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Health officials: 'New phase' in flu fight

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State health officials have announced that their response to the novel H1N1 influenza virus is moving into a new phase, with a new approach to tracking the illness and new recommendations for handling potential flu cases in schools.

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Officials at the Minnesota Department of Health will now be asking health care providers to submit lab specimens only when a patient has been hospitalized for influenza-like symptoms. The MDH lab will also continue to accept specimens from the state's 29 sentinel influenza surveillance sites, and for ill health care workers.

MDH is also providing new guidance to schools about how to prevent spread of the virus in school settings. The new guidelines stress the importance of being alert for symptoms of the illness and responding promptly. School authorities are being advised that they can close schools at their discretion based on an assessment of their own situation. MDH is working with school systems in the state where closures have already taken place, in order to determine next steps for those schools. The new guidelines are available at www.health.state.mn.us/divs/idepc/diseases/flu/h1n1/schools/index.html.

MDH officials are making these changes based on the observation that - in terms of severity - H1N1 seems to be behaving more like regular, seasonal influenza. Officials also noted that the virus now appears to be widespread in Minnesota and nationwide, making the identification of each individual case less useful in tracking the overall course of the outbreak.

Officials emphasized that, even if H1N1 now seems to more closely resemble seasonal flu, there is still cause for concern. They are asking schools to observe students, staff and faculty for influenza and have ill people stay home. MDH is also emphasizing the continued importance for everyone of self-protection measures like handwashing and covering coughs and sneezes.

"The fact that the novel influenza is currently behaving like regular flu does not mean we can relax," said Dr. Sanne Magnan, Minnesota Commissioner of Health. "Seasonal flu is a major health concern in its own right. It's one of our leading causes of death, year in and year out."

Magnan emphasized that people should continue to follow standard recommendations for preventing the spread of the flu virus:

Cover your nose and mouth with your sleeve when you cough or sneeze.

Clean your hands frequently and thoroughly - with soap and water or an alcohol-based hand rub solution.

Limit your contact with others who may be ill.

Clean your hands after shaking hands or having other close contact with other people - before eating or preparing food, or touching your eyes, nose or mouth.

Stay home from work or school - and generally avoid going out in public - if you are sick.

If you are an employer, encourage your employees to stay home if they are sick.

At this point, there is no reason to caution against attending public events or gatherings, as long as you are not sick, Magnan said.

Because of the change in how surveillance is done, information about new cases of the illness should be interpreted carefully, said Dr. Ruth Lynfield, Minnesota State Epidemiologist.

"Because we are only looking for severe cases of the illness right now, it may tend to create the impression that the disease is becoming more virulent," Lynfield said. "That's not necessarily the case."

The new approach to surveillance may also generate smaller numbers of reported cases, Lynfield noted. She also cautioned against concluding that the potential threat from H1N1 is over.

"Influenza viruses are notorious for changing," Lynfield said. "We need to remain vigilant, and we will communicate any new recommendations to the public as quickly as possible."

The latest information about H1N1 novel influenza, including current case numbers, is available on the MDH Web site at www.health.state.mn.us. Minnesota currently has one confirmed and six probable cases of H1N1 novel influenza. Two additional probable cases identified over the weekend were later determined to be seasonal flu, based on work done in the MDH lab.

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