May 1, 2009

Swine Flu: Health Care Provider Obligations

         On April 28, 2009, the Indiana State Department of Health (ISDH) confirmed Indiana's first case of H1N1 Influenza Type A, commonly known as the "swine flu."  Hospitals and other medical providers have certain obligations with respect to these types of illnesses under Indiana law.  Although H1N1 does not constitute a "dangerous communicable disease or condition" under ISDH regulations, ISDH has the authority to adopt emergency rules to include mandatory reporting of emerging infectious diseases and outbreaks of influenza-like illness that must be reported to ISDH by physicians, hospital administrators and laboratories immediately upon suspicion.

         ISDH requests health care providers to collect specimens from any patient with a "suspected case," which is defined as meeting the following criteria:

The patient presents with signs and symptoms characteristic of influenza (fever ≥100 degrees Fahrenheit with a cough or sore throat), AND

a) Has had a positive test result for influenza A, OR

b) Has traveled to another state or country with confirmed cases of A/H1N1/North America/Human influenza within seven days of illness, OR

c) Has been in contact with someone ill with a suspected, probable, or confirmed case of the current outbreak strain within seven days of illness.

Specimen from patients that meet the above criteria will be tested at the ISDH Laboratory.

         Hospitals and other medical providers should keep in close contact with the ISDH to ensure that they are updated regularly on any additional agency actions.  For example, ISDH has the power to establish quarantine and may do what is reasonably necessary for the prevention and suppression of disease.  Additionally, local boards of health may take certain actions to control communicable diseases, including confinement of infected individuals.

         It is important to remember that prior approval from a patient is not required before releasing medical or epidemiological information to state or local health departments; however, all information obtained in these situations is confidential and may not be released to the public, except under very limited circumstances.

         Hospitals and medical providers should have infection control programs in place designed for the identification, surveillance, investigation, control and prevention of infections and communicable diseases in patients and health care workers.

         The Centers for Disease Control and Prevention (CDC) has issued swine flu guidance documents for clinicians and public health professionals and other information that is updated regularly.  For more information about the efforts of ISDH, visit the ISDH Web site.

         If you need any other information or if a situation arises and you need legal advice, please contact Kevin Woodhouse, Margaret Emmert or Lisa Gethers of our Health Care Practice Group.

This publication is intended for general information purposes only and does not and is not intended to constitute legal advice.  The reader must consult with legal counsel to determine how laws or decisions discussed herein apply to the reader's specific circumstances.