Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths - one case positive for H1N1, another for unspecified influenza A
Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths - one case positive for H1N1, another for unspecified influenza A
[Source: Alabama Department of Health, full PDF document: (
LINK). H / t HealthMap via Twitter.]
Alabama Department of Public Health ALERT Message 5/21/13
On 5/16/13, a pulmonologist in Southeast Alabama reported to the Alabama Department of Public Health (ADPH) that three patients had been hospitalized with cough, shortness of breath, and pneumonia, were on ventilators, and had no known cause for their illness. The ADPH and the Houston County Health Department began an epidemiology investigation to interview the families about travel and exposure.
Specimens were requested and submitted to the ADPH Bureau of Clinical Laboratories (BCL) in Montgomery.
On 5/17/13,
BCL reported one of the three patients tested positive for 2009 H1N1. On 5/18/13, this patient died. On 5/19/13, the same hospital reported that a transferred patient on a ventilator with respiratory symptoms had died. On 5/19/13, this hospital had nine additional patients present to the emergency department with influenza-like illness and three of those patients were admitted. Specimens have been collected on all patients. The BCL has tested all specimens on a PCR flu panel and one
tested positive for AH3. The specimens were also forwarded to CDC for additional testing.
At this time, there is no epidemiological link between these patients. While two patients have tested positive for influenza, the exact role of influenza in this cluster is unknown. On 5/21/13, ADPH sent a News Release regarding the situation.
ADPH has reiterated that healthcare providers should use standard precautions when dealing with patients with respiratory illness. Physicians should use clinical judgment in determining the best treatment for their patients since the etiology of the outbreak is unknown at this time.
REPORTING
Please report all patients currently hospitalized with pneumonia, with unknown cause (regardless of quick flu test results), to
www.adph.org/epi, Respiratory Illness REPORT Card.
SPECIMEN COLLECTION
For patients who present with fever (>100.4F) and cough or shortness of breath with unknown cause (regardless of quick flu test results), please submit an upper tract specimen, ie, oropharyngeal (OP) swab or nasopharyngeal (NP) swab, to the Bureau of Clinical Laboratories as part of ADPH's year-round influenza surveillance program. For more information about collecting, packing, and submitting lab specimens, please go to
http://adph.org/bcl/assets/Guide_Lab_Test_Inf_Virus_092210.pdf or call BCL 334-260-3429, Microbiology Division.
For patients who present with pneumonia with unknown cause (regardless of quick flu test results), please collect and submit a lower tract specimen, ie, bronchoalveolar lavage, tracheal aspirate, or sputum, to the BCL.
For patients admitted to the hospital with cough or shortness of breath, and pneumonia (regardless of quick flu test results), with unknown cause, please send both upper and lower tract specimens. Multiple respiratory specimen types with ample volume are preferred.
If you have any questions, please contact the Epidemiology Division at 1-800-338-8374 and ask to speak with staff involved in the Respiratory Illness Outbreak.
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