Welcome to Disasterville - June 2009

June 1 marks the beginning of the Atlantic Hurricane Season. Check out the newest issue of "Welcome to Disasterville," KCER's monthly newsletter.

http://www.kcercoalition.com/newsletter.htm

Hurricane Preparedness Week

Atlantic Hurricane Season begins June 1. Hurricane Preparedness Week is May 24-30. Each day of the week focuses on a different aspect of hurricane preparedness. Visit http://www.nhc.noaa.gov/HAW2/english/intro.shtm

ATLANTIC BASIN SEASONAL HURRICANE FORECAST FOR 2009
Forecast Parameter and 1950-2000 Climatology (in parentheses) Issue Date 9 April 2009

Named Storms: 12
Named Storm Days: 55
Hurricanes: 6
Hurricane Days: 25
Intense Hurricanes: 2
Intense Hurricane Days: 5


PROBABILITIES FOR AT LEAST ONE MAJOR (CATEGORY 3-4-5) HURRICANE LANDFALL ON EACH OF THE FOLLOWING COASTAL AREAS:

1. Entire U.S. coastline - 54% (average for last century is 52%)
2. U.S. East Coast Including Peninsula Florida - 32% (average for last century is 31%)
3. Gulf Coast from the Florida Panhandle westward to Brownsville - 31% (average for last century is 30%)
4. Average major hurricane landfall risk in the Caribbean

Interim Additional Guidance for Infection Control for Care of Patients with Confirmed, Probable, or Suspected Novel Influenza A (H1N1) Virus Infection in Outpatient Hemodialysis Settings

May 8, 2009 3:30 PM ET

These recommendations supplement the Centers for Disease Control and Prevention's Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting. This information is provided to clarify novel influenza A (H1N1) virus infection control recommendations that are specific to outpatient hemodialysis centers. This information complements, but does not replace the general infection control recommendations for novel influenza A (H1N1).

1. Hemodialysis patients meeting criteria for isolation precautions for novel H1N1 influenza (confirmed, probable, or suspected novel H1N1 infection – see guidance on case definition) may be dialyzed in outpatient dialysis centers if they would not normally be referred to a higher level of care based on their symptomatology. Patients should be triaged at or prior to arrival at the facility and symptomatic patients with febrile respiratory illness (defined as fever [greater than 37.8° Celsius] plus one or more of the following: rhinorrhea or nasal congestion; sore throat; cough) should be segregated from other patients as soon as possible.
2. Patients should wear a surgical mask and be placed in a separate room (if available) for dialysis with the door closed. Hepatitis B isolation rooms used to dialyze hepatitis B surface antigen positive patients should not be used for these patients unless: 1) the patient with suspected or confirmed novel H1N1 influenza virus is hepatitis B surface antigen positive or 2) the facility has no hepatitis B surface antigen positive patients who would require treatment in the isolation room.
3. If a separate room is not available, the patient should wear a surgical mask and should be treated at a corner or end-of-row station, away from the main flow of traffic if available. The patient should be separated by at least 6 feet from the nearest patient stations (in all directions). If a facility has more than one patient meeting criteria for novel H1N1 influenza isolation precautions, consideration should be given to cohorting these patients and the staff caring for them together in the unit and/or on the same shift.
4. Contact and Standard Precautions with eye protection (goggles or face shield) should be used by healthcare personnel when coming within 6 feet of patients meeting criteria for novel H1N1 influenza isolation precautions. This includes the use of a N95 respirator, nonsterile gloves and gown. Respirators, gowns and gloves should be removed and discarded and hand hygiene, with soap and water or alcohol based hand sanitizer, performed prior to leaving the dialysis station.
5. As with all hemodialysis patients, all supplies taken to the station should be reserved for that patient alone and either discarded after use or cleaned and disinfected prior to use by another patient (information available at the MMWR report: Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis Patients).
6. Equipment such as chairside computers used for medical charting, should be utilized for that patient alone during the treatment of that patient and appropriately cleaned and disinfected before use for another patient
7. Environmental surfaces should also be cleaned and disinfected in accordance with standard facility protocols after the patient has vacated the station and before setting up the machine and arrival of a new patient into that station
8. Precautions should be kept in place for 7 days after the onset of the patient's symptoms or at least 24 hours after symptoms have resolved, whichever is longer.

CDC: Hepatits B Vaccine Shortages

http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm

In December 2008, Merck communicated with CDC that it expected to deplete available adult and dialysis formulations of their hepatitis B vaccine, Recombivax HB® in the first quarter of 2009. Once depleted, these formulations will be unavailable for the remainder of 2009. Supply of GSK's Adult hepatitis B vaccine (Adult Engerix-B®) and Adult hepatitis A/hepatitis B combination vaccine (Twinrix®) is sufficient to meet demand for routine adult usage of this vaccine as well as CDC's ongoing High Risk Adult Hepatitis B Initiative.

FDA: Disetronic Medical Systems Inc. ACCU-CHEK Spirit Insulin Pump

Disetronic Medical Systems Inc. ACCU-CHEK Spirit Insulin Pump

Audience: Diabetes healthcare professionals, patients

Disetronic Medical Systems Inc. and FDA notified healthcare professionals about a defect in the “up” and/or “down” buttons of some ACCU-CHEK Spirit insulin pumps. This failure may present as an intermittent or complete loss of function of the “up” and/or “down” buttons. If the buttons do not function, users may not be able to change any programmed setting on the pump. If this failure occurs, the pump may not respond with a vibration or acoustic confirmation signal to a button press and the display will remain unchanged. Users may contact ACCU-CHEK Spirit hotline noted in the Press Release for a replacement pump or for any other questions regarding this potential defect.

Read the complete MedWatch 2009 Safety summary, including a link to the firm's press release, at:
http://www.fda.gov/medwatch/safety/2009/safety09.htm#Spirit

Pandemic Preparedness for Kidney Patients and Providers

Over the past few years, the KCER Coalition's Pandemic Preparedness Response Team has worked diligently developing information and resources for pandemic planning for the kidney community. Their webpage (www.kcercoalition.com/pandemic.htm) is filled with free resources to help patients prepare themselves and to assist dialysis facilities in developing their pandemic plans.

Some documents of interest are:

PANDEMIC PREPAREDNESS: MOST IMPORTANT THINGS TO KNOW

PANDEMIC FLU PLANNING CHECKLIST FOR INDIVIDUALS WITH CHRONIC KIDNEY DISEASE AND THEIR FAMILIES

RECOMMENDATIONS FOR DEVELOPING A DIALYSIS FACILITY PANDEMIC PLANNING CHECKLIST

Patient Education

Part of the CMS Conditions for Coverage require dialysis facilities to provide patient education on emergencies - including pandemic influenza. There are many resources available to promote patient education in your dialysis facility.

http://cdc.gov/h1n1flu/ The CDC is a clearinghouse for everything you need to know about swine flu (H1N1).

http://www.pandemicflu.gov/ One-stop access to U.S. Government swine, avian and pandemic flu information.

http://www.ready.gov/ "Ready's" pandemic influenza information

http://www.kcercoalition.com/ The KCER Coalition provides free educational resources, as well as useful links for swine flu.

State H1N1 (swine flu) hotline numbers posted to the KCER Website

The KCER Coalition posted state general information hotline numbers for H1N1 flu (swine flu). Please visit www.kcercoalition.com.