Martha Roby: Preventative actions to take during flu season
Congresswoman Martha Roby discusses the risks of the coronavirus outbreak and the benefits of flu prevention.
Auburn pharmacy researcher recommends antivirals as key defense this flu season
By: Matt Crouch | Auburn University’s Harrison School of Pharmacy The Centers for Disease Control and Prevention reports the flu is “widespread” across the United States with 48 states reporting widespread activity. With this year’s strain having such an impact, Dr. Marilyn Bulloch, a clinical faculty member in Auburn University’s Harrison School of Pharmacy, suggests the use of antivirals in prevention and treatment. Both the influenza A and influenza B viruses are prominent this year with nearly 15,000 flu-related hospitalizations since October. Vaccines are available through pharmacists and physicians and have shown some resistance to this year’s strain. According to Bulloch, antivirals have shown to be an effective complement to the flu vaccine. “Anyone who is diagnosed with the flu and does not have a reason to not seek therapy can receive antivirals,” said Bulloch. “Studies have shown that they decrease symptoms by several days. This season, the virus has been particularly virulent, and a few days without symptoms such as fever, gastrointestinal upset and muscle aches may help reduce complications of the flu such as hospitalizations.” Current options include Tamiflu (oseltamivir) which is available orally and Relenza (zanamivir), which is an inhalation product that comes as a Diskhaler. For children, Zanamivir is approved for treatment in those over seven and prevention in children over five. Oseltamivir is historically the most common antiviral and can be used for treatment at any age over two-weeks old and for the prevention of influenza in patients over three months of age. There is a one-dose IV product available but it is unknown how many hospitals and urgent care centers have it available. Only Tamiflu is recommended for patients who are hospitalized. There are certain populations that antivirals are strongly recommended this flu season. They include: children over two and adults over 65, those with compromised immune systems, children on long-term aspirin therapy, pregnant women and women who gave birth less than two weeks before influenza diagnosis, American Indians and obese patients with a BMI over 40. Treatment is recommended for patients with certain chronic conditions involving the lung, heart, kidney or liver; those with diabetes, sickle cell, seizures or a history of stroke should also seek antiviral treatment. While it is highly suggested for those populations, anyone with a chronic medical treatment should discuss with their physician the benefit and need for antiviral treatment. “Treatment is most effective when it is started soon after symptom developed, ideally within 48 hours. However, there is some data suggesting patients may still benefit even if treatment is delayed as long as 72 hours after symptom development,” said Bulloch. “Antivirals are recommended for anyone with a severe case of influenza, whose illness is complicated by other issues such as pneumonia, and for those whose influenza does not start to resolve with time.” The good news for those who may come into contact with the flu is that resistance to the medications used to treat it has been almost non-existent this season. While treatments have been effective, prevention is still key and those susceptible to the flu should be prepared. “People who are exposed to those with diagnosed influenza, including household contacts, should strongly consider getting antivirals for the prevention of influenza rather than waiting to become infected,” said Bulloch. For more information on the flu this season, visit www.cdc.gov/flu/. Republished with permission from Auburn University.
State Health Dept. investigates 100 possible flu-related deaths
This season’s aggressive strain of the flu virus has already claimed several lives in Alabama. The Alabama Department of Public Health (ADPH) released updated numbers on Wednesday confirming that influenza has already taken the lives of two children and seven adults, with an additional 98 adult cases under investigation. The flu is a contagious respiratory illness, spread by a virus. The Centers for Disease Control and Prevention (CDC) is reporting this to be the worst influenza season in over a decade. “In severe seasons in the past over 700,000 people have been hospitalized and 56,000 people died from influenza. We may be on track to reach or even exceed those records,” said Anne Schuchat, CDC acting director. Flu season typically runs from October to May, typically peaking in February. Symptoms include sudden onset of fever, headache, extreme fatigue, dry cough, sore throat, runny or stuffy nose, and muscle aches. Children may also have nausea, vomiting and diarrhea. Although most people who get the flu recover in a few days to two weeks, some develop complications like pneumonia that can be life-threatening, the CDC said. Those at highest risk include people 65 and older, people with chronic medical conditions such as asthma, diabetes, or heart disease, pregnant women, and the very young. ADPH said its still not too late to get the flu shot. The chart above indicates ILI activity is still increasing through much of Alabama. [Photo Credit: ADPH]
Southern Research programs aim to shield against pandemic flu dangers
With experts predicting another deadly influenza pandemic in the future, Southern Research scientists are working on several fronts to help limit the death toll from a catastrophic flu outbreak that one day slams the nation. Birmingham-based Southern Research conducts tests on emerging pandemic strains and participates in strategic government vaccine programs focusing on highly pathogenic avian influenza (HPAI) strains that pose potentially grave public health risks. In addition, Southern Research has performed toxicology studies for flu vaccine platforms and provided pre-clinical studies on vaccine candidates, along with clinical trial support for vaccine makers. The nonprofit organization has also researched antiviral treatment approaches that could protect people after infection. “Scientists will tell you it’s not if, it’s when we have a pandemic. That’s the way the flu virus works,” said Landon Westfall, Ph.D., a senior project manager and infectious disease scientist at Southern Research. “It’s like the San Andreas fault – the big one is coming one day. The idea is since we can’t prevent it, we should prepare for it. That’s the goal.” Pandemic influenza strains pose a much greater threat than even the nastiest strains of seasonal flu. The dominant seasonal strain this year, H3N2*, fits that description, causing an above-average rate of hospitalizations and prompting Alabama to declare a public health emergency. The current flu season’s misery is worsened because the available vaccine is only moderately effective. “That’s the challenge with flu. Vaccines don’t always work,” Westfall said. “Most of the time, they protect 55 to 60 percent of the population. That’s kind of the goal of influenza vaccines. But there will always be subsets of the population that won’t be protected.” Elevated dangers Novel avian or swine flu strains, however, have the potential to cause lethal damage on a global scale. Because these dreaded strains are new, very few people have immunity against them, so they can spread widely and rapidly, sickening a large segment of the population, Westfall said. When pandemics emerge, more than half of an affected population can be infected in a single year, while the number of deaths stemming from the flu outbreak can sharply exceed normal levels. The goal is to prevent a global calamity like the 1918 Spanish flu pandemic, which killed more than 50 million people, and outbreaks in 1957 and 1968 that each killed at least 1 million people worldwide. The last pandemic, the 2009 H1N1 swine flu outbreak, killed as many as 575,000 people. More information on pandemics.That’s why the work being conducted by Southern Research and other organizations as part of the U.S. government’s influenza preparedness programs is critically important, Westfall said. For more than a decade, pandemic fears have centered on the highly lethal H5N1 avian influenza, despite the fact that the so-called “bird flu” virus does not infect humans easily. If a mutated form of the H5N1 virus became easily transmissible from person to person while retaining its severe effects, the public health consequences could be very serious, the World Health Organization warns. “For the most part, avian influenza affects birds. When the virus makes a jump from one species to another, say from bird to human, that’s a big thing,” said Westfall, who oversees the influenza virology program for Southern Research’s Drug Development division. “That’s a rapid evolution for a virus that will likely cause major problems. In cases where the avian flu has infected humans, the mortality rate has been around 60 percent.” Southern Research scientists have worked on influenza projects for government agencies including the National Institutes of Health, the National Institute of Allergy and Infectious Diseases, and the Biomedical Advanced Research and Development Authority. The organization has also worked with a number of commercial clients. “We’re recognized as one of the leading supporters for clinical vaccine research, especially for flu,” Westfall said. “That is partly because of our history in the field but also because of our capabilities to test a large volume of samples in a relatively short time.” The next pandemic Although most experts believe another influenza pandemic is inevitable, Westfall said it is impossible to predict when or where it will occur, or how severe its impact will be. It’s almost impossible to predict with certainty the subtype of influenza virus most likely to cause the next worldwide outbreak. While the Centers for Disease Control and Prevention says the risk of H7N9 is currently low because human-to-human transmission is rare, the CDC still rates the strain as having the greatest potential to cause a pandemic.Late in 2017, scientists reported that a new strain of H7N9 avian flu circulating in China showed the ability to transmit easily among animals with highly lethal results, raising alarm about its potential to trigger a global human pandemic. Westfall said the evolving nature of influenza viruses presents tough challenges to the research community. “Flu is like a malleable pathogen that can change from week to week, from month to month, and from region to region,” he said. “Every person who gets infected with the flu basically creates a small change in that virus that’s then passed on to multiple people. Flu constantly changes that way.” *In the designation of influenza subtypes, the H refers to hemagglutinin, a protein found on the surface of flu viruses, while the N refers to viral neuraminidase, another protein present on the surface of the virus. This story originally appeared on the Southern Research website. Republished with permission from the Alabama NewsCenter.
Kay Ivey declares State of Emergency due to widespread flu outbreak
The past month has seen an explosion of influenza (flu) cases across Alabama leading Gov. Kay Ivey to declare a State Public Health Emergency on Thursday. According to the Alabama Department of Public Health (ADPH) Alabama is experiencing widespread flu activity, and hospitals are at or over normal patient capacity due in large part to the number of patients presenting with seasonal influenza-like symptoms. Emergency departments and outpatient clinics are also seeing very high volumes of patients.At this time, this is not a pandemic flu situation, but a major seasonal flu situation. According to the governor’s proclamation, healthcare facilities in the state are overwhelmed by the number of patients with the flu and are taxed to such an extent that care of patients may now no longer be provided in the traditional, normal, and customary manner nor is the utilization of traditional, normal, and customary standards of care possible. The emergency declaration allows those facilities to implement “alternative standards of care” plans. ADPH says alternative standards of care allow medical personnel to both streamline and simplify the support process to preserve lives. The proclamation also states the State of Emergency is to remain in effect until it is rescinded by the governor. Ivey’s declaration follows the Centers for Disease Control and Prevention (CDC) saying the 2018 flu season is expected to be one of the worst in recent years. Widespread cases have been reported in 46 states, including Alabama. According to the CDC, the flu has already resulted in the deaths of over 100 individuals, at least 13 of which were children, since it began in October. To avoid getting and spreading the flu, the ADPH urges the general public to follow “Do 10 – Fight the Flu” actions: Get vaccinated Wash your hands Cover your coughs and sneezes Stay home with fever Stockpile supplies Clean and disinfect Know your office emergency plan Learn home care Call your doctor if symptoms get worse Stay informed Flu can cause mild to severe illness, and at times can lead to death. The flu is different from a cold. The flu usually comes on suddenly. People who have the flu often feel some or all of these symptoms: Fever or feeling feverish/chills Cough Sore throat Runny or stuffy nose Muscle or body aches Headaches Fatigue (tiredness) Some people may have vomiting and diarrhea, although this is more common in children than adults. If you are able to contact your doctor within 48 hours of onset of symptoms, you can potentially be administered an antiviral drug which will reduce the severity of symptoms in addition to the length of the illness.
Health department recommends Alabamians get a flu shot
Health officials are urging Alabama residents to get the flu shot as flu cases are on the rise. Across the country, flu season is beginning to peak and is widespread in a whopping 43 states, including the Yellowhammer State. With more than 14,000 cases reported nationwide each week, the Alabama Department of Public Health (ADPH) is reminding Alabamians that influenza vaccine is the most important preventive measure against the flu. Flu symptoms include: 100.1 degree Fahrenheit or higher fever Cough and/or sore throat Runny or stuffy nose Headaches and/or body aches Chills Fatigue The ADPH said Thursday the state is experiencing a spike in influenza-like illnesses this winter, and that vaccines can lower the chances of catching the flu by more than 60 percent. Immunity usually follows roughly 7 to 10 days after immunization. “It is not too late to vaccinate for flu and reduce the risk of illness,” said Dr. Karen Landers of the ADPH. “In addition, it is important that people wash hands, cover coughs, and stay home when they have influenza-like illnesses.” On average each year, flu kills 36,000 and hospitalizes 200,000 in the U.S.
