The Spread Continues

Prevalence of Disease


First the bad news. Reports from the CDC in Atlanta this week show that the number of states reporting widespread disease has doubled in the last week and the number of people reporting flu like symptoms has now reached levels exceeding the peak of flu season last winter.


Now the good news. Total influenza hospitalization rates for adults and children are similar to or lower than seasonal influenza hospitalization rates depending on age group. The H1N1 infection continues to appear to be no worse a bug then the influenza strains we encounter on a routine basis year after year.


We continue to see children of all ages with Influenza-Like-Illnesses (ILI). Recommendations on who is considered for treatment has not changed. Each case has to be considered individually. Once we make the diagnosis of ILI, treatment or no treatment with antivirals, we emphasize the importance of symptomatic treatment, isolation for prevention of spread, and signs of complications. Complications include prolonged fever over 4 total 24 hour periods, recurrence of fever after gone for a full 24 hours, shortness of breath or difficulty breathing, chest pain, wheezing, persistent vomiting or signs of dehydration should prompt timely medical evaluation.

In our office, we have observed that the return visit rate for prolonged fever or one of the other complications from flu has been much less this year reflecting what has been seen nationwide.



Vaccine Status


The vaccine has now been approved by the FDA. It has been approved for single dosing for children older then 9 years and for two doses for children younger. However, the clinical data needed to establish these recommendations has yet to be published so we wait for the official recommendations on dosing. It appears that the supply will be plentiful.


There continues to be concern on the H1N1 vaccine being a "new" vaccine. It is manufactured exactly like the usual seasonal flu vaccine. Had H1N1 appeared before this years flu vaccine started production it would be one of the three strains that this year's seasonal flu shot contains. In reality, every year's seasonal flu shot is a "new" vaccine because the 3 strains included are determined each year based on the current circulating strains of both Influenza type A and B. Understand that this target approach is the best we have when the target i.e. the strains of flu that will predominate is constantly changing. Admittedly, some years the vaccine is right on target and other years it definitely misses it's mark. Therefore that one year that you took the vaccine and got the flu anyway happens. That doesn't mean you shouldn't continue to receive the vaccine. I would encourage you all to look at the vaccine in a little different light this year. When you take the vaccine ( and yes I have already received the seasonal dose on 9/7 and plan to be the first to role up my sleeve when the H1N1 vaccine rolls into our office) please realize that you are not only protecting yourself but also protecting those around you, those that mean the most to you, your family. Take a look around you as you read this blog and imagine getting that first chill, that first ache, that first deep cough and realize that you have already over the previous 24 hours exposed those around you to the flu and it's potential complications. PREVENTION IS THE KEY! GET IMMUNIZED, GET YOUR CHILDREN IMMUNIZED, AND PROTECT THOSE THAT MATTER THE MOST TO YOU.