Welcome to the Provincial Health Officer’s H1N1 Site for the Physicians of B.C.

Site Last Updated: November 19, 2009

At the request of B.C.’s physicians, this web resource has been established to provide a centralised and ongoing source of current information about the emerging issues surrounding the novel H1N1 flu virus.

Throughout the influenza season we will update and revise this information as necessary and also provide access to provincial- and health authority-specific information, including:

• Clinical Information
• Epidemiology
• Clinical impacts (hospitalizations, service changes)
• Pertinent information from the Medical Services Commission

You are encouraged to sign up to receive notification when significant updates or additions are available.

Message from the Provincial Health Officer (PDF 47K)

Message from the College of Physicians and Surgeons of BC (PDF 82K)

Message from the BCMA (PDF 34K)

Sincerely,

New Information this Week:

• Weekly pH1N1 Vaccine Sequencing Schedule (November 19, 2009)  (PDF 62K)  *UPDATED*
• PHAC H1N1 Flu Vaccine Dosing Recommendations (November 13, 2009) *NEW*
• Influenza A (H1N1) 2009 Pandemic Monovalent Vaccine (Without Adjuvant) Product Information Leaflet – A link to the UnAdjuvanted H1N1 Pandemic Influenza Vaccine Product Information Leaflet from GlaxoSmithKline  (November 13, 2009)  *NEW*
• For Patients – Questions & Answers – H1N1 Vaccine Information  (November 19, 2009)  (PDF 67K) *UPDATED*
• Updated Adjuvanted pH1N1 Vaccine Dosing Recommendations for children ages 6 months to 9 years (inclusive) (November 12, 2009)  (PDF 43K) *NEW*
• Co-administration of Pandemic H1N1 (pH1N1) Vaccine and Seasonal Influenza Vaccine  (November 10, 2009)  (PDF 40K)  *NEW*

PHO and Related Correspondence

• Message from the College of Physicians and Surgeons of BC (November 6, 2009) (PDF101K)
  RE:     pH1N1 Vaccine Prioritization and use in a Time of Limited Supply
• Letter to Health Professionals (October 23, 2009) (PDF 67K)
  RE:     Appropriate Antiviral Use for Pandemic (H1N1) 2009 Influenza in British Columbia
• Clarification: The above letter states that “Oseltamivir is available at no charge to any patient with a prescription who meets” the criteria for treatment. PLEASE NOTE: The drug cost is fully covered along with $8.60 of the dispensing fee. Dispensing fees vary somewhat from pharmacy to pharmacy.
• PHO Letter to Physicians re H1N1 Visit Fee (October 20, 2009) (PDF 128K )
  

  RE:	New PG13700 – GP Office Visit for H1N1
  	After Hours Coverage
  	H1N1 Testing for Clinical Management
  	Subscribe Function – H1N1 Physician Website

Epidemiology: novel H1N1 (2009) in BC

Please Note: Confirmed cases will be updated weekly on Tuesdays. More detailed BC Influenza Surveillance Bulletins can also be access through this link.

Preparing your office, staff and patients

• H1N1 Physician Fee Codes (PDF 67K)
  • Frequently Asked Questions – H1N1 Physician Fee Items (October 16, 2009)
• Guidelines for Pandemic Influenza-related Office Management and Infection Control for Private Physicians (October 30, 2009) (PDF 968K)
  • Appendix A - Clinic Pandemic Preparedness Checklist (PDF  89K)
  • Appendix B - Possible Signage at reception (PDF 239K)
  • Appendix C - Basic Personal measures and Cough Etiquette (PDF 125K)
  • Appendix D - Waiting Room Configuration (PDF 121K)
  • Appendix E - Hand Hygiene (PDF 233K)
  • Appendix F - Surgical Masks (PDF 124K)
  • Appendix G - N95 Respirators (PDF 171K)
  • Appendix H - Facial (eye) Protection (PDF 134K)
  • Appendix I - Sequence for Putting on / Taking off PPE for Exposure to Body Fluids (PDF 173K)
  • Appendix J - General Cleaning Instructions (PDF  75K)
  • Appendix K - Disinfectants (PDF  73K)
  • Appendix L - Example of a General Telephone Welcome Message on Automated Attendant System (PDF  70K)
  • Appendix M – Estimates of Private Physician Office Personal Protective Equipment (PPE) (October 23, 2009) (PDF 101K)
• Information and resources useful to Medical Office Assistants (October 8, 2009) (PDF 54K)
• Suggested Letter Template for patients at high risk of Influenza complications and their caregivers (October 23, 2009) (PDF 20K)
• Medical Office Assistant Telephone Script: Pre-visit Influenza Screening (PDF 99K)
  This Telephone Script is intended to be a tool to help identify influenza-like illness (ILI) among patients, prior to their visit to the physician’s office. By identifying patients with influenza-like symptoms over the phone, the MOA has the opportunity to provide direction to patients at that time, which helps to minimize transmission of influenza to others during a visit to the physician’s office.

Immunization

• Pandemic H1N1 Immunization Programs and Priority Groups
• Weekly pH1N1 Vaccine Sequencing Schedule (November 13, 2009) (PDF 62K) *UPDATED*
• PHAC H1N1 Flu Vaccine Dosing Recommendations (November 13, 2009)  *NEW*
• Updated Adjuvanted pH1N1 Vaccine Dosing Recommendations for children ages 6 months to 9 years (inclusive) (November 12, 2009)  (PDF 43K) *NEW*
• Co-administration of Pandemic H1N1 (pH1N1) Vaccine and Seasonal Influenza Vaccine  (November 10, 2009)  (PDF 40K)  *NEW*
• Influenza A (H1N1) 2009 Pandemic Monovalent Vaccine (Without Adjuvant) Product Information Leaflet – A link to the UnAdjuvanted H1N1 Pandemic Influenza Vaccine Product Information Leaflet from GlaxoSmithKline  (November 13, 2009)  *NEW*
• Arepanrix H1N1 Product Information Leaflet – A link to the AS03 Adjuvanted H1N1 Pandemic Influenza Vaccine Product Information Leaflet from GlaxoSmithKline  (November 6, 2009)
• Message from the College of Physicians and Surgeons of BC – pH1N1 Vaccine Prioritization and Use in a Time of Limited Supply  (November 6, 2009)  (PDF 101K) 
• Public Health Agency of Canada Recommendations for pH1N1 Vaccine in Pregnancy  (October 30, 2009)
• Q and A for Health Care Providers – Seasonal and Pandemic Vaccines (November 6, 2009) 
• Administration of H1N1 and Seasonal Influenza Vaccine to Egg Allergic Individuals (October 28, 2009) – A statement from The Canadian Society of Allergy and Clinical Immunology for physicians of patients with a diagnosed egg allergy who are candidates for the influenza vaccine (both H1N1 and seasonal).
• Seasonal Influenza Immunization Program
• Seasonal Influenza Immunization Program  (November 6, 2009)  (PDF 82K)
• Q and A for Health Care Providers – Seasonal and Pandemic Vaccines  (November 6, 2009)
• The National Advisory Committee on Immunization (NACI) Statement on Seasonal Trivalent Inactivated Influenza Vaccine (TIV) for 2009 – 2010  (November 6, 2009)  
• Pneumococcal Immunization Program
• Pneumococcal Immunization Programs  (November 10, 2009) (PDF 96K)

Clinical  Care

• Diagnosis and management
• Testing Guidelines (October 23, 2009) (PDF 140K) – Clarification on testing priorities.
• Treatment Guidelines (September 25, 2009) (PDF 126K)
• Antibiotic Therapy Guidance: Antibiotics for Secondary Pneumonia in Community and Acute Care Settings (October 20, 2009) (PDF 186K)
• For Health Professionals – Frequently Asked Questions about Antiviral Medication – Information from the Ministry of Health Services (September 30, 2009)
• Health Canada Advisory – Potential Medication Errors with Liquid Tamiflu (October 8, 2009)

• Considerations for specific populations:
• The Society of Obstetricians and Gynaecologists of Canada
  SOGC President’s letter to members regarding H1N1 (September 2, 2009)
• First Nations Communities
• Pandemic Preparedness and Response for Remote First Nations Communities in British Columbia: Action Plan 2009/2010 (PDF 1.8M)

Patient Information Resources

• The HealthLink BC Files on the H1N1 Flu Virus and the H1N1 Vaccine.
• Province of B.C.’s public H1N1 site: www.gov.bc.ca/h1n1
• HealthLink BC provides non-emergency health information, self-care assistance and telephone triage 24/7 at www.HealthLinkBC.ca or toll-free at 8-1-1. Translation services are available through 8-1-1 on request in over 130 languages.
• Frequently Asked Questions about Antiviral Medication – Information for patients from the Ministry of Health Services (October 8, 2009)
• Questions & Answers – H1N1 Vaccine Information  (November 13, 2009)  *UPDATED*

Influenza Immunization Clinic Schedules by Health Authority

Additional Considerations

• An Ethical Framework for Decision- Making: Supporting British Columbia’s Pandemic Influenza Planning and Response (October 23, 2009)

Public Health Measures

• Public Health Measure Summary (October 23, 2009)

• Technical Document to follow.

Advisory Resources

• The PHO’s Pandemic influenza Clinical Care Advisory Group (PDF  13K)
• The PHO’s Pandemic Influenza Public Health Advisory Group (PDF  11K)
• Medical Health Officers of BC Contacts (PDF  27K)

Other useful links

• H1N1 Influenza Site for Nurses
• H1N1 Influenza Site for Pharmacists
• The Lancet's H1N1 Resource Centre
• CME opportunity – Infectious Disease Outbreak: Tools and strategies for front-line clinicians (PDF  49K)

PDF Format

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