Over the past month, much has been learned about H1N1 influenza. This virus currently is acting like seasonal influenza in terms of the severity of illness and transmission of infection. Current cases have no relationship to travel or to other identified cases and are commonly occurring in communities. On June 11, 2009 the World Health Organization declared an Influenza Pandemic alert level 6, which is an indicator of how widespread the transmission of this virus is, not its severity.

As of June 12, 2009, NH has confirmed 153 cases of H1N1 influenza in nearly every county of the state. The NH Public Health Laboratories has tested nearly 1300 samples with 23 positive for seasonal influenza (non H1N1) and 1,085 samples negative for influenza. NH DHHS has posted H1N1 case counts to the department website. We expect that our traditional surveillance for influenza will continue to detect H1N1 along with other circulating strains of influenza virus. Because of our continuing routine surveillance and the mild course of the illness, it is not feasible nor is it necessary to identify every case of H1N1.

Whether or not there is a confirmed case of H1N1 influenza in your community, it is likely the virus is circulating. It should be assumed that a person could be exposed to H1N1 influenza at school, at work, or anywhere else in the community. Therefore, it is important to highlight, promote and disseminate key common sense prevention messages that include:

• Washing your hands frequently with soap and warm water, or using an alcohol-based hand sanitizer;
• Staying away from sick people who are coughing or sneezing;
• Covering your mouth when you cough or sneeze. Use a tissue, or cough into your sleeve if you don’t have one;
• Stay at home even if you have mild flu-like illness;
• Return to work or school when you are symptom free for at least 24 hours;

Signs and symptoms of H1N1 Influenza are similar to those of seasonal influenza and include the following:

• Fever
• Cough
• Sore throat
• Headache
• Body aches

It is recommended that persons at high risk for complications from influenza infection should consult with their doctor if they are experiencing signs or symptoms of influenza. While we continue to learn more about novel H1N1 influenza, groups at high risk for complications from seasonal influenza include:

• Children less than 5 years old (highest risk among children less than 2 years old);
• All persons aged 65 years or older;
• Children and adolescents (under 18 years) who are receiving long term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza infection;
• Pregnant women;
• Adults and children who have chronic pulmonary (including asthma) cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);
• Adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV);
• Residents of nursing homes and other chronic care facilities

For further information and updates visit the following web sites:

• Centers for Disease Control & Prevention:
  http://www.cdc.gov/swineflu/whatsnew.htm
• NH Health & Human Services: http://www.dhhs.state.nh.us
• The State of New Hampshire’s: http://www.nh.gov/

For any questions regarding the contents of this message, please contact NH DHHS Communicable Disease Control and Surveillance Section at 603-271-4496 (after hours 1-800-852-3345 ext.5300). The Governor has established a public telephone inquiry line. The phone line is open to anyone who has questions about the swine flu outbreak, including possible symptoms, travel information or any other questions about this illness. The inquiry line number is: 1-888-330-6764. The phone line is open from 8 a.m. to 8 p.m. until further notice.