H1N1 Influenza (Flu)

Current Update 11.19.09

Flu activity in Texas has been downgraded from "widespread" to "regional" activity. the "regional" classification is used when there are increases in flu-like illnesses and recent lab-confirmed flu cases in at least two but in fewer than half of the state's regions. The "widespread" classification means that at least half of the state's health regios have seen a significant increase in activity. CDC's flu-activity classifications range from no activity to sporadic, local, regional and widespread. CDC continues to report that flu activity in the U.S. is elevated for this time of year. Flue activity in Texas is higher than normal for this time of year, however, has not caused significant health care resource issues at this time. Current guidance from the CDC regarding protection of health care workers can be found at: Of particular interest is the recommendation for N95 respirators for health care workers with known or suspected cases of H1N1. Please review this document and assure that clinic staff are taking appropriate precautions.

H1N1 vaccine shipments to Texas continue. Quantities are still relatively small, as anticipated, however shipments will continue until needs are met. It is expected that Texas will receive up to 15 million doses by the end of January. To date, approximately 4 million doses of the H1N1 vaccine have been allotted to Texas by the CDC.

  • Approximately one-third of vaccines are the nasal mist type and two-thirds are injectable form.
  • There have been concerns about some of the vaccine containing preservatives that some believe are potentially harmful tot he developing fetus. CDC and TDSHS indicate that there is no evidence that the vaccine is harmful for pregnant women. A limited amount of preservative-free vaccine is available, however, pregnant women should consult with their healthcare provider to determine which vaccine is appropriate for them.
  • CDC allocates vaccine to the various state health departments each week based on populations (pro-rata). The U.S. Centers for Disease Control's Advisory Committee on Immunization recommends the following as priority groups for the H1N1 vaccine:
  • Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
  • Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications an cannot be vaccinated. Vaccination of those in close contact with infants younger than 6 months old might help protect infants by "cocooming" them from the virus;
  • Health care and emergency medical services personnel because infections among health care workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce health care system capacity;
  • All people from 6 months through 18 years of age because cases of 2009 H1N1 influenza have been seen in children who are in close contact with each other in school and day care settings, which increases the likelihood  of disease spread, and
  • Young adults 19 through 24 years of age because many cases of 2009 H1N1 influenza have been seen in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
  • Persons age 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.
  • TDSHS then apportions Texas' allotment based on vaccine formulation, priority vaccination groups, geography and other factors. With a limited supply of H1N1 vaccine available to all states, the Texas Department of State Health Services is using a strategic approach by allocating it to Texas providers who serve the CDC-identified priority groups or subsets of those groups. To date, vaccine in Texas is being targeted to the following:

  • Pregnant women
  • Household contacts of children younger than 6 months of age
  • Health care and emergency medical services personnel who provide direct patient care
  • Children from 6 months through 4 years of age
  • People 5 years through 64 years of age with health conditions associated with higher risk of medical complications from influenza

Other priority groups and subsets of those groups will be addressed as the vaccine supply allows, followed by availability to non-priority groups.

H1N1 vaccine has been received by TTUHSC campuses in very small amounts. The vaccine has been used primarily for health care workers and the highest risk patient populations. Vaccine will continue to be delivered in small small quantities until all needs are met. Please be patient and understand that vaccines will be available soon.

The Texas Higher Education Coordinating Board indicates that there have been no reports of any college or university campus closures at this time.

Continue to observe good hygienic practices (hand washing, cough/sneeze etiquette, etc.) to prevent spread of disease.

If you are sick with flu-like illness, stay home from work or school until at least 24 hours after you have been fever-free (without fever-reducing medicine) and symptom free.

For health care providers, CDC guidelines have been revised. You should stay at home from work for at least 24 hours after you have been fever-free and symptom-free, unless you work with immunocompromised patients, in which case you should remain at home for seven days from onset of symptoms or for at least 24 hours after you have been fever-free and symptom free, whichever is longest.

Business Continuity Planning

TDSHS has established a telephone line for questions about flu-like illness. You can now dial 2-1-1 to receive over-the-phone medical guidance about what you should do if you or family members have flu symptoms. The state's 2-1-1 health information helpline is now staffed with medical professionals who can provide information about managing flu symptoms and advice on when to seek medical care from a physician or at an ER.

All TTUHSC departments are advised to review their Business Continuity Plans to assure that personnel are familiar with their roles and responsibilities in implementation of the plans in the event that absenteeism becomes widespread as a result of illness. Information on plan development and implementation is available at the CDC.

Additional information is available from: Ready Business, a campaign by the U.S. Department of Homeland Security and the Advertising Council, and Blueprint for Pandemic Flu Preparedness Planning for Colleges and Universities.


  • Body aches
  • Chills
  • Cough
  • Fatigue
  • Fever
  • Headache
  • Possible diarrhea and vomiting
  • Sore throat


  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissues in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleansers also are effective.
  • Avoid touching your eyes, nose or mouth
  • Avoid close contact with sick people.
  • Influenza is thought to be spread mainly person-to-person through coughing or sneezing of infected people.
  • If you get sick, stay home from work or school and limit contact with others to keep from infecting them.
  • Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.
  • Try not to touch surfaces that may be contaminated with the flu virus.