Issue
Number 427
November 26, 2003
CONTENTS OF THIS ISSUE
- CDC Health Update warns that the 2003-04
influenza season could be more severe than those in the recent past
- The National Influenza Summit urges the public
to get immunized against influenza this season
- CDC offers clinicians a host of resources for
the current influenza season
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November 26, 2003
CDC HEALTH UPDATE WARNS THAT THE 2003-04 INFLUENZA SEASON COULD BE MORE
SEVERE THAN THOSE IN THE RECENT PAST
On November 21, the Centers for Disease Control and Prevention (CDC) issued
the following official CDC Health Update; it is reprinted below in its
entirety.
****************************
This is an official CDC Health Update
Distributed via Health Alert Network
November 21, 2003 20:10 EST (8:10 PM EST)
UPDATE: INFLUENZA ACTIVITY IN THE UNITED STATES, 2003-04 SEASON
Current surveillance data indicate that the United States is experiencing an
early influenza season that could be more severe than in the past 3 years.
The situation underscores the need for timely immunization of those people
most at risk from serious complications of influenza and the people taking
care of them, especially health-care workers.
The United States and some European countries are experiencing influenza
morbidity earlier than usual. So far, the majority of the influenza viruses
identified in the United States this winter have been type A(H3N2) viruses,
which historically have been associated with relatively severe influenza
epidemics. Of the influenza A(H3N2) viruses from the United States that have
been analyzed at CDC, 78% are similar to the A/Fujian/411/2002 strain, which
evolved or "drifted" from the A/Panama/2007/99 strain present in the current
vaccine, and the remaining 22% are similar to the vaccine strain. The
A/Fujian/411/2002 drift variant was the predominant influenza strain
circulating in Australia and New Zealand during their most recent influenza
season, which was characterized as "moderately severe." These factors could
portend higher morbidity and mortality in the United States during the
2003-04 influenza season.
The influenza vaccine is safe and is the most effective way to prevent the
disease and its complications. Although this year's vaccine contains the
Panama strain of influenza A(H3N2), it is expected to provide some
cross-protection against the Fujian-like viruses that are currently
circulating. The other two virus strains (influenza A[H1N1] and influenza B)
in the vaccine closely match their circulating counterparts.
CDC recommends the following individuals get vaccinated against influenza:
- persons 50 years and older;
- residents of nursing homes and other
long-term care facilities that house persons of any age who have long-term
illnesses;
- adults and children 6 months of age and
older who have chronic heart or lung conditions, including asthma;
- adults and children 6 months of age and
older who need regular medical care or had to be in a hospital because of
metabolic diseases (like diabetes), chronic kidney disease, or weakened
immune system (including immune system problems caused by medicine or by
infection with HIV);
- children and teenagers (6 months to 18
years of age) who are on long-term aspirin therapy and therefore could
develop Reye syndrome after influenza;
- women who will be more than 3 months
pregnant during the influenza season.
In addition, CDC recommends vaccination of
the following groups of people to reduce the risk of spreading influenza to
persons at high risk for complications:
- doctors, nurses, and other employees in
hospitals and doctors' offices, including emergency response workers;
- employees of nursing homes and long-term
care facilities who have contact with patients or residents;
- employees of assisted living and other
residences for people in high-risk groups;
- people who provide home care to those in
high-risk groups;
- household members (including children)
of people in high-risk groups.
- CDC also encourages, when feasible,
vaccination of children aged 6-23 months and their caregivers.
The primary contraindication to influenza
vaccination is allergy to eggs. For more information about influenza, visit
CDC's website at www.cdc.gov
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November 26, 2003
THE NATIONAL INFLUENZA SUMMIT URGES THE PUBLIC TO GET IMMUNIZED AGAINST
INFLUENZA THIS SEASON
On November 25, the National Foundation for Infectious Diseases (NFID)
issued the following press release on behalf of the members of the
National Influenza Summit, a partnership of more than 50 organizations
including the Centers for Disease Control and Prevention (CDC), American
Medical Association (AMA), NFID, and the Immunization Action Coalition.
The press release is the start of a major public health initiative to
encourage health professionals to get immunized against influenza and to
continue immunizing beyond December and January; it is also intended to
persuade the public to seek influenza immunization through December and
beyond.
The press release is reprinted below in its entirety.
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Bethesda, MD
November 25, 2003
NATION'S TOP HEALTH GROUPS ISSUE CRITICAL INFLUENZA MESSAGE: GET
IMMUNIZED THIS SEASON
AMA, CDC, and NFID Join 50+ Organizations to Launch Nationwide
Initiative Urging Influenza Vaccination Before Virus Strikes
Over 50 medical and health organizations today announced a major
national public health initiative aimed at urging everyone who has not
already done so to be immunized against one of the top 10 causes of
death in the United States--influenza. It is particularly important for
those at high risk of complications from influenza to get vaccinated as
soon as possible. Vaccination is the best protection against what the
Centers for Disease Control and Prevention (CDC) warns may be a "more
severe season than in the previous three years."
The CDC, American Medical Association, National Foundation for
Infectious Diseases, and other key partners in the National Influenza
Summit are working together to encourage Americans, and particularly
those at high risk of serious complications from influenza, to get their
flu shot as soon as possible. As part of this initiative, the National
Influenza Summit is also encouraging health care professionals to get
vaccinated and to continue to offer influenza vaccination to patients in
December and beyond.
"Flu viruses are circulating at a higher level than usual at this time
with cases of influenza being reported in communities across the
country," said Julie L. Gerberding, MD, MPH, director of CDC. "We are
urging Americans, particularly those at high risk of complications from
influenza, to get their flu shot as soon as possible. We are concerned
the public has become complacent about influenza, and we need to get the
word out that there is plenty of vaccine available and a flu shot is the
best protection against influenza, which kills about 36,000 Americans
during an average year."
As part of the National Influenza Summit initiative, the nation's
leading medical and health organizations, which include public health
agencies, health professional associations, health insurers, and others,
have committed to implementing a unified communications program with
activities to help ensure immunizers continue to stock the vaccine and
immunize patients.
The campaign is designed to increase public awareness about the
importance of influenza immunization, particularly for everyone aged 50
or older and people of any age who have a chronic illness. Vaccination
is strongly recommended for people who were not immunized during the
optimal vaccination months of October and November. Activities in the
joint campaign will deliver flu shot messages during November, December,
and January.
"We are collaborating on a far-reaching communications program to
encourage people to be vaccinated in December and the remaining months
of this influenza season," said Donald Palmisano, MD, JD, president of
the AMA. "At the same time, we are appealing to health care
professionals to continue their vaccination efforts during this time."
Outreach activities include nationwide television and radio public
service announcements, featuring Tommy Thompson, Secretary of the U.S.
Department of Health and Human Services (HHS), encouraging flu shots for
everyone. Also planned are broadcast news releases, media tours, radio
promotions, and website communications. Organizations involved with the
National Influenza Summit also are considering ways to ensure they
participate in the program and disseminate information to their
constituents and the general public.
Get Vaccinated Sooner Rather Than Later
Multiple factors influence each influenza season, making the impact of
influenza notoriously difficult to predict, according to Dr. Gerberding.
Influenza cases have already been reported in more than 40 states,
including Arizona, Alabama, Colorado, Florida, Louisiana, North Dakota,
South Carolina, Texas, Utah, and Washington.
Public health officials report influenza vaccination activities
typically decline as Thanksgiving approaches, suggesting that immunizers
may stop offering the vaccine and that the general public is unaware of
the CDC's recommendations to continue immunization programs into
December, January, and beyond.
"If you haven't been vaccinated yet, see your doctor as soon as possible
or find out where in your community the vaccine is being offered," said
William Schaffner, MD, NFID board member and professor and chair of the
department of preventive medicine at Vanderbilt University School of
Medicine. "We hope this national awareness program will make sure
everyone knows that you can still get a flu shot in December and into
the winter season if you have not already done so."
Vaccination Appropriate For Most, Recommended For Many
CDC recommends vaccination for anyone who wants to avoid influenza and
especially for groups considered at high risk of influenza-related
complications. CDC's list of groups at risk for complications if they
get the flu includes adults aged 65 and older; anyone with a chronic
health problem such as heart or lung disease, asthma, diabetes, cancer,
or HIV/AIDS; and pregnant women past their first trimester. Vaccination
is recommended for those aged 50 to 64 and encouraged for healthy
children 6 to 23 months of age and their caregivers. These young
children are at as great a risk for being hospitalized due to
flu-related complications as persons 65 years of age and older, a group
already targeted for annual flu vaccinations. Health care workers and
others who have close contact with people at high risk also should be
vaccinated to reduce the odds of passing influenza to someone for whom
it can be life threatening.
According to CDC, it takes 10 to 14 days after vaccination for the body
to develop protection against influenza. Individuals with egg allergies
or those who have had a previous vaccine-associated allergic reaction
should talk with their health care providers before getting the vaccine.
Persons with acute febrile illnesses (high fever) should usually wait
until symptoms subside. However, flu shots may be given in the presence
of minor illnesses, with or without fever, particularly among children
with mild upper respiratory tract infections or hay fever.
An alternative vaccine option available to healthy persons is the
intranasal spray also known as "live-attenuated influenza vaccine" or "LAIV."
The intranasal vaccine is approved for use in healthy persons aged 5 to
49 years to prevent influenza A and B. While LAIV can be used in healthy
people aged 5 to 49 years, the injectable inactivated influenza vaccine
can be used for anyone, healthy or high-risk, 6 months of age and older.
CDC estimates that vaccine manufacturers will produce sufficient vaccine
this season so all persons wishing to avoid influenza, regardless of age
or health status, can be vaccinated.
National Influenza Summit Participants
The National Influenza Summit is comprised of more than 50
organizations, including AMA, CDC, NFID and other partners with an
interest in issues related to influenza vaccine research, production,
distribution, and vaccine administration. Participants in the National
Influenza Summit advise on and respond to issues of influenza
vaccination throughout the year. For a complete list of the National
Influenza Summit partners, visit the AMA website at
http://www.ama-assn.org/ama/pub/article/1826-7688.html
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To access the press release, go to:
http://www.ama-assn.org/ama1/pub/upload/mm/36/flu_late_season_rele.doc
CDC has created an influenza immunization toolkit to help physician and
other health care professionals provide influenza vaccination to their
patients and the public. The AMA is working with the CDC to help
distribute the toolkit. To access the toolkit from the AMA website, go
to:
http://www.ama-assn.org/ama/pub/category/11733.html
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November 26, 2003
CDC OFFERS CLINICIANS A HOST OF RESOURCES FOR THE CURRENT INFLUENZA
SEASON
On November 21, National Immunization Program, Centers for Disease
Control and Prevention (CDC) sent the Immunization Action Coalition a
list of influenza and SARS [Severe Acute Respiratory Syndrome] resources
for clinicians available on the CDC website. Following are links to
CDC's clinician resources.
INFLUENZA RESOURCES FOR PROVIDERS
The primary link is to Flu Information for Healthcare Providers:
http://www.cdc.gov/nip/Flu/provider.htm This web page includes
links to pages discussing virtually all aspects of influenza vaccination
of concern to clinicians, including the following:
1. Flu Information for Healthcare Providers
* Qs & As for FluMist (posted Oct. 28):
http://www.cdc.gov/ncidod/diseases/flu/laiv.htm
* No Recalled Influenza Vaccine (a press release posted Oct. 17):
http://www.cdc.gov/od/oc/media/pressrel/r031017a.htm
* Materials for Immunize Now provider kit (posted Oct. 8):
http://www.cdc.gov/nip/Flu/providerkit.htm
2. Recent Changes to Flu VIS and Flu Dosage
Chart (posted Sept. 23):
http://www.cdc.gov/nip/Flu/provider.htm#changes
* Vaccine Information Statement for trivalent
inactivated influenza vaccine (TIV):
http://www.cdc.gov/nip/flu/pubs_04/vis_flushot03_pt.pdf
* Vaccine Information Statement for live activated influenza vaccine (LAIV):
http://www.cdc.gov/nip/publications/VIS/vis-flulive.pdf
* Changes to the influenza VIS:
http://www.cdc.gov/nip/publications/VIS/flunote.htm
* Influenza vaccine dosage chart:
http://www.cdc.gov/nip/Flu/gallery.htm#chart
3. Webcast for Immunization Update 2003 (new
as of Sept. 12):
http://www.phppo.cdc.gov/PHTN/Imm-up2003/default.asp
4. Vaccine Supply, Storage, and Handling (updated Sept. 26):
http://www.cdc.gov/nip/Flu/provider.htm#Supply
5. Safety of Thimerosal-Containing Flu Vaccine:
http://www.cdc.gov/nip/Flu/provider.htm#thimerosal
6. Influenza Prevention and Management (revised Sept. 25):
http://www.cdc.gov/nip/Flu/provider.htm#Treatment
7. ACIP Recommendations for 2003-04 Flu Season:
http://www.cdc.gov/nip/Flu/acip03-04_recs.htm
8. Flu Vaccine and SARS (updated Oct. 3):
http://www.cdc.gov/nip/Flu/provider.htm#sars
9. CDC Flu Surveillance:
http://www.cdc.gov/nip/Flu/provider.htm#watcher
10. State Flu Contingency Plans:
http://www.cdc.gov/nip/Flu/provider.htm#Contingency
11. Flu Shot to Be Recommended for Children 6-23 Months (new Nov. 18; exit
CDC site):
http://www2.efamilypracticenews.com/scripts/om.dll/serve?article=aqf030332201
12. Quick Qs & As for Influenza (new; exit site):
http://www.immunize.org/nslt.d/n28/exprt28.htm#influenza
13. Why Patients with Asthma Need Flu Vaccine (posted Oct. 31):
http://www.cdc.gov/nceh/airpollution/asthma/flushot.htm
14. National Center for Infectious Diseases (NCID) Influenza Information for
Healthcare Providers:
http://www.cdc.gov/ncidod/diseases/flu/hc_providers.htm
15. NCID Flu Site:
http://www.cdc.gov/ncidod/diseases/flu/fluvirus.htm
16. 2003-04 MMWRs for Influenza (updated Oct. 30):
http://www.cdc.gov/nip/Flu/News.htm#Reports
* ACIP recommendations for FluMist vaccine:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5213a1.htm
* FluMist Storage and Handling:
http://www.cdc.gov/nip/Flu/acip03-04_recs.htm#laivspec
* Racial & Ethnic Disparities in Influenza Vaccination:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5240a3.htm
17. Research that Works for YOU:
Communicating about Immunization:
http://www.cdc.gov/nip/Flu/flu_qualresearch.htm
18. Change to Inactivated Influenza Vaccine VIS:
http://www.cdc.gov/nip/publications/VIS/flunote.htm
19. Gallery of Influenza Patient Education Materials:
http://www.cdc.gov/nip/Flu/gallery.htm
SARS RESOURCES FOR PROVIDERS
1. This is CDC's SARS home page with links to the latest clinician,
laboratory, and other SARS information on the CDC website:
http://www.cdc.gov/ncidod/sars
2. This is the principal CDC website for clinician information on SARS:
http://www.cdc.gov/ncidod/sars/clinicians.htm |
