Credit CDC FluView
With the caveat that - `As a result of the end of year holidays and elevated influenza activity, some sites may be experiencing longer than normal reporting delays and data in previous weeks are likely to change as additional reports are received’ – the CDC has released their latest FluView Report, and has just completed a media briefing on this year’s flu season.
At noon EST today Tom Frieden, M.D., M.P.H., Director, Centers for Disease Control and Prevention and Margaret A. Hamburg, M.D., Commissioner, Food and Drug Administration held a telephone briefing.
Dr. Frieden stressed that while the flu season is roughly half-way through, influenza is still on the rise in some western states and he characterized it as shaping up to a `worse-than-average season’.
Hospitalizations and deaths, he warned are likely to increase for weeks to come.
Dr. Frieden also stressed the importance of early treatment with Tamiflu (oseltamivir) for high risk patients, and reiterated the confidence the CDC has in the beneficial effects of Tamiflu when taken promptly.
This year he warned that antivirals are being underused, and that somewhere between 1/3rd and 1/2 of those hospitalized with influenza were not prescribed Tamiflu prior to admission.
Dr. Frieden also reminded the media that flu vaccine is still available (although some spot shortages exist) – more is in the pipe line - and that it isn’t too late to get vaccinated. While available, you may need to call around to find vaccine in your vicinity.
He also urged people who are sick to stay home, and suggested that the elderly might want to limit their exposure to children right now.
Dr. Hamburg addressed the spot shortages of pediatric Tamiflu, and assured that pharmacists can easily compound liquid Tamiflu suspension using the capsules.
Dr. Hamburg also described some of the newer vaccines coming available, including cell-based vaccines, recombinant FluBlok vaccine, and quadravalent vaccines to come next year.
Some of the highlights of this week’s report include:
During week 2 (January 6-12), influenza activity remained elevated in the United States, but decreased in some areas.
- Viral Surveillance: Of 12,360 specimens tested and reported by collaborating laboratories, 3,638 (29.4%) were positive for influenza.
- Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold.
- Influenza-Associated Pediatric Deaths: Nine influenza-associated pediatric deaths were reported.
- Influenza-Associated Hospitalizations: A cumulative rate for the season of 18.8 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported. Among all cases, 49.6% were in adults 65 years and older.
- Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 4.6%; this is above the national baseline of 2.2%. All 10 regions reported ILI above region-specific baseline levels. Thirty states and New York City experienced high ILI activity; 10 states experienced moderate activity; 7 states experienced low activity; 3 states experienced minimal activity, and the District of Columbia had insufficient data.
- Geographic Spread of Influenza: Forty-eight states reported widespread geographic influenza activity; 2 states reported regional activity; the District of Columbia reported local activity; Guam reported no influenza activity, and Puerto Rico and the U.S. Virgin Islands did not report.
Three notable graphics from this week’s report.
First the 122 City P&I Mortality rate, which – due to the time patients may be hospitalized, and reporting delays – is usually a trailing indicator of flu activity shows its biggest jump this season.
And second, pediatric influenza-related deaths which adds 9 to this season’s total, albeit not all occurring during this last reporting week. In non-pandemic years, we often see 70 to 100 pediatric deaths reported, so while always tragic, the number of child deaths to date are running below average.
And finally, the age breakdown among influenza-confirmed hospitalizations shows a recent steep climb for those over the age of 65 indicating this is a particularly rough season for the elderly.
This is the highest rate (82 per 100,000 pop) that we’ve seen in recent years.
Patients under the age of 4 come in second place, followed by adolescents and young adults. This is the normal pattern we expect to see with an H3N2 seasonal flu.