Microsoft word - ga swine flu notice 4-28-09.doc

WellCare Health Plans, Inc.
Swine Flu Virus – Take Steps to Protect Patients

Dear Provider,
A variant and virulent strain of swine influenza virus was recently detected in Mexico City.
According to the Centers for Disease Control and Prevention (CDC), as of April 27, 2009, there
have been 40 confirmed cases in the United States, including in California, Kansas, New York
City, Ohio and Texas.
The CDC advised that more confirmed cases are expected as awareness of the virus spreads.
While the fact that the U.S. is near the end of the 2008-09 flu season might mitigate the number
of severe cases, some can be expected.
The CDC stresses the need to reinforce good infection-control procedures (covering coughs, washing hands frequently, not going to work or school while sick and seeing a doctor when symptoms persist or get worse) to slow transmission. What Should Health Care Providers Know?
The CDC has published guidance related to this disease that you can use to inform and help treat
patients. Please refer to the important information below:
Detecting Swine Flu
A confirmed case of swine influenza A (H1N1) virus infection is defined as a person with an
acute respiratory illness with laboratory-confirmed swine influenza A (H1N1) virus infection at
CDC by one or more of the following tests:
A suspected case of swine influenza A (H1N1) virus infection is defined as: 1. A person with acute respiratory illness who was in close contact to a
confirmed case of swine influenza A (H1N1) virus infection during the case’s infectious period, OR 2. A person with an acute respiratory illness who traveled to or resides in an area
where there are confirmed cases of swine influenza A (H1N1) virus infection
Close contact – Within about 6 feet of an ill person
Acute respiratory illness – Recent onset of at least two of the following:
rhinorrhea or nasal congestion, sore throat, cough (with or without fever or
Mailing Address:
The infectious period for a confirmed case of swine influenza A (H1N1) virus infection is
defined as one day prior to the patient’s illness onset to seven days after onset.
WellCare Health Plans, Inc.
Special Considerations for Children
Aspirin or aspirin-containing products (e.g. bismuth subsalicylate – Pepto Bismol) should not be administered to anyone 18 years old and younger confirmed or suspected to be ill with swine influenza A (H1N1) virus infection because of the risk of Reye syndrome. Antiviral Resistance
This swine influenza A (H1N1) virus is sensitive (susceptible) to the neuraminidase
inhibitor antiviral medications zanamivir and oseltamivir. It is resistant to the adamantane
antiviral medications amantadine and rimantadine.
Antiviral Treatment

For Suspected Cases –
Antiviral treatment with either zanamivir alone or with a
combination of oseltamivir and either amantadine or rimantadine should be initiated as soon
as possible after the onset of symptoms. Recommended duration of treatment is five days.
Antiviral doses and schedules recommended for treatment of swine influenza A (H1N1) virus
infection are the same as those recommended for seasonal influenza and are available at:
For Confirmed Cases –
Either oseltamivir or zanamivir may be administered.
Recommended duration of treatment is five days.

For Pregnant Women –
Oseltamivir, zanamivir, amantadine and rimantadine are all
“Pregnancy Category C" medications. Because of the unknown effects of influenza antiviral
drugs on pregnant women and their fetuses, these four drugs should be used during pregnancy
only if the potential benefit justifies the potential risk to the embryo or fetus; the
manufacturers' package inserts should be consulted.

Antiviral Chemoprophylaxis –
Either oseltamivir or zanamivir are recommended. Duration
of antiviral chemoprophylaxis is 7 days after the last known exposure to an ill confirmed case
of swine influenza A (H1N1) virus infection.
For further information, including a podcast and documented guidance relating to the virus, visit World Health Organization updates are available in English and Spanish at If you have additional questions or concerns, please contact Provider Services at (866) 231-1821 for Medicaid or (866) 334-7730 for Medicare. Thank you for your cooperation and for caring for our members. Sincerely, Mailing Address:
SVP and Chief Medical Officer WellCare Health Plans, Inc.


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