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Health officials issue guidance for patients presenting with influenza
e-Reports, Jan. 26, 2015
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The number of influenza deaths reported in Indiana this year has been higher than the total number of deaths reported for each of the past 10 years, and the flu season is only halfway through.

Health officials advise that you not wait for a confirmatory laboratory test to treat a patient if you suspect influenza. Antiviral therapy, when started early, offers the greatest chance to decrease the severity and length of flu symptoms.

“Relying solely on rapid diagnostic testing, such as a commercial rapid test kit, is not optimal for making treatment decisions,” explained Joan Duwve, M.D., chief medical officer for the Indiana State Department of Health (ISDH). “During the height of influenza season when prevalence is high, false negative test results are likely to occur. This could result in a high-risk patient who is misdiagnosed and not treated with antiviral therapy when it is likely to be most effective.”

So far, 85 influenza-associated deaths have been reported to the ISDH. While the flu is responsible for one pediatric death, the majority of cases involve patients over 65 years old with at least one underlying medical condition. Pneumonia also was common among these patients.

“The 2014-2015 season has so far been an Influenza A H3N2 predominant season with the severity of influenza activity and influenza-associated hospitalizations slightly worse than the 2012-2013 H3N2 predominant season,” noted Dr. Duwve.

This year, the Centers for Disease Control and Prevention (CDC) detected a circulating drifted H3N2 strain that is antigenically different than the H3N2A/Texas/50/2012 vaccine strain.

The CDC reported that the early season estimate of vaccine effectiveness was 23 percent, which is relatively low compared to seasons when the vaccine and circulating strains were well matched. Throughout the season, the vaccine may still protect against severe influenza-associated complications, and continue to protect against co-circulating influenza A H1N1 and B viruses.

The reduced protection from the vaccine emphasizes the need for prompt infection control, medical attention and antiviral treatment, ideally within 48 hours of symptom onset, for patients who present with influenza-like illness.

Antiviral treatment is highly recommended for persons who are at high risk of influenza complications, including:

  • Adults over 65 years old
  • Children younger than 2 years old
  • Hospitalized or severely ill patients
  • Persons with underlying medical conditions or immunosuppression
  • Pregnant and postpartum women

Three neuraminidase inhibitor antiviral medications are currently approved by the FDA for treatment of influenza during the 2014-2015 season: oral oselatamivir (Tamiflu®), inhaled zanamivir (Relenza®) and intravenous peramivir (Rapivab®).

Find more information at in.gov.

Copyright: Information written and displayed on www.ismanet.org is the property of ISMA and may not be reproduced without expressed written permission of the Indiana State Medical Association.

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