HEALTH

East Coast reeling from flu, bug begins making its trek west

BY Michael Johnsen

ATLANTA — The worst of the flu season may be over, at least for those on the East Coast. In a late morning press conference with reporters on Friday, Thomas Frieden, director of the Centers for Disease Control and Prevention, said, "We are seeing a decrease in some regions." 

Just don’t tell that to anyone living in New York, Boston or Chicago, at least not before slipping on a facemask first.  

New York state Gov. Andrew Cuomo over the weekend declared a Public Health Emergency for all of New York State in response to this year’s increasingly severe flu season the state’s residents are experiencing right now. As of Jan. 5, people living in New York, New Jersey, Puerto Rico and the U.S. Virgin Islands were reporting an "elevated" level of out-patient influenza-like illness activity with levels approaching 6.8% of all hospital visits vs. a regional baseline of 2%. The New York State Department of Health noted that ILI activity has been reported in all 57 counties plus New York City and has been trending up 7% for the week ended Jan. 5 as compared to the week prior. 

The New York governor also issued an executive order allowing pharmacists to administer pediatric flu vaccinations, suspending for the next 30 days the section of New York State Education Law that limits the authority of pharmacists to administer immunizing agents only to individuals 18 years of age or older. 

“We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City,” Cuomo said. “Therefore, I have directed my Administration, the State Health Department and others to marshal all needed resources to address this public health emergency and remove all barriers to ensure that all New Yorkers – children and adults alike – have access to critically needed flu vaccines.”

The ensuing run on flu shots created retail supply shortages heading into this past weekend throughout Boston, the Boston Business Journal reported on Monday. Boston opened up several flu clinics across the area, serving up some 7,000 influenza vaccinations the BBJ reported.  

Flu cases are now accounting for over 4% of all emergency department visits at Boston hospitals, compared to about 1% during non-influenza season.  

With demand running high through New York City and Boston, a little further west in Chicago, Supervalu announced Monday it will be resupplying its Illinois-region Jewel-Osco pharmacies with some 7,000 additional influenza vaccinations. "There is still an uptick in flu incidence heading West and there is no guarantee that this season has reached its peak," the Minnesota-based supermarket retailer stated. 

"Only the next week or two will show if we have in fact crossed the [peak]," noted Thomas Frieden. "As we often say — the only thing that’s predicable about the flu is that it’s unpredictable," he said. 

While the East Coast has been hit particularly hard by flu incidence, the flu storm may be traveling west. "Most of the country has seen or is seeing a lot of flu. This may continue for the next few weeks," Frieden said. "It does appear that in parts of the South and Southeast it does look [as though] we’re past the peak." It’s a common progression for the flu begin its uptick across the South and Southeast and then head West, he added. 

One clue that the flu is about to hit hard, at least in Hollywood, was at last night’s Golden Globe Awards. Hugh Jackman, who hugged many of Hollywood’s elite on his way to the stage to accept the award for "Best Actor" for his performance in "Les Miserables" told the audience that he was just getting over the flu and had been "kicking himself for not getting the flu shot earlier. 

Actually all of California is bracing for an uptick in flu cases, Ron Chapman, director of the California Department of Public Health announced in a release on Friday. “California is seeing an accelerated increase in flu activity over the past few weeks,” he said, urging citizens to get their flu shots if they haven’t already. "California generally sees an increase in cases in late December or early January and it often peaks in February or March. According to CDPH surveillance indicators, influenza activity in California is beginning to show a steady increase," he said. “There is no shortage of vaccine in California and it is not too late to get vaccinated. Our flu season may not peak for several more weeks, so I encourage everyone to get vaccinated to protect not only themselves, but those with whom they come into contact.”

Addressing reports on vaccine shortages elsewhere, Frieden suggested that those who want to be vaccinated should still be able to locate the vaccine. "By this time of year, a lot of doctor’s offices [are out]," Frieden said. "It may be that you have to call a lot of places before you go out but it should be available for you," he suggested. "More than 130 million doses that were produced by the vaccine manufacturers this year have already been given."

And a good amount of those vaccines have been administered through retail. Toward the end of 2012, Walgreens had already administered 5 million flu shots. Before the demand for flu shots reached a frenzy, CVS/pharmacy had been projecting 3 million flu shots for the season and Rite Aid another 2 million. 

There have also been spot shortages of the pediatric liquid formulation of Tamiflu, the CDC reported. 

Across the front-end, on the other hand, demand for cough and cold formulations and the number of ancillary products that go with that — hand sanitizer, facial tissue — has all been high. 

According to data posted online Friday, influenza-associated hospitalizations are running at a rate of 13.3 per 100,000 population. The most-affected group is over the age of 65. Among all hospitalizations, 86.2% were associated with influenza A and 13% with influenza B. Among hospitalizations with influenza A subtype information, 98.7% were attributed to H3 and 1.3% were attributed to 2009 H1N1. 

As of Jan. 11, 24 states and New York City were reporting high levels of influenza-like illness, 16 states were reporting moderate levels, five states were reporting low levels, and five states reported minimal levels, including California, Connecticut, Kentucky, Maine and Montana. The region that includes Arizona, California, Guam, Hawaii and Nevada reported "normal" levels of flu incidence for the week ended Jan. 5, the CDC reported. 

"The bottom line, it’s the flu season," Frieden said.


FOR MORE COVERAGE OF THE FLU EPIDEMIC CLICK HERE

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Study: Egg allergies may not be automatic disqualifier for getting flu shot

BY Michael Johnsen

ARLINGTON HEIGHTS, Ill. — Egg allergies may no longer be a valid reason to not get a flu shot, the American College of Allergy, Asthma and Immunology announced Friday. 

“The influenza vaccine is grown in chicken eggs, therefore it contains trace amounts of egg allergen,” stated allergist James Sublett, chair of the ACAAI Public Relations Committee. “It has been long-advised that children and adults with an egg allergy do not receive the vaccination. However, we now know administration is safe. Children and adults should be vaccinated, especially when the flu season is severe, as it is this year.”

A study published in the December 2012 issue of Annals of Allergy, Asthma & Immunology, ACAAI’s scientific journal, showed that flu vaccinations contain such a low amount of egg protein that it won’t cause children to have an allergic reaction.

“The benefits of the flu vaccination far outweigh the risks,” Sublett said. “The best precaution for children that have experienced anaphylaxis, a life-threatening allergic reaction, after ingesting eggs in the past is to receive the vaccination from an allergist.”

Egg allergy is one of the most common food allergies in children. By age 16, about 70% of children outgrow their egg allergy. Most allergic reactions to egg involve the skin.

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Less than 45% of children receive flu shot over recent five-year period

BY Michael Johnsen

WINSTON-SALEM, N.C. — According to a new study by researchers at Wake Forest Baptist Medical Center released Thursday, less than 45% of children were vaccinated against the flu during a five-year study period.

“Our research showed that 1-in-6 children under age 5 years who went to an emergency department or clinic with fever and respiratory symptoms during the peak flu seasons had the flu,” stated Katherine Poehling, associate professor of pediatrics and epidemiology at Wake Forest Baptist and lead author of the study, published in the online edition of the February issue of Pediatrics. “Many of those illnesses could have been prevented by vaccination.”

The researchers found that children less than 6 months of age had the highest hospitalization rates with flu. 

The study, funded by The Centers for Disease Control and Prevention, reported population-based data on confirmed flu cases in children younger than 5 years old in three counties in Ohio, New York and Tennessee. More than 8,000 children seen in inpatient, emergency department and clinic settings were included during five flu seasons from 2004 through 2009.

During the study period, the researchers found that the overall flu vaccination coverage changed little, whereas the rates of influenza hospitalization and prevalence of influenza among outpatients varied annually. The proportion of infants less than 6 months old diagnosed with flu increased to 48% as compared to 28% in a previous study conducted by the research team from 2000 to 2004.

However, for children between the ages 6 months and 5 years, the proportion diagnosed with the flu remained similar in both studies. These data suggest that doctors’ awareness of the flu among young infants has increased, but hasn’t among older children.

The study also showed that seasonal flu remains an important cause of hospitalization, emergency department and outpatient visits among children and that the use of tools known to reduce flu rates — vaccination and antiviral medications — were underused, Poehling said.


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