Thursday, January 17, 2013

Influenza activity continues to be widespread, heightened in MN

Minnesota continues to experience vigorous, widespread influenza activity, with high levels of hospitalizations and deaths reported. The Minnesota Department of Health (MDH) updated its Weekly Influenza Activity summary ( on its website today. Some important points to note about the current situation:

To date, MDH has received reports of 1,842 hospitalizations due to influenza-like illness and has confirmed 60 deaths due to influenza or complications from influenza.

These numbers are current for reports received as of the week ending Jan. 12.

By comparison, Minnesota recorded 285 hospitalizations for influenza-like illness in all of 2008-09; 965 in ’10-’11 and 552 in ’11-12. In the pandemic year of 2009-10, there were 1,824 hospitalizations.

Influenza can cause a viral pneumonia, and influenza can be a gateway for secondary infections such as a bacterial infection including bacterial pneumonia. In addition people with certain medical conditions can have a worsening of their condition when they are ill with influenza.

One of the reasons why we are seeing more influenza this year may be because one of the predominant circulating strains is the H3N2 strain of the virus. In years in which H3N2 is the predominant strain, we typically see more severe cases of illness, particularly in the very young and the elderly, and more cases overall.

The south central, central and metro areas of the state continue to have the highest levels of activity. While this is challenging their resources, they appear to be managing well.

Regional health care coalitions continue to monitor hospital bed count and resource needs. This public/private partnership between public health, hospitals, clinics and local business partners continues to play a critical role in the success of Minnesota’s response to influenza.

In the coming week, we expect to continue to see reports of hospitalizations and deaths from influenza, however the rate of reports to the department seems to be slowing somewhat, but we can’t say for certain whether cases have peaked or not until we see and evaluate two more weeks of data.

The past several influenza seasons [since 2008 and excluding the pandemic] have been mild so many Minnesota residents may not be accustomed to seeing higher levels of seasonal influenza activity. The amount and severity of influenza varies from season to season; we are having a severe seasonal influenza year, which happens every so often.

Recommendations for individuals

Vaccine availability

We are still encouraging people to be vaccinated. It is not too late to get vaccinated. Our goal is to use all doses of vaccine available.

Vaccine is still available from the Minnesota Vaccines for Children (MnVFC) program for those with federal (Medicaid) insurance and vaccine distributors still have vaccine for sale for those that are privately insured. The majority of clinics that we are speaking to have adequate vaccine. This is a changing situation and we are in contact with partners and are continually assessing the situation.

It is possible that some providers may have exhausted their supply at this point in the season; you may need to check with a few clinics to find vaccine. Based on the information we have available, it should be possible to find a provider who has vaccine available. We strongly advise people to keep looking. The MDH flu clinic locator may be helpful for this.

To find the location of a flu clinic near you, visit

If you are going to a retail store pharmacy site be sure to check about age groups being served. Not all pharmacies serve persons under age 18 years.

Because people with medical conditions or the elderly, who are at high risk for influenza complications may not have the best immune response to the vaccine, it is important that those around them are vaccinated.

Many of our deaths are occurring in the elderly – over 66 percent were in those over age 80 – so it is very important that those who live, visit or work around the elderly, particularly health care workers and long-term care workers, are vaccinated.

While the vaccine doesn’t offer perfect protection, it is still the best tool we have for preventing influenza and its complications. If you don’t get it, you don’t have protection.

The CDC recently released a report that estimated 60% effectiveness for this year’s flu vaccine against medically attended influenza. This is a preliminary estimate.

Given this level of efficacy, some vaccinated persons will become ill with influenza. Therefore, antivirals should be used as recommended for at risk patients regardless of their vaccination status.

Antivirals continue to be available. Pediatric suspensions are the only formulation for which FDA is reporting intermittent shortages. Pharmacists can compound their own pediatric formulations.

What else you can do

Most people can fight the flu at home with rest and fluids. If you or your child develop concerning symptoms, call your health care provider. If you are at risk for becoming very ill from influenza, call your health care provider as soon as symptoms of flu illness develop – they will determine whether influenza testing and possible treatment are needed.

New guidance for the public is available: “When to Get Medical Help for Flu Symptoms” provides general guidance for persons experiencing flu symptoms and when to seek medical attention.

MDH and the CDC recommend that everyone get vaccinated for influenza, but especially those at high risk for complications from influenza. Those include:

Children younger than 5, but especially children younger than 2 years old.

Adults 65 years of age and older (

Pregnant women (

American Indians and Alaskan Natives seem to be at higher risk of flu complications.

People who have medical conditions such as asthma, diabetes, heart disease, neurological disease, kidney and liver disorders and others. For a list, see CDC’s website:

During flu season, besides getting vaccinated, there are other steps people can take to avoid spreading or catching influenza:

Do your best to stay healthy. Get plenty of rest, physical activity and healthy eating.

Stay home from school or work if you have a respiratory infection. Avoid exposing yourself to others who are sick with flu-like illness.

Cover your nose and mouth with a tissue whenever you cough or sneeze, then throw the tissue away. If you don't have a tissue, cough or sneeze into your sleeve.

Clean surfaces you touch frequently, such as doorknobs, water faucets, refrigerator handles and telephones.

Wash your hands often with soap and water or with an alcohol-based hand sanitizer when soap and water are not available.

Symptoms, treatment, etc.

The symptoms of influenza, which tend to come on suddenly, can include a sore throat, coughing, fever, headache, muscle aches and fatigue. People who become severely ill with influenza-like symptoms should see a physician.

Influenza is caused by a virus and antibiotics which are used against bacteria are not effective against it. Antivirals such as oseltamivir and zanamivir can be used against influenza.

More information on influenza can be found at