UPDATED Thursday, January 7, 2010 --- 12:25 p.m.

MADISON, Wis. (AP) -- State health officials say three more people died this week from the H1N1 flu.

The Department of Health Services says the deaths were reported over the past week in Milwaukee, Outagamie and Winnebago counties.

The agency says 50 people in Wisconsin have died from the H1N1 flu since April 2009. About 1,230 people have been hospitalized since September.

The agency says swine flu has slowed in the state but it easily could make a return. However, officials say vaccine is now widely available statewide.

Copyright 2010 by The Associated Press. All Rights Reserved.
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UPDATED Thursday, January 7, 2010 --- 12:12 p.m.

Press Release from the Department of Health Services:

H1N1 Situation Report
January 7, 2010 at 12:00 Hours

Overview
Vaccine is widely available throughout the state and now is an optimal time for individuals to get vaccinated. Vaccine is available through private health care providers, local and tribal health departments and pharmacies.

Nationally, the U.S. Centers for Disease Control and Prevention (CDC) reports H1N1 influenza activity continues to decline with the number of states now reporting widespread flu activity down from 7 to 4. CDC notes that flu is unpredictable and activity can rise and fall throughout the season and is likely to continue for months, caused by either H1N1 or regular seasonal flu viruses.

H1N1 activity is low in Wisconsin. However, three additional H1N1 related deaths have been reported in the past week and another wave of H1N1 cases could occur yet this influenza season.

People are encouraged to obtain H1N1 and seasonal vaccinations, follow good hygiene precautions such as hand washing, covering their cough/sneeze with their sleeve or a tissue, and stay home when ill. Call your health care provider first to determine if you should be seen by your local physician or if you should go to the ER/urgent care for treatment.

H1N1 Surveillance
H1N1 activity is low throughout Wisconsin. However, three additional H1N1 related deaths have been reported in the past week and another wave of H1N1 cases could occur yet this influenza season. Now is an optimal time for individuals to get vaccinated.

Since September 1, 2009, there have been 1,229 hospitalizations due to H1N1 virus infection in Wisconsin. There have been three additional H1N1-related deaths reported in Milwaukee (West Allis), Outagamie (Appleton) and Winnebago counties. This brings the H1N1-related death total to 50 statewide since cases began occurring in April 2009.

There have been sporadic seasonal influenza cases identified throughout the state.

H1N1 Vaccine Update
Vaccine is widely available throughout the state. Public health departments, private health care providers and pharmacies are vaccinating members of the general public and those within the CDC target groups. People may call 2-1-1 to find an H1N1 or seasonal influenza vaccine clinic nearest them. A “clinic finder” is also available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

At this time, Wisconsin has been allocated 2,505,600 doses.
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UPDATED Wednesday, December 16, 2009 --- 12:25 p.m.

MADISON, Wis. (AP) -- Four more people have died in Wisconsin from the H1N1 flu.

The state Department of Health Services reported Wednesday the death toll from the illness has risen to 47 people since April. The new deaths were reported in the last week in Bayfield, Dane, Milwaukee and Polk counties.

The department says the number of H1N1-flu related hospitalizations has also increased to 854 even though the number of overall cases is declining all over the state at the moment.

Public health officials say another wave of cases could be coming, and now is a good time to get vaccinated.

Copyright 2009 by The Associated Press. All Rights Reserved.

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UPDATED Wednesday, December 16, 2009 --- 12:17 p.m.

Press Release from the Department of Health Services:

H1N1 Situation Report
December 16, 2009 at 12:00 Hours

Overview
Nationally, the U.S. Centers for Disease Control and Prevention (CDC) reports H1N1 influenza activity continues to decline with the number of states now reporting widespread flu activity down from 25 to 14. Visits to doctors for influenza-like illness and flu-associated hospitalizations also declined from the previous week.

H1N1 activity has declined in all five of Wisconsin’s public health regions. However, another wave of H1N1 cases could occur and now is an optimal time for individuals to get vaccinated.

DHS has announced that public health departments and private health care providers can start vaccinating members of the general public. However, DHS has instructed all health care providers to continue efforts to reach out to and vaccinate those in the CDC target groups. The CDC stresses there will be adequate supplies of H1N1 vaccine available for everyone who wants it.

People are encouraged to follow good hygiene precautions such as hand washing, covering their cough/sneeze with their sleeve or a tissue, and staying home when ill. Call your health care provider first to determine if you should be seen by your local physician or if you should go to the ER/urgent care for treatment.

H1N1 Surveillance
H1N1 activity has declined in all five of Wisconsin’s public health regions and there is no indication the H1N1 virus has changed or is more severe than in the spring. However, another wave of H1N1 cases could occur and now is an optimal time for individuals to get vaccinated.

Since September 1, 2009, there have been 854 hospitalizations due to H1N1 virus infection in Wisconsin. There have been four additional H1N1-related deaths reported in Bayfield, Dane, Milwaukee, Polk counties. This brings the H1N1-related death total to 47 statewide since cases began occurring in April.

There have been sporadic seasonal influenza cases identified throughout the state.

H1N1 Vaccine Update
On December 14th, DHS announced that public health departments and private health care providers could start vaccinating members of the general public. However, DHS has instructed all health care providers to continue efforts to reach out to and vaccinate those in the CDC target groups. The CDC’s target group includes:

* Pregnant women
* Persons who live with or provide care for infants age 6 months or younger (examples: parents, siblings, daycare providers)
* Healthcare and emergency medical services personnel
* All people from 6 months through 24 years of age
* Persons 25-64 years of age with conditions associated with higher risk of complications from influenza

The CDC also announced that 800,000 doses of H1N1 made by Sanofi Pasteur are being voluntarily recalled because the antigen content is below specified limits. The vaccine is safe, and the non-safety voluntary recall is based upon testing of pre-filled syringes intended for young children, ages 6 months to three years. Some of the lots have a lower potency, although it is unlikely there will be a significant reduction in effectiveness for those who have received vaccine from the affected lots. In addition, children under age three are in the category of receiving two doses of vaccine. Therefore, they should have adequate protection against the virus.

The CDC continues to stress there will be adequate supplies of H1N1 vaccine available for everyone who wants it. People may call 2-1-1 to find an H1N1 or seasonal influenza vaccine clinic nearest them. A “clinic finder” is also available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

At this time, Wisconsin has been allocated 1,652,900 doses. There is a lag time between the state receiving its H1N1 vaccine allocation and the shipment of doses to providers.

Additional DHS Activities
DHS is working with pharmacies across the state to have allocations of H1N1 vaccine shipped to them, which will significantly increase the number of vaccination sites available to the general public. Some pharmacies may not be able to vaccinate children, so DHS recommends checking with the pharmacy before bring children to the vaccination site.

Partner Items
Health care providers and other organizations across Wisconsin are calling 2-1-1 and providing detailed information on the type of flu shot that is available (seasonal or H1N1), date, time and locations of vaccination clinics on the flu clinic finder available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

School Closures
The CDC and DHS continue to stress that a school closure should be used as a last resort due to disruption of learning and the social impact. School closure information is listed on the DPI website at http://dpi.wi.gov/sspw/pandemicflu.html or can be found in the Media Room at http://pandemic.wisconsin.gov/.

Parents are reminded that keeping sick children home from school until 24 hours after they are free of fever (100°F [37.8°C] or greater) without the aid of medication is the safest way to prevent the spread of any illness. DHS is also encouraging parents to have a predesignated plan for caring for a sick child at home for the duration of a school exclusion period. Wisconsin businesses are also encouraged to adopt similar plans with their employees.

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UPDATED Monday, December 14, 2009 --- 9:25 p.m.
By NBC15's Barclay Pollak:

Tuesday public health departments and private health care providers can start giving the H1N1 vaccination to members of the general public.

Up until now, the H1N1 Vaccine was only being distributed to certain members of the population. Tuesday everyone else can get in line for the H1N1 vaccine.

With the holidays coming up and more people spending time with their family -- public health officials say getting the vaccine may not be a bad idea for people not in one of those "targeted communities."

Monday, Carlos Waldschmidt and his two brother's, Antonio and Justin, were at the Alliant Energy Center to get their H1N1 vaccinations. "It didn't really hurt that much so it was just like water going up my nose." Carlos and his brother's are in what health care officials call the "targeted community."

That community includes pregnant women, people under age 24, people with chronic medical conditions and health care personnel.

Janel Heinrich with Public Health Madison and Dane County says the free clinic focused on that "targeted community." "People are able to... who are in those risk groups have been able to get vaccinated."

After speaking to health care providers and health departments around the state, and hearing that same sentiment, the State of Wisconsin Department of Health Services announced Monday that members of the general population can start getting vaccinated.

Dan Hopfensperger the Director of the Wisconsin Immunization Program says, " We feel we are in a situation to open it up where anyone who requests the vaccine should have it available to them in the coming weeks. "

There are about 1.5 million doses of the H1N1 vaccination in the state right now. So there isn't enough for everyone to get vaccinated tomorrow. But, new shipments are constantly coming in. Hopfensperger says, "We get allocations almost daily. They fluctuate in the amount of vaccine that comes in and the presentation that it comes in."

Even though the vaccine will be made available to the general public focus will remain on the "target community."

If you are planning on getting vaccinated officials with the Department of Health Services say you should contact your local health department or health care provider and check on availability before setting up your appointment.

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UPDATED Monday, December 14, 2009 --- 12:15 p.m.

Press Release from the Department of Health Services:

The Department of Health Services (DHS) announces today that public health departments and private health care providers have been notified that they may start vaccinating members of the general public. However, DHS has instructed all health care providers to continue efforts to reach out to and vaccinate those in the CDC target groups.

“With more than 1.5 million doses of H1N1 vaccine in the state, we have reached a point where we can begin to offer the vaccine to individuals outside of the target group populations,” said State Health Officer Dr. Seth Foldy. “While this is good news, it should not be interpreted as an indication that those most-at-risk have all been vaccinated. Protecting pregnant women, everyone under the age of 24 and those with underlying health conditions remain our top priority.”

H1N1 activity is expected to continue throughout the influenza season and DHS recommends that all individuals, especially those on the CDC target list, get vaccinated as another wave of H1N1 cases could occur later this season. The H1N1 vaccine is safe and effective and even those who’ve had flu-like symptoms should be vaccinated as there are a variety of respiratory illnesses that circulate during cold and flu season. Children age 10 and under require two doses of the H1N1 vaccine, with an optimal time of four weeks between first and second doses.

For the last several weeks, DHS has been closely monitoring the vaccine supply and distribution at public and private vaccination sites across the state. The decision to expand to the general public has been discussed with the major hospital systems and public health directors.

In addition, DHS will begin distribution of H1N1 vaccine to pharmacies across the state, which will significantly increase the number of vaccination sites available to the general public. Some pharmacies may not be able to vaccinate children, so DHS recommends checking with the pharmacy before bring children to the vaccination site.

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UPDATED Thursday, December 10, 2009 --- 12:33 p.m.

MADISON, Wis. (AP) -- Three more people have died in Wisconsin from swine flu.

The state Department of Health Services reported Thursday that 43 people have died from swine flu so far this fall.

The news comes even though the department also says Wisconsin is following the national trend with a decline in overall cases. However, swine flu cases are expected to be seen throughout the flu season and another wave could occur.

Since September there have been 821 hospitalizations due to swine flu in Wisconsin. Two of the three new deaths were reported in Sheboygan County and the third was in West Allis.

Copyright 2009 by The Associated Press. All Rights Reserved.

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UPDATED Wednesday, November 25, 2009 --- 12:17 p.m.

Press release from the Department of Health Services:

H1N1 Situation Report
November 25, 2009 at 12:00 Hours

Overview
Nationally, the U.S. Centers for Disease Control and Prevention (CDC) reports H1N1 influenza activity is widespread in 43 states and has decreased slightly. Visits to doctors for influenza-like illness declined from last week, but are still higher than expected for this time of year. Flu-related hospitalizations and deaths have declined slightly, but are still very high nationwide compared to what is expected for this time of year.

In Wisconsin, activity peaked in late October, but is still widespread with all 72 counties reporting confirmed H1N1 cases. H1N1 activity is expected to continue throughout the season and it is anticipated that another wave of H1N1 cases could occur. There is no indication the H1N1 virus has changed or is more severe than in the spring. Seasonal influenza cases are expected to occur later in the season, perhaps in December or January.

On November 23rd, DHS issued guidance which recommended providers expand the vaccine target group to include healthy school age children and young adults. With that expansion, Wisconsin’s public and private health care providers have the flexibility of vaccinating individuals within the CDC’s original target group. It is anticipated that public health departments may begin more school-based clinics now that the group has been expanded to include healthy school age children.

DHS continues to monitor the vaccine supply and will continue to expand the vaccine groups as quickly as possible. The CDC continues to stress there will be adequate supplies of H1N1 vaccine available for everyone who wants it.

People are encouraged to follow good hygiene precautions such as hand washing, covering their cough/sneeze with their sleeve or a tissue, and staying home when ill. Call your health care provider first to determine if you should be seen by your local physician or if you should go to the ER/urgent care for treatment.

H1N1 Surveillance
In Wisconsin, activity peaked in late October, but is still widespread with all 72 counties reporting confirmed H1N1 cases. H1N1 activity is expected to continue throughout the season and it is anticipated that another wave of H1N1 cases could occur. There is no indication the H1N1 virus has changed or is more severe than in the spring. Seasonal influenza cases are expected to occur later in the season, perhaps in December or January.

Since September 1, 2009, there have been 667 hospitalizations due to H1N1 virus infection in Wisconsin. Since the last situation report on November 18th, there have been three additional confirmed H1N1-related deaths reported in Dane, Menominee, Outagamie, and Washington counties. This brings the H1N1-related death total to 35 statewide since the spring.

H1N1 Vaccine Update
Wisconsin’s vaccine allocations during the past few weeks continue to be close to CDC projections. At this time, Wisconsin has been allocated 1,129,500 doses, and the CDC indicates more than 938,000 of those have been shipped to providers. There is a lag time between the state receiving its H1N1 vaccine allocation and the shipment of doses to providers.

Wisconsin H1N1 Vaccine Allotments
On November 23rd, DHS issued guidance recommending providers expand the vaccine target group to include
healthy school age children and young adults, based upon the H1N1 vaccine supply and feedback from providers. With that expansion, Wisconsin’s public and private health care providers have the flexibility of vaccinating individuals within the CDC’s original target groups. This includes:

* Pregnant women
* Persons who live with or provide care for infants age 6 months or younger (examples: parents, siblings, daycare providers)
* Healthcare and emergency medical services personnel
* All people from 6 months through 24 years of age
* Persons 25-64 years of age with conditions associated with higher risk of complications from influenza

DHS continues to monitor the vaccine supply and will continue to expand the vaccine groups as quickly as possible. The CDC continues to stress there will be adequate supplies of H1N1 vaccine available for everyone who wants it. Community vaccination clinics will resume as H1N1 vaccine becomes more readily available. People may call 2-1-1 to find an H1N1 or seasonal influenza vaccine clinic nearest them. A “clinic finder” is also available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

Partner Items
Health care providers and other organizations across Wisconsin are calling 2-1-1 and providing detailed information on the type of flu shot that is available (seasonal or H1N1), date, time and locations of vaccination clinics on the flu clinic finder available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

School Closures
The CDC and DHS continue to stress that a school closure should be used as a last resort due to disruption of learning and the social impact. School closure information is listed on the DPI website at http://dpi.wi.gov/sspw/pandemicflu.html or can be found in the Media Room at http://pandemic.wisconsin.gov/.

Parents are reminded that keeping sick children home from school until 24 hours after they are free of fever (100°F [37.8°C] or greater) without the aid of medication is the safest way to prevent the spread of any illness. DHS is also encouraging parents to have a predesignated plan for caring for a sick child at home for the duration of a school exclusion period. Wisconsin businesses are also encouraged to adopt similar plans with their employees.

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UPDATED Wednesday, November 18, 2009 --- 12:35 p.m.

MADISON, Wis. (AP) -- State health officials say there are 11 additional confirmed H1N1 flu-related deaths in Wisconsin in the past week.

Those deaths happened in Dane, Jefferson, Kenosha, Marathon, Oconto, Ozaukee, Portage, Racine and Waupaca counties. Statewide, 31 people have died of H1N1-related illnesses since spring. 71 of Wisconsin's 72 counties have reported confirmed H1N1 flu cases.

About 695,000 does of H1N1 flu vaccines have been sent to Wisconsin as of Nov. 11, both in nasal and injectable forms.

Copyright 2009 by The Associated Press. All Rights Reserved.

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UPDATED Wednesday, November 18, 2009 --- 12:30 p.m.

Press release from the Department of Health Services:

H1N1 Situation Report
November 18, 2009 at 12:00 Hours

Overview
Nationally, the Centers for Disease Control and Prevention (CDC) reports H1N1 influenza activity remains high and is widespread in 46 states, although the slight downward trend in cases is continuing. However, the CDC cautions against making any assumptions about the H1N1 virus with these modest case declines. Flu-related hospitalizations and deaths continue to increase and are very high nationwide compared to what is expected for this time of year.

Wisconsin is following the national pattern with widespread activity throughout the state, with all five public health regions experiencing a modest decrease in cases. It is anticipated that another wave of H1N1 cases could occur later in the influenza season. Seasonal influenza cases are expected to occur later in the season, perhaps in December or January.

Although Wisconsin’s vaccine allocations during the past few weeks have increased and have been close to what the CDC has projected, DHS recommends that providers continue to complete vaccinations of those who have underlying medical conditions which put them at higher risk for influenza-related complications. The CDC continues to stress there will be adequate supplies of H1N1 vaccine available for everyone who wants it.

People are encouraged to follow good hygiene precautions such as hand washing, covering their cough/sneeze with their sleeve or a tissue, and staying home when ill. Call your health care provider first to determine if you should be seen by your local physician or if you should go to the ER/urgent care for treatment.

H1N1 Surveillance
In Wisconsin, activity is widespread with 71 of the 72 counties reporting confirmed H1N1 cases. Wisconsin is following the national pattern with all five public health regions experiencing a modest decrease in cases; however, there is still widespread activity throughout the state. While current H1N1 activity in Wisconsin may be at or past its peak, widespread H1N1 activity will likely occur for the next several months. It is also anticipated that another wave of H1N1 cases could occur later in the influenza season. Seasonal influenza cases are expected to occur later in the season, perhaps in December or January.

Since September 1, 2009, there have been 405 hospitalizations due to H1N1 virus infection in Wisconsin, with approximately 82% of those individuals having underlying medical conditions. Since November 11th, there have been 11 additional confirmed H1N1-related deaths reported in Dane (2), Jefferson, Kenosha, Marathon, Oconto, Ozaukee, Portage (2), Racine and Waupaca counties. This brings the statewide H1N1-related death total to 31 since the spring.

There is no indication the H1N1 virus has changed or is more severe than in the spring. The increase in hospitalization and death numbers is due to confirmed data becoming available which links hospital admissions and cause of death to an H1N1-related illness.

H1N1 Vaccine Update
As of November 11th, approximately 695,000 of Wisconsin’s allocated doses had arrived in the state in both the nasal and injectable forms. Wisconsin’s vaccine allocations during the past few weeks have been close to what the CDC has projected. There is a lag time between the state receiving its allocation and the shipment of doses to the providers.

Although Wisconsin’s vaccine allocations during the past few weeks have increased and have been close to CDC projections, DHS recommends that providers continue to complete vaccinations of the recommended subset of the target group including:
Pregnant women
Persons who live with or provide care for infants age 6 months or younger (examples: parents, siblings, daycare providers)
Health care and emergency medical services personnel who have direct contact with patients or infectious material
Children age 6 months - 4 years
Children and adolescents age 5-18 years who have chronic medical conditions that put them at higher risk for influenza-related complications

On November 12th, DHS issued guidance recommending providers expand the vaccine target group to include those between the ages 19-64 who have underlying medical conditions which put them at higher risk for influenza-related complications, if their vaccine supply is adequate to meet demand for those most-at-risk.

DHS will continue to monitor the vaccine supply during the next few weeks and work with local public health and health care systems in determining their success in reaching the target populations. This analysis will help assess when an adequate vaccine supply exists that allows Wisconsin to extend vaccinations to other groups statewide.

The CDC continues to stress there will be adequate supplies of H1N1 vaccine available for everyone who wants it. Community vaccination clinics will resume as H1N1 vaccine becomes more readily available. People may call 2-1-1 to find an H1N1 or seasonal influenza vaccine clinic nearest them. A “clinic finder” is also available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

DHS Activities
On November 12th, DHS issued guidance asking public health organizations and private health care providers to aggressively target the subsets of individuals most-at-risk of serious health complications from the H1N1 virus. DHS has expanded the vaccine target group to include those between the ages 19-64 who have underlying medical conditions which put them at higher risk for influenza-related complications. As part of ongoing communication with providers, DHS has issued a survey to help assess if the target groups have been reached and if an adequate vaccine supply exists that allows Wisconsin to extend vaccinations to other groups statewide.

DHS continues to staff a call center for health professionals pertaining to vaccine ordering questions and information. DHS also continues to host weekly webcasts for health professionals statewide and issue updated guidance as needed.

Health care providers and other organizations across Wisconsin are calling 2-1-1 and providing detailed information on the type of flu shot that is available (seasonal or H1N1), date, time and locations of vaccination clinics on the flu clinic finder available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

Partner Items
DHS is working with an established provider network to provide health care for individuals who are uninsured and are experiencing influenza-like symptoms. Uninsured individuals can receive an outpatient visit for evaluation and treatment at no cost when they see a physician within the established provider network. To locate a provider within the network, uninsured individuals can call 2-1-1 or their local public health department. Non-flu related services provided during the visit and follow-up visits are not covered and payment for non-flu related services will remain the individual’s responsibility.

School Closures
The CDC and DHS continue to stress that a school closure should be used as a last resort due to disruption of learning and the social impact. School closure information is listed on the DPI website at http://dpi.wi.gov/sspw/pandemicflu.html or can be found in the Media Room at http://pandemic.wisconsin.gov/.

Parents are reminded that keeping sick children home from school until 24 hours after they are free of fever (100°F [37.8°C] or greater) without the aid of medication is the safest way to prevent the spread of any illness. DHS is also encouraging parents to have a pre-designated plan for caring for a sick child at home for the duration of a school exclusion period. Wisconsin businesses are also encouraged to adopt similar plans with their employees.

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UPDATED Wednesday, November 11, 2009 --- 12:12 p.m.

Press release from the Department of Health Services:

H1N1 Situation Report
November 11, 2009 at 12:00 Hours

Overview
Nationally, the Centers for Disease Control and Prevention (CDC) reports most states are reporting widespread influenza activity and many southern states are experiencing a downward trend in cases. This may be related to the fact that this autumn’s wave of H1N1 infections began earlier in those southern states. H1N1-related pediatric deaths for the fall have already exceeded the pediatric deaths for each of the last three influenza seasons.

In Wisconsin, activity is widespread with 70 of the 72 counties reporting confirmed H1N1 cases. Although H1N1 activity is widespread throughout the state, all five public health regions are experiencing a modest decrease in cases. While current H1N1 activity in Wisconsin may be nearing its peak, widespread H1N1 activity will likely occur for the next several months. States in the southern U.S. which saw their H1N1 activity peak several weeks ago are still reporting widespread activity. It is also possible that another wave of H1N1 cases could occur later in the influenza season. Seasonal influenza cases are expected to occur later in the season, perhaps in December or January.

The DHS guidance issued on October 27th to local health departments and health professionals asking them to target H1N1 vaccine for a subset of individuals most-at-risk remains in effect. Although Wisconsin’s vaccine allocations during the past few weeks have increased and have been close to what the CDC has projected, DHS recommends that providers continue to complete vaccinations of this subset.

People are still encouraged to follow good hygiene precautions such as hand washing, covering their cough/sneeze with their sleeve or a tissue, and staying home when ill. Call your health care provider first to determine if you should be seen by your local physician or if you should go to the ER/urgent care for treatment.

H1N1 Surveillance
In Wisconsin, activity is widespread with 70 of the 72 counties reporting confirmed H1N1 cases. Although H1N1 activity is widespread throughout the state, all five public health regions are experiencing a modest decrease in cases. While current H1N1 activity in Wisconsin may be nearing its peak, widespread H1N1 activity will likely occur for the next several months. It is also anticipated that another wave of H1N1 cases could occur later in the influenza season. Seasonal influenza cases are expected to occur later in the season, perhaps in December or January.

There is no indication the H1N1 virus has changed or is more severe than in the spring, although hospitalizations are on the rise due to widespread illness. While Wisconsin may begin to experience a decline in H1N1 cases overall, the number of hospitalizations may continue to rise as more data becomes available linking hospital admissions to the cause of illness.

Since September 1, 2009, there have been 288 hospitalizations due to H1N1 virus infection in Wisconsin, with approximately 82% of those individuals having underlying medical conditions. In the last week, there have been four additional confirmed H1N1-related deaths reported in Dodge, Grant, Ozaukee and St. Croix counties, bringing the statewide death total to 20 since the spring.

H1N1 Vaccine Update
As of Friday, November 6th, the CDC reports it had allocated 38 million doses of H1N1 vaccine nationwide. At that time, Wisconsin has been allocated 697,700 thousand doses. As of today, Wisconsin has been allocated a total of 751,400 doses.

Wisconsin’s vaccine allocations during the past few weeks have been close to what the CDC has projected. Although Wisconsin’s vaccine allocations during the past few weeks have increased and have been close to what the CDC has projected, DHS recommends that providers continue to complete vaccinations of the recommended subset of the target group including:

* Pregnant women
* Persons who live with or provide care for infants age 6 months or younger (examples: parents, siblings, daycare providers)
* Health care and emergency medical services personnel who have direct contact with patients or infectious material
* Children age 6 months - 4 years
* Children and adolescents age 5-18 years who have chronic medical conditions that put them at higher risk for influenza-related complications

The CDC continues to stress there will be adequate supplies of H1N1 vaccine available for everyone who wants it, but it will take a longer time than previously projected for adequate supplies to become available.

The ordering of the H1N1 vaccine is a continuous process as newly manufactured vaccine approved by the U.S. Food and Drug Administration (FDA) is allocated to the states and distributed each week. There is a lag time between the state receiving its allocation and the shipment of doses to the providers.

Wisconsin H1N1 Vaccine Allotments
As of November 6, total doses allocated to WI = 697,700
November 9, Daily doses allocated to WI = 3,400, total doses allocated to WI = 701,000
November 10, Daily doses allocated to WI = 50,300, total doses allocated to WI = 751,400
November 11, Daily doses allocated to WI = 0, total doses allocated to WI = 751,400

On November 9th, DHS issued new guidance to Wisconsin physicians and pharmacists regarding the use of antivirals to treat H1N1 influenza illness in conjunction with updated CDC guidance. Per the CDC’s November 6th advisory, the new CDC recommendations include:

* It is not too late to treat patients with antivirals even if symptoms began more than 48 hours ago.
* Outpatients, particularly those with risk factors for severe illness who are not improving, might also benefit from treatment initiated more than 48 hours after illness onset.
* All hospitalized patients with suspected or confirmed H1N1 infection should receive antiviral treatment as early as possible.
* Some persons without risk factors for severe disease may also benefit from antivirals.
* When antiviral treatment is indicated, it should be started empirically and should not be delayed waiting for laboratory test results.

DHS Activities
DHS continues to staff a call center for health professionals pertaining to vaccine ordering questions and information. DHS also continues to host weekly webcasts for health professionals statewide and issue updated guidance as needed.

Health care providers and other organizations across Wisconsin are calling 2-1-1 and providing detailed information on the type of flu shot that is available (seasonal or H1N1), date, time and locations of vaccination clinics on the flu clinic finder available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info.

School Closures
The CDC and DHS continue to stress that school closure should be used as a last resort due to disruption of learning and the social impact. However, if high rates of student or staff absenteeism make it difficult for schools to operate, a limited closure may be the best option to decrease exposure to influenza. In most cases, the decision to close schools is a joint decision made by local health departments and school administrators in consultation with DHS.

School closure information is listed on the DPI website at http://dpi.wi.gov/sspw/pandemicflu.html or can be found in the Media Room at http://pandemic.wisconsin.gov/.

Parents are reminded that keeping sick children home from school until 24 hours after they are free of fever (100°F [37.8°C] or greater) without the aid of medication is the safest way to prevent the spread of any illness. DHS is also encouraging parents to have a pre-designated plan for caring for a sick child at home for the duration of a school exclusion period. Wisconsin businesses are also encouraged to adopt similar plans with their employees.

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UPDATED Wednesday, October 28, 2009 --- 12:24 p.m.

MADISON, Wis. (AP) -- The Wisconsin Department of Health Services says four more people in the state have died from the swine flu.

Department spokeswoman Stephanie Marquis said Wednesday the deaths were reported over the last week. There was one in Eau Claire County, two in Milwaukee County and one in Oconto County.

That brings the death total to five since Sept. 1 and 14 altogether including those in the spring. She had no other information on ages, sexes or health background.

The Oconto County Health Department said Tuesday a woman there with underlying health condition died from the complications related to the swine flu.

The department said Tuesday it would tell health care providers to stop conducting mass swine-flu vaccinations starting next week until vaccine supplies increase and only target high-risk groups.

Copyright 2009 by The Associated Press. All Rights Reserved.

Below: Press release from the Department of Health Services.

H1N1 Situation Report
October 28, 2009 at 12:00 Hours

Overview
Nationally, the Centers for Disease Control and Prevention (CDC) reports that flu activity is now widespread in 46 states. Visits to doctors for influenza-like-illness are increasing steeply and are now higher than what is seen at the peak of many regular flu seasons. In addition, flu-related hospitalizations and deaths continue to go up nation-wide and are above what is expected for this time of year. In Wisconsin, activity is widespread with H1N1 cases being reported in 65 of the 72 counties.

On October 27th, DHS issued guidance to local health departments and health professionals asking them to target H1N1 vaccine for a subset of individuals most-at-risk during the next several weeks as the vaccine supply continues to fluctuate (detailed list provided below in the H1N1 Vaccine section). DHS has also requested that, beginning next week, public and private health care providers refrain from mass public vaccination clinics, unless they are targeted at those most at risk.

H1N1 vaccine is being provided for free from the federal government, and DHS strongly advises that anyone within the target group who presents to a provider for an H1N1 vaccine be immunized on-site, rather then being referred elsewhere. In addition, DHS has directed local health departments to vaccinate anyone within the newly-designated target group, regardless of that individual’s city or county of residence. Local health departments are receiving federal funding for administering the vaccine and should not turn away anyone in the target group.

The CDC continues to stress there will be adequate supplies of H1N1 vaccine available for everyone who wants it, but it will take a longer time than previously projected for adequate supplies to become available.

A variety of schools districts across the state are reporting limited school closures, which are posted online at the Wisconsin Department of Public Instruction (DPI) website at http://dpi.wi.gov/sspw/pandemicflu.html.

People are encouraged to follow good hygiene precautions such as hand washing, covering their cough/sneeze with their sleeve or a tissue, and staying home when ill. Call your health care provider first to determine if you should be seen by your local physician or if you should go to the ER/urgent care for treatment.

H1N1 Surveillance
Influenza activity is widespread across the state and continues to increase in all five public health regions. Influenza-like activity is higher than normal for this time of year, with 65 of the 72 counties reporting confirmed H1N1 cases.

There is no indication the H1N1 virus has changed or is more severe than in the spring, although hospitalizations are on the rise due to widespread illness.

Since September 1, 2009, there have been 70 hospitalizations due to H1N1 virus infection in Wisconsin. Since the October 21st situation report, three more counties have reported H1N1-related deaths, bringing the statewide death total to 14 since the spring. The new H1N1-related deaths include one death in Eau Claire County, two in Milwaukee County and one in Oconto County.

H1N1 Vaccine Update
On October 27th, DHS issued guidance to local health departments and health professionals asking they target H1N1 vaccine to a subset of those individuals most-at-risk during the next several weeks as the vaccine supply continues to fluctuate.

DHS is now recommending that the public health and health care community focus vaccination efforts on the following subset of CDC’s target groups:

* Pregnant women
* Persons who live with or provide care for infants age 6 months or younger (examples: parents, siblings, daycare providers)
* Health care and emergency medical services personnel who have direct contact with patients or infectious material
* Children age 6 months - 4 years
* Children and adolescents age 5-18 years who have chronic medical conditions that put them at higher risk for influenza-related complications

These recommendations are consistent with the Advisory Committee on Immunization Practices guidelines when vaccine supply is limited. The Advisory Committee on Immunization Practices advises the CDC.
DHS has also requested that, beginning next week, public and private health care providers refrain from H1N1 mass public vaccination clinics, unless they are targeted at those most-at-risk. DHS strongly encourages that any public vaccination announcements include a message about the limited supply of vaccine, the importance of concentrating on vaccinating people in the target groups and a notice that there is a possibility that the vaccination clinic – or future clinics – may need to be postponed.

Public health agencies and health care providers must be cautious and only commit to conducting vaccination clinics that they feel reasonably certain can be supplied with H1N1 influenza vaccine. Community vaccination clinics will resume as H1N1 vaccine becomes more readily available. The CDC continues to stress there will be adequate supplies of H1N1 vaccine available for everyone who wants it, but it will take a longer time than previously projected for adequate supplies to become available. The ordering of the H1N1 vaccine is a continuous process as newly manufactured vaccine approved by the U.S. Food and Drug Administration (FDA) is allocated to the states and distributed each week.

As of October 27th, Wisconsin had been allocated a total of 407,000 doses of H1N1 vaccine from the CDC. The CDC indicates there is a lag time between allocation, ordering, and shipment of doses. Approximately 300,000 of Wisconsin’s allocated doses have already arrived in the state in both the nasal and injectable forms, most of which have already been administered to the health care workforce and individuals within target groups.

DHS Activities
DHS continues to staff a call center for health professionals pertaining to vaccine ordering questions and information. The call center is receiving approximately 70-100 calls each day. DHS also continues to host weekly webcasts for health professionals statewide and issue updated guidance as needed.

In conjunction with 2-1-1 Wisconsin, DHS launched the flu clinic finder which is available online at http://pandemic.wisconsin.gov or www.wisconsinfluclinic.info. Health care providers and other organizations across Wisconsin are calling 2-1-1 and providing detailed information on the type of flu shot that is available (seasonal or H1N1), date, time and locations of vaccination clinics. Community vaccination clinics will resume as H1N1 vaccine becomes more readily available. People may also call 2-1-1 to find out an H1N1 or seasonal influenza vaccine clinic nearest them.

The ABC New Medical Unit has named Wisconsin one of the best states for keeping their public informed about where the limited supply of H1N1 vaccine can be found. The ABC News story indicated that a state-by-state comparison of flu websites revealed that Wisconsin, New Jersey and Kansas are helping the vaccine process run a little smoother by providing vaccine locating tools, lists of local doctors who will provide the vaccine, and even phone numbers for hotlines devoted to helping the public locate a H1N1 vaccine clinic or doctor nearby.

Partner Items
Calls to 2-1-1 Wisconsin have increased dramatically. The majority of the calls relate to H1N1 vaccine availability, with other calls pertaining to issues such as flu symptoms, prevention of the illness, and seasonal flu vaccine availability.

School Closures
Unusually high rates of student absenteeism (approximately 30-40%) due to influenza-like illness have led to a variety of temporary school closures in some districts around the state. The CDC and DHS continue to stress that school closure should be used as a last resort due to disruption of learning and the social impact. However, if high rates of student or staff absenteeism make it difficult for schools to operate, a limited closure may be the best option to decrease exposure to influenza. In most cases, the decision to close schools is a joint decision made by local health departments and school administrators in consultation with DHS.

School closure information is listed on the DPI website at http://dpi.wi.gov/sspw/pandemicflu.html or can be found in the Media Room at http://pandemic.wisconsin.gov/.

Parents are reminded that keeping sick children home from school until 24 hours after they are free of fever (100°F [37.8°C] or greater) without the aid of medication is the safest way to prevent the spread of any illness. DHS is also encouraging parents to have a pre-designated plan for caring for a sick child at home for the duration of a school exclusion period. Wisconsin businesses are also encouraged to adopt similar plans with their employees

_____________________________________________

UPDATED Wednesday, October 7, 2009 --- 1:23 p.m.

Press Release from the Department of Health Services:

H1N1 Situation Report
October 7, 2009 at 12:00 Hours

Overview
Nationally, the Centers for Disease Control and Prevention (CDC) report that influenza activity is increasing in most of the United States with more than half of all states reporting widespread influenza activity. In Wisconsin, influenza activity is also on the rise.

People are encouraged to follow good hygiene precautions such as hand washing, covering their cough/sneeze with their sleeve or a tissue, and staying home when ill and calling their health care provider first rather than going directly to the ER or urgent care for treatment.

H1N1 Surveillance
Currently, Wisconsin is experiencing elevated flu activity in most areas of the state, with cases reported from 48 of Wisconsin’s 72 counties. 99% of all the circulating influenza viruses have been confirmed as H1N1. Flu activity is currently higher than what is normally seen at this time of the year.

DHS has not yet seen the type of week-to-week community escalation that occurred in the spring, however, in the Southern United States – where schools opened in August – they are experiencing escalating outbreaks that we could very well see here in Wisconsin.

No H1N1 viruses in the state have been found to be resistant to antiviral medications. Since September 1, 2009, Wisconsin has had 17 hospitalizations and 1 death. There have been 9 deaths statewide since the first H1N1 cases were seen in Wisconsin this spring.

School Closures
The Wisconsin Dells School District announced on Tuesday October 6th that they would be closing five schools due to increased influenza like illness (ILI). Schools will reopen on Monday October 12th. Wisconsin Dells High School had 170 out of 587 students out sick on Monday October 5th, and 180 students out sick on Tuesday October 6th, and many more at school who were showing ILI symptoms. An adjacent middle school and grade school also had significant illness with 10% of each schools student body out sick.

CDC and DHS continue to stress that school closure should be used as a last resort. However, if there are a significant number of sick students in one school or a number of schools that share facilities or buses, a limited closure may be the best option. In most cases those decisions are made by the local health department in consultation with the school, the school district and DHS.

Parents are reminded that keeping sick children home from school until 24 hours after they are free of fever (100°F [37.8°C] or greater) with the aid of medication is the safest way to prevent the spread of any illness. DHS is also encouraging parents to have a pre-designated plan for caring for a sick child at home for the duration of a school exclusion period, which for most children will by 3 to 5 days. Wisconsin businesses are also encouraged to adopt similar plans with their employees.

H1N1 Vaccine Update
DHS established pre-registration for health care providers to place their vaccine orders with the state – and more than 2,000 pre-registered to receive the vaccine.

Wisconsin was among the first states to submit vaccine orders to CDC last week and providers in the state began receiving those shipments on Monday. Initial shipments were limited and only consisted of nasal mist which is only recommended for those between the ages of 2 and 49 years of age and is not recommended for pregnant women or those with asthma.

Wisconsin was allocated a total of 46,000 doses which were targeted toward larger hospitals, clinic systems and public health agencies so they could begin to vaccinate the health care workforce. Approximately 80 providers received shipments this week.

DHS has yet to receive a total allocation for next week’s vaccine shipment, however, it is expected to be larger and it is expected to include the injectable form of the vaccine. These shipments will again be targeted toward the health care workforce and will be expanded to include smaller hospitals, clinics and public health agencies who did not receive vaccine in the first week’s shipment. There are an estimated 250,000 health care workers and emergency first responders in Wisconsin.

After the week of October 11th, vaccine will start to be targeted toward public health agencies and private health care providers and toward the later part of October public vaccination clinics and school based clinics will begin to occur around the state.

DHS Activities
DHS has activated a call center for health professionals pertaining to vaccine ordering questions and information. Although October 12th has been designated a state-employee required furlough day, staff schedules will be adjusted to ensure that health professionals will be able to contact the call center on October 12th and calls will not go unattended. DHS staff scheduled for the call center on October 12th will take their required furlough day at an alternative time.

DHS is also working with 2-1-1 Wisconsin to develop a website and phone system where people across the state can find information on local vaccination clinics over the phone or the internet.

Partner Items
DHS is continuing its regular conference calls, webcasts and issued guidance to health professional statewide.

_____________________________________________

UPDATE Posted Wednesday September 30, 2009 -- 4:48 pm
By Zac Schultz

Madison: The Wisconsin Department of Health Services is taking orders for the H1N1 vaccine.

"Today the first order forms went out," spokesman Seth Boffeli said Friday. "We'll probably start to get them back today already."

There are 2,000 local providers across the state, including hospitals, clinics and local health departments.

Kevin Wernet is the Preparedness Coordinator for Public Health of Madison and Dane County. "We do know that over the next few months we'll be ordering close to 100,000 total doses."

But Boffeli says the whole state may only get 50,000 in that first batch next week. "The first shipment that will probably start arriving middle of next week, it's going to be focused on health care workers."

"We'll be ordering 1,000 doses to be made available initially for our healthcare workers," says Wernet.

The state will decide whether Public Health gets their full shipment. "When we know from CDC, you have X-number available, then we transmit the order," says Boffeli. "It says, send 500 to this hospital, 200 to this hospital."

After health care workers, kids and the immuno-compromised will be priorities. Wernet says it will take a while before the general public gets served. "We're looking at mid to late-October, but it's very dependent on the delivery of vaccine in significant quantities to be able to provide the school based clinics."

_____________________________________________

UPDATED Wednesday, September 30, 12:32 p.m.

Press Release from the Department of Health Services:

H1N1 Situation Report
September 30, 2009 at 12:00 Hours

Overview
Nationally, the Centers for Disease Control and Prevention (CDC) reports that influenza activity is increasing in most of the United States with more than half of all states reporting widespread influenza activity. In Wisconsin, influenza activity is also on the rise.
People are encouraged to follow good hygiene precautions such as hand washing, covering their cough/sneeze with their sleeve or a tissue, and staying home when ill.

As H1N1 vaccine becomes available, people are encouraged to become immunized. The CDC is recommending that target groups be the first to receive the immunization as the H1N1 manufacturing process continues and is phased in until anyone who wants to receive the vaccine will be able to do so.

H1N1 Surveillance
Influenza-like illness activity continues to be elevated for this time of year. Influenza-like illness in the southern region, which increased in early September primarily due to illnesses at UW-Madison, has decreased. Influenza-like illness activity is moderate in the western and southeastern portions of the state, which are seeing sporadic cases. Influenza-like illnesses are also on the rise in the western and northeastern portions of the state, with the most active areas including the Green Bay area and the Fox Valley region.

Family practice visits for influenza-like symptoms have increased slightly over the past 3 weeks. Some family practice visits are due to other respiratory illnesses circulating in the state.
No H1N1 viruses in the state have been resistant to antiviral medications. Since September 1, 2009, Wisconsin had 9 hospitalizations and 0 deaths.

Seasonal Influenza Update
DHS is being contacted by some public and private providers due to a delay in receiving their seasonal influenza vaccine shipments. DHS has contacted the CDC which indicates seasonal influenza vaccine is available, but does acknowledge that some providers have not yet received their seasonal vaccine orders. DHS will be following CDC recommendations in encouraging the public to receive both seasonal and H1N1 influenza vaccines as both viruses will be circulating this season.

H1N1 Vaccine Update
As reported previously, the H1N1 vaccine has been approved by the U.S. Food and Drug Administration (FDA). The vaccine is being manufactured using the seasonal influenza vaccine process, and the CDC is indicating the vaccine is safe and effective. Therefore, DHS is following the CDC’s established vaccine distribution system where H1N1 vaccine orders are placed through each state’s public health department.

DHS established pre-registration for health care providers to place their orders with the state – and more than 2,000 pre-registered to receive the vaccine. In addition, DHS has activated a call center for health professionals pertaining to vaccine ordering questions and information.

The CDC will be supplying states with H1N1 vaccine based upon population rates. The CDC continues to work with the FDA to establish the vaccine lot approval and distribution process. All states are able to place their first H1N1 vaccine order today, September 30, and the vaccine distributors will ship orders directly to providers. The CDC is continuing to identify the amount of vaccine doses each state will receive each week.

Distributors will ship the majority of Wisconsin’s first allocation to local health departments and larger health care systems in order to vaccinate health care professionals who are caring for sick individuals potentially ill due to H1N1. It is expected providers in Wisconsin will receive initial shipments the middle of next week. Initial shipments will be nasal-spray flu vaccine and the flu shot will be incorporated into later shipments. The CDC may be posting vaccine order information on its website, but it is anticipated that actual shipment and vaccine information may not be included in the data online.

Because manufacturers are still producing the vaccine, the CDC is recommending that the target groups listed below be the first to receive the H1N1 vaccine:

• Pregnant women
• Household contacts and caregivers for children less than 6 months of age
• Healthcare and emergency medical services personnel
• All people from 6 months through 24 years of age
• Persons 25-64 years of age with conditions associated with higher risk of complications from influenza

Additional vaccine will be manufactured and distributed throughout the influenza season and the CDC is indicating there will eventually be enough vaccine for anyone who wishes to receive it.

DHS Activities
DHS established pre-registration for health care providers to place their vaccine orders with the state – and more than 2,000 pre-registered to receive the vaccine.

In addition, DHS has activated a call center for health professionals pertaining to vaccine ordering questions and information. Although October 12th has been designated a state-employee required furlough day, staff schedules will be adjusted to ensure that health professionals will be able to contact the call center on October 12th and calls will not go unattended. DHS staff scheduled for the call center on October 12th will take their required furlough day at an alternative time.

Partner Items
DHS is continuing its regular conference calls, webcasts and issued guidance to health professional statewide. In addition, DHS will be hosting a webcast for law enforcement and first responders on October 7th.

New Guidance Issued
New guidance issued by the CDC, the U.S. Department of Health and Human Services or DHS’ Division
of Public Health is available online at http://pandemic.wisconsin.gov/.

Items recently published include:
• H1N1 Asthma Information for Patients and Parents
• H1N1 Guide for Community and Faith-Based Organizations

_____________________________________________

Updated Wednesday, September 23, 2009 --- 1:44 p.m.

MADISON, Wis. (AP) -- Six people in Wisconsin have been hospitalized so far this month for H1N1, but no one has died.

That statistic is included in the first of what will be weekly updates on the flu from the state Department of Health Services released on Wednesday.

Between April 25 and Aug. 29, eight people died in the state from H1N1. The virus is expected to become more prevalent in the fall and winter.

The state health department says it expects Wisconsin to receive its first shipment of vaccine in early to mid-October. Orders for the vaccine come to the state from public and private health care providers, which then distribute it.

Copyright 2009 by The Associated Press. All Rights Reserved

_____________________________________________

Posted Wednesday, September 23, 2009 --- 12:25 p.m.

Press Release from the Department of Health Services:

H1N1 Situation Report
September 23, 2009 at 12:00 Hours

Overview
The Department of Health Services (DHS) has continued statewide H1N1 surveillance throughout summer. As fall and winter approaches, DHS will continue to provide guidance to local health departments and clinicians based upon the U.S. Center of Disease Control and Prevention (CDC) recommendations and the H1N1 situation in Wisconsin. In addition, DHS will monitor the seasonal influenza strain this season per standard protocol.

Based upon local, statewide and national reports, as well as surveillance in the southern hemisphere, the H1N1 virus is continuing to circulate in the population and is similar in severity to seasonal influenza. Therefore, DHS will be focusing on hospitalization rates and fatalities to monitor the virulence of the disease. Case counts may be used initially and sporadically this fall to identify the rate of spread of the H1N1 virus, but hospitalization and fatality information will be more useful and accurate in determining the severity of the disease in Wisconsin.

People are encouraged to follow good hygiene precautions such as hand washing, covering their cough/sneeze with their sleeve or a tissue, and staying home when ill. As H1N1 vaccine becomes available, people are encouraged to become immunized. The CDC is recommending that priority groups be the first to receive the immunization as the H1N1 manufacturing process continues and is phased in until anyone who wants to receive the vaccine will be able to do so. More information is detailed under the vaccine portion of the situation report.

The pandemic website (pandemic.website.gov) is routinely updated when new CDC guidance is issued or other relevant information becomes available. In addition, DHS is encouraging the general public to call 2-1-1 with general questions or their health care provider if they become ill.

DHS will resume issuing regular situation reports as necessary. At this time, it is anticipated these reports will be issued weekly on Wednesday around noon.

H1N1 Surveillance
Overall, influenza-like illness activity in Wisconsin is higher than normal and sporadic cases of H1N1 have been identified statewide. The southern region has a higher number of H1N1 cases due to a large number of cases at the University of Wisconsin-Madison, although UW-Madison reports that the number of students they saw for influenza-like symptoms declined last week. The other four public health regions – (northeastern, northern, southeastern and western) continue to report low influenza-like illness activity. With schools now open statewide, it is expected that influenza-like illnesses will increase.

Information from emergency room admissions and family practitioners indicates there was a slight rise in H1N1 cases the past two weeks, but those emergency room admissions have already started to decline. A decline in cases is not typical of what you see in accelerated influenza activity, so it is expected that Wisconsin has not begun to experience widespread H1N1 influenza activity.

No H1N1 viruses in the state have been resistant to anti-virals and 99% of laboratory confirmed cases in Wisconsin have been identified as H1N1. Wisconsin had 8 deaths related to H1N1 influenza and 239 hospitalizations from April 25 to August 29, 2009. New hospitalization and death rates are being calculated since September 1, 2009, and Wisconsin had 6 hospitalizations and 0 deaths since September 1st.

Seasonal Influenza Update
Seasonal influenza activity is expected to increase later this autumn, although 99% of current confirmed laboratory cases in Wisconsin have been identified as H1N1.

The CDC indicates there is plenty of season influenza vaccine available. Seasonal influenza vaccine is being shipped to providers statewide and DHS is encouraging people to receive their seasonal influenza shot now, prior to the H1N1 vaccine becoming available. DHS will be following CDC recommendations in encouraging the public to receive both seasonal and H1N1 influenza vaccines as both viruses will be circulating this season.

H1N1 Vaccine Update
The H1N1 vaccine has been approved by the U.S. Food and Drug Administration (FDA). The vaccine is being manufactured using the seasonal influenza vaccine process, and the CDC is indicating the vaccine is safe and effective.

The CDC has established a vaccine distribution system where H1N1 vaccine orders are placed through each state’s public health department. DHS has already established the ability for public and private health care providers to place their orders with the state. DHS will be able to place the first H1N1 vaccine order on September 30th with the CDC (all states will do so on that date), and the vaccine distributors will ship orders directly to providers. It is expected providers in Wisconsin will receive initial shipments by early to mid-October.

The CDC anticipates there will be enough H1N1 vaccine for anyone who wants it, although they are using a phased-in approach for distribution because manufacturers are still producing the vaccine. In a normal year, the U.S. distributes 100 million doses of seasonal vaccine and the CDC has ordered 195 million doses of H1N1 vaccine, with the ability to order more.

Because manufacturers are still producing the vaccine, the CDC is recommending that the priority groups listed below be the first to receive the H1N1 vaccine:

Pregnant women

Household contacts and caregivers for children less than 6 months of age

Healthcare and emergency medical services personnel

All people from 6 months through 24 years of age

Persons 25-64 years of age with conditions associated with higher risk of complications from influenza

Additional vaccine will be manufactured and distributed throughout the influenza season and the CDC is indicating there will eventually be enough vaccine for anyone who wishes to receive it.

DHS Activities
DHS continued H1N1 surveillance since the virus was first identified this spring. In addition, the Division of Public Health has held regular conference calls, webcasts and issued guidance to health professional statewide.

DHS has also been working closely with the Division of Public Instruction, the Wisconsin State Laboratory of Hygiene and local and tribal health departments. These partners will continue to be critical as DHS continues to conduct virus surveillance, closely watch any surges on the health care system, and monitor vaccine and anti-viral supplies.

Partner Items
DHS is coordinating with 211 Wisconsin to gather information about public H1N1 flu clinics as they become scheduled this fall in order to help answer questions from the public. DHS is also staffing an H1N1 awareness booth at the farmers market in Madison in conjunction with the Wisconsin Department of Military Affairs’ activities for preparedness month.

New Guidance Issued
New guidance issued by the CDC or the Division of Public Health is available online at http://pandemic.wisconsin.gov/. Items recently published include:
CDC Guidance on Helping Child Care and Early Childhood Programs Respond to Influenza during the 2009–2010 Influenza Season