This document provides interim planning guidance that focuses on several nonpharmaceutical measures that might be useful during this outbreak of swine influenza A (H1N1) virus aimed at reducing disease transmission and associated morbidity and mortality.
Human cases of swine influenza A (H1N1) virus infection have been identified in several states and in other countries. This is a novel influenza A virus that has not been identified in people before, and human-to-human transmission of the virus appears to be ongoing.
Unlike the experience in Mexico, the United States is currently observing a less severe clinical spectrum of disease with infection by the identical virus strain. In Mexico, many patients have experienced rapidly progressive pneumonia, respiratory failure requiring mechanical ventilation and acute respiratory distress syndrome (ARDS). Therefore, the experience of these two countries has been markedly different to date. Getting better information to explain these differences is a high priority for the ongoing investigation.
The previously published United States government guidance on community mitigation relies on knowledge of the Pandemic Severity Index (PSI) to characterize the severity of a pandemic and identify the recommendations for specific interventions that communities may use for a given level of severity, and suggests when these measures should be started and how long they should be used.
The substantial difference in the severity of the illness associated with infections from the same virus, the relatively low number of cases detected in the United States, and insufficient epidemiologic and clinical data to ascribe a PSI, present a formidable challenge in terms of assessing the threat posed by this novel influenza A virus until additional epidemiologic and virologic information is learned.
Novel influenza A virus infections in humans, including swine influenza A (H1N1) virus, represent a pandemic threat. Recognizing the historical precedent for the emergence of a pandemic influenza virus which could have waves of disease with different morbidity and mortality and epidemiologic profiles, public health departments in the United States must remain vigilant.
It is prudent for communities to act in the absence of sufficient data to protect their citizens and take advantage of a narrow window of opportunity for intervention. CDC recommends that affected states with at least one laboratory-confirmed case of swine influenza A (H1N1) virus infection consider activating community mitigation interventions for affected communities. As public health officials in the United States learn more about this emerging virus, updated guidance will be issued.
When Human Infection with Swine Influenza A (H1N1) Virus is Confirmed in a Community
1. remain home at the earliest sign of illness;
2. minimize contact in the community to the extent possible;
3. designate a single household family member as the ill person’s caregiver to minimize interactions with asymptomatic persons.
School Dismissal and Childcare Facility Closure
Other Social Distancing Interventions
These recommendations are subject to change as additional epidemiological and clinical data become available.
Interim CDC Guidance for Mitigation in Response to Human Infections with Swine Influenza (H1N1) Virus: Created on April 27th, 2009. Last Modified on April 27th, 2009
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