H1N1 Flu: For Physicians

General Information and Specialty-Specific Resources

Review Your Sick-Leave Policy Before Flu Season Hits
American Medical News, October 2009
With influenza A(H1N1) circulating this season, in addition to the usual viruses, experts advise doctors to take a close look at how the practice reacts when employees get sick...

Physician Resources for Novel H1N1 Virus
American Academy of Allergy, Asthma & Immunology, ongoing
The American Academy of Allergy, Asthma & Immunology (AAAAI) offers this guide for clinicians regarding information on the novel H1N1 virus, including treatment recommendations, vaccine news, case studies and information for your patients. These updates are posted by date, with the most current posted first. For your convenience, you may use the categories to the right to narrow your search of these posts by topic...

H1N1 Flu
American Academy of Family Physicians, ongoing
Your Academy is keeping abreast of the recent H1N1 flu outbreak, and keeping you informed and prepared is our priority. The resources cited below may be helpful to you in preparation for an outbreak in your area...

Here's How to Get Paid for Administering H1N1 Vaccine
American Academy of Family Physicians, September 2009
The FDA's approval of four vaccines against the novel influenza A (H1N1) virus is official. Now, physicians in private practice need details from health insurance companies about how to code and bill payers for administering the vaccine to receive timely payment for this service.

Novel Influenza A (H1N1) Virus (Swine Flu) Information for Health Care Professionals
American Academy of Pediatrics, ongoing
Includes quick links, practice guidance, vaccine recommendations / administration, prevention / control, antiviral therapy, suggestions on communicating with families, guidance for specific populations and guidance for educational institutions.

H1N1 Flu (Swine Flu) Information
American Academy of Pediatrics, ongoing
Latest information on H1N1 and tips for patients.

National Strategic Plan for Emergency Department Management of Outbreaks of Novel H1N1 Influenza (PDF)
American College of Emergency Physicians
The National Strategic Plan For Emergency Department Management of Outbreaks of Novel H1N1 Influenza was produced under contract to the Office of the Assistant Secretary for Preparedness and Response (ASPR) and the Emergency Care Coordination Center (ECCC). This document was developed in collaboration with ASPR, ECCC and the American College of Emergency Physicians (ACEP)...

2009 H1N1 Influenza
AMA, ongoing
The American Medical Association (AMA) is committed to providing physicians with timely, concise and up-to-date clinical guidance, treatment information, resources and news about H1N1 flu. We encourage you to explore the H1N1-related pages on the site and read the open letter to physicians from AMA President Nancy J. Nielsen, MD, PhD, which provides some excellent and practical advice about this flu...

H1N1 on the Horizon: Here's How to Prepare Your Practice -- and Staff
American Medical News, September 2009
Physicians are urged to be ready for potential employee and supply shortages, as well as a surge of patients...

Flu Fact Sheet for Patients
CDC, December 18 2009
Fact sheet for patients who have received the rRT-PCR Swine Influenza detection panel test results.

Flu Fact Sheet for Health Care Providers
CDC, December 18, 2009
Fact sheet for health care providers to interpret the rRT-PCR Swine Influenza detection panel results.

H1N1 Clinicians Questions and Answers
CDC, September 2009
FAQ for clinicians regarding the H1N1 vaccine.

Update on Influenza A (H1N1) 2009 Monovalent Vaccines
CDC, October 2009
On September 15, 2009, four influenza vaccine manufacturers received approval from the Food and Drug Administration for use of influenza A (H1N1) 2009 monovalent influenza vaccines in the prevention of influenza caused by the 2009 pandemic influenza A (H1N1) virus.* Both live, attenuated and inactivated influenza A (H1N1) 2009 monovalent vaccine formulations are available; each contains the strain A/California/7/2009(H1N1)pdm. None of the approved influenza A 2009 (H1N1) monovalent vaccines or seasonal influenza vaccines contains adjuvants (1--5). CDC's Advisory Committee on Immunization Practices has made recommendations previously for which persons should be the initial targets for immunization with influenza A (H1N1) 2009 monovalent vaccines and has issued guidelines on decisions for expansion of vaccination efforts to other population groups (6). Children aged 6 months--9 years receiving influenza A (H1N1) 2009 monovalent vaccines should receive 2 doses, with doses separated by approximately 4 weeks; persons aged ≥10 years should receive 1 dose (1--4)...

H1N1 Influenza: Prevention and Treatment—How and for Whom
ConsultantLive, September 2009
Not all patients in whom infection with the H1N1 influenza virus is suspected or confirmed need to be treated. Many patients with mild disease can forgo pharmacotherapy. In fact, in many cases, it may even be prudent to discourage such patients from coming into their health care provider's office, in the interest of infection control. However, all patients with severe disease and those considered at high risk for complications from seasonal influenza should be offered therapy with antiviral agents...

Healthcare Providers and Facilities - Decision Tree for 2009 H1N1 Vaccination
Flu.gov, October 2009
Purpose of this document:
To provide a decision tool for providers and healthcare facilities including:

• Provider offices (pediatricians, family practice physicians, internists, primary care providers, obstetricians/gynecologists)
• Federally Qualified Health Centers and "look-alikes", Community health clinics, Urgent Care clinics, Retail-based clinics
• Hospitals
• Long-term care facilities
  

AMA Creates New CPT Codes for H1N1 Flu Immunizations
Infection Control Today, September 2009
With both seasonal influenza and H1N1 influenza circulating this flu season, the American Medical Association (AMA) today announces it has expedited the publication of a new code specific to vaccine administration and revised existing code 90663 to include the H1N1 vaccine...

H1N1Vaccine Adverse Events, and How to Reassure Patients
KevinMD, November 2009
Failure to account for background rates when considering adverse events from pandemic H1N1 flu vaccination could spark public panic, researchers cautioned. Coincidental cases of dramatic events including sudden death, Guillain-Barré syndrome, and spontaneous abortion can be expected to boost the true incidence of adverse events after immunization, said Steven Black, of Cincinnati Children’s Hospital, and colleagues online in The Lancet.

How will the H1N1 Vaccine be Distributed to Patients?
KevinMD, September 2009
A minimum of 3.4 million doses of vaccine against H1N1 pandemic flu will be available in the first week of October, the CDC said.
How will the H1N1 vaccine be distributed to patients? Those doses — all in the form of a live attenuated nasal spray vaccine — may be supplemented by some injectable vaccine, according to Jay Butler, MD, the chief of the agency’s 2009 H1N1 vaccine task force...

CMS Releases H1N1 Vaccine and Administration Codes
MGMA, September 2009
In anticipation of the vaccine for H1N1 influenza, the Centers for Medicare & Medicaid Services (CMS) has created two new codes for medical providers. G9142 (Influenza A [H1N1] vaccine, any route of administration) describes the vaccine, while G9141 (Influenza A [H1N1] immunization administration, including physician counseling the patient/family) describes the administration of the vaccine. Both codes become effective on Oct. 1...

Risk of Confusion in Dosing Tamiflu Oral Suspension in Children
New England Journal of Medicine, September 2009
To the Editor: The medical community should be made aware of the serious potential for dosing errors in children prescribed Tamiflu (oseltamivir) oral suspension, as illustrated in the case described below.
After the diagnosis of novel H1N1 influenza, a 6-year old received a prescription for Tamiflu (oseltamivir) oral suspension (12 mg per milliliter) at a dose of 3/4 teaspoon PO BID. However, the parents, one a primary care physician and the other one of the authors, had great difficulty determining the correct dose to administer to their child. The medication bottle was accompanied by a prepackaged syringe with markings of 30, 45, and 60 mg (Figure 1)...

Medical Society Examples

Swine Flu Information
California Medical Association, ongoing
Governor Schwarzenegger has declared a state of emergency in California to deal with swine flu. As a practical matter, this will allow state agencies greater flexibility in dealing with the outbreak, particularly in regards to contracting for materials or services. For example, California has just been approved by the Centers for Disease Control (CDC) to administer the lab test to confirm suspected swine flu cultures. The US Department of Health and Human Services has also declared a public emergency on the issue, which allows them to manage the allocation and distribution of antiviral medications, like TamiFlu. Public officials at the state and federal level continue to caution that these are preparatory steps in case the flu outbreak becomes more severe...

H1N1 Flu Updates and Surveillance Guidance
Duval County Medical Society, ongoing
As this rapidly developing event continues to unfold, the Duval County Medical Society's Bioterrorism, Disaster Response and Homeland Security Committee, in cooperation with the Duval County Health Department and other local health partners, will post any pertinent H1H1 Flu updates and links for DCMS members on our website. The DCHD will continue to monitor the ESSENCE syndromic system for increases in local influenza-like illness activity...

Antiviral guidance for H1N1 influenza
Iowa Medical Society, June 2009
The CDC says it's important to get the word out to clinicians to emphasize early, empiric antiviral treatment for hospitalized patients and high-risk outpatients with suspected, probable, or confirmed novel swine-origin influenza A (H1N1) virus infection. This message is particularly important for those in primary care (including internists, pediatricians, family practitioners, and OB-GYN physicians) and hospital-based clinicians (emergency physicians, hospitalists, and intensivists)...

Novel Influenza A (H1N1) Informational Documents
Monroe County Medical Society
Repository for documents related to H1N1 treatment and legislation.

News and Updates on Influenza A (H1N1) Outbreak
North Carolina Medical Society, ongoing
Attention Physicians: The CDC has asked the AMA/NCMS to help them get the word out to physicians that antiviral treatment of H1N1 infection is not where it should be and needs to be better.

Physician Preparedness - Tips & Tools
South Carolina Medical Society, July 2009
The South Carolina Medical Association (SCMA) is using grant funds from the South Carolina Department of Health and Environmental Control (SC DHEC) to educate physicians and South Carolinians on the potential threats of a pandemic influenza. The SCMA will play an important role in preparing South Carolina for a potential pandemic flu crisis by educating physicians across the state. According to SC DHEC, 15% to 40% of the South Carolina’s population could be infected in the first wave of the illness...

Public Health and Science
Texas Medical Association, ongoing
FAQs, alerts, education projects, initiatives, physician and patient resources, policy resources.

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