Each flu season seems to have some kind of surprise in store for parents and pediatricians.
Last year, the big surprise was that the flu shots that were available didn't provide very good protection against the flu strains that were going around.
Early on in this year's flu season, the biggest surprise seemed to be that there were plenty of flu shots to go around for everyone that wanted one.
Another surprise this year has been the new recommendation from the CDC's Advisory Committee on Immunization Practices (ACIP) that all children between the ages of 5 and 18 years of age should get an annual flu vaccine. This is in addition to the previous recommendations that all children between the ages of 6 months and 5 years get a flu vaccine each year.
A late surprise this year is the reports of swine flu that is spreading around the world.
This Year's Flu Shot
The big question each year is often whether or not the flu shot is going to work. Remember that three strains of the flu are typically chosen each year in advance and are included in that year's flu vaccine. If they don't match the flu strains that are going around that year, the flu shot may be less effective at preventing people from getting sick with the flu.
This year, it seemed like the seasonal influenza A (H1N1), influenza A (H3N2), and one strain of influenza B was a good match for this year's flu vaccine. Another strain of influenza B that has been going around wasn't in the flu vaccine.
Flu Season Peaking?
Flu season activity was decreasing in late April, but we have started to see a sharp increase in seasonal flu in May, a time when flu season is usually ending. This is most likely because of increase testing for swine flu virus infections and not because of an increase in seasonal flu virus infections.
Whether you are concerned about seasonal flu or swine flu, parents should take some steps to help avoid the flu to keep you and your family from getting sick with the flu. This can include frequently washing your hands, avoiding close contact with people who are sick with the flu, and disinfecting contaminated surfaces, including toys and kitchen counter-tops. A flu medication, such as Tamiflu and Relenza (zanamivir) can also work as a preventative if you take them after being exposed to someone with the flu.
An early report showing that some strains of the seasonal flu virus have become resistant to Tamiflu might be concerning. It could mean that if you get the flu, then you might have to stick it out, suffer through the symptoms, and wait for them to go away.
Fortunately, the same report didn't show resistance to Relenza or the older flu medications, amantadine and Flumadine (rimantadine). Depending on the strain of flu your child has, your pediatrician may prescribe Tamiflu, Tamiflu plus Flumadine, or Relenza.
Fortunately, the swine flu H1N1 A virus is still sensitive to Tamiflu and Relenza.
Flu Activity Reports
As of mid-May, following reports of decreasing flu activity in late-April, the CDC reports that flu activity has begun to increase, which is likely an artifact secondary to high levels of swine flu testing.
Eight states, Arizona, California, Delaware, Georgia, New Jersey, New Mexico, Texas, and Virginia, are reporting widespread flu activity.
Fourteen states, Alabama, Alaska, Colorado, Connecticut, Florida, Hawaii, Maine, Maryland, Massachusetts, Nevada, New Hampshire, New York, Tennessee, and Utah, are reporting regional flu activity.
Seventeen states, Alabama, Alaska, California, Connecticut, Kentucky, Massachusetts, Michigan, Missouri, Montana, Nevada, North Carolina, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, and Wyoming, are reporting local flu activity.
Thirteen states, Arkansas, Indiana, Kentucky, Louisiana, Minnesota, Mississippi, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Vermont, and West Virginia, are reporting sporadic flu activity.
As of May 15, the CDC is also reporting 4,714 confirmed and probable cases of swine flu virus infections in the United States.
Remember that when it comes to flu activity reports, widespread > regional > local > sporadic > no activity.
Google's Flu Trends, which relates flu searches in an area to how many people are actually sick with the flu, continues to report a low level of flu activity in the United States. That is the second level on their scale of minimal < low < moderate < high < intense. 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 been decreasing the past few months.
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 to see if you are a candidate for one of the flu medications, such as Tamiflu or Relenza.
Flu Deaths
Each year, the flu is reported to be responsible for almost 36,000 deaths, including about 46 to 74 deaths in children. Last year, 83 deaths in children have already been reported to the National Notifiable Diseases Surveillance System. Unfortunately, this is not unusual in a typical flu season.
There have been fifty-nine influenza-associated pediatric death this season.
Sources:
Prevention & Control of Influenza - Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR July 17, 2008 / 57(Early Release), 1-60.
Update: Influenza Activity --- United States and Worldwide, 2007--08 Season. MMWR Morb Mortal Wkly Rep. 2008 June 27;57(25):692-700
CDC. Key Facts About Seasonal Flu Vaccine
US Flu Activity Reports.
CDC. Questions & Answers about the 2008-2009 Flu Season
