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Grayson county health department
GRAYSON COUNTY HEALTH DEPARTMENT
515 North Walnut
205 N. Houston
Sherman, TX. 75090
Denison, TX. 75021
Steve Devore, Director
Wayne Bell, M.D., Medical Director and Grayson County Health Authority
HEALTH AUTHORITY STATEMENT:
H1N1 Influenza Update
The following information has been gathered from both the Centers for Disease Control and Prevention (CDC), and the Texas Department of State Health Services. The Grayson County Health Department and Grayson County’s Health Authority is working closely with the Texas Department of State Health Services, the Governor’s Division of Emergency Management, as well as the Grayson County Emergency Management Office.
As of April 30, 2009 at 11:00 AM, there have been 26 laboratory confirmed human cases of Swine Influenza A (H1N1) in Texas. A total of 109 cases have been confirmed in the U.S., including the states of Arizona, California, Indiana, Kansas, Massachusetts, Michigan, Nevada, New York, Ohio, South Carolina and Texas. The list of states as well as the number of confirmed cases are updated daily at 11:00 AM atInvestigations are ongoing to determine the source of the infection and whether additional people have been infected with the swine influenza virus. No confirmed cases have been reported in Grayson County. The Centers for Disease Control and Prevention announced yesterday that a 22-month old Texas toddler became the first confirmed Swine Flu death within the United States. The 22-month-old boy, from Mexico City, had several underlying health problems and had traveled with his family to visit relatives in Texas. Monday, the Center for Disease Control and Prevention issued a travel warning recommending that people should avoid non-essential travel to Mexico.
Influenza is always serious – each year, in the United States, seasonal influenza results, on average, in an estimated 36,000 deaths from flu related causes. The CDC expects that we will see more cases, more hospitalizations and more deaths from this outbreak of swine flu. This outbreak certainly poses the potential to be at least as serious as seasonal flu if not more so. Because this is a new virus, most people will not have immunity to it. Therefore, the illness may be more severe and widespread as a result. Internationally, more countries are reporting cases of infection with this new virus.
Grayson County Health Authority Statement April 30, 2009 Page 1 of 5
Symptoms of swine flu in people are similar to those of regular or seasonal flu and
include fever, lethargy, lack of appetite and coughing. Some with swine flu have also
reported a runny nose, sore throat, nausea, vomiting and diarrhea. At this time the
Grayson County Health Department is not testing patients for influenza. You should
contact your doctor if you have fever>100°F and
cough and/or sore throat.
It is important to understand that if an individual receives a positive Influenza A test
result from their doctor, it does not necessarily mean the individual is infected with the
new Swine Flu (H1N1). Patients with a positive Influenza A test result may just have the
seasonal flu. Only the Texas Department of State Health Services Laboratory can
determine if a positive Influenza A test result is the seasonal flu or a non-sub-
typeable Influenza A.
If the test result is non-subtypeable at the Texas Department of
State Health Services Laboratory, it then becomes a probable case and the sample is sent
to the Centers for Disease Control and Prevention (CDC) for final evaluation. Only the
CDC can make the determination if the non-subtypeable Influenza A positive test sample
is the new swine flu. The CDC makes the final determination.
The Federal Government is mounting an aggressive response to this outbreak. The
CDC’s goals during this public health emergency are to reduce transmission and illness
severity, and provide information to assist health care providers, public health officials
and the public in addressing the challenges posed by this newly identified influenza virus. Young children and pregnant women
are at high risk for serious complications from
seasonal flu and it would not be surprising to find a pattern where they also are at high
risk of serious complications from this new virus. Individuals should take precautions; be
aware of warning signs; and seek medical care sooner rather than later. The CDC has
developed a real-time RT-PCR (rapid test) Detection Panel to expand and maintain the
operational capabilities of public health or other qualified laboratories by providing a
detection tool for the presumptive presence of this influenza A /H1N1 virus. This
diagnostic test is being distributed to states nationwide to increase their capacity to test at
the state level. In addition, distribution of antiviral drugs, personal protective equipment,
and respiratory protection devices from CDC’s Division of the Strategic National
Stockpile (SNS) to all 50 states and U.S. territories continues. The Strategic National
Stockpile has 49.9 million regimens of antiviral drugs. Laboratory testing on these
viruses so far indicate that they are susceptible
(sensitive) to the antiviral drugs in our
nations stockpile. Influenza antiviral drugs are an important weapon in our arsenal
against influenza. The SNS deployment includes approximately 11 million antiviral
regimens, masks, N95 respirators, Gowns, Gloves and face shields.
Currently, there is not a vaccine available to protect against this virus, but the CDC has begun the process of developing a vaccination. However, two influenza antiviral medications are recommended for use against swine influenza. These are oseltamivir (trade name Tamiflu ®) and zanamivir (Relenza ®). 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.
Grayson County Health Authority Statement April 30, 2009 Page 2 of 5
The Texas Department of State Health Services and the Centers for Disease Control and
Prevention (CDC) recommend the public should follow standard precautions to reduce
the spread of any respiratory illness. You have a role in protecting yourself and your
Stay home when you are sick to avoid spreading illness to others.
Cough or sneeze into the crook of your elbow or a tissue and properly dispose of
Wash hands frequently and thoroughly with soap and warm water or use an
Avoid touching your eyes, nose, or mouth.
Avoid close contact with people who are sick. Influenza is thought to spread
mainly person-to-person through coughing or sneezing of infected people.
If a child has a fever, do not give the child aspirin.
Get plenty of sleep, manage your stress, drink plenty of fluids, and eat nutritious
If you don’t have one yet, consider developing a family emergency plan as a
precaution. This should include storing a supply of extra food, medicines, facemasks and other essential supplies.
Stay informed. Health officials will provide additional information as it becomes available. Visi
Answers to commonly asked questions on the Centers for Disease Control and
Prevention website (www.cdc.gov/swineflu).
What is Swine Influenza?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by the type A
influenza virus that regularly causes outbreaks of influenza in pigs. Swine flu viruses
cause high levels of illness and low death rates in pigs. Swine influenza viruses may
circulate among swine throughout the year, but most outbreaks occur during the late fall
and winter months similar to outbreaks in humans. The classical swine flu virus (an
influenza type A H1N1 virus) was first isolated from a pig in 1930.
Grayson County Health Authority Statement April 30, 2009 Page 3 of 5
Swine Flu in Humans
Can humans catch swine flu?
Swine flu viruses do not normally infect humans. However, sporadic human infections
with swine flu have occurred. Most commonly, these cases occur in persons with direct
exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In
addition, there have been documented cases of one person spreading swine flu to others.
For example, an outbreak of apparent swine flu infection in pigs in Wisconsin in 1988
resulted in multiple human infections, and, although no community outbreak resulted,
there was antibody evidence of virus transmission from the patient to health care workers
who had close contact with the patient.
What are the symptoms of swine flu in humans?
The symptoms of swine flu in people are expected to be similar to the symptoms of
regularand include fever, lethargy, lack of appetite and
coughing. Some people with swine flu also have reported runny nose, sore throat, nausea,
vomiting and diarrhea.
Can people catch swine flu from eating pork?
No. Swine influenza viruses are not transmitted by food. You can not get swine influenza
from eating pork or pork products. Eating properly handled and cooked pork and pork
products is safe. Cooking pork to an internal temperature of 160°F kills the swine flu
virus as it does other bacteria and viruses.
How does swine flu spread?
Influenza viruses can be directly transmitted from pigs to people and from people to pigs.
Human infection with flu viruses from pigs are most likely to occur when people are in
close proximity to infected pigs, such as in pig barns and livestock exhibits housing pigs
at fairs. Human-to-human transmission of swine flu can also occur. This is thought to
occur in the same way as seasonal flu occurs in people, which is mainly person-to-person
transmission through coughing or sneezing of people infected with the influenza virus.
People may become infected by touching something with flu viruses on it and then
touching their mouth or nose.
How can human infections with swine influenza be diagnosed?
To diagnose swine influenza A infection, a respiratory specimen would generally need to
be collected within the first 4 to 5 days of illness (when an infected person is most likely
to be shedding virus). However, some persons, especially children, may shed virus for 10
days or longer. Identification as a swine flu influenza A virus requires sending the
specimen to CDC for laboratory testing.
What medications are available to treat swine flu infections in humans?
There are four different antiviral drugs that are licensed for use in the US for the
treatment of influenza: amantadine, rimantadine, oseltamivir and zanamivir. While most
swine influenza viruses have been susceptible to all four drugs, the most recent swine
influenza viruses isolated from humans are resistant to amantadine and rimantadine. At
Grayson County Health Authority Statement April 30, 2009 Page 4 of 5
this time, CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine influenza viruses.
Is there a vaccine for swine flu?
Vaccines are available to be given to pigs to prevent swine influenza. There is no vaccine
to protect humans from swine flu. The seasonal influenza vaccine will likely help provide
partial protection against swine H3N2, but not swine H1N1 viruses. The CDC is taking
initial steps to begin the development of a vaccine against this strain, but a decision to do
so has not been made yet. If/when, that is done; it will take 4-6 months for it to be
Department of State Health Services Guidelines for General Public Guidance: 1-888-777-5320
Grayson County Health Department contact for Schools and Clinicians: 903-893-0131 ext. 243
Media Contact for Grayson County Health Department: 903-465-2878 ext.243
Media Contact for Grayson County Office of Emergency Management: 903-814-7866
Updates will be released as new information is received.
Grayson County Health Authority Statement April 30, 2009 Page 5 of 5
1. Assinale a alternativa INCORRETA: (a) A interdição do pródigo o privará de, sem curador, transigir e dar quitação;(b) Não existindo mais cônjuge, ascendentes ou descendentes do pródigo, este poderá pedir ao juiz o levantamento da interdição;(c) O cônjuge, os ascendentes, os descendentes e o Ministério Público são legitimados para requerer a interdição do pródigo;(d) A c
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