More than half the nation is experiencing the worst influenza outbreak since 2009.
Indiana is among 47 states experiencing widespread influenza activity. At presstime, the Indiana State Department of Health (ISDH) reported 25 deaths, including two under age 18. Of those deaths, nine were vaccinated, and 19 of those patients also suffered underlying chronic health conditions.
|Sentinel reported influenza-like illness (ILI) by age category for the most current week reported - Indiana, 2012-13
|2012/2013 deaths associated with lab confirmed influenza, by age - Indiana, Jan. 16, 2013
|* Data obtained from the ISDH Sentinel Influenza System.
* Sentinel data has limited timliness, so the data reported is for the week before the most current week. This data is subject to change as sentinel sites can back-date their weekly reports.
“At least two of the deaths in Indiana were attributable to a co-infection of Influenza B and H3N2. This is something we don’t usually see,” noted Joan Duwve, M.D., chief medical officer for the ISDH.
While influenza is not reportable, all physicians, laboratories and hospitals must report influenza-associated deaths to the health department within 72 hours of knowledge of death. In Indiana, emergency departments and physician sentinels around the state report influenza-like illness weekly.
Dr. Duwve explained that while cases of H1N1 and Influenza B have been reported, the H3N2 strain appears predominant and has historically been responsible for more severe flu seasons.
Health officials noted that this year’s vaccine is a good match for the current flu strains: H3N2, H1N1 and Influenza B. According to a recent study by the CDC, early flu season data show this year’s vaccine is 62 percent effective overall at preventing disease requiring medical attention. This number is similar to studies of flu vaccine efficacy published previously.
“It is important for physicians to be aware that the vaccine won’t always prevent flu illness,” said Dr. Duwve. “Fortunately, the antivirals zanamivir (Relenza) and oseltamivir (Tamiflu) are effective at treating influenza when started early during the course of illness. The CDC regularly monitors influenza virus for resistance to antivirals, and all circulating virus is sensitive 0to both these drugs.”
Tips for physicians
For your patients with flu-like symptoms, Dr. Duwve suggests:
- Separate the times of well visits and sick visits, if possible
- Provide masks
- Take patients to an exam room as quickly as possible
- Test all patients who come in with flu-like symptoms
“If you diagnose flu in a high risk patient, regardless of vaccination status, strongly consider prescribing an effective antiviral drug,” commented Dr. Duwve. High risk patients include infants and young children, pregnant women, people over 65 years of age, and anyone with an underlying medical condition.
“Patients are more likely to get vaccinated if it is recommended by their physician and readily available during their visit,” she said. “If you are unable to get more vaccine, identify places near your office where vaccine is still available and let your patients know.”
Additionally, if clinical staff develop flu-like symptoms they should stay home until their symptoms improve, usually three to five days.
“It is critical that every member of a physician’s team or anyone who comes in contact with patients be vaccinated,” said Dr. Duwve. “This is important if we want to offer the highest level of protection to our patients.”
The ISDH provides weekly influenza reports on the in.gov website.
Find information from the CDC on their website.