Three more cases of H1N1 have been confirmed at Fort Gordon.

The most recent confirmation, a 21-year-old Family member of a Fort Gordon service member was confirmed June 29 as the fourth person with H1N1 at the post.

The female Family member was examined at Dwight D. Eisenhower Army Medical Center on June 19, and sent home to recover without antiviral medication.

Public health officials are investigating whether there are any known links among the last three H1N1 cases, from different Families, that have been reported at Fort Gordon.

Two cases were confirmed June 26 at Fort Gordon— a 22-year-old and a 15-year-old, both Family members.The confirmations came from the Department of Defense laboratory at Brooks Air Force Base, San Antonio, Texas.

The 22-year-old was examined and tested at Dwight D. Eisenhower Army Medical Center on June 16, with mild flu-like symptoms, including fever and respiratory problems.

The man was not given anti-viral medication, and was sent home for isolation and recovery. Follow-up was conducted by the physician and a public health nurse by telephone.

The 15-year-old was examined and tested on June 23, and did not receive antiviral medication. He is recovering at home.

The two young men are not related.

DDEAMC physicians said the patients are fully recovered, and they took appropriate actions to mitigate exposure to the community.

State and local public health departments have been notified.

Physicians and staff at DDEAMC have been educated to thoughtfully evaluate patients who seek care with influenza-like symptoms, to include specific questions regarding recent travel or contact with ill individuals. Laboratory testing to confirm the diagnosis of novel influenza A virus is preceded by a rapid antigen test in our facility that provides an initial indication of the existence of influenza.This initial test takes approximately 1 hour to complete, but is not specific for H1N1. If the rapid test is positive or there is high suspicion for influenza, health care providers initiate a treatment plan which may include medications, self-care at home, or hospitalization. A positive rapid test for influenza A is referred to the DoD reference laboratory located at Brooks City Base, San Antonio, Texas.

This laboratory is a participating member of the United States disease surveillance system which types samples by real-time polymerase chain reaction to determine if the sample is a seasonal strain of influenza or the novel H1N1 strain. Once the DoD reference laboratory processes the sample, the results are communicated back through the medical system to the referring physician.

If medical providers at DDEAMC identify a patient with influenza-like illness whose rapid test is positive for influenza A, the patient is immediately treated and precautions are taken to prevent the spread of influenza. These precautions include identification of recent, close contacts and social distancing recommendations to preclude future additional exposures.

DDEAMC has also responded to the potential threat by placing masks near all entrances and ensuring additional hand sanitizer dispensers are available throughout the facility. Posters and educational materials have been placed throughout the medical center and its outlying clinics emphasizing cough etiquette and hand hygiene which are important measures for preventing spread of influenza.

Medical providers began enhanced influenza surveillance by screening all patients who presented with fever, sore throat, and cough by collecting specimens for testing as appropriate.

Locally, DDEAMC officials have been preparing for a pandemic-like scenario as part of the emergency preparedness program. DDEAMC and Fort Gordon officials have developed plans and exercised responses for several years. Additionally, both organizations have been working closely with the East Central Health District and local hospitals to coordinate a unified response. The novel 2009 influenza A virus outbreak enabled DDEAMC and Fort Gordon to test the emergency reponse system. Both DDEAMC and Fort Gordon have established a response team to implement the existing infectious disease response plan. This plan includes staff education on management of patients of influenza-like illness during this outbreak and necessary precautions for protecting patients and the public from exposure. Specific laboratory and treatment protocols are validated and reiterated along with notification procedures for local medical authorities.

DDEAMC and Fort Gordon will continue to monitor the situation closely. Appropriate surveillance in accordance with CDC recommendations will continue to allow identification of patients with influenza-like illness so that appropriate treatment and control measures may be implemented to protect the health of the patient, their Family, and the community.