Tag Archives: arizona influenza

We’ve Got It!

germ-158107_640Well….we think we’ve got it!  Just like Brophy in HIGH ANXIETY, the Mel Brooks Classic.

We think we’ve got the right flu shot mix this year.

Last year, due to poor selection of the viruses in the flu shot, we saw only a 20% effectiveness rating for last year preventive, compared to a 60-80% effectiveness rating for most years.  This year, to correct that error, new flu strains have been chosen,  Which ones are in this year’s flu vaccine?

Trivalent vaccines will include A/California/7/2009 (H1N1)-like virus, an A/Switzerland/9715293/2013 (H3N2)-like virus, and a B/Phuket/3073/2013-like (Yamagata lineage) virus. These A (H3N2) and B viruses are different from the previous season. 

So…we are expecting a much more effective flu shot this year, and we will begin, as usual, in early October.   It’s OK to get the shot end of September if you like…and we will announce our flu clinic as we get our shipment, so keep your eyes pealed for information.

Read more on the flu vaccine here

 

FLU VACCINE HAS HOLE IN IT

dreamstime_l_20046833The flu vaccine this year is a rather poor match for the current strain circulating in the U.S. this year, making the flu shot less effective.  The H3 strain of flu this year is different than the one in the vaccine provided for the 2014-2015 flu season.

If you have had the flu shot, then do be aware that if you develop the flu your shot will help reduce symptoms but probably it will not help ‘prevent’ the infection.  As a result, if you have severe symptoms of fever, aches, and cough, and have underlying health issues like diabetes, emphysema, or asthma, then you should call or come in to get the TAMIFLU pill.

Do not fret….most of us handle a flu infection without complications, but armed with knowledge we can make better decisions in getting treatment when we need.

Read more >>>>> HERE

 

FLU SHOT WITHOUT EGGS….THEY CAN BE FOUND

virus puzzleThe flu vaccine has a long history of production in chicken eggs and as a result, patients who have reported egg allergies are told to avoid the influenza vaccine.

That issue has been resolved with the development of a genetically engineered flu vaccine that does not use eggs in it’s production.

FLUBLOK is that flu vaccine, but there are several things to know before you get this particular vaccine:

1.  It is approved for ages 18-49 only (although I presume it is safe in older age groups, there is no official approval and it has not been tested)

2.  It is difficult to find….  but there are locations for it and you can find them  >>>>>HERE.

3.  Despite the reported egg allergy, nearly all people can take the standard flu vaccine that contains eggs in it.  The Center for Disease Control has an algorithm for determining which flu shot to take….

RIV3=FLUBLOCK

IIV=STANDARD FLU VACCINE WHICH CONTAINS EGG

IIThe figure above is a flow chart detailing recommendations regarding influenza vaccination of persons who report allergy to eggs in the United States for the 2014-15 influenza season. Persons with a history of egg allergy who have experienced only hives after exposure to egg should receive influenza vaccine. Because relatively few data are available for use of live attenuated influenza vaccine in this setting, inactivated influenza vaccines (IIV), or trivalent recombinant influenza vaccine (RIV3) should be used. RIV3 may be used for persons aged 18 through 49 years who have no other contraindications. However, IIV (egg- or cell-culture based) may also be used, with certain additional safety measures.

MONITORING THE FLU SEASON

dreamstime_l_20046833There is lots of information available on the flu in Arizona and around the country, and if you are on-line a lot, like I am , it’s easy to avail yourself of this information.

First, I recommend our Twitter Feed and look for the BUGS IN TOWN report…that reports what we are seeing in the office and what the status of flu is in Arizona.  You can find that information on TWITTER WITH DOCTOR LAKIN or on the ROTATING SCREEN on the front page of the website.

Additional and more formal information is availble at these sites:

ARIZONA INFLUENZA

CENTERS FOR DISEASE CONTROL INFLUENZA REPORT

Keep up to date on what’s happening with the flu in AZ and the US and you’ll be better prepared.

A PATIENT ASKS…WHICH FLU SHOT TO GET? OVER 65 IT’S THE HIGH DOSE, TRIVALENT

BOOK ON HEALTHDr Lakin,

I read about new types of flu shots.  What do you recommend for me?

Ivy

 

Dear Ivy;

It used to be simple to get the flu shot…there was only one type and everyone was to get the same one.  Now, there are multiple options and it’s a bit confusing, so I’d like to give some clarification.

There are a few options out there, but generally, you will get what is available at the office or pharmacy that you go to.  For instance, our office will have the trivalent low and high dose only.  We will not have any of the other special vaccines, for logistical reasons.

So….first….let me go through the options and availability.  I’ll start with the most important that….the ones that apply to most people in my practice:

Low Dose (standard…OK) vs. High Dose (recommended):  The higher dose flu shot has become available in the past few years and provides a stronger immune reaction.  It is thought this will provide better protection, but there is no definitive proof.

It has been proven as safe as the standard flu shot in two seasons of widespread use.

Trivalent (3 flu strains…standard….recommended) vs. Quadrivalent (4 flu strains):   All flu shots contain the same virus protection, as it is based on national recommendations from the government bodies in charge of this issue.  Trivalent contains 2 Type A flu strains + 1 Type B.  Quadrivalent contains 2 Type A flu straines + 2 Type B.

Since Type B is a minority of the flu we see, and since this is a new vaccine, I would recommend passing on this shot until it has been used for a few seasons and proven safe and effective.  Then I may change my mind.

Live vs. Inactivated/Dead virus (recommended):   The live virus (weakened) is available as a nose spray only and is for people 2-49 years old.  This does not apply, in general, to our patient base.  They are equally effective, although perhaps the nose spray is better for children…but that is unclear.

Egg based (recommended) vs. Non-Egg based:  If you do not have an egg allergy of note (and most people who claim to have an egg allergy do not) then there is no advantage to the non-egg based flu shots.  That said, these are a great advance in the technology of flu immunization production and may become more common in the future.  Again, they are new and I would like to see them available for a few seasons before generally considering them.  For egg allergic patients who want the flu shot, this is a great option that was not formerly available.

Intramuscular (recommended) vs. Intradermal:  There are flu shots that can be given with a very tiny needle, like a bee stinger, just under the skin.  These flu shots are just as good as the standard one with the longer needle and will soon become standard, but they are not currently generally available.  In the next few years these will be the flu shot of choice.

So, rather than confuse the issue, this year I am recommending for those over 65 the HIGH DOSE, TRIVALENT VACCINE, but we do have the STANDARD DOSE, TRIVALENT VACCINE as well.  Either is fine.

As for the specialty vaccines, I would ask your local pharmacy if they have them available for special circumstances that may apply to you.

 

 

I recommend for all adults over 65:

Trivalen

FLU UPDATE….ACTIVE, BUT WANING

virus greensThe influenza outbreak this year has been heavy the past few weeks, with the largest group of sick patients we’ve seen in a few years, at least at one point in time.  The good news, is that it appears to be waning.  That is what we’ve seen in the office, and that is what is suggested by the data.

Fortunately, in the Southwest, the flu has been relatively mild in it’s intensity, with most patients feeling poorly, but very few requiring the hospital.  In fact, we’ve had ZERO patients sent to the hospital for pneumonia from the flu this year, at least from our offices…and that is rather unusual and mild.

So, be aware that the flu is around, but be emboldened by the fact that it is waning.   If you get a cough and fever, call for the Tamiflu or Relenza inhaler

See me about the flu this year in the Southwest as indicated by this interesting, interactive graph:

http://www.nejm.org/doi/full/10.1056/NEJMp1300375?query=featured_home

 

THE FLU IS HERE….SO NOW WHAT?

The flu is widespread throughout the country and in Arizona.

http://www.cdc.gov/flu/weekly/usmap.htm

 

In the past two weeks we have seen more flu, in one compressed timeframe, than at any other time in my career.

The said, the flu is milder than in years past.  We have sent ‘ZERO’ people from the office, to the hospital with pneumonia, which suggests to me that this is flu is less virulent than in previous seasons and that the flu shot this year was quite effective.

Many people who had the flu shot are still getting the flu this year, it is just much milder than it would have otherwise been.  This is logical, as the flu shot this year has been confirmed as being made up of the subtypes of flu that are prevalent.

At this point, if you have not had the flu shot, it is a coin-toss whether you get the flu shot now.  By the time  it becomes active in your immune system, the flu season will have peaked, that is for certain.  Whether the season will drag on, or not, is anybody’s guess.

See these graphs to compare this season to the last two and you will see the current one is not extraordinary, despite what the popular media would have you believe.virus blue

http://www.azdhs.gov/phs/oids/epi/flu/pdf/2012-2013/influenza-2012-13-week1.pdf

 

If you do get the flu now (cough, fever or no fever, aches, sore throat)….you can benefit form the TAMIFLU or RELENZA, the two anti-viral medications that will shorten the flu episode.

So….know what’s out there and know that all is going to be fine.  Get your flu treatment if you get sick at this point, but not to worry.

AND SO IT BEGINS…….

Based on the latest flu data reports from the state, Arizona is beginning it’s flu season.

It is starting slowly, but currently resembles the 2010-2011 season, which peaked in February.

We know that this year’s flu shot is ‘right on’ and will cover much of the flu-strain that is out in the community, so I anticipate a subdued flu season this year.  That said, we can never know, so keep apprised of  the latest by viewing:
1.  This Blog

2.  The Bugs In Town viewer on the rotating screen (front page of www.Doctordoug.com)

3.  Getting our Twitter feed         https://twitter.com/DoctorLakin

Read more here:

http://www.azdhs.gov/phs/oids/epi/flu/