Re: Texas Encourages Vigilance in Flu Treatment, Precautions (DoH, December 20 2013)
[Source: ProMedMail.org, full page: (LINK). Edited.]
Published Date: 2013-12-21 19:32:56 / Subject: PRO/EDR> Influenza (67): USA (TX) H1N1 / Archive Number: 20131221.2129781
INFLUENZA (67): USA (TEXAS) H1N1
A ProMED-mail post http://www.promedmail.org / ProMED-mail is a program of the International Society for Infectious Diseases http://www.isid.org
Date: Fri 20 Dec 2013 / Source: Texas Department of State Health Services (DSHS) [summ., edited] / http://www.dshs.state.tx.us/news/releases/Influenza-Health-Alert-122013.pdf
Influenza health alert
Statewide influenza-like illness (ILI) activity continues to increase and is above baseline levels. ILI intensity is high in Texas, and influenza is now widespread. All Texas regions have reported laboratory confirmed influenza. Over 90 per cent of positive influenza tests reported from Texas laboratories have been typed as influenza A. Of those influenza A viruses that have been subtyped, 90 per cent have been the 2009 pandemic H1N1 subtype. This subtype of influenza is included in this season's [2013-14] influenza vaccine. No novel influenza cases have been reported in Texas. No antiviral resistant influenza strains have been reported in Texas.
Background
Influenza viruses can be spread by large respiratory droplets generated when an infected person coughs or sneezes in close proximity to an uninfected person. Symptoms can include fever, dry cough, sore throat, headache, body aches, fatigue, and nasal congestion. Among children, otitis media, nausea, vomiting, and diarrhea are common. Most people generally recover from illness in 1-2 weeks, but some people develop complications and may die from influenza. The highest rates of influenza infection occur among children; however, the risks for serious health problems, hospitalizations, and deaths from influenza are higher among people 65 years of age or older, very young children, and people of any age who have medical conditions that place them at increased risk for complications from influenza.
Vaccination
Everyone who is at least 6 months of age should get a flu vaccine this season [2013-14]. It is not too late for vaccination. There are several flu vaccine options available for the 2013-2014 flu season. All these vaccines contain the currently circulating H1N1 strain. DSHS [Department of State Health Services] does not recommend one flu vaccine over another, although there are special indications for some (such as a high-dose inactivated trivalent vaccine approved for persons age 65 years and older).
Rapid Lab Test
Rapid influenza diagnostic tests (RIDTs) can be useful to identify influenza virus infection, but false negative test results are common during influenza season. Clinicians should be aware that a negative RIDT result does NOT exclude a diagnosis of influenza in a patient with suspected influenza. When there is clinical suspicion of influenza and antiviral treatment is indicated, antiviral treatment should be started as soon as possible, even if the result of the RIDT is negative, without waiting for results of additional influenza testing.
Treatment: oseltamivir and zanamivir are chemically related antiviral medications known as neuraminidase inhibitors that have activity against both influenza A and B viruses. Early antiviral treatment can shorten the duration of fever and illness symptoms, may reduce the risk of complications and death, and may shorten the duration of hospitalization. Clinical benefit is greatest when antiviral treatment is administered early, especially within 48 hours of influenza illness onset. Decisions about starting antiviral treatment should not wait for laboratory confirmation of influenza.
Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who
- is hospitalized,
- has severe, complicated, or progressive illness,
- is at higher risk for influenza complications.
Persons at higher risk for influenza complications recommended for antiviral treatment include:
- children aged younger than 2 years,
- adults aged 65 years and older,
- persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, or hematological disease (including sickle cell disease); metabolic disorders (including diabetes mellitus); or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability [mental retardation], moderate to severe developmental delay, muscular dystrophy, or spinal cord injury),
- persons with immunosuppression, including that caused by medications or by HIV infection,
- women who are pregnant or postpartum (within 2 weeks after delivery),
- persons aged younger than 19 years who are receiving long-term aspirin therapy.
- American Indians/Alaska Natives.
- persons who are morbidly obese (that is, body-mass index is equal to or greater than 40).
- residents of nursing homes and other chronic-care facilities.
Clinical judgment, on the basis of the patient's disease severity and progression, age, underlying medical conditions, likelihood of influenza, and time since onset of symptoms, is important when making antiviral treatment decisions for high-risk outpatients.
Additional details regarding antiviral treatment can be found at http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm.
In Texas, influenza-associated pediatric mortality is required to be reported within one work day. Clusters or outbreaks of any disease, including influenza, should be reported immediately. Reports of influenza-associated pediatric mortality and influenza or influenza-like illness outbreak should be made to your local health department or to 1-800-705-8868.
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communicated by: ProMED-mail promed@promedmail.org
[The correspondent has added the following commentary in relation to the information above. "This outbreak now appears to involve an H1N1 virus. The vaccine inefficacy statement from the County health authorities press release highlights, coupled with the apparent unreliability of rapid diagnostic tests cited in media reports, suggests to me that H1N1 virus circulating in Texas may be a new [more virulent ?] drifted or reasserted strain. The current Texas state flu bulletin for week of 7-14 Dec 2013 issued today (20 Dec 2013) does not seem to discuss this issue http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2014/."
It seems likely that the fatalities observed in Texas are due to a possibly more virulent strain of the seasonal H1N1 influenza virus, rather than a novel pathogenic agent. Further information is awaited to substantiate this conclusion. - Mod.CP]
(?)
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Texas: H1N1 on the rise; second person dies in Gregg County
Source: http://www.ketknbc.com/news/update-2...dies-from-h1n1
UPDATE: H1N1 on the rise; second person dies in Gregg County
POSTED: Friday, December 20, 2013 - 10:48am
UPDATED: Friday, December 20, 2013 - 2:44pm
Tyler (KETK) ? Although the World Health Organization announced the H1N1 pandemic ended in August 2010, the virus has lingered ever since, and two deaths have been reported in East Texas: a second person died on Friday as a result of H1N1 in Gregg County, According to the Northeast Texas Public Health District.
As of week 49, or December 2-8 of this year, more than 40 East Texas cases of H1N1 showed positive results through a "rapid test." While the rapid test is usually accurate, it can produce a false negative. Therefore, the true number of cases are not known, according to Director of Public Health Emergency Preparedness Russell Hopkins...Leave a comment:
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Re: Texas Encourages Vigilance in Flu Treatment, Precautions (DoH, December 20 2013)
[Source: Texas State Department of Health, full PDF document: (LINK). Edited.]
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
DAVID L. LAKEY, M.D., COMMISSIONER
P.O. Box 149347, Austin, Texas 78714-9347, 1-888-963-7111, TTY: 1-800-735-2989, www.dshs.state.tx.us
**INFLUENZA HEALTH ALERT**
December 20, 2013
Dear Colleague:
Statewide influenza-like illness (ILI) activity continues to increase and is above baseline levels. ILI intensity is high in Texas, and influenza is now widespread. All Texas regions have reported laboratory confirmed influenza.
Over 90% of positive influenza tests reported from Texas laboratories have been typed as influenza A. Of those influenza A viruses that have been subtyped, 90% have been the 2009 pandemic H1N1 subtype. This subtype of influenza is included in this season's influenza vaccine.
No novel influenza cases have been reported in Texas.
No antiviral resistant influenza strains have been reported in Texas.
Encourage patients to get vaccinated for influenza.
Clinicians should consider antivirals even if the Rapid Influenza Diagnostic Test is negative.
Background:
Influenza viruses can be spread by large respiratory droplets generated when an infected person coughs or sneezes in close proximity to an uninfected person. Symptoms can include fever, dry cough, sore throat, headache, body aches, fatigue, and nasal congestion. Among children, otitis media, nausea, vomiting, and diarrhea are common. Most people generally recover from illness in 1-2 weeks, but some people develop complications and may die from influenza. The highest rates of influenza infection occur among children; however, the risks for serious health problems, hospitalizations, and deaths from influenza are higher among people 65 years of age or older, very young children, and people of any age who have medical conditions that place them at increased risk for complications from influenza (see Treatment).
Vaccination:
Everyone who is at least 6 months of age should get a flu vaccine this season. It is not too late for vaccination. There are several flu vaccine options available for the 2013-2014 flu season. All these vaccines contain the currently circulating H1N1 strain. DSHS does not recommend one flu vaccine over another, although there are special indications for some (such as a high-dose inactivated trivalent vaccine approved for persons age 65 years and older).
The 2013-2014 trivalent influenza vaccine is made from the following three viruses:
- An A/California/7/2009 (H1N1)pdm09-like virus
- An A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011
- A B/Massachusetts/2/2012-like virus
The quadrivalent vaccine contains the above three viruses and a B/Brisbane/60/2008-like virus.
Rapid Lab Tests:
Rapid Influenza Diagnostic Tests (RIDTs) can be useful to identify influenza virus infection, but false negative test results are common during influenza season. Clinicians should be aware that a negative RIDT result does NOT exclude a diagnosis of influenza in a patient with suspected influenza.
When there is clinical suspicion of influenza and antiviral treatment is indicated, antiviral treatment should be started as soon as possible, even if the result of the RIDT is negative, without waiting for results of additional influenza testing.
Treatment:
Oseltamivir and zanamivir are chemically related antiviral medications known as neuraminidase inhibitors that have activity against both influenza A and B viruses. Early antiviral treatment can shorten the duration of fever and illness symptoms, may reduce the risk of complications and death, and may shorten the duration of hospitalization. Clinical benefit is greatest when antiviral treatment is administered early, especially within 48 hours of influenza illness onset. Decisions about starting antiviral treatment should not wait for laboratory confirmation of influenza.
Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who
- Is hospitalized.
- Has severe, complicated, or progressive illness.
- Is at higher risk for influenza complications.
Persons at higher risk for influenza complications recommended for antiviral treatment include:
- Children aged younger than 2 years.
- Adults aged 65 years and older.
- Persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, or hematological disease (including sickle cell disease); metabolic disorders (including diabetes mellitus); or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability [mental retardation], moderate to severe developmental delay, muscular dystrophy, or spinal cord injury).
- Persons with immunosuppression, including that caused by medications or by HIV infection.
- Women who are pregnant or postpartum (within 2 weeks after delivery).
- Persons aged younger than 19 years who are receiving long-term aspirin therapy.
- American Indians/Alaska Natives.
- Persons who are morbidly obese (i.e., body-mass index is equal to or greater than 40).
- Residents of nursing homes and other chronic-care facilities.
Clinical judgment, on the basis of the patient's disease severity and progression, age, underlying medical conditions, likelihood of influenza, and time since onset of symptoms, is important when making antiviral treatment decisions for high-risk outpatients.
Additional details regarding antiviral treatment can be found at http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm.
Disease Reporting Requirements/Statute:
Several Texas laws (Health & Safety Code. Chapters 81, 84, and 87) require specific information regarding notifiable conditions to be provided to DSHS. Health care providers, hospitals, laboratories, schools, childcare facilities and others are required to report patients who are suspected of having a notifiable condition (Chapter 97, Title 25, Texas Administrative Code).
In Texas, influenza-associated pediatric mortality is required to be reported within one work day. Clusters or outbreaks of any disease, including influenza, should be reported immediately. Reports of influenza-associated pediatric mortality and influenza or influenza-like illness outbreak should be made to your local health department or to 1-800-705-8868.
David Lakey, M.D. Commissioner, Texas Department of State Health Services
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Texas Department of Health, Influenza Health Alert (December 20 2013)
[Source: Texas State Department of Health, full PDF document: (LINK). Edited.]
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
DAVID L. LAKEY, M.D., COMMISSIONER
P.O. Box 149347, Austin, Texas 78714-9347, 1-888-963-7111, TTY: 1-800-735-2989, www.dshs.state.tx.us
**INFLUENZA HEALTH ALERT**
December 20, 2013
Dear Colleague:
Statewide influenza-like illness (ILI) activity continues to increase and is above baseline levels. ILI intensity is high in Texas, and influenza is now widespread. All Texas regions have reported laboratory confirmed influenza.
Over 90% of positive influenza tests reported from Texas laboratories have been typed as influenza A. Of those influenza A viruses that have been subtyped, 90% have been the 2009 pandemic H1N1 subtype. This subtype of influenza is included in this season's influenza vaccine.
No novel influenza cases have been reported in Texas.
No antiviral resistant influenza strains have been reported in Texas.
Encourage patients to get vaccinated for influenza.
Clinicians should consider antivirals even if the Rapid Influenza Diagnostic Test is negative.
Background:
Influenza viruses can be spread by large respiratory droplets generated when an infected person coughs or sneezes in close proximity to an uninfected person. Symptoms can include fever, dry cough, sore throat, headache, body aches, fatigue, and nasal congestion. Among children, otitis media, nausea, vomiting, and diarrhea are common. Most people generally recover from illness in 1-2 weeks, but some people develop complications and may die from influenza. The highest rates of influenza infection occur among children; however, the risks for serious health problems, hospitalizations, and deaths from influenza are higher among people 65 years of age or older, very young children, and people of any age who have medical conditions that place them at increased risk for complications from influenza (see Treatment).
Vaccination:
Everyone who is at least 6 months of age should get a flu vaccine this season. It is not too late for vaccination. There are several flu vaccine options available for the 2013-2014 flu season. All these vaccines contain the currently circulating H1N1 strain. DSHS does not recommend one flu vaccine over another, although there are special indications for some (such as a high-dose inactivated trivalent vaccine approved for persons age 65 years and older).
The 2013-2014 trivalent influenza vaccine is made from the following three viruses:
- An A/California/7/2009 (H1N1)pdm09-like virus
- An A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011
- A B/Massachusetts/2/2012-like virus
The quadrivalent vaccine contains the above three viruses and a B/Brisbane/60/2008-like virus.
Rapid Lab Tests:
Rapid Influenza Diagnostic Tests (RIDTs) can be useful to identify influenza virus infection, but false negative test results are common during influenza season. Clinicians should be aware that a negative RIDT result does NOT exclude a diagnosis of influenza in a patient with suspected influenza.
When there is clinical suspicion of influenza and antiviral treatment is indicated, antiviral treatment should be started as soon as possible, even if the result of the RIDT is negative, without waiting for results of additional influenza testing.
Treatment:
Oseltamivir and zanamivir are chemically related antiviral medications known as neuraminidase inhibitors that have activity against both influenza A and B viruses. Early antiviral treatment can shorten the duration of fever and illness symptoms, may reduce the risk of complications and death, and may shorten the duration of hospitalization. Clinical benefit is greatest when antiviral treatment is administered early, especially within 48 hours of influenza illness onset. Decisions about starting antiviral treatment should not wait for laboratory confirmation of influenza.
Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who
- Is hospitalized.
- Has severe, complicated, or progressive illness.
- Is at higher risk for influenza complications.
Persons at higher risk for influenza complications recommended for antiviral treatment include:
- Children aged younger than 2 years.
- Adults aged 65 years and older.
- Persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, or hematological disease (including sickle cell disease); metabolic disorders (including diabetes mellitus); or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability [mental retardation], moderate to severe developmental delay, muscular dystrophy, or spinal cord injury).
- Persons with immunosuppression, including that caused by medications or by HIV infection.
- Women who are pregnant or postpartum (within 2 weeks after delivery).
- Persons aged younger than 19 years who are receiving long-term aspirin therapy.
- American Indians/Alaska Natives.
- Persons who are morbidly obese (i.e., body-mass index is equal to or greater than 40).
- Residents of nursing homes and other chronic-care facilities.
Clinical judgment, on the basis of the patient's disease severity and progression, age, underlying medical conditions, likelihood of influenza, and time since onset of symptoms, is important when making antiviral treatment decisions for high-risk outpatients.
Additional details regarding antiviral treatment can be found at http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm.
Disease Reporting Requirements/Statute:
Several Texas laws (Health & Safety Code. Chapters 81, 84, and 87) require specific information regarding notifiable conditions to be provided to DSHS. Health care providers, hospitals, laboratories, schools, childcare facilities and others are required to report patients who are suspected of having a notifiable condition (Chapter 97, Title 25, Texas Administrative Code).
In Texas, influenza-associated pediatric mortality is required to be reported within one work day. Clusters or outbreaks of any disease, including influenza, should be reported immediately. Reports of influenza-associated pediatric mortality and influenza or influenza-like illness outbreak should be made to your local health department or to 1-800-705-8868.
David Lakey, M.D. Commissioner, Texas Department of State Health Services
-
-------Leave a comment:
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Texas Encourages Vigilance in Flu Treatment, Precautions (DoH, December 20 2013)
[Source: Texas State Department of Health, full page: (LINK).]
Texas Encourages Vigilance in Flu Treatment, Precautions
News Release / Dec. 20, 2013
Though recent increases in flu activity are not unusual, Texas issued flu testing and treatment guidance today to doctors and is continuing to encourage everyone to get vaccinated now to protect themselves.
The level of flu-like illness is classified as ?high? in Texas, and medical providers are seeing an increase in flu in multiple parts of the state.
Unusually severe cases of flu-like illness are routinely investigated during the flu season by local health departments in coordination with the Texas Department of State Health Services.
H1N1 is the most common circulating flu strain so far this season. This year?s flu vaccine includes protection against the most common flu strains, including H1N1.
DSHS advises clinicians to consider antiviral treatment, even if an initial rapid-flu test comes back negative.
A negative result does not exclude a diagnosis of flu in a patient with suspected illness. Antiviral treatment is recommended for anyone with confirmed or suspected flu who is hospitalized, has severe or progressive illness or is at a higher risk for complications.
?Flu is on the rise and causing severe illness in certain people. It is not unexpected this time of year, but it?s a good reminder for people to get vaccinated and stay home if they?re sick,? said Dr. David Lakey, DSHS commissioner. ?Flu can be deadly. People who have not been vaccinated should do so now. It?s the best defense we have.?
Flu is a serious disease that kills an average of 23,600 Americans a year, according to estimates from the Centers for Disease Control and Prevention. People over 65, pregnant women, young children and people with chronic health conditions are most at risk for complications, so it?s especially important for them to be vaccinated.
Flu cases and flu-related deaths in adults are not required to be reported to DSHS. Healthcare providers are required to report pediatric flu deaths to their local health department within one business day. There are no confirmed pediatric flu deaths in Texas this season.
DSHS recommends everyone six months old and older get vaccinated. People should talk to their health care provider about the best type of flu vaccine for them. A nasal spray version is available for healthy people ages 2 to 49 who are not pregnant, and a high-dose vaccine is approved for people 65 and older.
Dr. Lakey also urged people to follow standard illness-prevention steps:
- Wash hands frequently with soap and water or alcohol-based hand sanitizer;
- Cover coughs and sneezes;
- Stay home if sick
For more information, go to www.TexasFlu.org.
DSHS Influenza Health Alert: www.dshs.state.tx.us/news/releases/Influenza-Health-Alert-122013.pdf
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(Media Contact: DSHS Press Office, 512-776-7119)
Last updated December 20, 2013
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Re: Texas: Bell and McLennan Co. Health Officials Warn Of Aggressive Flu
Doctors Warn About Jump in Flu Cases and RSV
(KCEN) ? Representatives from Scott and White, Bell County Health District and the Mclennan County Health Department held a press conference on Thursday to discuss the drastic increase in flu and RSV cases over the last few weeks.
Lacey Sanders with Bell County says the numbers are the worst she's seen since the H1N1 outbreak in 2009. Just last week she says there were more than 200 cases test positive for the flu. They're currently investigating their first possible flu related death of the year. They say it's an adult under the age of 60 who died last week.
Sanders says the numbers are jumping across the nation and state, with 90% of all cases in Texas being the H1N1 strain. "It is attacking quite differently than it normally did. We have a lot of people sick and hospitalized," Sanders said.
In fact she says they've had nine people hospitalized for the flu since last week, four of which were children.
Kelly Craine with Mclennan County says they've seen 344 positive cases of the flu just last week alone, and these numbers don't include people who do not get tested at the doctor.
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Texas - Seasonal flu 2013/2014 (other than Dallas or Houston areas)
Source: http://www.kwtx.com/home/headlines/L...1.html?ref=521
Local Health Officials Warn Of Aggressive Flu
By: Rachel Cox
(December 19, 2013) Health officials in Bell and McLennan Counties say they?ve seen a spike in flu cases and they warned residents Thursday to get vaccinated now.
Lacey Sanders of the Bell County Public Health District said this week alone 146 confirmed cases of flu have been reported and of those 60 involve the H1N1 virus.
Nine people have been hospitalized since last week and health officials are investigating the death of an adult in Holland that may be related to the illness, she said...
...The Waco-McLennan County Public Health District reported 29 cases three weeks ago, 113 more cases two weeks ago and 344 cases last week.
Kelly Craine with the McLennan County Public Health District said the same spike is being reported around the state and the country, but said health officials haven?t seen a comparable increase in H1N1 cases since 2009...
Leave a comment: