Microsoft word - testing for h1n1 influenza unnecessary in most cases.doc

NEWS RELEASE Mobile County Health Department
Aug. 20, 2009

Contact: David Mann, Public Information Officer, 690-8823, [email protected]

Testing for H1N1 influenza unnecessary in most cases

An Aug. 19 update on novel H1N1 influenza (swine flu) issued by Dr. Don Williamson, State Health
Officer, included the following information:
Novel H1N1 is widely prevalent in Alabama. Over the last four weeks, the Alabama Department of Public
Health (ADPH) laboratory confirmed 652 cases of influenza, all of which were novel H1N1. Patients with
flu-like symptoms most likely have H1N1 disease, and clinicians are justified in making this diagnosis
based solely on presentation.
Rapid influenza diagnostic tests positive for A or A/B are highly predictive of novel H1N1. H1N1 is less
likely if the rapid test is positive for B. Negative rapid tests do not rule out H1N1. Several commercial
laboratories offer H1N1 PCR testing, but routine confirmatory testing is not necessary and treatment
decisions should not be delayed pending off-site test results. Because of the widespread prevalence of the
disease and finite capacity of the ADPH laboratory, ADPH must restrict testing to hospitalized patients,
pregnant women, and a fixed number of patients seen weekly by a statewide network of designated
practices. This approach will allow ADPH to confirm the diagnosis in severely ill persons and pregnant
women and identify circulating influenza subtypes.
Although there have been a few case reports of resistance to Tamiflu, H1N1 is sensitive to both it and
Relenza. H1N1 is resistant to adamantine and Flumadine. For maximum benefit, antiviral treatment
should begin as close to the onset of illness as possible. Many persons with mild symptoms and no
underlying risk factors for severe illness recover from H1N1 illness without taking antivirals.
The Centers for Disease Control and Prevention (CDC) says persons with influenza-like illness should
remain at home until at least 24 hours after they are free of fever (100° F), or signs of a fever, without the
use of fever-reducing medications. This is often three to five days. This recommendation applies to
schools, businesses, mass gatherings, camps, and other community settings where the majority of people
are not at increased risk for influenza complications. Because viral excretion can persist after cessation of
fever, convalescent healthcare workers should remain at home for seven days from symptom onset or
until the resolution of symptoms, whichever is longer.
Note: Because recommendations may change, check CDC's and ADPH's Web sites ( and frequently.



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