Each flu season seems to have some kind of surprise in store for parents and pediatricians.
Last year, the big surprise was that we had such a mild flu season. Before that of course, there was the emergence of swine flu and the swine flu pandemic.
The other big surprise last year was the early, widespread availability of flu shots and the availability of over 166 million doses of seasonal flu vaccine.
Of course, the big surprise this year has been the early, intense level of flu that we saw across the United States. Experts are describing it as the worst start to flu season in a decade.
As flu season winds down, the new surprise is the emergence of a new strain of bird flu in China, H7N9, which has gotten more than 131 people very sick in China and has caused 32 deaths. Fortunately, "the increase in case counts has fallen off from the month of April, when multiple cases were being reported each day." And "there is still no evidence of sustained (ongoing) human-to-human transmission with this virus and no cases have been reported outside of China."
Especially with the bad flu season we faced this year, parents should take steps to help avoid the flu and to keep their family from getting sick. In addition to getting a flu vaccine, this can include frequent hand washing, avoiding close contact with people who are sick with the flu, disinfecting contaminated surfaces, including toys and kitchen counter-tops.
Flu vaccine recommendations for the 2012-13 flu season didn't change much from last year. Experts still recommend the vaccination of all people who are at least six months old. Since "postvaccination antibody titer decline over the course of a year," everyone still needs to get a flu vaccine this year though. The availability of 145 million doses should make that easy too, although some pediatricians may have already run out of their flu vaccine supply.
And children who are less than nine years of age, still need two doses of the flu vaccine if this will be the first time that they are getting vaccinated. Your kids might also need two doses if they are less than nine years of age and haven't had at least two doses of seasonal flu vaccine since July 1, 2010.
If your own pediatrician is out of flu shots, you might check with your local health department, hospital, or pharmacies, and find a flu shot wherever you can. Early estimates indicate that this year's flu vaccine has "moderate effectiveness against circulating influenza viruses."
Flu Season Activity Reports
The CDC is now reporting that "seasonal influenza activity continues to decline across the nation." In addition to starting 4 weeks early, the CDC describes this year's flu season as "intense" and that it has lasted "slightly longer than average."
More specifically, the CDC reports that while "flu season moves toward a close, it's important to remember that flu viruses can continue to circulate at low levels," with:
No states reporting widespread flu activity.
Five states, Connecticut, Hawaii, Maine, Massachusetts, and New York, still reporting regional flu activity.
Three states, Alaska, Ohio, and Pennsylvania now reporting local flu activity.
Thirty-seven states, Alabama, Arizona, Arkansas, California, Colorado, Delaware, Florida, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming, now reporting sporadic flu activity.
Five states, Georgia, Idaho, Kansas, Mississippi, and Utah, now reporting no flu activity.
Google's Flu Trends, which relates flu searches in an area to how many people are actually sick with the flu, is still reporting a low level of flu activity in the United States - one step about minimal, there lowest level of flu activity. Remember that Google Flu Trends is supposed to 'estimate flu activity faster than traditional systems,' like the CDC and based on their scale, flu activity has begun to decrease below the moderate level we saw for most of the winter.
Knowing where there is flu activity can be helpful, because if you have classic flu symptoms in an area where there are a lot of flu infections, especially widespread or intense flu infections, then you likely have the flu and should see your doctor right away if your child is a candidate for one of the flu medications, such as Tamiflu (oseltamivir) or Relenza.
Keep in mind that the FDA has expanded the approved use of Tamiflu, at a dose of 3 milligrams per kilogram twice daily for five days, to treat children as young as 2 weeks old. As with older children and adults, Tamiflu is for those infants who have flu symptoms for no longer than two days. But unlike older children and adults, Tamiflu can not be used to prevent flu in infants.
Because of the increased demand for the oral suspension form of Tamiflu, as in past years, it is on back order and is likely hard to find in many areas. Your pharmacist should be able to compound the 75mg Tamiflu capsules into a suspension for your child though in the event of a Tamiflu shortage. The CDC also states that "for those patients who cannot swallow capsules, the capsules can be opened and the contents may be mixed with chocolate syrup or some other thick, sweet liquid, as directed by a healthcare professional" who can figure out an age-appropriate dose for your child, perhaps by using the 30mg or 45mg Tamiflu capsules.
Each year, the flu is reported to be responsible for almost 36,000 deaths, including about 85 deaths in children. In the 2009-10 flu season, 281 deaths in children were reported to the National Notifiable Diseases Surveillance System.
There were 34 pediatric deaths from flu during the 2011-2012 flu season.
There have been 138 pediatric flu deaths already during the 2012-2013 flu season, including one new report of a child dying from the flu this past week.
The CDC has also reported that during this year's flu season:
- 90% of pediatric flu deaths were in children who had not received a flu vaccine
- 40% of the flu deaths were in children who had no underlying chronic health problems
- 40% of children had received a flu vaccine by mid-November
- this year's flu vaccine reduced a child's risk of having to go to the doctor by at least 60%
CDC. FluView. 2012-2013 Influenza Season Week 18 ending May 5, 2013
CDC. Early Estimates of Seasonal Influenza Vaccine Effectiveness — United States, January 2013. MMWR. January 11, 2013 / 62(Early Release);1-4.
CDC. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2012-13 Influenza Season. MMWR. August 17, 2012 / 61(32);613-618