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Pandemic Influenza A H1N1

This report provides an overview of the global and national situation regarding the H1N1 influenza pandemic, including vaccination efforts for health care workers. The report includes information on the number of cases and deaths, vaccine availability, planning and coordination at the state level, target population, cold chain capacity, vaccination planning, adverse events monitoring, and timeline for vaccine rollout.

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Pandemic Influenza A H1N1

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  1. Pandemic Influenza A H1N1 Vaccinating Health Care Workers

  2. International Scenario • WHO reported ‘at least’ 13554 deaths as on 10th January 2010 from 208 Countries. • Influenza Activity is declining in most countries except for countries in East Europe, North Africa and some parts of Asia • Whether a fresh surge would emerge cannot be predicted.

  3. Global Spread Cases and Deaths Cases only 208 Countries affected

  4. Country Specific Cases/ deaths

  5. Countries reporting mutation in H1N1 virus

  6. Countries reporting anti viral resistance 185 Cases ; 20 Countries

  7. National Scenario • 28,110 persons tested positive • 1,111 persons died • Influenza activity is showing declining trend in Rajasthan, Delhi and Haryana but renewed activity is seen in Gujarat and Maharashtra (Pune). • There is an overall decline in morbidity and mortality.

  8. 96 % cases recovered/recovering 117094 persons tested for H1N1 –27712 positive, 1059 dead 117094 persons tested till 10 January 2010 -77 % of them negative

  9. Weekly Trend of Cases

  10. Pandemic Vaccine • Four Indigenous Manufacturers • Serum Institute, Zydus Cadila, Panacea, Bharat Biotech • Clinical Trials Started • Commercial lot expected in April/ May 2010. • Import of Vaccine • 1.5 million doses to vaccinate Health Care Workers.

  11. Pandemic Vaccination Objective • Protect those most at risk of infection with this new virus. • Among the high risk group, the health care workers in the hospitals from CHC and above would be targeted, to ensure that the health facilities providing medical care/ H1N1 care are able to continue its operations even in future worst case scenario.

  12. Planning and coordination at State level • State Pandemic Influenza Deployment Plan : The State Governments need to develop an operational plan • At State Level, co-ordination mechanism needs to be established between the Medical Education/ Health/ Hospital/ Family Welfare Departments etc to ensure that the target population is vaccinated. • State Nodal Officer: Nodal Officer need to be identified to role out the vaccination programme in the State. • MOHFW has sent Checklist / Proforma to all the states.

  13. Target Population The health care workers • Doctors, nurses, pharmacists, Paramedical Staff and Support staff of • CHCs • Sub-District Hospitals • District hospitals • Medical colleges • Tertiary Care hospitals • Ayush Hospitals • Hospitals under local bodies/ Government owned Societies etc. • Health Workers in Identified Private Hospital managing H1N1 • Laboratory Staff of Labs Testing H1N1

  14. Pandemic Vaccine • Inactivated, non-adjuvanted vaccine • 0.5 ml single dose for the identified target group • Intra Muscular • Comes in multi dose vial of 5ml. • Needs storage and transportation at 2-8 degree Celsius

  15. Cold Chain Capacity • Central Level • Storage at GMSD Delhi and Karnal • States need to identify: • Minimum Additional net Capacity of 200 Litres at State/ Regional Level ( Equivalent to 300 Litre ILR) • Additional Net Capacity of 20 Litres in Medical Colleges / District level.

  16. AD Syringes • The vaccine would require use of AD syringes. • State has to ensure the availability from the Immunization Programme. • The AD syringes utilized on account of pandemic vaccine would be replaced. • Dry Storage Space for AD Syringes.

  17. Vaccination Planning • Micro plan for the District • Distribution plan • Logistic support for supply chain/ cold chain • Health Facility where vaccination would be carried out • Identified Vaccinators • Vaccination Day(s) • Training

  18. Adverse Events • Being an inactivated vaccine very few adverse events are expected. • However, there had been rare reporting of serious adverse events with seasonal influenza vaccine. • Hence the vaccinated population needs to be monitored for Adverse Event Following Immunization (AEFI). • information on AEFI : The State Nodal Officer would arrange the training of the identified vaccinators / dissemination of information on AEFI.

  19. Wastage • Expensive vaccine • Wastage norms as applicable to UIP vaccines should not be applied to pandemic vaccine. • Special attention needs to be taken to avoid wastage.

  20. Time line • The vaccine is expected in the Delhi/ Karnal GMSD by third week of January 2010. • The roll out is expected to start from February first week. • The states confirming of cold storage capacity is expected to receive the vaccine in the first week of February itself. • It is expected that the state would further deploy the vaccine to the vaccination centres in another week to 10 days.

  21. State EPI/ UIP Officers Meeting • A meeting of State Nodal Officers (Immunization) has been called on 22nd January 2010 • Operational plan, guidelines and other issues would be discussed and finalized.

  22. Thank you

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