Tuesday, February 5, 2019

Baby Boomers and the Flu


As we move into March please visit the Centers for Disease Control and Prevention (CDC) website to review current U.S. flu activity.

Latest CDC Update: Feb 22, 2018
2018-2019 Influenza Season Week 7 ending February 16, 2019

View Interactive Map


CDC Update:
Influenza activity continues to increase in the United States. Influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B viruses continue to co-circulate. Below is a summary of the key influenza indicators for the week ending February 16, 2019:
Viral Surveillance: The percentage of respiratory specimens testing positive for influenza viruses in clinical laboratories increased. While influenza A(H1N1)pdm09 viruses predominated in most areas of the country, influenza A(H3) viruses have predominated in HHS Region 4 and accounted for 47% of subtyped influenza A viruses detected nationally during week 7. During the most recent three weeks, influenza A(H3) viruses were reported more frequently than influenza A(H1N1)pdm09 viruses in HHS Regions 6 and 7 and influenza A(H1N1)pdm09 and influenza A(H3) viruses were reported in approximately equal numbers in HHS Region 2.

Virus Characterization: The majority of influenza viruses characterized antigenically are similar to the cell-grown reference viruses representing the 2018–2019 Northern Hemisphere influenza vaccine viruses.

Antiviral Resistance:The vast majority of influenza viruses tested (>99%) show susceptibility to oseltamivir and peramivir. All influenza viruses tested showed susceptibility to zanamivir.

Influenza-like Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) increased to 5.1%, which is above the national baseline of 2.2%. All 10 regions reported ILI at or above their region-specific baseline level.

ILI State Activity Indictor Map: New York City and 30 states experienced high ILI activity; the District of Columbia and 11 states experienced moderate ILI activity; six states experienced low ILI activity; the U.S. Virgin Islands and three states experienced minimal ILI activity; and Puerto Rico had insufficient data.

Geographic Spread of Influenza: The geographic spread of influenza in Puerto Rico and 48 states was reported as widespread; one state reported regional activity; the District of Columbia reported local activity; the U.S. Virgin Islands and one state reported sporadic activity; and Guam did not report.

Influenza-associated Hospitalizations A cumulative rate of 27.4 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported. The highest hospitalization rate is among adults 65 years and older (75.6 hospitalizations per 100,000 population)

Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.

Influenza-associated Pediatric Deaths: Seven influenza-associated pediatric deaths were reported to CDC during week 7.

Continue reading: https://www.cdc.gov/flu/weekly/index.htm

Preliminary In-Season U.S. Influenza Burden Estimates
The 2018-2019 flu season is the first season CDC has reported in-season burden estimates of flu in the U.S. These in-season estimates will be updated over the course of the flu season.CDC estimates that, from October 1, 2018 through January 26, 2019, there have been:
--10.1 million – 11.7 million flu illnesses
--4.7 million – 5.6 million flu medical visits
--118,000 – 141,000 flu hospitalizations
Read the report, here...….

Public Health Agency of Canada:
The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch
British Columbia Influenza Surveillance Bulletin Influenza
Influenza activity remains elevated in BC and is dominated by the H1N1 strain. 
Joint ECDC - WHO/Europe Weekly Flu Update: https://flunewseurope.org/Severity

News
Feb 22, 2019
U.S. News - CDC: 41 Child Deaths Linked to Flu
The pediatric death total continues to tick up during the current flu season. The deaths of seven more children in connection with the flu have been reported to the Centers for Disease Control and Prevention, bringing the total number of pediatric deaths this season to 41 as of Feb. 16. In total, the CDC estimates there had been 13,600 to 22,300 flu deaths from October through mid-February, and that up to 20.4 million people had gotten sick. Flu season typically peaks in February, and agency researchers previously said that so far, this has been a "low-severity influenza season."
Read the article, here.

HealthDay Reporter - More Severe Flu Strain Starts to Spread Widely
FRIDAY, Feb. 22, 2019 (HealthDay News) -- Americans aren't out of the woods yet, as the flu season continues to spread across the country, health officials reported Friday. One major shift that's occurred is in the viruses that are circulating. At the start of the flu season, the predominant strain was influenza A H1N1, but now a more severe strain, influenza A H3N2, accounts for nearly half of all the new cases, according to the U.S. Centers for Disease Control and Prevention. "It looks like we are moving from an H1 wave to an H3 wave," said Lynnette Brammer, lead of CDC's domestic influenza surveillance team. "There's still a lot of flu to come."
Read the article, here.

Why Flu Vaccines Don’t Work as Well in the Elderly, as we age, something hampers our immune system’s ability to produce ever-stronger antibodies in response to infections. As a result, older people are relying on mostly memory B-cells to make antibodies from long-past immune responses that are ill-equipped to squash rapidly evolving pathogens like the flu virus.

Feb 18
Research: 'Killer' cells raise hope of universal flu vaccine.

Feb 13
Earlier Tamiflu May Cut Death Risk in Some Severe Cases, observed 30% decrease in mortality with early oseltamivir among influenza A/H3N2 patients in ICU.
Influenza Vaccines Prevented 8,000 Deaths Last Flu Season
Fighting the Flu: Paid Sick Leave Reduces Infection Rates 

Feb 6
Influenza Vaccine Tied to Lower Hospitalization Rates in COPD Patients
Previous research has shown that people with HCV, especially older patients, have increased prevalence and faster progression of COPD. Over at MD Magazine, a recent study found people with COPD vaccinated for the flu were 38% less likely to require influenza-related hospitalization, read it here.
SURVEY: Three In Ten Parents Believe Flu Shot Is Conspiracy...
CDC: 2 More Child Deaths Linked to Flu
Pregnant women with severe flu more likely to have poor outcomes

January

Video:
This flu season should serve as a wake-up call – we need to redouble our efforts to prevent and treat the flu
Seasonal outbreaks of the flu cause thousands of deaths even in a good year, and the last flu season, 2017-2018, was a terrible one. It killed 80,000 Americans and sent 900,000 to the hospital, making it the worst influenza season in decades.


Baby Boomers and the Flu 
Did you know that you are more susceptible to flu-related complications if you're over 65, living with chronic liver disease, or viral hepatitis? Yep, I knew it too. 

Currently information on this blog is aimed at people living with or treating hepatitis C, for the most part that is the baby boomer generation; born between 1946 to1964. 

Speaking of baby boomers, if you haven't read the CDC's eye- opening report on last years flu season, it was reported 80,000 flu-related deaths occurred in the US, the highest in 40 years. The death rate among young baby boomers, aged 50 to 64 were shocking as well; 
"Death rates were highest in the over-65 age group, which is typical, but the second most affected group comprised those aged 50 to 64 years old; normally, the second highest death rates occur in children, from birth through age 4 years. The ferociousness of the flu season overall, combined with above-average impacts on younger baby boomers, made 2017-2018 one for the record books."
Read the article: Flu Season 2017-2018: A Look at What Happened and What's to Come, CDC report, here. Or read this more recent article, updated Oct 19, 2018: 80,000 Americans died of the flu last winter.That’s more than the number killed in traffic collisions, from gun violence, or from opioid overdoses.

 Liver Disease & The Flu
As we age our immune system is less effective in fighting infections, and new infections can have a severe impact on the liver. This can be especially serious for liver transplant recipients and people who have cirrhosis. Flu-related complications could develop into bronchitis or pneumonia, which in rare cases can also be fatal.

Even though the flu vaccine won’t keep everyone from getting sick, it helps prevent serious flu complications. For instance people over 65 who were vaccinated had a lower rate of flu-related death, according to a 2017 study, found on the CDC's website.
"Flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients; with the greatest benefits being observed among people 65 years of age and older."
October - In The News
October 29, 2018
Getting Flu Vaccine One Year Doesn't Reduce Vaccine Effectiveness the Next Year
By Amy Orciari Herman
Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH
Getting the flu vaccine every year doesn't reduce its effectiveness — and might even boost its performance — suggests a study in JAMA Network Open.

Researchers examined the vaccination status of nearly 3400 children who presented with acute febrile respiratory illness during one of three successive flu seasons between 2013 and 2016. About one-fourth had flu confirmed on reverse-transcription polymerase chain reaction testing; the rest were considered negative for flu.

The researchers found that while vaccine effectiveness varied by vaccine type (e.g., live attenuated influenza vaccine [LAIV) or inactivated influenza vaccine) and flu virus strain, past-season vaccination did not reduce vaccine effectiveness. In fact, in some cases — for example, the effectiveness of LAIV against influenza A(H3N2) — previous vaccination appeared to improve the vaccine's effectiveness.

Of note, residual protection from past-season flu vaccine alone was observed only for influenza B.
A commentator writes, "The results thus suggest additional support for the current Advisory Committee on Immunization Practices' recommendation that children be vaccinated annually against influenza."
LINK(S):
JAMA Network Open article (Free)
JAMA Network Open commentary (Free)
Background: Physician's First Watch coverage of American Academy of Pediatrics recommendation of inactivated flu vaccine over LAIV (Free)

Oct 28, 2018
New Flu Drug Offers Convenience, Fast Activity, and a Novel Mechanism — at a Price
Last week, the FDA approved a new drug for treatment of influenza, baloxavir marboxil (Xofluza).
The drug is indicated for treatment of symptomatic influenza in patients 12 years of age or older. As with existing treatments, it should be started within 48 hours of symptom onset....

Oct 24, 2018
"I figured [the flu] was something that's dangerous to the elderly and the young, not somebody who is healthy and in their 30s," says Hinderliter, who is 39 and the director of government affairs at the St. Louis Realtors association. 
"Turns out, I was wrong," he says. 
Read the article, here.....

Should I or Shouldn't?
September 27, 2018
"People say they never had the flu until they got the shot. That argument doesn’t hold water. Either you got your shot too late, you got a strain of the flu that isn’t covered by the vaccine, or you had a one-day immune response which may make you feel like crap for the day, but isn’t anywhere like having the flu. If you are over 65, high dose flu shots are recommended, and some people feel a bit low and fluish the next day. This is not the flu – it is an immune system reaction"
Read the article: The Flu Shot Debate, written by HCV advocate Lucinda Porter.

CDC Information
People 65 years and older should get a flu shot and not a nasal spray vaccine.
They can get any flu vaccine approved for use in that age group with no preference for any one vaccine over another. There are regular flu shots that are approved for use in people 65 and older and there also are two vaccines designed specifically for people 65 and older:
High Dose Flu Vaccine:
The “high dose vaccine” contains 4 times the amount of antigen as a regular flu shot. It is associated with a stronger immune response following vaccination (higher antibody production). Results from a clinical trial of more than 30,000 participants showed that adults 65 years and older who received the high dose vaccine had 24% fewer influenza infections as compared to those who received the standard dose flu vaccine. The high dose vaccine has been approved for use in the United States since 2009.
Learn more about high dose flu vaccine here.

Adjuvanted Flu Vaccine:
The adjuvanted flu vaccine, Fluad, is made with MF59 adjuvant an additive that creates a stronger immune response to vaccination. In a Canadian observational study of 282 people aged 65 years and older conducted during the 2011-12 season, Fluad was 63% more effective than regular-dose unadjuvanted flu shots. There are no randomized studies comparing Fluad with Fluzone High-Dose. This vaccine was available for the first time in the United States during the 2016-2017 season. Learn more about adjuvanted flu vaccine here.

For Adults with LIVER DISEASE: Important information about a dangerous infection
If you have chronic liver disease, you are more likely to have serious complications if you get pneumococcal disease

Get pneumococcal vaccines 
People who are 65 years of age and older should also be up to date with pneumococcal vaccination to protect against pneumococcal disease, such as pneumonia, meningitis, and bloodstream infections. Talk to your doctor to find out which pneumococcal vaccines are recommended for you. Pneumococcal pneumonia is an example of a serious flu-related complication that can cause death. 

You can get the pneumococcal vaccine your provider recommends when you get the flu vaccine.

 CDC - Got Questions?
Flu vaccines recommended this season.

Detailed flu and flu vaccine information specific to the current flu season

If you have HIV, you are at high risk of serious influenza-related complications and should get an injectable influenza vaccine (a flu shot).

Recommended Reading:
Flu and Colds: In Depth
What do we know about the effectiveness of complementary approaches for flu and colds?

Is It A Nasty Cold Or The Flu?
So, if you do have the flu, it's important to consult with your health care provider about treatment. And distinguishing between a cold and flu may be easier than you think, Ejnes says.

Stay healthy!
Tina
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