Battling the Flu

TMA’s Flu Fighters want you to have the latest information on the 2013-14 seasonal influenza. While you are likely receiving a great deal of information on influenza, the Flu Fighters will cull through the national and state guidance and data for you, and highlight key messages and important guidance for your patients in the coming weeks.

Influenza is widespread. The Texas Department of State Health Services reports that influenza is widespread throughout the state, in contrast to many other states experiencing less flu activity. Severe respiratory illness such as pneumonitis with respiratory failure and severe secondary pneumonia with influenza appears to be occurring especially among young and middle-aged adults.

It’s not too late to vaccinate your patients. The Centers for Disease Control and Prevention recommends influenza vaccination for those 6 months or older. The vaccines for the 2013-14 flu season include the 2009 H1N1 virus, which is the predominant strain in current lab-confirmed influenza cases.

Test, then treat. Rapid influenza diagnostic tests (RIDTs) have limited sensitivities. Even with a negative test result, you still should provide empiric treatment to patients with clinical symptoms of influenza. With widespread influenza in the community, a clinical illness consistent with influenza, with fever and cough, is enough evidence to support a diagnosis of influenza.

Treat with antiviral drugs. Initiate oseltamivir or zanamivir as early as possible for symptomatic patients who have severe or progressive illness, are hospitalized, or are at higher risk for influenza complications. Antiviral treatment can reduce the duration of illness and the risk of complications, and still may be beneficial even if started after 48 hours from symptom onset.

Your patients who are pregnant, 65 years of age or older, or under the age of 2, or who have chronic medical conditions such as asthma, chronic lung disease, morbid obesity, renal disease, or immunosuppression are at highest risk for severe respiratory illness and should be particularly targeted for vaccination and early antiviral treatment.

Do you have a question for the TMA Flu Fighters? Contact the TMA Knowledge Center with your question at (800) 880-7955 or email knowledge@texmed.org.

CDC provides health alerts and thorough guidance to physicians on antiviral drugs, vaccination, and flu activity, and surveillance.

The Flu Fighters are John Carlo, MD, MS, AIDS Arms, Inc. CEO, Dallas and chair of TMA’s Council on Science and Public Health; Wendy Chung, MD, SM, Dallas County Health and Human Services’ chief epidemiologist and chair of TMA’s Committee on Infectious Diseases (CID); Lisa Cornelius, MD, MPH, infectious diseases, medical officer, Texas Department of State Health Services; Bruno P. Granwehr, MD, MS, The University of Texas MD Anderson Cancer Center, Houston; Gilberto Handal, MD, pediatrics, Texas Tech University Health Science Center, El Paso; Philip P. Huang, MD, MPH, medical director, Austin/Travis County Health and Human Services; Charles J. Lerner, MD, infectious disease consultant to CID, San Antonio; Donald Murphey, MD, medical director, pediatric infectious diseases, Cook Children’s Medical Center, Fort Worth; and Seema Shah, MD, MPH, Department of Medicine, The Methodist Hospital, Houston.


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