Wednesday, December 5, 2018

Baby Boomers and the Flu

Updated
Dec 6, 2018

2018-2019 Influenza Season Week 47 ending November 24, 2018
FluView Activity Update (Key Flu Indicators)
According to this week’s FluView report, seasonal influenza activity increased slightly in the United States. The proportion of people seeing their health care provider for influenza-like-illness (ILI) is above the national baseline for the first time this season, however this increase may be influenced in part by a reduction in routine health care visits during the Thanksgiving holidays. Twenty-one states are now reporting regional or local flu activity(Alaska, Arizona, California, Connecticut, Florida, Georgia, Idaho, Kentucky, Louisiana, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, and Utah). That means those states are seeing outbreaks of flu and laboratory-confirmed flu in at least one or less than half of the regions of the state, respectively. However 28 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands continue to report only sporadic flu activity, which means those states are seeing small numbers of flu or one laboratory confirmed flu outbreak. Influenza A(H1N1)pdm09 viruses have been the most commonly identified flu viruses since September 30, 2018. CDC also reported two additional flu-associated pediatric deaths for the 2018-2019 flu season. While activity is slowly increasing, it’s too early to say the 2018-2019 flu season has started.

An annual flu vaccine is the best way to protect against influenza and its potentially serious complications. There are many benefits to vaccination, including reducing the risk of flu illness, doctor’s visits, hospitalization, and even death in children. CDC recommends that everyone 6 months and older get vaccinated now; continue reading the CDC's "FluView report" for the key flu indicators week ending November 24, 2018.

Remember flu activity tends to increase between Thanksgiving and Christmas!

Public Health Agency of Canada: 
The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch

Joint ECDC - WHO/Europe Weekly Flu Update:
https://flunewseurope.org/Severity

December - In The News
Influenza: Lessons from Last Season, Looking Ahead to the Next
DECEMBER 05, 2018
Cecilia Pessoa Gingerich
The 2018-2019 influenza season is upon us, but while there’s no way to predict when this season will peak, over the years, data has shown that the influenza season in the United States picks up in October and peaks from December to February, sometimes lasting as late as May.. 

Study analyzes all severe influenza cases in 12 Catalan hospitals between the 2010-2011 and 2015-2016 campaigns

Nov 16, 2018

Nov 12, 2018
First Universal Flu Vaccine to Enter Phase 3 Trial
Numerous experimental vaccines that aim to provide multi-season protection are in human studies.
Ashley P. Taylor
For decades, scientists have been trying to develop a universal vaccine that would protect people against seasonal flu for years, and also against pandemics, which emerge when viral strains completely novel to people’s immune systems start spreading. “A universal flu vaccine is often referred to as ‘The Holy Grail’ of influenza research, and like the Holy Grail, it is challenging to achieve,” Tamar Ben-Yedidia, chief scientific officer of BiondVax, whose universal flu vaccine is now in Phase 3 clinical trials, tells The Scientist in an email.

It has been about 20 years in the making to get to the point of a Phase 3 study—the first universal flu vaccine to have progressed to that stage—and there are numerous others following behind. All of these vaccines employ variations on a similar strategy, which is to generate immunity to parts of the virus that are the least variable from strain to strain...

Maryn McKenna
At first glance, that response makes sense: If a vaccine won’t protect you from illness, why take it? But the effectiveness of flu vaccine is more complex than the binary of Sick or Not Sick. People who get the shot may still end up with flu infection, yet because they got the shot, they are less likely to experience grueling symptoms, be admitted to the hospital, or die.

Nov 8, 2018
Are you prepared for another flu season? 
Test yourself on essential core components of influenza and refresh your knowledge of best practices with this quick quiz. Although the quiz is aimed at physicians, patients may find the information beneficial as well.
Begin here: https://reference.medscape.com/viewarticle/904316

Video:
Nov 4, 2018
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).

Stay healthy!
Tina

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