Josephine County Online-Info for Clinicians

715 NW Dimmick Street
Grants Pass, OR 97526
Phone: (541) 474-5325
Fax: (541) 474-5353
Contact: Diane Hoover, PhD, FACHE
Email:
Hours: 9:00 - 3:30 PM Mon-Th (Closed 12-12:30 for lunch), and Closed Fridays, WIC 8:00-5:15M-Th (Closed for lunch 12:30-1:00pm), Closed Fridays

Info for Clinicians

If you suspect H5N1 infection, institute infection control measures, and then contact Josephine County Communicable Disease at 541-474-5347 to facilitate specimen handling.

Current Suspect Case Definition and Laboratory Testing Criteria (updated 6/7/06)

(From Oregon State Public Health Investigative Guidelines)

Testing for avian influenza A (H5N1) virus infection is recommended for:

A patient who has an illness that:

requires hospitalization or is fatal; AND
has or had a documented temperature greater than 38 C (100.4 F); AND
has radiographically confirmed pneumonia, acute respiratory distress syndrome (ARDS), or other severe respiratory illness for which an alternate diagnosis has not been established; AND
has at least one of the following potential exposures within 10 days of symptom onset:

A) History of travel to a country with influenza H5N1 documented in poultry, wild birds, and/or humans, AND had at least one of the following potential exposures during travel:

direct contact with (e.g., touching) sick or dead domestic poultry;

direct contact with surfaces contaminated with poultry feces;

consumption of raw or incompletely cooked poultry or poultry products;

direct contact with sick or dead wild birds suspected or confirmed to have influenza H5N1;

close contact (approach within 1 meter [approx. 3 feet]) of a person who was hospitalized or died due to a severe unexplained respiratory illness

B) Close contact (approach within 1 meter [approx. 3 feet]) of an ill patient who was confirmed or suspected to have H5N1;

C) Worked with live influenza H5N1 virus in a laboratory.

Testing for avian influenza A (H5N1) virus infection can be considered on a case-by-case basis, in consultation with local and state health departments, for:

A patient with mild or atypical disease (hospitalized or ambulatory) who has one of the exposures listed above (criteria A, B, or C); OR
A patient with severe or fatal respiratory disease whose epidemiological information is uncertain, unavailable, or otherwise suspicious but does not meet the criteria above (examples include: a returned traveler from an influenza H5N1-affected country whose exposures are unclear or suspicious, a person who had contact with sick or well-appearing poultry, etc.)

Algorithm for Suspected Cases of Novel Influenza

A list of countries where poultry are currently affected can be obtained from:

http://www.oie.int/downld/AVIAN%20INFLUENZA/A_AI-Asia.htm

Updated Case Definitions will be made available as the global, US, and regional situation requires.

Services Available at the Oregon State Public Health Laboratory (OSPHL)

Reverse transcriptase polymerase chain reaction (RT-PCR) testing for Novel Influenza types H5 and H7 is available at the OSPHL. Click here for the virology request form to accompany specimens (go to page 7); complete the patient and submitter information plus source and onset under the VIRUS ISOLATION section; "novel influenza by PCR" is already completed. Throat or nasal swabs or nasal washings in viral transport media sent on cold packs are preferred. Testing criteria are under constant evolution and will be updated as needed. Clinicians may contact OSPHL at 503 229-5882 for additional specific information on submitting specimens.

Culture is not performed at the OHPHL for safety reasons; specimens from patients at high risk for novel influenza should not be submitted for culture.

Links

Infection Control Recommendations from CDC

"Cover Your Cough" Posters from CDC

More Information for Health Professionals from CDC