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Flu shot can help prevent infection with resistant strain

LocalHealthGuide | December 23, 2008

influenza-viruses Reports that some of this winter’s influenza viruses are resistant of the drug Tamiflu underscores the importance of getting your flu shot, say Public Health – Seattle & King County officials in a health advisory.

The warning was issued in response to a report by the U.S. Centers for Disease Control (CDC) and Prevention that a strain of the influenza virus circulating in the U.S.A. is resistant to Tamiflu (oseltamivir), the drug commonly used to treat the flu.

The CDC urges doctors to choose another drug or add a second drug in addition to Tamiflu when treating influenza.

On average, more than 200,000 Americans are hospitalized because of flu complications and some 36,000 die.

Two years ago in King County, three children died from complications of seasonal influenza, Seattle officials say.

Public Health – Seattle & King County recommends the vaccination for:

Children aged six months up to their 19th birthday
Pregnant women
People 50 years of age and older
People of any age with certain chronic medical conditions
People who live in nursing homes and other long-term care facilities
People who live with or care for those at high risk for complications from flu, including health care workers, household contacts of persons at high risk for complications from the flu, and household contacts and out of home caregivers of children less than six months of age

The vaccine is widely available this year and at doctors’ offices, clinics, pharmacies, Public Health centers and other providers, Public Health officials note.

PHOTO CREDIT: CDC

To learn more:

CDC alert: Seasonal Flu
Reuters: U.S. flu shows resistance of flu drug
For complete information about seasonal influenza, where to get a flu vaccine, and costs, please visit Public Health – Seattle & King County’s flu season web pages.
To find where you can get a flu shot visit: www.flucliniclocator.org
For more general information and educational materials about preventing the spread of infections, visit Public Health’s Stop Germs, Stay Healthy! webpage
Read Public Health – Seattle & King County’s announcement marking National Influenza Vaccination Week below.
Or call Public Health’s information line at 206-296-4949
Read the Public Health – Seattle & King County’s health advisory below.

Health advisory: Interim Influenza Antiviral Treatment Guidance
December 22, 2008

ACTION REQUESTED:

Resistance to antiviral medications highlights the importance of continuing to vaccinate patients throughout the flu season to protect as many individuals from influenza infection and its complications as possible. Influenza activity remains low locally.
Influenza antiviral drug treatment is most important for patients at high risk for severe complications of influenza infection (I.e., patients requiring hospitalization).
Consider use of influenza tests that can distinguish influenza A from influenza B. Patients testing positive for influenza B may be given either oseltamivir or zanamivir (no preference).
Treatment strategy should take into account that information regarding viral subtype (H1N1 or H3N2) is rarely available in a timely enough manner to guide treatment decisions, and in some cases influenza viral type (A or B) may not be available.
- Review local influenza virus surveillance data weekly during influenza season to determine which types and subtypes of influenza A virus are currently circulating.
- Local influenza surveillance data and links to CDC and state and national data
- Oseltamivir should be used alone only if recent local surveillance data indicates that circulating viruses are likely to be influenza A(H3N2) or influenza B viruses.
If a patient tests positive for influenza A or tests negative for influenza by rapid antigen test but for whom antiviral treatment is desired based on influenza symptoms during a period of high influenza activity locally, zanamivir should be considered if treatment is indicated.
- Combination treatment with oseltamivir and rimantadine is an acceptable alternative, and might be necessary for patients that cannot receive zanamivir, (e.g., patient is <7 years old, has chronic underlying airways disease, or cannot use the zanamivir inhalation device), or if zanamivir is unavailable. Amantadine can be substituted for rimantadine if rimantadine is unavailable.
For persons with complicated influenza requiring hospitalization, please consult with an infectious disease specialist for treatment recommendations.
Review the complete interim guidance from CDC on influenza drug treatment.

Background: Of 50 H1N1 viruses tested by CDC to date from 12 states, 98% were resistant to oseltamivir, and all were susceptible to zanamivir, amantadine and rimantadine. Influenza A (H3N2) and B viruses remain susceptible to oseltamivir. The proportion of influenza A (H1N1) viruses among all influenza A and B viruses that will circulate during the 2008-09 season cannot be predicted, and will likely vary over the course of the season and among communities.