Home

Pandemic Influenza Response Plan

Oct. 8, 2009
Influenza update: Preparing for seasonal, H1N1 flu outbreaks
From Dr. Paul Johns, Occupational Medicine director:

The weather in eastern Idaho has changed and the influenza (flu) season is upon us. Several cases of influenza have been reported among INL employees as well as in the community. According to the Centers for Disease Control and Prevention, influenza activity remains elevated in the United States. Eastern Idaho Public Health District is reporting that the influenza being seen is primarily the H1N1 (swine flu) influenza, and that it is similar to the regular influenza for the season.

Symptoms and precautions -- Symptoms include fever, headache, tiredness, dry cough, sore throat, runny or stuffy nose, muscle aches and gastrointestinal symptoms of nausea, vomiting and/or diarrhea, which are more common in children. These symptoms are variable and can affect each person differently. General precautions remain the best avoidance strategy. These include washing your hands frequently, covering your coughs and sneezes, staying home if you are ill, avoiding contact with someone who has a respiratory infection, and practicing a healthy lifestyle.

Seasonal flu -- The seasonal influenza vaccine is available at all the usual places, that is, doctor's offices, pharmacies, urgent care centers, flu-shot clinics, etc. Seasonal flu shots will not be provided at INL's Occupational Medicine facilities. For more information about seasonal flu symptoms, how to avoid the flu and who should be vaccinated, click on this link from the CDC seasonal flu Web site: http://www.cdc.gov/flu/keyfacts.htm. Those with chronic illnesses or disabilities that could result in a severe case of the influenza should get the vaccine. Otherwise, it's recommended that you get the vaccination to lessen the severity of the influenza in case you become infected. Consider this recommendation in light of your own experience with previous influenza vaccinations, as the vaccination can cause symptoms. Also, heed the recommendations of your personal physician.

H1N1 influenza -- It's difficult to give definitive information about the specific H1N1 vaccine because it is not yet widely available. This vaccine is different from the seasonal influenza vaccine because of the specific influenza viruses that have been targeted. The distribution of the vaccine and flu mist (nasal spray) is being coordinated by health districts, specifically in our area by Eastern Idaho Public Health District and Southeastern District Health Department. Through clinics and distribution points, the H1N1 vaccine will be provided to individuals in the priority groups -- vaccinations will be administered as directed by the amount of vaccine received and in accordance with whatever health district and CDC directives come with it. We don't yet know the implications for INL. As soon as we receive further information, we will pass it along. Your current best source for information about the availability of H1N1 vaccine or nasal spray is through the health district in your area.

Insurance coverage -- INL will cover both flu vaccinations under our three medical plans -- whether obtained in-network or out-of-network -- at 100 percent of the in-network allowable benefit with no deductible. Depending on the dispensing location, it's possible that no fee will be charged. If a fee is charged, keep the receipt and file a claim for reimbursement with Aetna. Claim forms are available online at the Aetna Web site (http://www.aetna.com/members/health_coverage/forms/forms.html). Our group number is 885638.

Regardless of the type of flu, one of the best, most proactive things you can do for yourself and your family is to stay informed. Ultimately, you are responsible for staying abreast of the changing influenza landscape.

CDC H1N1 flu Web site: http://www.cdc.gov/h1n1flu/
Eastern Idaho Public Health District H1N1 flu information: http://www2.state.id.us/phd7/Current%20News/Swine%20Flu/Swine%20Flu%20Main.htm
Southeastern District Health Department: http://www.sdhdidaho.org/
Idaho H1N1 information: http://healthandwelfare.idaho.gov/default.aspx?tabid=871

Sept. 28, 2009
Pandemic influenza update: INL preparing contingency response plans for potential impacts to lab
From the INL Pandemic Steering Committee:

As Idaho and the nation enter the fall flu season, INL is stepping up its contingency planning for potential impacts to the lab that might arise from a pandemic influenza escalation. In response to the H1N1 influenza (swine flu) outbreak, INL continues to beef up its Pandemic Influenza Response Plan (PLN-2420), which will be used in the unlikely event that this outbreak of influenza reaches elevated proportions. Key organizations across the lab are identifying critical activities required to maintain minimum operations and are refining specific responses to various levels of impacts ranging from a business-as-usual approach to a partial or full curtailment of operations.

INL is continuing to monitor the situation inside and outside the lab, and taking guidance, as appropriate, from Eastern Idaho Public Health District, the Centers for Disease Control and Prevention (CDC), the World Health Organization and the U.S. Department of Energy. In the event that the current state of the H1N1 virus progresses to a more local level, the Pandemic Steering Committee is preparing additional precautions to be put into place. You will need to watch future editions of iNotes or monitor the "INL Influenza Update" Web page for timely and accurate communication updates regarding the H1N1 virus. As circumstances change, additional information will be provided.

In the meantime, employees are advised to take a common-sense approach toward seasonal and H1N1 influenzas. One of the most considerate and effective actions that every employee can take is to stay home if you are sick or have flu symptoms. Remember to wash your hands often with soap and water for at least 20 seconds, especially before eating or after you cough or sneeze. Alcohol-based hand cleaners are also effective. Attached are two useful guides with information that is pertinent both on and off the job. One explains the difference between seasonal and H1N1 flu and offers a description of flu symptoms, an explanation of how flu is spread and guidance for protecting yourself. The other provides helpful information for parents.

Flu facts: http://ihome.inel.gov/iNotes/Attachments/09.24.09_Flu_Facts.pdf
A Guide for Parents: http://ihome.inel.gov/iNotes/Attachments/09.24.09_A_Guide_for_Parents.pdf  
World Health Organization: http://www.who.int/en/
CDC H1N1 flu Web site: http://www.cdc.gov/h1n1flu/

June 11, 2009
H1N1 influenza infection: World Health Organization calls it a pandemic, elevates the alert level
From the INL Pandemic Steering Committee:
 

The World Health Organization (WHO) has declared the H1N1 influenza virus (also called "swine flu") a pandemic and has upgraded its warning level to phase 6, the highest on the pandemic alert scale. The H1N1 virus has swept through 74 countries and all 50 of the United States. As of today, June 11, Idaho has 29 confirmed cases of H1N1 infection (including four in Bonneville County, two in Bannock County and two in Madison County) and 508 negative reports.

While most of the influenza cases are mild and require no treatment, WHO cautions that a rash of new infections could overwhelm hospitals and health authorities -- especially in poorer countries.

In a statement to the news media today, Dr. Margaret Chan, director-general of WHO, described the action of the agency. "We are in the earliest days of the pandemic. The virus is spreading under a close and careful watch." She noted, however, that WHO was recommending no restrictions on travel and no border closures.  

INL is continuing to monitor the situation, coordinating with state and area health departments that are reviewing recommendations from the Centers for Disease Control, and will implement actions accordingly. Since the outbreak of the H1N1 influenza virus a few weeks ago, the INL Pandemic Steering Committee has continued to oversee a graded implementation of the "Pandemic Influenza Response Plan" (PLN-2420).

Employees are reminded to maintain good personal hygiene -- covering coughs, frequently washing hands, etc. -- whether in personal or business situations or when traveling. If the situation changes dramatically on the local, state, national or international front, employees will be notified about INL's response.  

Travel kits -- For business travelers who wish them, travel kits are available. The kits include an N95 face mask, antibacterial sanitizer and gloves. They are available through Logistics and Property Management, stock catalog identification No.164416. The unit cost for issue from stock is $8.50 each. You may request a kit through the Asset Suite system by submitting a Material Request (MR), by phone (526-1857 or 533-7334) or via walk-up counter service.  When ordered online, the kits will be delivered through normal supply distribution processes and are also available for pickup at REC 606-IAB Room 81, CFA-601, TAN-688 or MFC-781.

World Health Organization: http://www.who.int/en/
CDC H1N1 flu Web site: http://www.cdc.gov/h1n1flu/
CDC Travelers' Health:
http://wwwn.cdc.gov/travel/
Idaho swine flu information:
http://www.healthandwelfare.idaho.gov/Health/DiseasesConditions/H1N1Influenzaswineflu/tabid/328/Default.aspx
Flu prevention poster:
http://ihome.inel.gov/iNotes/Attachments/05.04.09_Flu_Prevention.pdf

June 4, 2009
Monitoring continues: INL update on the H1N1 influenza outbreak
From the INL Pandemic Steering Committee:
 

Since its outbreak a few weeks ago, the H1N1 influenza virus (also called "swine flu") received much initial media attention and prompted response plans by governments and businesses. The INL Pandemic Steering Committee continues to oversee a graded implementation of the "Pandemic Influenza Response Plan" (PLN-2420).

The H1N1 influenza outbreak -- which has received less media coverage within the last couple of weeks -- is still infecting people and causing deaths, though not at the magnitude first expected. As of Wednesday, June 3, Idaho has 19 confirmed cases of H1N1 infection (including one in Bonneville County), 485 negative reports and five reports under investigation.

In response to the seemingly less critical current conditions, INL has lifted its travel restrictions, but continues to emphasize precautions for INL business travelers. The lab will continue monitoring the situation as it relates to local conditions as well as to state and national conditions. Likewise, the lab urges all travelers -- whether for business or personal reasons -- to pay attention to areas where they are traveling and to take any necessary precautions.

Travel kits -- For business travelers who wish them, travel kits are now available. The kits include an N95 face mask, antibacterial sanitizer and gloves. They are available through Logistics and Property Management, stock catalog identification No.164416. The unit cost for issue from stock is $8.50 each. You may request a kit through the Asset Suite system by submitting a Material Request (MR), by phone (526-1857 or 533-7334) or via walk-up counter service.  When ordered online, the kits will be delivered through normal supply distribution processes and will also be available for pickup at REC 606-IAB Room 81, CFA-601, TAN-688 or MFC-781.

Because of the recent less critical nature of the flu, the Pandemic Influenza Response Plan portal on Nucleus has been relocated. Note, however, that if conditions warrant, the portal will be placed in a more prominent location with updated information. The possibility does remain that the H1N1 influenza virus could become a major threat. Dr. Margaret Chan, director-general of the World Health Organization, said in a recent speech, "This virus may have given us a grace period, but we do not know how long this grace period will last. No one can say whether this is just the calm before the storm."

May 19, 2009
INL update on the H1N1 influenza outbreak: Travel restrictions to Mexico lifted
From the INL Pandemic Steering Committee:
 

While INL continues to monitor the H1N1 influenza outbreak both nationally and internationally, it has lifted the prohibition against traveling to Mexico and is taking a precautionary approach. The lab is taking its lead from the Centers for Disease Control, which has downgraded its recommendation about traveling to Mexico from a warning to a precaution. As such, INL is encouraging any employee with plans for business travel to Mexico to evaluate the need with his/her manager.

For all other business-travel plans at this point, INL is allowing business-essential travel, but is continuing to emphasize that discretionary business travel is optional. (Refer to the iNotes message and/or Nucleus update of May 12 for a full explanation: http://ihome.inel.gov/iNotes/Archives/iNote20090512143900.html).

As of Monday, May 18, Idaho had nine confirmed cases of H1N1 infection, 396 negative reports and three reports under investigation. Information about the H1N1 influenza outbreak is being updated as needed, depending on the developing situation. Also, this information is posted on Nucleus in the "Pandemic Influenza Response Plan" portal. 

May 12, 2009
General update: Guidelines during current H1N1 influenza outbreak
From the INL Pandemic Steering Committee:

INL continues to monitor the national and international situation as conditions develop with the outbreak of the H1N1 influenza virus. These actions are part of the graded implementation of INL's "Pandemic Influenza Response Plan" (PLN-2420). Current details about the status of the influenza outbreak (also called "swine flu") can be found at the links below and at the "INL Influenza Update" Web page linked on Nucleus.

  • Continue business as usual:
    To date, two confirmed cases of H1N1 infection have been reported in Idaho (one in Kootenai County and one in Ada County). Two other cases are listed as "probable" -- one in Ada County and one in Madison County. At this time, the Pandemic Steering Committee is simply taking precautions to ensure employee safety in the case of further outbreak of the virus.

  • Planned business travel:
    Currently at INL, business travel to Mexico is prohibited. There are no other travel restrictions. INL will continue to follow any travel restriction guidelines from the Centers for Disease Control and the Department of Energy. All business travel must be reviewed with division directors, who will determine whether planned travel is business-essential. (Note: While a division director should review travel plans, he/she does not necessarily have to be the approver on the travel form.) For example, traveling to meet with collaborators on a time-sensitive project may be deemed essential business travel. As another example, traveling to a professional society conference may be discretionary to the operations of INL. Your organizational management, including the division director, can help you determine whether your travel is essential. If you feel uncomfortable about taking a trip, perhaps because it is in an area with a high influenza incidence, discuss the issue with your manager. Any employee who feels uncomfortable traveling for discretionary business reasons has the option to cancel or reschedule without financial consequence.

  • Travel kits:
    The INL Travel Office had hoped to offer travel kits -- an N95 face mask, antibacterial sanitizer, gloves and guidelines -- to business travelers who desired them. The INL-provided travel kits are on order, but may take some time to arrive. Such kits are in short supply nationwide.

  • Use common sense and practice good hygiene:
    Practice a common-sense approach toward your co-workers and family members. Cover your mouth when you cough, wash your hands frequently and stay home from work or other public activities if you are experiencing any flu-like symptoms.

This information is being updated as needed, depending on the developing situation. Also, this information is posted on Nucleus in the "Pandemic Influenza Response Plan" portal.

May 4, 2009
H1N1 influenza virus: Pandemic Committee provides guidelines, resources for 'swine flu'
From the INL Pandemic Steering Committee:

In response to the H1N1 influenza outbreak, the INL Pandemic Steering Committee convened last week to oversee a graded implementation of "Pandemic Influenza Response Plan" (PLN-2420). Current details concerning the status of the influenza outbreak can be found at the links below and at the "INL Influenza Update" Web page linked on Nucleus.

As circumstances change, additional information will be provided. Employees should review the April 28 iNotes message from Dr. Paul Johns, INL medical officer, which is reprinted on the "INL Influenza Update" Web page. In addition, employees are advised:

  • Continue business as usual:
    To date, there has been only one confirmed case of the H1N1influenza virus in the state of Idaho, in Kootenai County. At this time, the Pandemic Steering Committee is simply taking precautions to ensure employee safety in the case of further outbreak of the virus.

  • If you have planned business travel:
    All business travel must be reviewed with division directors. Business travel to Mexico is currently prohibited. All other business travel should defer to the Centers for Disease Control for travel restrictions and must be reviewed with your division director. Your division directors will determine whether planned travel is essential. If it seems that planned business travel is essential, you may obtain an INL-provided travel kit -- which includes an N95 face mask, antibacterial sanitizer, gloves and guidelines -- through the INL Travel Office prior to your departure (availability is forthcoming). If your director determines that business travel is not essential, you will be allowed to cancel or reschedule all discretionary travel without financial consequence to you.

  • Use common sense and practice good hygiene:
    Employees should continue to practice a common-sense approach. Cover your mouth when you cough, wash your hands frequently and stay home from work or other public activities if you are experiencing any flu-like symptoms.

In the event that the current state of the H1N1 virus progresses to a more local level, the Pandemic Steering Committee has prepared additional precautions that will be put in place. You will need to watch future editions of iNotes or monitor the "INL Influenza Update" Web page for timely and accurate communication updates regarding the H1N1 virus.

Apr. 28, 2009
From Dr. Paul Johns, Occupational Medicine director


A swine flu outbreak in Mexico, the United States and other countries is being reported by the news media. The details are changing rapidly, and the World Health Organization (WHO) and other groups -- nationally and locally -- are engaged in evaluating the situation and making recommendations. Our primary concern in issuing this message is for the health of INL employees and their families.

There has been some testing done in Idaho, and one confirmed case has been reported so far. Further information on this outbreak will be provided as significant changes occur.

The swine flu is an H1N1 influenza virus that is distinct from the human H1N1 influenza virus. It usually causes an influenza-like illness (ILI) with fever (>100 degrees F), lethargy, lack of appetite and cough or sore throat. Some people also will have a runny nose, nausea, vomiting and diarrhea. Many cases will be asymptomatic and -- in severe cases -- it can become fatal. The infection is spread by droplets from coughing and sneezing or by touching an infected surface and then touching one's mouth, nose or eyes. It can be spread from person-to-person, person-to-pig or pig-to-person, if they are in close proximity. The time of highest infectivity corresponds to the time of most severe symptoms. It cannot be spread by consuming appropriately prepared pork.

The Centers for Disease Control and Prevention (CDC) is recommending a "common sense" approach to prevention, including: washing hands frequently, covering the mouth when coughing or sneezing, and staying home if one is ill. It is recommended that people not touch their mouths or noses as they may transmit an infection. An M95 mask and eye shielding are recommended if close proximity to an infected individual, or pig, is necessary.

Swine flu can be diagnosed and treated. The medicines used are amantadine, rimantadine, oseltamivir and zanamivir. In the present outbreak, oseltamivir (Tamiflu) and zanamivir (Relenza) have generally been more effective. There is a vaccine to protect pigs from the swine flu, but not to protect humans from the swine flu. The seasonal influenza vaccine will likely provide partial protection against the H3N2 swine flu, but, unfortunately, not against the H1N1 swine flu.

INL has an established Pandemic Influenza Response Plan (PLN-2420), and it will be used in the unlikely event that this outbreak of influenza reaches elevated proportions.

The CDC issued a travel warning recommending that people avoid nonessential travel to Mexico. CDC continues to issue interim guidance daily on its Web site and through health alert network notices. If you plan to travel, visit the CDC Web site for information related to the area where you will be traveling.


Department of energy

DOE Office of Nuclear Energy
DOE-Idaho Office
Battelle