Jan. 24, 2013
Influenza still widespread, but new infections appear to be slowing in state
Influenza continues to be widespread and highly active in Minnesota, but the pace of new infections appears to be slowing. For the week ending Jan. 19 (Week 3):
- 208 hospitalizations due to influenza-like illness (ILI) were reported to MDH, compared with 541 for Week 2 and more than 600 for Week 1, bringing the total so far this season to 2,128.
- MDH confirmed 15 deaths due to influenza or complications from influenza during the week, bringing the total to 75.
- The MDH laboratory took in 554 ILI specimens for analysis, compared with more than 700 during Week 2.
- There were 9 outbreaks in long-term care facilities reported.
The exception to the decline in activity is in schools: MDH received reports of 112 school outbreaks of ILI for Week 3, an increase over the previous week, reflecting that school is back in session and some transmission is occurring.
It should be noted that the indicators of influenza activity MDH uses lag behind what is occurring in communities at the moment. Deaths, in particular, take time to be investigated and confirmed as influenza-related by MDH.
The vast majority of hospitalizations and deaths continue to occur among the elderly.
- Influenza can cause a viral pneumonia, and influenza can be a gateway for secondary infections such as bacterial pneumonia. In addition, people with certain medical conditions can have a worsening of their condition when they are ill with influenza.
- In years in which H3N2 is the predominant strain, we typically see more severe cases of illness, particularly in the very young and the elderly, and more cases overall.
- Regional health care coalitions continue to monitor hospital bed count and resource needs. This public/private partnership between public health, hospitals, clinics and local business partners continues to play a critical role in the success of Minnesota’s response to influenza.
Recommendations for individuals
- We are still encouraging people to be vaccinated. It is not too late to get vaccinated. Our goal is to use all doses of vaccine available.
- MDH continues to work with health care providers to make sure that the available supply of vaccine is fully utilized and directed where it is needed.
- It is possible that some providers may have exhausted their supply at this point in the season; you may need to check with a few clinics to find vaccine. Based on the information we have available, it should be possible to find a provider who has vaccine available. We strongly advise people to keep looking. The MDH flu clinic locator may be helpful for this.
- To find the location of a flu clinic near you, visit www.mdhflu.com.
- If you are going to a retail store pharmacy site be sure to check about age groups being served. Not all pharmacies serve persons under age 18 years.
- People with medical conditions or the elderly, who are at high risk for influenza complications, may not have the best immune response to the vaccine, so it is very important that those around them, especially health care and long-term care workers, are vaccinated.
- While the vaccine doesn’t offer perfect protection, it is still the best tool we have for preventing influenza and its complications. If you don’t get it, you don’t have protection.
The CDC recently released a report that estimated 60 percent effectiveness for this year’s flu vaccine against medically attended influenza. This is a preliminary estimate.
Given this level of efficacy, some vaccinated persons will become ill with influenza. Therefore, antivirals should be used as recommended for at risk patients regardless of their vaccination status.
- Antivirals continue to be available. Pediatric suspensions are the only formulation for which FDA is reporting intermittent shortages. Pharmacists can compound their own pediatric formulations.
- MDH and the CDC recommend that everyone get vaccinated for influenza, but especially those at high risk for complications from influenza. Those include:
- Children younger than 5, but especially children younger than 2 years old.
- Adults 65 years of age and older - http://www.cdc.gov/flu/about/disease/65over.htm.
- Pregnant women - http://www.cdc.gov/flu/protect/vaccine/pregnant.htm.
- American Indians and Alaskan Natives seem to be at higher risk of flu complications.
- People who have medical conditions such as asthma, diabetes, heart disease, neurological disease, kidney and liver disorders and others. For a list, see CDC’s website: http://www.cdc.gov/flu/keyfacts.htm.
What else you can do
- Most people can fight the flu at home with rest and fluids. If you or your child develop concerning symptoms, call your health care provider. If you are at risk for becoming very ill from influenza, call your health care provider as soon as symptoms of flu illness develop – they will determine whether influenza testing and possible treatment are needed.
- New guidance for the public is available at http://www.health.state.mn.us/divs/idepc/diseases/flu/basics/flumedhelp.html ‘When to Get Medical Help for Flu Symptoms” provides general guidance for persons experiencing flu symptoms and when to seek medical attention.
- During flu season, besides getting vaccinated, there are other steps people can take to avoid spreading or catching influenza:
- If you have symptoms of a respiratory illness, such as coughing, sneezing or runny nose, stay home. This means:
- Don’t go to work or school.
- Don’t visit friends or relatives in the hospital or long-term care facilities.
- Cover your nose and mouth with a tissue whenever you cough or sneeze, then throw the tissue away. If you don't have a tissue, cough or sneeze into your sleeve.
- Clean surfaces you touch frequently, such as doorknobs, water faucets, refrigerator handles and telephones.
- Wash your hands often with soap and water or with an alcohol-based hand sanitizer when soap and water are not available.
- Avoid exposing yourself to others who are sick with flu-like illness.
- Do your best to stay healthy. Get plenty of rest, physical activity and healthy eating.
Symptoms, treatment, etc.
The symptoms of influenza, which tend to come on suddenly, can include a sore throat, coughing, fever, headache, muscle aches and fatigue. People who become severely ill with influenza-like symptoms should see a physician.
Influenza is caused by a virus and antibiotics which are used against bacteria are not effective against it. Antivirals such as oseltamivir and zanamivir can be used against influenza.
More information on influenza can be found at www.mdhflu.com.
Infectious Disease Division Director