Archive for the ‘Flu’ Category

The Flu

Monday, October 22, 2018 // Flu

As most of you know the recent flu season was the worst flu season since 2009. It is now flu shot season.  When you see pumpkins, think flu shots. Patients with fall appointments will get the vaccination during their office visit.  We schedule brief appointments for individuals who want to get the vaccine to avoid waiting. We prefer not to do walk INS ins to minimize wait times. We will be giving the quadrivalent vaccine against 4 flu strains. For those over 65, a high dose vaccine is available which is a little more effective.  Let’s hope for a good match this year!

The flu takes a formidable toll each year. Researchers and health workers save lives by routinely rolling out seasonal vaccines and deploying drugs to fight the virus and its secondary infections. But in the U.S. alone the flu still kills tens of thousands of people and hospitalizes hundreds of thousands more.

A big part of the problem has been correctly predicting what strains of the influenza virus health officials should try to combat in a given season. A team of scientists from the U.S. and China now say they have designed a vaccine that could take the guesswork out of seasonal flu protection by boosting the immune system’s capacity to combat many viral strains.

The University of California, Los Angeles–led group reported in a recent Science that they may have created the “Goldilocks” of flu vaccines—one that manages to trigger a very strong immune response without making infected animals sick. And unlike current flu vaccines, the new version also fuels a strong reaction from disease-fighting white blood cells called T cells. That development is important because a T cell response will likely confer longer-term protection than current inoculations do and defend against a variety of flu strains (because T cells would be on the lookout for several different features of the flu virus whereas antibodies would be primarily focused on the shape of a specific strain). “This is really exciting,” says Kathleen Sullivan, chief of the Division of Allergy and Immunology at The Children’s Hospital of Philadelphia, who was not involved in the work.

FLU FACTS

The overall effectiveness of last season’s influenza vaccine has been estimated at 36%, according to an analysis in MMWR.

Researchers examined data on nearly 4600 patients who sought outpatient care for acute respiratory illness with cough within 7 days of symptom onset between November 2017 and February 2018. Some 38% tested positive for influenza on reverse-transcription polymerase chain reaction.

Roughly 43% of those with influenza had been vaccinated. Vaccine effectiveness was estimated for each virus type as follows:

  • Influenza A(H3N2): 25%
  • Influenza A(H1N1)pdm09: 67%
  • Influenza B: 42%

When examined by age group, statistically significant protection against influenza was observed only among children aged 6 months through 8 years (59% effective) and adults aged 18 through 49 (33% effective).

The report’s authors write, “Even with current vaccine effectiveness estimates, vaccination will still prevent influenza illness, including thousands of hospitalizations and deaths. Persons aged ≥6 months who have not yet been vaccinated this season should be vaccinated.”

Dr. Anne Schuchat noted that three out of four children who’ve died from flu this season were not vaccinated.

0 Comments Read more

 

Flu Vaccine 2017

Sunday, October 1, 2017 // Blog, Flu, Prevention, Vaccines

Information for 2017-2018

Getting an annual flu vaccine is the first and best way to protect yourself and your family from the flu. Flu vaccination can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations. The more people who get vaccinated, the more people will be protected from flu, including older people, very young children, pregnant women and people with certain health conditions who are more vulnerable to serious flu complications. This page summarizes information for the 2017-2018 flu season.

What viruses will the 2017-2018 flu vaccines protect against?

There are many flu viruses, and they are constantly changing. The composition of U.S. flu vaccines is reviewed annually and updated to match circulating flu viruses. Flu vaccines protect against the three or four viruses that research suggests will be most common. For 2017-2018, three-component vaccines are recommended to contain:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus
  • an A/Hong Kong/4801/2014 (H3N2)-like virus
  • a B/Brisbane/60/2008-like (B/Victoria lineage) virus

Four-component vaccines, which protect against a second lineage of B viruses, are recommended to be produced using the same viruses recommended for the trivalent vaccines, as well as a B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

We will be giving the Quadrivalent Flu Vaccine this fall.  A high dose vaccine will be available for those 65 and over.  It is marginally more effective and does not appear to have any greater risk of side effects.  If you have a scheduled appointment this fall, we will give it then.  Otherwise, you can call to schedule an appointment.  The optimal time is late October and early November.  Think pumpkins when thinking of the optimal time.  It is readily available, so if it is more convenient for you to get it at your pharmacy, work or school, it is fine to get it there.

– – – – – –

Words written in italic are directly from Mark L. Thornton, M.D., F.A.C.P.

0 Comments Read more
 

Flu Vaccine

Wednesday, December 16, 2015 // Flu, Vaccines

Everyone over the age of 6 months should get the flu vaccine. It used to be so simple; there was just one flu vaccine.  Now we have high dose, trivalent, quadrivalent, intranasal and intradermal, to name a few.  Here is a list of the vaccines available and their indications:

flu-vaccine

To avoid ordering multiple types of flu vaccine we have chosen the vaccine that would suit the needs of the majority of our patients, the standard dose trivalent vaccine.  Some patients have asked about the high dose vaccine–it contains much more antigen than the standard dose, but studies so far show that it is no more effective, or may be only marginally better, depending on which study one reads.

0 Comments Read more
 

Flu Vaccine

Friday, January 23, 2015 // Flu, News

Most patients have received their flu vaccine by now. Unfortunately, it’s not a great match with the strain that is circulating now as the following article from Journal Watch outlines, but it is all we have available and offers some protection.

 

Flu Vaccine Not a Perfect Match to Circulating Viruses

By Kelly Young Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS Roughly half of the circulating influenza A (H3N2) viruses collected in the U.S. early this flu season are antigenically different from the H3N2 virus included in this year’s vaccine, prompting CDC officials to remind healthcare providers about using neuraminidase inhibitors to treat and prevent influenza. H3N2 has been present in about 90% of influenza-positive tests this flu season. Years with high H3N2 activity tend to see higher flu morbidity and mortality. The World Health Organization recommended components for the Northern Hemisphere vaccine in February. Antigenically drifted H3N2 viruses were detected in March and became more prevalent in September, too late to change the vaccine. “They’re different enough that we’re concerned that protection from vaccination … may be lower than we usually see,” CDC Director Tom Frieden told reporters on Thursday.The CDC is still recommending that people get vaccinated against the flu because it provides partial protection and the B strains are well matched. But Frieden said that if clinicians suspect influenza in high-risk patients, they should start neuraminidase inhibitor treatment without waiting for confirmatory test results. – See more here.

I was very surprised by the recommendation of the Tamiflu-like medications (neuraminidase inhibitors) given recent articles on their lack of efficacy. Again, from Journal Watch.

 

Tamiflu, Relenza Data Show Little Clinical Benefit Against Flu
By Joe Elia

The neuraminidase inhibitors oseltamivir (Tamiflu) and zanamivir (Relenza) have only marginal benefits in the treatment and prevention of influenza, a series of BMJ articles concludes. Investigators reviewed documents submitted to regulatory agencies concerning both drugs. Tamiflu data showed it reduced symptom duration by roughly 17 hours but made no difference in hospital admissions or rates of carefully defined pneumonia. Tamiflu increased nausea and vomiting. As prophylaxis, it greatly reduced symptomatic (but not asymptomatic) cases. The Relenza analysis similarly showed a modest reduction in symptom duration (14 hours) and no effect on pneumonia. As prophylaxis, it acted like Tamiflu and had fewer side effects. Editorialists observe that the analyses show “with greater clarity than ever” that the current system for drug regulation is broken. And one commented that, given these results, “it is difficult to conceive that many patients would actively seek treatment.”. NEJM Journal Watch Infectious Diseases associate editor Stephen Baum wrote: “Clean out your medicine cabinet: these reviews call into question the drugs’ efficacy and side effects, as well as the ways in which data were selectively used to promote them.” – See more here

Still, most people who are sick would gladly shorten their sickness by 17 hours. If you have headache, fever and a cough you can call, email or text. Make sure to do it in the first 48 hours. It is not considered good medical practice to prescribe medications for people who are not your patients. It is also a big liability to prescribe drugs with potential side effects for people with whose medical history you are not familiar.. For those reasons I don’t call in Tamiflu for non patients, and recommend calling their physician.

 

 

Other News:

0 Comments Read more