Flu

June Physician Focus: Infectious Disease: Fear vs. Evidence

Posted in Ebola, Flu, H1N1, Physician Focus, Public Health on June 10th, 2016 by MMS Communications – Comments Off on June Physician Focus: Infectious Disease: Fear vs. Evidence

The outbreak of an infectious disease is one of medicine’s most difficult challenges.  At the same time that public health agencies must contain the infection, they must also try to quell the public’s fears – a difficult task in today’s world of instant communication, multiple media channels, and constant media attention.  The experiences of Severe Acute Respiratory Syndrome in 2003, H1N1 Bird Flu in 2009, Ebola in 2014, Middle East Respiratory Syndrome in 2014, and now the Zika virus in 2016, are the most recent examples of threats targeting the public health.

June Physician Focus features Dr. Steven Hatch (r), with host Dr. Bruce Karlin

June Physician Focus features Dr. Steven Hatch (r), with host Dr. Bruce Karlin

The June edition of Physician Focus provides some perspective on the topic of media and public reaction to outbreaks of infectious disease through the experiences of Steven C. Hatch, M.D., an infectious disease specialist at UMass Memorial Medical Center and an Assistant Professor in the Division of Infectious Disease at UMass Medical School in Worcester. Hosting this edition is Bruce Karlin, M.D., a primary care physician in Worcester.

In 2014, Dr. Hatch spent five weeks in Liberia with the International Medical Corps treating patients stricken with Ebola and subsequently returned to that country several times to treat patients. Among the topics of conversation are what public health agencies must consider in reacting to infectious disease outbreaks, comments on how the media covered the Ebola outbreak in the U.S., and Dr. Hatch’s perspective on the latest outbreak of Zika.

Physician Focus is distributed to public access television stations throughout Massachusetts, reaching residents in more than 275 cities and towns. It is also available online at www.massmed.org/physicianfocus, www.physicianfocus.org/disease2016, and on YouTube.

 

MMS Flu Advisory: Billing For Flu Vaccine

Posted in Flu, Flu Advisory on January 29th, 2013 by Erica Noonan – Comments Off on MMS Flu Advisory: Billing For Flu Vaccine

In response to the flu vaccine crisis, MassHealth wants to inform physicians, group practices and independent nurse practitioners that they will be reimbursed for privately-purchased flu vaccine if they exhaust state-provided supply from local boards of health or the Massachusetts Department of Public Health.

In accordance with 130 CMR 433.443 (c)(2)(a), reimbursement for privately-purchased vaccine can be obtained by using the following codes: 90655, 90656, 90657, 90658, 90660, 90661 and 90662.

For questions, please contact MassHealth Customer Service at providersupport@mahealth.net  or call  (800) 841-2900.

 

MMS Flu Advisory: DPH Issues Orders for Antiviral Prescribing and Guidance for Clinicians and Institutions

Posted in Flu, Flu Advisory on January 14th, 2013 by MMS – Comments Off on MMS Flu Advisory: DPH Issues Orders for Antiviral Prescribing and Guidance for Clinicians and Institutions

The state Department of Public Health (DPH) has issued orders allowing pharmacists to compound oral suspension of oseltamivir onsite (a non-sterile procedure) in light of a shortage. Such compounding does not require consultation with the prescriber where the prescription does not specifically authorize compounding.

DPH advises physicians prescribing oseltamivir oral suspension to prescribe medication in mg (milligrams) rather than ML or tsp, and include the statement, “May substitute compounded suspension” although this statement is not required for pharmacists to compound the suspension. Oseltamivir oral suspension is especially important to treat pediatric patients and certain adults with difficulty swallowing oral dosage forms. The orders, and guidance for prescribers and pharmacists, regarding oseltamivir oral suspension are available here.

The DPH has also issued separate guidance, effective today for acute care hospitals and emergency rooms, long term care facilities and EMS personnel to help manage the large influx of patients with influenza like illness (ILI).

DPH provided recommendations to acute care hospitals and emergency rooms regarding (1) Reducing or eliminating the need for boarding patients in the emergency department, and (2) Authorization and guidelines for use of alternate space for treatment of ambulatory patients presenting with Influenza-like Illness (ILI).

DPH also advises long term care facilities that a diagnosis of influenza is not a valid reason for denial of admission to a long term care facility. The advice includes 2012-13 Influenza and Pneumococcal Disease Control Recommendations.

The policy for EMS personnel addresses dispatch/triage, field treatment and transport, and post-transport guidance.

MMS Issues Q&A on Seasonal Flu

Posted in Flu, Flu Advisory, Public Health on December 13th, 2012 by MMS Communications – Comments Off on MMS Issues Q&A on Seasonal Flu

The Massachusetts Medical Society, adding its voice to those encouraging patients to get a flu shot, has issued a Q&A on Seasonal Flu to news publications across the state.  The Centers for Disease Control and Prevention has indicated that this year’s flu season has arrived unusually early – the earliest arrival in almost a decade, in fact – and that the season could be more severe than those of previous years.

The Q&A, written for the patient population, covers such areas as complications from the flu, categories of those individuals who are most at risk, who should not be vaccinated, how the flu vaccine is given, and best preventive measures. It also lists websites to visit for more information, and the Flu Vaccine Finder, to help patients find locations offering flu shots. The Q&A may be read here.

Tools Available to Reduce Unnecessary Antibiotics Use

Posted in Flu on February 6th, 2012 by Erica Noonan – Comments Off on Tools Available to Reduce Unnecessary Antibiotics Use

For the second straight year, the MMS and seven other health care organizations are providing physicians with tools to help them reduce the unnecessary utilization of antibiotics during the flu season.

About 80 percent of adults with acute bronchitis receive a prescription for antibiotics, yet most bronchitis is due to viral infection for which antibiotic therapy offers no benefit.

The MMS is offering a collection of tools for physicians to make decisions about antibiotics and communicate effectively with their patients. These include bronchitis and sinusitis treatment algorithms, office posters and patient handouts.

To view and download the materials for free, visit www.massmed.org/antibiotics.

Thanks to the Massachusetts Department of Public Health, Massachusetts Association of Health Plans, the Massachusetts Hospital Association, Blue Cross Blue Shield of Massachusetts, the Partnership for Healthcare Excellence, Atrius Health, and the Reliant Medical Group for again participating in this effort.

MMS Flu Advisory: State Issues 2010-11 Flu Season Recommendations

Posted in Flu, Flu Advisory on September 2nd, 2010 by MMS – Comments Off on MMS Flu Advisory: State Issues 2010-11 Flu Season Recommendations

Flu Advisory BoxThe annual flu vaccine is now recommended for everyone 6 months of age and older.

The Massachusetts Department of Public Health has distributed recommendations and resources for health care providers related to vaccine dosing, high risk groups, Medicare reimbursement, surveillance and testing, chemoprophylaxis and treatment, and infection control.

Please see the full document (.pdf) for information about:

  • Massachusetts regulations requiring licensed clinics, dialysis centers, hospitals, and long-term care facilities to provide every employee with information about the risks and benefits of flu vaccine and to provide flu vaccine at no cost to all employee;
  • High risk groups, including two groups newly identified as at increased risk: American Indians/Alaska Natives and people who are morbidly obese;
  • An algorithm to determine dosing recommendations for children;
  • Use of trivalent inactivated influenza vaccine (TIV) for people at higher risk of influenza complications;
  • Screening for possible reactive airway disease before using LAIV for children aged 2 – 4 years, and not using LAIV in children with asthma or a recent wheezing episode;
  • Use only of oseltamivir or zanamivir for chemoprophylaxis or treatment of influenza;
  • Medicare reimbursement for administration of flu and pneumococcal vaccines;
  • How to purchase vaccine, and target populations and dosing for each vaccine;
  • Testing and treatment recommendations, including use of antivirals and infection control.

MMS Flu Advisory: 2010-11 Seasonal Flu; Vaccine Distribution; Health Care Worker Vaccine Requirements

Posted in Flu, Flu Advisory on August 5th, 2010 by MMS – Comments Off on MMS Flu Advisory: 2010-11 Seasonal Flu; Vaccine Distribution; Health Care Worker Vaccine Requirements

Flu Advisory BoxSeasonal Flu in U.S.

Influenza A (H3N2) virus infections have been recently detected in people in 12 states across the U.S., including two small localized outbreaks in Iowa, according to a CDC Health Alert. Sporadic cases of influenza and localized summer outbreaks from seasonal influenza viruses are detected each summer. Clinicians are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses, including pneumonia, even during the summer months. See CDC alert and recommendations.

Antigenic characterization of the influenza A (H3) viruses received at CDC are pending. However, based on hemagglutinin gene sequencing data from four viruses isolated from July specimens, these viruses are expected to be antigenically similar to A/Perth/16/2009-like H3N2 viruses. An A/Perth/16/2009-like H3N2 virus is included in the 2010-11 seasonal influenza vaccine. Perth-like H3N2 viruses were first identified in early 2009, but have not yet circulated widely in the United States. Past influenza vaccines did not contain this strain, so vaccination with last year’s seasonal vaccine would not be expected to provide substantial protection against this H3N2 Perth-like strain.

ACIP Seasonal Influenza Vaccination Recommendations

Highlights include:

  1. Annual vaccination be administered to all persons aged >=6 months for the 2010-11 influenza season
  2. Children aged 6 months-8 years whose vaccination status is unknown or who have never received seasonal influenza vaccine before (or who received seasonal vaccine for the first time in 2009-10 but received only 1 dose in their first year of vaccination) as well as children who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine regardless of previous influenza vaccine history should receive 2 doses of a 2010-11 seasonal influenza vaccine (minimum interval: 4 weeks) during the 2010-11 season
  3. Vaccines containing the 2010-11 trivalent vaccine virus strains A/California/7/2009 (H1N1)-like (the same strain as was used for 2009 H1N1 monovalent vaccines), A/Perth/16/2009 (H3N2)-like, and B/Brisbane/60/2008-like antigens be used
  4. Information about Fluzone High-Dose, a newly approved vaccine for persons aged >=65 years; and
  5. Information about other standard-dose newly approved influenza vaccines and previously approved vaccines with expanded age indications.

Seasonal Flu Vaccine Distribution Underway

MedImmune has begun shipping intranasal influenza vaccine. GSK, Novartis, and Sanofi Pasteur have begun distribution of 2010-11 injectable seasonal influenza vaccine. Centers for Medicare and Medicaid Services (CMS) has confirmed that the new high dose formulation vaccine for patients 65 years and older, Fluzone HD, is covered by Medicare Part B and will be reimbursed for the upcoming 2010-2011 influenza season. CMS has updated its various pricing files to include Fluzone High-Dose vaccine in the “July 2010 AWP NDC – HCPCS Crosswalk File” for Medicare Part B Drugs.

Health Care Professional (HCP) Vaccine Requirements

The Massachusetts Department of Public Health (MDPH) has released its 2010-11 recommendations and guidelines for health care worker vaccination. (.pdf)

Sources: CDC; MMWR 2009;58:[No. RR-10]); MDPH

Seasonal Influenza (H3N2) Infections; ACIP 2010-11 Seasonal Flu Recommendations; Seasonal Flu Vaccine Distribution; MA 2010-11 Health Care Worker Vaccine Requirements

Seasonal Flu in U.S.

Influenza A (H3N2) virus infections have been recently detected in people in 12 states across the U.S., including two small localized outbreaks in Iowa, according to a CDC Health Alert. Sporadic cases of influenza and localized summer outbreaks from seasonal influenza viruses are detected each summer. Clinicians are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses, including pneumonia, even during the summer months. See CDC alert and recommendations. Antigenic characterization of the influenza A (H3) viruses received at CDC are pending. However, based on hemagglutinin gene sequencing data from four viruses isolated from July specimens, these viruses are expected to be antigenically similar to A/Perth/16/2009-like H3N2 viruses. An A/Perth/16/2009-like H3N2 virus is included in the 2010-11 seasonal influenza vaccine. Perth-like H3N2 viruses were first identified in early 2009, but have not yet circulated widely in the United States. Past influenza vaccines did not contain this strain, so vaccination with last year’s seasonal vaccine would not be expected to provide substantial protection against this H3N2 Perth-like strain.

ACIP has released its 2010 Seasonal Influenza Vaccination Recommendations.

Highlights include:

1. Annual vaccination be administered to all persons aged >=6 months for the 2010-11 influenza season;

2. Children aged 6 months-8 years whose vaccination status is unknown or who have never received seasonal influenza vaccine before (or who received seasonal vaccine for the first time in 2009-10 but received only 1 dose in their first year of vaccination) as well as children who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine regardless of previous influenza vaccine history should receive 2 doses of a 2010-11 seasonal influenza vaccine (minimum interval: 4 weeks) during the 2010-11 season;

3. Vaccines containing the 2010-11 trivalent vaccine virus strains A/California/7/2009 (H1N1)-like (the same strain as was used for 2009 H1N1 monovalent vaccines), A/Perth/16/2009 (H3N2)-like, and B/Brisbane/60/2008-like antigens be used;

4. Information about Fluzone High-Dose, a newly approved vaccine for persons aged >=65 years; and

5. Information about other standard-dose newly approved influenza vaccines and previously approved vaccines with expanded age indications.

Seasonal Flu Vaccine Distribution Underway

MedImmune has begun shipping intranasal influenza vaccine. GSK, Novartis, and Sanofi Pasteur have begun distribution of 2010-11 injectable seasonal influenza vaccine. Centers for Medicare and Medicaid Services (CMS) has confirmed that the new high dose formulation vaccine for patients 65 years and older, Fluzone HD, is covered by Medicare Part B and will be reimbursed for the upcoming 2010-2011 influenza season. CMS has updated its various pricing files to include Fluzone High-Dose vaccine in the “July 2010 AWP NDC – HCPCS Crosswalk File” for Medicare Part B Drugs.

Health Care Professional (HCP) Vaccine Requirements

The Massachusetts Department of Public Health (MDPH) has released its 2010-11 recommendations and guidelines for health care worker vaccination.

Sources: CDC; MMWR 2009;58:[No. RR-10]); MDPH

DPH Rescinds Emergency Flu Vaccine Orders of Fall 2009

Posted in Flu, Flu Advisory on May 25th, 2010 by MMS – Comments Off on DPH Rescinds Emergency Flu Vaccine Orders of Fall 2009

Flu Advisory BoxMassachusetts Department of Public Health Commissioner John Auerbach has rescinded the emergency order he issued in September 2009 to allow certain designated health care professionals—EMTs-paramedic level, pharmacists, and dentists—and medical and nursing students to administer seasonal and H1N1 influenza vaccine.

He also rescinded the emergency order issued November 6, 2009 which allowed for certain compounding and dispensing of Tamiflu® by licensed pharmacies.

Order Flu Vaccine for 2010-2011 Flu Season

Posted in Flu, Flu Advisory on March 17th, 2010 by MMS – Comments Off on Order Flu Vaccine for 2010-2011 Flu Season

Flu Advisory BoxPhysicians are encouraged to order their 2010-2011 flu vaccine now.

The Massachusetts Department of Public Health (MDPH) will not supply influenza vaccine to nursing homes and private providers for vaccination of adults. Please note that the universal distribution of H1N1 vaccine for the 2009 – 2010 influenza season was a special program fully funded by the federal government. There will be no such program in place for seasonal influenza vaccine for 2010-2011 season.As in previous years, MDPH plans to provide some state-supplied influenza vaccine to the following provider types:

  • Pediatric care providers
  • Schools (K-12)
  • Obstetricians
  • VNAs (for public vaccination clinics)
  • Public sites that provide care to adults
  • Community health centers
  • Local health departments
  • State hospitals and agencies
  • Free community-based clinics
  • TB clinics
  • Correctional facilities
  • Integrated Counseling, Testing and Referral Sites
  • Health care for the homeless

MDPH will not be able to supply a sufficient number of doses to meet all of the demand even at the sites listed above. Providers will be notified what their allocation of doses will be by early summer. All providers should plan to purchase some influenza vaccine for the 2010-2011 flu season.

All providers should determine how much vaccine they will need for their patients and employees in 2010 – 2011, and place orders for vaccine with manufacturers or distributors as soon as possible.

To purchase seasonal influenza vaccine, contact your regular vaccine distributor or the vaccine manufacturers. Locate a vaccine distributor (Excel spreadsheet)

View a list of influenza vaccine products (pdf) expected to be available for the 2010 – 2011 flu season, and the age indications for each.

If you have questions about the availability of seasonal flu vaccine, please contact the MDPH Vaccine Unit at 617-983-6828.

MMS Flu Advisory: H1N1 Vaccine Recommendations Expanded to All Residents

Posted in Flu, Flu Advisory, H1N1 on December 17th, 2009 by MMS – Comments Off on MMS Flu Advisory: H1N1 Vaccine Recommendations Expanded to All Residents

Flu Advisory BoxAlthough it remains focused on vaccinating priority groups, the state Department of Public Health (DPH) today expanded H1N1 vaccine recommendations to all residents. To date, DPH has distributed over two million doses of the H1N1 vaccine, and expects to receive additional large shipments from the federal government in the next month.

DPH’s initial target for shipments were health care providers vaccinating the priority groups, including pediatric and obstetric providers, but it is now shipping vaccine to internal medicine. While not all physicians who have registered with the DPH have received their full supply, DPH expects they will in the next several weeks. Physicians who would like to receive vaccine must register with the DPH; there is no charge for the vaccine.

DPH has also asked local public health departments to begin planning large-scale public flu clinics open to all residents. As these clinics are planned they will be posted on http://flu.masspro.org.