Flu Widening Its Grip on the United States: CDC

FRIDAY, Jan. 4, 2019 (HealthDay News) — The flu is now spreading throughout the United States, health officials said Friday.

Since last week, when nine states and New York City were reporting high flu activity, 19 states and New York City are now seeing a lot of flu, and it’s widespread in 24 states, according to the U.S. Centers for Disease Control and Prevention.

“The season is really starting to pick up,” said Lynnette Brammer, the lead of CDC’s domestic influenza surveillance team.

The most common type of flu around is the influenza A strain H1N1. That strain has been circulating and was pandemic in 2009 and in 1918.

In 1918, H1N1 flu killed 50 million people around the world. But the current vaccine works exceedingly well against H1N1 — it is up to 65 percent effective, which is highly effective for a flu vaccine, according to the CDC.

“H1N1 is the most common [strain] in most of the country,” Brammer said. “But it’s odd that in the Southeast, the H3N2 virus is more common.”

The influenza A H3N2 strain is the one that made last year’s flu season so severe. When that strain predominated, nearly 1 million Americans were hospitalized and 80,000 died.

According to the CDC, flu activity is high in Alabama, Arizona, Colorado, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Mississippi, Nevada, New Jersey, New Mexico, Oklahoma, South Carolina, Texas, Utah and Virginia.

It’s too early to tell how severe this season will be or what the mix of viruses will be, Brammer said. Right now, the hospitalization rate is still relatively low compared with last year, and deaths are still below epidemic levels, she said.

“But as we see a jump in activity as we did this week, we would expect an increase in hospitalizations, and unfortunately, probably an increase in mortality,” Brammer said.

The CDC doesn’t track adult deaths from flu, but they do keep tabs on pediatric deaths. This week two more children have died from flu, bringing the total to 13.

“There’s still a lot more flu season to come,” she said. “I expect activity to continue for several more weeks.”

The best way to protect yourself and those around you is to get a flu shot, and there’s still plenty of time to get vaccinated, Brammer said.

“Anybody who hasn’t been vaccinated should go and get vaccinated,” she said. This year’s vaccine is well matched to the circulating strains of flu and a lot of vaccine is available, Brammer added.

The CDC recommends that everyone 6 months and older get vaccinated. Getting your kids their flu shot is the best way to protect them and prevent deaths from the complications of flu, she said.

Getting a flu shot should be at the top of the list for those at high risk for flu, including the elderly and people with heart disease or lung disease and pregnant women.

Getting vaccinated won’t guarantee that you won’t come down with flu, but if you do, your illness will be milder, health experts say.

If you get the flu, antiviral drugs such as Tamiflu and Relenza can make your illness less severe. But if you’re sick, the CDC recommends that you stay home so you won’t infect others.

Brammer can’t predict when the flu season will peak, but it most likely won’t be until the end of February or March. So there’s still a long way to go, she said.

More information

For more on the flu, visit the U.S. Centers for Disease Control and Prevention.

AHA: Flu Season Can Send More Heart Failure Patients to Hospital

FRIDAY, Nov. 9, 2018 (American Heart Association) — Getting the flu may not only make you feel crummy, it also might land you in the hospital for heart problems.

A team of researchers analyzed monthly flu reports from the Centers for Disease Control and Prevention in four communities across the United States between October 2010 and September 2014. For every 5 percent increase in flu activity, they found that hospitalization rates for heart failure rose by approximately 24 percent in the same month.

The findings will be presented Saturday during the American Heart Association’s Scientific Sessions conference in Chicago.

“Influenza can influence cardiovascular events especially in high-risk individuals, so we should not be complacent about vaccination,” said Dr. Scott Solomon, the study’s senior author and a professor of medicine at Harvard Medical School and Brigham and Women’s Hospital in Boston. “The single best way to improve influenza-related outcomes is to vaccinate people.”

Research earlier this year found that people were six times more likely to have a heart attack in the week after being diagnosed with the flu. But the impact of the virus on heart failure, a condition in which the heart muscle becomes too weak or stiff to pump blood efficiently through the body, hasn’t been as clear, Solomon said.

“The goal of this study was really to look at whether we could relate influenza activity occurring regionally and temporarily, or at a particular time of the year, with heart failure hospitalizations that were occurring around the same time,” he said.

Donna Arnett, an epidemiologist and dean of the University of Kentucky College of Public Health, who was not involved in the new research, said the increased risk of heart failure hospitalization found in the study was small but significant enough to send a message.

“The biggest takeaway here is that people who already have heart disease and may be susceptible to heart failure should definitely be vaccinated because influenza is, for the most part, preventable with vaccination,” she said.

The mechanics behind how the flu actually contributes to heart failure is unclear, but Arnett said that’s not “as relevant as what we already know about preventing influenza.”

“From my perspective as an epidemiologist, we have a vaccine to prevent the disease. We should employ that vaccine as widely as possible, particularly for those who are susceptible to heart failure,” she said.

Flu activity in the U.S. usually begins in October or November, peaks between December and February, and can last as late as May, according to the CDC. Each year in the U.S., the flu is estimated to cause between 12,000 and 56,000 deaths and up to 710,000 hospitalizations.

Flu Activity Is Low — For Now

THURSDAY, Oct. 25, 2018 (HealthDay News) — Although this flu season is off to a slow start, U.S. health officials are urging everyone to get vaccinated now.

Why? Last year was one of the worst flu seasons on record, yet fewer Americans got a flu shot than in years past. In fact, less than four in 10 adults were protected against flu and its complications last winter, according to the U.S. Centers for Disease Control and Prevention.

“Right now flu activity is low, with just a smattering of cases,” said Dr. Alicia Fry. She is chief of the epidemiology and prevention branch in the CDC’s influenza division.

“Now is the perfect time to get vaccinated … it gives your body enough time to respond to the vaccine and mount a good immune response so you’re ready for the flu season,” Fry said.

October is the best time to get a flu shot. The vaccine reduces your odds of influenza, and if you get the flu it makes it much milder, she added.

The vaccine also reduces deaths among children, as well as hospitalizations among pregnant women, Fry said.

The vaccine is particularly important for women who have children too young to get a flu shot, people aged 65 and older, and anyone with chronic heart or lung disease.

About 132 million doses of the vaccine have been distributed so far, and about 168 million will be available through the 2018-2019 flu season, according to Fry.

Several viruses are circulating, including influenza A strains H1N1 and H3N2, and two influenza B viruses. “It’s not clear if there is going to be one virus that’s going to win and be the dominant virus,” she noted.

Fry said she hopes this flu season will be milder than the last, “but we can’t predict that.”

Last flu season saw record numbers of deaths and hospitalizations. The CDC estimates that the flu sickened 49 million, hospitalized nearly 1 million and killed 79,000.

Nearly 12 million children came down with the flu, and 48,000 were hospitalized, CDC statistics show. Of those, 183 died. Among those aged 18 to 64, 30 million were sickened and 10,300 died.

In all, 70 percent of those hospitalized for flu were aged 65 and older, as were 90 percent of those who died, according to the CDC.

Last year was the worst season since 2009 when the pandemic H1N1 flu virus hit, health officials said.

This year’s vaccine should be a better match to the circulating virus than last year’s, Fry noted.

For H1N1, the vaccine is up to 60 percent effective, as it is for the influenza B viruses. For the H3N2 virus it’s less effective, since H3 viruses can change to fool the body’s immune system, she explained.

This year, the H3N2 virus component of the vaccine has been tweaked to better match the circulating strain, Fry added.

“The vaccine is the best protection against getting the flu or being hospitalized or dying from flu,” she stressed.

The flu activity report was published Oct. 26 in the CDC’s Morbidity and Mortality Weekly Report.

More information

The U.S. Centers for Disease Control and Prevention has more about the flu.

New One-Dose Flu Drug Shows Promise

THURSDAY, Sept. 6, 2018 (HealthDay News) — An experimental single-dose flu drug shows promise as a new way to alleviate the misery of influenza, researchers say.

The drug — called baloxavir — worked better than no treatment in one phase of a new study. The study also found it as effective as the current standard drug, oseltamivir (Tamiflu), at controlling symptoms such as coughing, sore throat, headache, fever, muscle and joint pain, and fatigue.

Moreover, in light of concerns about flu-drug resistance, most patients treated with baloxavir responded as expected, the study authors said.

“There are few approved influenza antivirals, and current treatments have limitations,” said study lead author Dr. Frederick Hayden, of the University of Virginia School of Medicine.

“For example, currently circulating influenza viruses are resistant to the older class of antivirals,” he said. These include the drugs amantadine (brand name Symmetrel) and rimantadine (Flumadine).

Resistance is also growing to the class of drugs including widely used Tamiflu and Relenza (zanamivir), Hayden said. “Consequently, there are medical needs for new anti-influenza agents with different mechanisms of action and greater potency,” he added.

Hayden, professor emeritus of clinical virology and medicine, said the new study indicates that baloxavir resolves flu symptoms as quickly, effectively and safely as current options, without yet raising concerns about resistance. It also demonstrated “significantly greater antiviral effects,” he added.

Also, while Tamiflu must be taken twice a day for five days, baloxavir requires just one dose.

The investigation was funded by the drug company Shionogi, Inc., which developed and manufactures baloxavir.

Baloxavir is approved for use in Japan. In the United States, it remains an “investigational drug,” with the U.S. Food and Drug Administration expected to decide on approval by the end of this year.

The new study, which was published Sept. 6 in the New England Journal of Medicine, unfolded in two trials, both involving otherwise healthy flu patients at low risk for influenza complications.

One trial was conducted during the 2015-2016 flu season. About 400 patients, aged 20 to 64, received one of three doses of baloxavir (ranging from 10 to 40 milligrams) or a placebo. Flu symptoms eased notably faster among all three baloxavir groups, compared with placebo (untreated) patients, the findings showed.

The following flu season, nearly 1,100 patients, aged 12 to 64, were treated with baloxavir or Tamiflu. The drugs relieved symptoms in roughly the same time period, with similar side-effect risk.

However, about 10 percent of the baloxavir patients had a less than robust response to the drug. Hayden acknowledged that “the clinical and public health implications of reduced susceptibility to baloxavir are not fully understood.”

Dr. Timothy Uyeki, author of an accompanying journal editorial, heads the influenza division at the U.S. Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases.

“There is a need for antiviral drugs with new mechanisms of action,” he agreed.

Uyeki highlighted the benefit of baloxavir’s single-dose regimen. Besides its convenience, it “avoids concerns about compliance with a five-day treatment course of oseltamivir,” he said.

But he also stressed the need for further testing.

It remains unclear what benefits might accrue from combining baloxavir with Tamiflu, Uyeki noted.

Also, he cautioned, the current research only included otherwise healthy people aged 12 to 64 who were not at high risk for flu complications. Whether baloxavir will benefit high-risk groups — young children, the elderly, pregnant women and others with underlying chronic medical conditions — remains unknown, Uyeki said.

“A lot more studies are needed of the clinical benefit of baloxavir treatment of influenza in high-risk outpatients,” he added.

More information

There’s more on flu treatment at the U.S. National Institute of Allergy and Infectious Diseases.

All Children Should Receive Flu Vaccine ASAP, Doctors Advise

MONDAY, Sept. 3, 2018 (HealthDay News) — All children 6 months of age and older should have a flu shot, the American Academy of Pediatrics (AAP) says.

A flu shot significantly reduces a child’s risk of severe illness and flu-related death, according to the policy statement published online Sept. 3 in the journal Pediatrics.

“The flu virus is common — and unpredictable. It can cause serious complications even in healthy children,” said Dr. Flor Munoz of the AAP Committee on Infectious Diseases. “Being immunized reduces the risk of a child being hospitalized due to flu.”

The 2017-2018 flu season was one of the most severe on record, according to the U.S. Centers for Disease Control and Prevention.

As of Aug. 18, 2018, thousands of U.S. children were hospitalized and 179 kids died of flu-related causes. About 80 percent of the children who died had not had a flu shot, according to the CDC.

Pediatricians should offer flu vaccine injections to all children 6 months and older as soon as it becomes available, preferably by the end of October, the AAP said in a news release.

An injection is the best choice, because it has provided the most consistent protection against all strains of the flu virus in recent years, the AAP advised.

The nasal spray vaccine has been less effective in the past few flu seasons. But it can be used for children who would otherwise not receive flu vaccine, as long as they are 2 years of age or older, are healthy and do not have an underlying medical condition, the AAP said.

For example, the nasal spray would be appropriate if a child refuses an injection or if a doctor’s office runs out of flu shots.

The number of doses of flu vaccine depends on a child’s age and vaccine history. Children between 6 months and 8 years of age require two doses the first time they are vaccinated against flu. Children 9 years of age and older require only one dose, regardless of their vaccination history, the AAP said.

Children with egg allergy can receive flu vaccine with the same precautions considered for any vaccine. Pregnant women can be given the injected flu vaccine at any time.

Video courtesy: American Academy of Pediatrics

More information

The U.S. Centers for Disease Control and Prevention has more on children and flu vaccination.

Most Seniors Think Flu Shot a Must for Nursing Home Staff

WEDNESDAY, Jan. 3, 2018 (HealthDay News) — With the flu season in full swing, a new poll shows that almost three-quarters of Americans over the age of 50 think all nursing home employees should get a flu vaccine every year.

“We’ve finally gotten to the point in the last few years where most inpatient hospitals require their staff to get vaccinated against the flu, or at least strongly promote it,” poll director Dr. Preeti Malani said in a University of Michigan news release.

“These results suggest that other types of care facilities should do the same to protect vulnerable patients — or potentially risk losing business,” Malani added. “I encourage everyone to ask nursing homes and other long-term care facilities about their vaccination policies.”

Malani is a professor of internal medicine, with a specialty in infectious diseases and geriatrics, at the University of Michigan’s Medical School.

The survey, which was published Jan. 3, was sponsored by the university and AARP. More than 2,000 men and women between the ages of 50 and 80 participated.

More than 60 percent of respondents said that all patients residing in a nursing home and/or an assisted living setting should get vaccinated as well.

And 70 percent said that if they knew that one-third of the staff at a nursing home wasn’t vaccinated it would make them less likely to reside there.

Most respondents also said that the flu vaccine should be offered to workers for free, and that those who don’t avail themselves of the vaccine should be required to stay at home whenever they get sick.

Many experts advocate a widespread vaccination approach to disease control based on the notion of “herd immunity.” The idea is to prevent chinks from developing in the overall vaccination armor.

That said, data from the U.S. Centers for Disease Control and Prevention shows that less than seven in 10 long-term care workers routinely get vaccinated against the flu. This is despite its recommendation that everyone over the age of 6 months do so. By comparison, roughly nine in 10 hospital workers get the flu vaccine each year.

More information

There’s more on the flu vaccine at the U.S. Centers for Disease Control and Prevention.

With Severe Flu Season Lurking, Shots a Must

FRIDAY, Oct. 27, 2017 (HealthDay News) — Early signs suggest that the United States will see a severe flu season, so it’s especially important for Americans to get their shots, health experts say.

Australia had its worst flu season on record, and what happens in the southern hemisphere typically predicts what happens in the northern hemisphere, said Kevin Harrod. He is a professor in the University of Alabama at Birmingham’s department of anesthesiology and perioperative medicine.

“These data tell us that we should see a worse-than-average flu season,” Harrod said.

This year’s vaccines are combating the H3N2 strain and B strains of influenza, according to Harrod. H3N2 viruses cause more severe disease in the elderly and young children, and they are associated with a high hospitalization rate, he noted.

The best protection against the flu is vaccination, Harrod said in a university news release.

“While getting the flu shot may not keep you from getting the flu, it will limit the severity and duration of the illness, and provide you with some protection against future infections in subsequent seasons,” Harrod said.

“Even in years when the flu vaccine is a ‘bad match,’ there is partial protection because one’s immune system can make antibodies that still recognize and bind to the influenza virus even when new strains emerge unexpectedly,” he added.

Dr. Leah Leisch, an assistant professor in the division of general internal medicine at UAB, noted that the U.S. Centers for Disease Control and Prevention recommends everyone 6 months and older — including pregnant women — get a flu shot.

“It is especially important for people at high risk for flu-related complications. This includes, but is not limited to, pregnant women, children younger than 5, adults older than 65 and people with certain medical conditions,” Leisch said.

Harrod said the CDC’s Advisory Committee on Immunization Practices does not recommend the use of the nasal spray flu vaccine in the 2017-2018 influenza season.

Leisch had some tips on what to do if you think you’re coming down with the flu.

“During flu season, if you experience flu-like symptoms, it is wise to let your doctor know within 24 to 48 hours of when the symptoms began,” Leisch said. “However, your doctor may not prescribe any medications, as most — otherwise healthy — adults under age 65 do not require prescription medication for flu.”

For most people, the best therapy is to stay home and get plenty of rest and fluids, she said. Young children, adults older than 65, and adults with certain medical conditions may require anti-viral medications.

“These medications are good at preventing complications of flu and shortening the duration of flu by one or two days,” Leisch said. “However, they will not make the symptoms go away immediately.”

Potential complications of flu include bacterial pneumonia, ear infections, sinus infections, dehydration and worsening of chronic medical conditions, such as heart failure, asthma or diabetes.

In 2014, about 970,000 Americans were hospitalized due to the flu and more than 40 million were affected by flu-related illnesses, according to the CDC.

While most flu-related hospitalizations and deaths occur among people 65 and older, healthy children and younger adults can also develop severe problems and even die. Each year, nearly 100 flu-related deaths among children are reported to the CDC.

More information

The U.S. Centers for Disease Control and Prevention has more on the flu.