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Fever, muscle aches, exhaustion- we have all gotten to experience the flu. What we have learned is that it is no fun and is something to avoid. Now there is talk of a new type of flu- The Swine Flu (H1N1 flu) which is causing some concern. THIS IS IMPORTANT: a flu shot will only protect you against the Seasonal Flu (actually their best guess as to the types of flu that will be common this year). It will not protect you against the Swine Flu. A vaccine for this will be available sometime in October. Seasonal Flu shots can be gotten in all types of places- from your doctor’s offer, to the county health department, to your local drug store. The distribution of the Swine Flu shot is still being organized, but we will give you information on how to stay in the loop. The government wants you to be prepared so they have established a website- http://www.flu.gov/ that has information on every aspect of the flu you can imagine. Check it out to learn more. In addition the Centers for Disease Control and Prevention has a wealth of information at http://www.cdc.gov/flu/ (Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333; 800-CDC-INFO). This newsletter is divided into two parts. Part A talks about the Swine Flu and Part B talks about the Seasonal Flu. So get your anti-bacterial soap and tissues ready and let’s begin.
According to the CDC:In an average year, seasonal flu causes 36,000 flu-related deaths (mostly among those aged 65 years or older) and more than 200,000 flu-related hospitalizations in the United States. The "seasonal flu season" in the United States is usually from November through April each year. During this time, flu viruses are circulating in the population. An annual seasonal flu vaccine (either the flu shot or the nasal-spray flu vaccine) is the best way to reduce the chances that you will get seasonal flu and lessen the chance that you will transmit to others.
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2009 H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. This virus is spreading from person-to-person worldwide, probably in much the same way that regular seasonal influenza viruses spread. The Swine Flu vaccine has been quickly developed and will be ready for distribution in October. One shot is sufficient coverage for those over 9 years of age and can be given in addition to the Seasonal Flu shot. Your seasonal flu shot does not protect against the Swine Flu. For more information on the H1N1 Flu go to http://www.cdc.gov/h1n1flu/qa.htm The first groups to receive the Swine Flu vaccine will include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems. One thing that appears to be different from seasonal influenza is that adults older than 64 years do not yet appear to be at increased risk of 2009 H1N1-related complications thus far. Initially the thought was that two doses would be necessary, but they determined that only one vaccine is needed to provide coverage against the H1N1 flu. There should be sufficient availability of both the Swine Flu and Seasonal Flu shots for everyone to be covered. For those interested in receiving an H1N1 shot, each state is currently developing a vaccine delivery plan. The vaccine will be available in a combination of settings such as vaccination clinics organized by local health departments, healthcare provider offices, schools, and other private settings, such as pharmacies and workplaces. To see who is offering the H1N1 vaccine in your are go to http://www.cdc.gov/h1n1flu/vaccination/statecontacts.htm You can also look at “Where Can You Get The Seasonal Flu Shot” in the section below. As the H1N1 vaccine becomes available many sites will be offering the shot. Call ahead to check availability, fees, as well as other information. More information on the H1N1 vaccine can be found at http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm
The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Illness with the new H1N1 virus has ranged from mild to severe. While most people who have been sick have recovered without needing medical treatment, hospitalizations and deaths from infection with this virus have occurred. About 70 percent of people who have been hospitalized with this 2009 H1N1 virus have had one or more medical conditions previously recognized as placing people at “high risk” of serious seasonal flu-related complications. This includes pregnancy, diabetes, heart disease, asthma and kidney disease.
Take these everyday steps to protect your health:
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. • Avoid touching your eyes, nose or mouth. Germs spread this way. • Try to avoid close contact with sick people. • If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.
Other important actions that you can take are:
• Follow public health advice regarding school closures, avoiding crowds and other social distancing measures. • Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs,* tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious
If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible. Staying at home means that you should not leave your home except to seek medical care. This means avoiding normal activities, including work, school, travel, shopping, social events, and public gatherings. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze. Employees who are well but who have an ill family member at home with 2009 H1N1 flu can go to work as usual. These employees should monitor their health every day, and take everyday precautions including washing their hands often with soap and water, especially after they cough or sneeze. Alcohol-based hand cleaners are also effective. If they become ill, they should notify their supervisor and stay home. Employees who have an underlying medical condition or who are pregnant should call their health care provider for advice, because they might need to receive influenza antiviral drugs to prevent illness.
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for 2 to 8 hours after being deposited on the surface. Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands. To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.
If you become ill and experience any of the following warning signs, seek emergency medical care.
In children, emergency warning signs that need urgent medical attention include:
• Fast breathing or trouble breathing • Bluish or gray skin color • Not drinking enough fluids • Severe or persistent vomiting• Not waking up or not interacting • Being so irritable that the child does not want to be held • Flu-like symptoms improve but then return with fever and worse cough
In adults, emergency warning signs that need urgent medical attention include:
• Difficulty breathing or shortness of breath • Pain or pressure in the chest or abdomen • Sudden dizziness • Confusion • Severe or persistent vomiting • Flu-like symptoms improve but then return with fever and worse cough
Are there medicines to treat 2009 H1N1 infection?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with 2009 H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current pandemic, the priority use for influenza antiviral drugs is to treat severe influenza illness (for example hospitalized patients) and people who are sick who have a condition that places them at high risk for serious flu-related complications.
You can stay informed of the latest news by going to the CDC’s H1N1 (Swine Flu) website at http://www.cdc.gov/H1N1FLU/
There are two different types of vaccines that protect against seasonal flu. The flu shot is an inactivated vaccine that is given with a needle, usually in the arm. The other vaccine is a nasal-spray flu vaccine that contains weakened live viruses and is administered by a nasal sprayer. This one is approved for those healthy people age 2-49 who are not pregnant. Each seasonal flu vaccine contains three different influenza viruses that the CDC believes will be the prevalent flu viruses affecting people this year. Again this is for seasonal flu viruses only- not the Swine Flu. The flu vaccines work by causing antibodies to develop in your body protecting you against infection. It is recommended that you get a flu shot as soon as they become available as the flu season can often run October to May. It does take two weeks for the vaccine to develop the antibodies and start working. Flu viruses do change from year to year so it is important to get a new vaccine each year to keep your immunity high.
Symptoms of seasonal flu include:
• fever (often high) • headache• extreme tiredness• dry cough• sore throat• runny or stuffy nose• muscle aches• Stomach symptoms, such as nausea, vomiting, and diarrhea, also can occur but are more common in children than adults. Some people who have been infected with the new H1N1 flu virus have reported diarrhea and vomiting.
The flu spreads from person to person through coughing and sneezing from people who have the flu. But the catch is you can be infectious one day before symptoms show, and up to 5-7 after you become sick.
People who should get a seasonal flu vaccination each year include:
1. Children aged 6 months up to their 19th birthday2. Pregnant women3. People 50 years of age and older4. People of any age with certain chronic medical conditions5. People who live in nursing homes and other long-term care facilities6. People who live with or care for those at high risk for complications from flu, including: a. Health care workers b. Household contacts of persons at high risk for complications from the flu c. Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)
Some people should not be vaccinated without first consulting a physician. They include:
• People who have a severe allergy to chicken eggs.• People who have had a severe reaction to an influenza vaccination in the past.• People who developed Guillian-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine previously.• Children less than 6 months of age (influenza vaccine is not approved for use in this age group).• People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.
If you have questions about whether you should get a flu vaccine, consult your health-care provider.
While getting a flu vaccine each year is the best way to protect you from flu, there also are drugs that can fight against influenza viruses, offering a second line of defense against the flu. These are called “influenza antiviral drugs.” Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder), not a vaccine, that fight against the flu by keeping flu viruses from reproducing in your body.
If you get sick with the flu, including the new 2009 H1N1 virus, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. Antiviral drugs are not sold over-the-counter and are different from antibiotics.
During the ongoing 2009 H1N1 pandemic, the priority use for antiviral drugs will be for people who are very sick (hospitalized) or people who are sick with the flu and who are at increased risk of serious flu complications, such as pregnant women, young children, those with chronic health conditions, and people age 65 years and older. For treatment, antiviral drugs work best if started within the first 2 days of symptoms.
During the current pandemic, the priority use for influenza antiviral drugs is to treat severe influenza illness (for example hospitalized patients) and people who are sick who have a condition that places them at high risk for serious flu-related complications. Influenza antiviral drugs only work against influenza viruses -- they will not help treat or prevent symptoms caused by infection from other viruses that can cause symptoms similar to the flu. While most healthy people recover from influenza virus infections and don’t have serious complications, some people are at higher risk for serious flu-related complications. It’s especially important that these people are protected from the flu.
There are four antiviral drugs approved to treat the flu.
• Oseltamivir (brand name Tamiflu®) is approved to both treat and prevent influenza A and B virus infection in people one year of age and older.• Zanamivir (brand name Relenza®) is approved to treat influenza A and B virus infection in people 7 years and older and to prevent influenza A and B virus infection in people 5 years and older.• Amantadine (Symmetrel®, generic) is approved to treat and prevent only influenza A viruses in people older than 1 year.• Rimantadine (Flumadine®, generic) is approved to prevent only influenza A virus infection among people older than 1 year. It is approved to treat only influenza A virus infections in people 13 and older.
For treatment, influenza antiviral drugs work best when started within 2 days after becoming sick, however hospitalized patients might benefit from treatment started more than 48 hours after symptoms begin. When used this way, these drugs can reduce flu symptoms and shorten the time you are sick by 1 or 2 days.If you become sick with flu-like symptoms this season, your doctor will consider the likelihood of influenza being the cause of your illness, the number of days you have been sick, side effects of the medication, etc. before making a recommendation about using antiviral drugs. He or she may test you for influenza, but testing is not required in order for a health care provider to recommend influenza antiviral medications for you.
The government likes to count everything, including the number of flu cases. To get updated flu statistics you can go to http://www.cdc.gov/flu/weekly/fluactivity.htm and find the latest numbers.
AlabamaDepartment of Public Health201 Monroe St.RSA TowerMontgomery, AL 36130334-206-53001-800-ALA-1818http://www.adph.org/http://www.adph.org/administration/Default.asp?id=505 (county health departments)
AlaskaDepartment of Health and Social ServicesP.O. Box 110610Juneau, AK 99811907-465 3030907-586-4265http://www.hss.state.ak.us/dph/http://www.hss.state.ak.us/dph/nursing/locations.htm (public health locations)
ArizonaDepartment of Health Services1740 W. Adams St.Phoenix, AZ 85007602-542-1000602-542-1025www.azdhs.govTo locate a flu shot clinic, visit http://www.cir.org/seasonal-flu.html or call (602) 263-8856 (Phoenix Metro area) or (800) 352-3792 (statewide)
ArkansasDepartment of Health4815 W. Markham St.Little Rock, AR 72205501-661-2000800-462-0599www.healthyarkansas.com/For more information on flu, call the ADH hotline at 1-800-651-3493http://www.healthyarkansas.com/flu/pdf/mass_flu_clinic_sites2009.pdf (mass flu clinic sites) There will be no charge to you for the flu shot at the mass flu clinics, but please bring your insurance, Medicare and/or Medicaid cards with you if you have one. Seasonal flu vaccinations provided at the local health units will be $20. Check here in the upcoming weeks for sites/dates/times near you http://www.healthyarkansas.com/flu/flu_overview2009.htm
CaliforniaDepartment of Health Services744 P St.Sacramento, CA 95814916-445 4171800-735-2922http://www.cdph.ca.gov/Pages/Default.aspxhttp://www.cdph.ca.gov/services/Pages/LocalServices.aspx Many local clinics sponsor free flu shot clinics. Call your local clinic to find out location near you.
ColoradoDepartment of Public Health and Environment4300 Cherry Creek Drive SouthDenver, CO 80246303-692 2000800-886-7689http://www.cdphe.state.co.us/http://www.immunizecolorado.com/ or call 877-462-2911 to find a flu clinic
ConnecticutDepartment of Public HealthP.O. Box 340308Hartford, CT 06134860-509-8000http://www.ct.gov/dph/site/default.asphttp://www.ct.gov/dph/cwp/view.asp?a=3136&q=388234&dphPNavCtr=|&ctfluwatchNav=| and http://www.ct.gov/ctfluwatch/cwp/view.asp?a=2533&q=315124 (flu information)
DelawareHealth and Social ServicesP.O. Box 637Dover, DE 19903888-459-2943302-744-4700http://www.dhss.delaware.gov/dhss/index.htmlhttp://www.dhss.delaware.gov/dhss/dph/fluclinics.html Free flu clinic schedules
District of ColumbiaDepartment of Health825 N. Capitol St., NE, 4th FloorWashington, DC 20002202-671-5000202-445-5955http://dchealth.dc.gov
FloridaDepartment of Health4052 Bald Cypress WayTallahassee, FL 32399850-245-4443http://www.doh.state.fl.us/http://www.doh.state.fl.us/chdsitelist.htm (public health offices)Florida Flu Information Line Now Available at 1-877-352-3581
GeorgiaPublic Health DivisionDepartment of Human Resources2 Peachtree St., NW, #15470Atlanta, GA 30303404-657 2700http://health.state.ga.us/To find flu clinics go to http://www.immunizeadultga.org/search.asp or call 404-657-3158
HawaiiDepartment of Health1250 Punchbowl St.Honolulu, HI 96813808-586 4400http://hawaii.gov/healthhttp://hawaii.gov/health/family-child-health/immunization/flu-shot-schedule.pdf (flu shot schedule)
IdahoDepartment of Health and Welfare450 W. State St., 10th FloorP.O. Box 83720Boise, ID 83720208-334 5500http://www.healthandwelfare.idaho.gov/ http://www.healthandwelfare.idaho.gov/Health/HealthDistricts/tabid/97/Default.aspx (public health districts) http://www.healthandwelfare.idaho.gov/Health/DiseasesConditions/SeasonalInfluenzaFlu/tabid/327/Default.aspx (flu information)
IllinoisDepartment of Public Health535 W. Jefferson St.Springfield, IL 62761217-782-4977800-782-7860http://www.idph.state.il.us/http://www.idph.state.il.us/flu/flushotlocations.htm (flu shot locator)
IndianaState Department of Health2 N. Meridian St.Indianapolis, IN 46204317-233-1325800-457-8283http://www.in.gov/isdh/http://www.in.gov/isdh/23926.htm (local health departments)http://www.in.gov/isdh/22104.htm (flu information)
IowaDepartment of Public HealthLucas State Office BuildingDes Moines, IA 50319515-281 7689866-227-9878http://idph.state.ia.us/ A toll-free Influenza Hotline has been established to answer your questions about seasonal flu and novel influenza A (H1N1). The Influenza Hotline number is 1-800-447-1985.
KansasDepartment of Health and Environment1000 SW JacksonTopeka, KS 66612785-296-1500http://www.kdheks.gov/http://www.kdheks.gov/flu/index.html (flu information)http://www.kdheks.gov/flu/vaccine.htm (flu vaccine information)
KentuckyDepartment for Public Health275 E. Main St.Frankfort, KY 40621502-564 3970800-462-6122http://chfs.ky.gov/dph/default.htm502-564-5353 Kentucky Influenza Hotlinehttp://chfs.ky.gov/dph/epi/preparedness/panflu/seasonal.htm
LouisianaDept. of Health and Hospitals1201 Capitol Access RoadP.O. Box 629Baton Rouge, LA 70821225-342-9500http://www.dhh.louisiana.gov/offices/?ID=79http://www.dhh.louisiana.gov/offices/?ID=79 (public health offices)http://www.dhh.louisiana.gov/offices/page.asp?id=249&detail=7358
MaineMaine Center for Disease Control11 State House Station157 Capitol St.Augusta, ME 04333207-287-8016http://www.maine.gov/dhhs/http://www.maine.gov/dhhs/boh/Influenza.htm (flu information)
MarylandDepartment of Health and Mental Hygiene201 W. Preston St.Baltimore, MD 21201877-463-3464410-767 6500http://www.dhmh.state.md.us/index.htmlhttp://cha.maryland.gov/html/local2.cfm (directory of health departments for flu shot)http://edcp.org/influenza/index.cfm (flu information)
MassachusettsDepartment of Public Health250 Washington St.Boston, MA 02108866-627-7968617-624-6000http://www.mass.gov/dph/dphhome.htmhttp://www.mass.gov/?pageID=eohhs2subtopic&L=7&L0=Home&L1=Provider&L2=Guidelines+and+Resources&L3=Guidelines+for+Services+%26+Planning&L4=Diseases+and+Conditions&L5=Influenza&L6=Seasonal+Flu&sid=Eeohhs2 (flu information)
MichiganDepartment of Community Health320 S. Walnut St.Lansing, MI 48913517-373-3740www.michigan.gov/mdchhttp://www.michigan.gov/mdch/0,1607,7-132-2943_52115---,00.html (free care guide)http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_22779---,00.html (flu information)
MinnesotaDepartment of HealthP.O. Box 64975St. Paul, MN 55164651-215-5800888-345-0823http://www.health.state.mn.us/http://www.health.state.mn.us/cgi-bin/idepc/fluschedule/fluclinic_search.cgi (flu clinic search engine)http://www.health.state.mn.us/divs/idepc/diseases/flu/index.html (flu information)
MississippiState Department of Health570 E. Woodrow Wilson Dr.Jackson, MS 39216601-576-7400http://www.msdh.state.ms.us/877-222-9FLU Flu Hotlinehttp://msdh.ms.gov/msdhsite/_static/4,0,204.html (local health departments provide flu shots)http://msdh.ms.gov/msdhsite/_static/14,0,199.html (flu information)
MissouriDepartment of Health & Senior ServicesP.O. Box 570Jefferson City, MO 65102573-751-6400http://www.dhss.mo.gov/http://www.dhss.mo.gov/LPHA/LPHAs.html (local public health agencies)http://www.dhss.mo.gov/Influenza/ (flu clinic locator)
MontanaDepartment of Public Health and Human ServicesCogswell Building1400 BroadwayHelena, MT 59620406-444 4473http://www.dphhs.mt.gov/http://www.dphhs.mt.gov/influenza/index.shtml (flu information)
NebraskaDepartment of HealthP.O. Box 95044Lincoln, NE 68509402-471 2306http://www.hhs.state.ne.us/index.htmhttp://www.hhs.state.ne.us/puh/oph/lhd.htm (local health departments)http://www.dhhs.ne.gov/flu/ (information on the flu)
NevadaState Health Division4150 Technology WayCarson City, NV 89710775-684-4200800-254-4202http://health.nv.gov/http://flu.nv.gov/Flu_Contacts.htm (state flu contacts)http://flu.nv.gov/ (flu information)
New HampshireDepartment of Health and Human Services129 Pleasant StreetConcord, NH 03301800-852-3345http://www.dhhs.state.nh.us/DHHS/DHHS_SITE/default.htmhttp://www.dhhs.nh.gov/DHHS/CDCS/fluclinics.htm (flu clinics)
New JerseyDepartment of Health and Senior ServicesP.O. Box 360Trenton, NJ 08625609-292 7837800-367-6543http://www.state.nj.us/health/http://www.state.nj.us/health/flu/findflushot.shtml (flu clinic locator)
New MexicoDepartment of Health1190 S. St. Francis Dr.Santa Fe, NM 87502505-827 2613http://www.health.state.nm.us/http://www.health.state.nm.us/FLU/index.shtml (flu information)http://www.immunizenm.org/flu.shtml (flu shot information)
New YorkDepartment of HealthCorning TowerEmpire State PlazaAlbany, NY 12237518-474 2011http://www.health.state.ny.us/http://www.health.state.ny.us/diseases/communicable/influenza/ (flu information)http://www.health.state.ny.us/nysdoh/lhu/map.htm (local health departments)
North CarolinaDepartment of Health and Human Services2001 Mail Service CenterRaleigh, NC 27699800-662-7030919-733-4534http://www.dhhs.state.nc.us/http://www.dhhs.state.nc.us/contacts/localagencycontacts.htm (local health departments)http://www.immunizenc.com/ (flu information)http://www2.thecarolinascenter.org/fcf/ (flu clinic finder)
North DakotaDepartment of HealthState Capitol600 E. BoulevardBismarck, ND 58505701-328 2372http://www.ndhealth.gov/http://www.ndflu.com//FluClinic.aspx (flu clinics)http://www.ndflu.com/default.aspx (flu information)
OhioDepartment of Health246 N. High St.P.O. Box 118Columbus, OH 43216614-466 3543http://www.odh.ohio.gov/http://www.odh.ohio.gov/odhPrograms/idc/immunize/influen.aspx (flu information)http://www.odh.ohio.gov/localHealthDistricts/localHealthDistricts.aspx (local health departments)
OklahomaDepartment of Health1000 NE 10th StreetOklahoma City, OK 73117405-271 4200800-522-0203http://www.ok.gov/health/http://www.ok.gov/health/Disease,_Prevention,_Preparedness/Acute_Disease_Service/Seasonal_Disease_Topics/Seasonal_Influenza_Information/ (flu information)http://www.ok.gov/triton/modules/health/map/county_map.php (County health departments
OregonHealth DivisionDepartment of Human Resources800 NE Oregon St.Portland, OR 97232503-731 4000http://Oregon.gov/dhs/ph/http://oregon.gov/DHS/ph/imm/FluPage.shtml (flu clinics and flu information)
PennsylvaniaDepartment of HealthP.O. Box 90Harrisburg, PA 17108877-724-3258http://www.dsf.health.state.pa.us/health/site/default.asphttp://www.dsf.health.state.pa.us/health/cwp/view.asp?a=180&Q=199440&healthRNavrad71C25=|# (local health departments)http://www.dsf.health.state.pa.us/health/cwp/browse.asp?a=178&C=35605&healthPNavCtr=|&TNID=4792#4792 (flu clinic locator and flu information) Rhode IslandDepartment of Health3 Capitol HillProvidence, RI 02908401-222 2231800-924-7434http://www.health.state.ri.us/ http://www.health.state.ri.us/flu/about/vaccination/index.php (flu clinic and flu information)Flu Hotline at 1-800-555-7858
South CarolinaHealth and Environmental Control2600 Bull St.Columbia, SC 29201803-898-3432http://www.scdhec.nethttp://www.scdhec.gov/flu/clinics.asp (flu clinics)http://www.scdhec.gov/flu/ (flu information)
South DakotaDepartment of Health600 E. CapitolPierre, SD 57501800-738-2301605-773 3361http://doh.sd.gov/http://doh.sd.gov/Flu/ (flu information)South Dakota will be offering free flu vaccines for children 6 months to 18 years. Check out http://doh.sd.gov/Flu/Child.aspx
TennesseeDepartment of HealthCordell Hull Bldg.425 5th Avenue N.Nashville, TN 37247615-741 3111http://health.state.tn.us/http://health.state.tn.us/findcare.htm (local clinics: check to see if they offer flu shots)
TexasDepartment of State Health Services1100 W. 49th St.Austin, TX 78756888-963-7111512-458 7111http://www.dshs.state.tx.us/http://www.dshs.state.tx.us/txflu/default.shtm (flu information)http://www.dshs.state.tx.us/immunize/flu.shtm#clinics (flu clinics)
UtahDepartment of HealthP.O. Box 1010Salt Lake City, UT 84114801-538 6101http://hlunix.ex.state.ut.us/http://health.utah.gov/immu/apps/flu/index.php (flu clinics)Utah Immunization Hotline at 1-800-275-0659
VermontDepartment of Health108 Cherry St.Burlington, VT 05402800-464-4343802-863 7200http://healthvermont.gov/http://healthvermont.gov/prevent/flu/index.aspx (flu information)http://healthvermont.gov/prevent/flu/flu_clinics.aspx (flu clinics)
VirginiaDepartment of Health1500 E. Main St.Richmond, VA 23219804-864-7002http://www.vdh.state.va.us/http://www.vdh.state.va.us/Epidemiology/factsheets/Influenza.htm (flu information)
WashingtonDepartment of Health1112 SE QuinceP.O. Box 47890Olympia, WA 98504800-525-0127360-236-4501http://www.doh.wa.gov/http://www.doh.wa.gov/FluNews/influenza.htm (flu information)http://www.doh.wa.gov/cfh/Immunize/diseases/influenza/flu-update.htm (flu shot locator)
West VirginiaDepartment of Health and Human ResourcesBuilding 3, Room 206State Capitol ComplexCharleston, WV 25305304-558 0684http://www.wvdhhr.org/http://www.wvdhhr.org/immunizations/influenza.asp (flu information)
WisconsinDepartment of Health and Family Services1 W. Wilson St.Madison, WI 53702608-266 1865http://dhs.wisconsin.gov/http://dhs.wisconsin.gov/communicable/FactSheets/Influenza.htm (flu information)http://dhs.wisconsin.gov/localhealth/index.htm (local health departments)
WyomingDepartment of Health117 Hathaway BuildingCheyenne, WY 82002307-777 7656866-571-0944http://wdh.state.wy.us/http://wdh.state.wy.us/phsd/epiid/flu.html (flu information)
*Information above was taken from the CDC Key Facts About Seasonal Influenza at http://www.cdc.gov/flu/keyfacts.htm and 2009 H1N1 Flu (Swine Flu) http://www.cdc.gov/H1N1FLU/