Blue Shield of California Swine Flu Statement

Blue Shield of California is closely monitoring the swine influenza outbreak, which has now affected persons in multiple countries and states, including California. The CDC has issued a health advisory related to the recent outbreak, and while it has determined that the swine influenza A (H1N1) virus is contagious and is spreading from human to human, the number of cases is still relatively small. The facts of the outbreak and the flu virus are rapidly changing, so please refer to the CDC website for emerging details.

What are the symptoms?

The symptoms of swine flu in people are similar to the symptoms of conventional flu and include fever, cough, sore throat, body aches, headache, sudden dizziness, difficulty breathing, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu.

What preventative steps should people take?

The CDC recommends taking traditional precautions:

• 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 hands cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread that way.
• Try to avoid close contact with sick people: influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
• If you get sick, the CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
• Tamiflu is FDA-approved for use in patients one (1) year of age or older, although the FDA has approved the use of Tamiflu for children younger than one year of age under an Emergency Use Authorization (EUA).
• Relenza is FDA-approved for use only in patients five (5) years of age or older.
• Doses to treat/prevent swine flu A are the same as those for seasonal influenza or as defined by the FDA under the EUA.
• Dosing recommendations are available at http://www.cdc.gov/swineflu/recommendations.htm. Note: older antivirals used for influenza are not effective for swine flu A (H1N1).

What treatments are available?

Currently, Tamiflu (oseltamivir) and Relenza (zanamivir) are recommended antiviral drugs to treat swine influenza type A (H1N1), or to prevent infection for those at high risk for the infection or in close/frequent household contact with someone who is infected. Definitions of confirmed or suspected infection and close contacts, as well as treatment recommendations are available at the CDC website.

What treatments does Blue Shield of California cover?

Effective immediately, Blue Shield of California is providing coverage of both Tamiflu and Relenza to either treat any members who are infected with Swine Flu, or to prevent infection for those at a high risk of exposure, as defined by the CDC. Tamiflu is already in our formulary, and we have temporarily added Relenza to our formulary as well. Coverage is also being extended for conditions authorized by the FDA under Emergency Use Authorization. This coverage update will apply to all our members.

Blue Shield does not support nor encourage stockpiling of antiviral medications, and supplies for stockpiling will not be covered. Blue Shield will comply with all state and federal requirements regarding coverage of antiviral medications for our members.

What should you do if you are traveling to Mexico?

The CDC recommends that people not travel to Mexico at this time. However, if you must travel to Mexico, please see a travel medicine specialist or your primary care physician, ideally at least 4-6 weeks before you leave to answer your questions and make specific recommendations for you.