1. Novel Influenza A H1N1 (swine-like) Virus Update Liz Delamater June 17, 2009

2. Background Two original cases detected in Southern California Two original cases detected in Southern California One of those, a 10-year-old boy, traveled to Dallas for an extended visit with relatives One of those, a 10-year-old boy, traveled to Dallas for an extended visit with relatives April 23 press release stated that swine flu had been confirmed by the CDC in two 16-year-old boys from Guadalupe County near San Antonio April 23 press release stated that swine flu had been confirmed by the CDC in two 16-year-old boys from Guadalupe County near San Antonio We received our first specimens on 4/24/09, one was reported as “Influenza A – Unable to type” on an 18-year-old boy from Guadalupe County We received our first specimens on 4/24/09, one was reported as “Influenza A – Unable to type” on an 18-year-old boy from Guadalupe County Confirmed by the CDC as Swine Flu Confirmed by the CDC as Swine Flu

3. First Response April 24, 2009 it was decided that the ICS (Incident Command Structure) would be used for the response April 24, 2009 it was decided that the ICS (Incident Command Structure) would be used for the response On April 25, 2009, the MACC was staffed. Unlike responses to natural disasters, the laboratory was included with a representative incident commander On April 25, 2009, the MACC was staffed. Unlike responses to natural disasters, the laboratory was included with a representative incident commander

5. Overwhelmed Front Page of Austin American Statesman on May 2, 2009 Front Page of Austin American Statesman on May 2, 2009 “Flood of flu tests clogs up state lab” “Flood of flu tests clogs up state lab” Received over 11,150 specimens total Received over 11,150 specimens total Requested assistance from other state laboratories, Tennessee and Virginia agreed to help with testing Requested assistance from other state laboratories, Tennessee and Virginia agreed to help with testing

7. In the USA

8. What Next? Series of Hotwash meetings with various groups, both DSHS and regional/local staff Series of Hotwash meetings with various groups, both DSHS and regional/local staff Developed a Flu Charter Workgroup to improve planning for the fall Developed a Flu Charter Workgroup to improve planning for the fall

9. Epi/Lab Workgroup Identify objectives of surveillance Identify objectives of surveillance What is needed by leadership? What is needed by leadership? Criteria for submission to the laboratory Criteria for submission to the laboratory When do we stop? When do we stop?