance demonstrated in 2005-06, the ACIP recommends that neither amantadine nor rimantadine be used for the treatment or prophylaxis of influenza A in the U.S. until susceptibility to these antiviral medications has been re-established among circulating influenza A viruses. Recommendations for the use of antiviral medications can be found in the 2006 ACIP recommendations mentioned above.
Laboratory Testing for Influenza
Many commercial rapid tests are available and can detect influenza viruses in 30 minutes, making these tests very convenient for use in outpatient settings. These tests differ in the types of influenza viruses they can detect, and whether they can distinguish between influenza virus types. As with any test for influenza, the sensitivity and specificity can vary depending on the lab that performs the test, type of test used, type of specimen tested, and the timing of specimen collection.
Despite the availability and convenience of rapid diagnostic tests, none of these tests can provide information regarding influenza A subtypes. Collecting clinical specimens for viral culture remains critical, since only culture isolates can provide specific information regarding circulating strains and subtypes of influenza viruses. The NH Public Health Laboratories are available year-round for identification of influenza virus subtypes, and are a critical component of influenza surveillance in NH and in the U.S.
Prevention and Control
Preventing an influenza outbreak in any clinic setting or health care facility is critical. All health care staff should be follow infection control recommendations to help prevent the spread of influenza or any other respiratory infection. The Communicable Disease Control Section staff is available 24 hours a day/ 7 days a week to help answer questions regarding infection control practices, or to offer assistance should an outbreak occur. Staff can be reached during business hours at 1-603-271-4496, or after hours at 1-800-852-3345 Ext. 5300.
Public Awareness & Education
Educating the public, including your patients, on how to prepare for flu season is key to prevention. The Division of Public Health Services provides access to printed materials that can be distributed and displayed in public places where the public is most likely to seek health information.
- Influenza Fact Sheet- 2-page hand out that provides general information about influenza, such as prevention, treatment and symptoms.
- Influenza Tool Kit - Educational materials available through the American Lung Association and the Granite State Immunization Partnership.
- Hand Hygiene Posters - Two versions of this poster, one for health care workers and one for children, provide information about the importance of hand washing, when to wash, and how to wash for preventing the spread of disease.
- Flu Awareness & Prevention Posters - Three posters that promote vaccination and provide tips for prevention.
Pandemic Preparedness
The State of New Hampshire Influenza Pandemic Public Health Preparedness & Response Plan (99 pages) is published to advise health care workers, health care facilities, State and local health departments, and NH communities with appropriate preparedness and response activities that can help protect the public against a potential influenza pandemic. The plan was reviewed and accepted by the NH Communicable Disease Epidemic Control Committee, a group of health officials from the Community and State levels, and continues to be updated. Additional information regarding pandemic preparedness, and avian influenza, can be found on the State's avian flu website: www.avianflu.nh.gov.
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