Jan 16, 2013 (CIDRAP News) – Despite the early start to the flu season and widespread activity in most states, no unusual disease patterns have emerged among children, the US Centers for Disease Control and Prevention (CDC) said yesterday.
In a separate update, the agency said that, in spite of spot shortages, most providers still have flu vaccine doses to administer.
In an update targeted to pediatricians, the CDC said that as of Jan 5 hospitalization rates for children are high compared with last year's mild season but are well below levels seen during the 2009 H1N1 pandemic and within the expected range for a moderate to moderately severe flu season.
For children ages 0 through 4, the hospitalization rate was 22.4 per 100,000, and for kids ages 5 through 17 the level was 4.8 per 100,000, the CDC said. For comparison, the hospitalization rate during the entire 2011-12 flu season was 14.2 per 100,000 in the younger group and 4.2 per 100,000 in the older group of kids.
The most commonly reported underlying medical conditions in kids who have been hospitalized for flu this season have been asthma, neurologic disorders, and immune suppression, the CDC said.
The 20 reports of flu-related pediatric deaths will likely increase, because flu activity in the United States will likely continue for several more weeks and fit a pattern seen during two seasons—2003-04 and 2007-08—that showed similar flu patterns. Pediatric flu deaths reached 153 and 88, respectively, for those seasons.
An early clinical profile of kids who died from flu this year is similar to that seen in previous years, with 55% having underlying medical conditions, most younger than 12, and about 80% not vaccinated against flu, the CDC reported.
The CDC told pediatricians that its recommendations for preventing and treating flu haven't changed, though it warned them about spot shortages of oseltamivir (Tamiflu) pediatric suspension. It it's not available, however, it can be compounded by pharmacists from 75-mg adults capsules based on previously published instructions from Roche, the drug maker, and the US Food and Drug Administration.
In an update for pharmacists, the CDC said that although some providers are out of flu vaccine, most still have doses, according to the results of a National Influenza Vaccine Summit survey that was conducted from Jan 10 to Jan 14. Vaccine manufacturers have produced 145 million doses of flu vaccine, and, as of Jan 4, 128 million had been distributed.
Two large US pharmacy chains, CVS and Rite Aid, are experiencing vaccine shortages due to increased demand, Bloomberg News reported yesterday. A spokesman from CVS told Bloomberg that the chain is working to resupply its pharmacies and clinics. Meanwhile, a Rite Aid spokeswoman said the company is moving supplies to address shortages, according to the report.
Last week representatives from flu vaccine makers Novartis and MedImmune said the companies are watching the situation. Novartis said it has completed Fluvirin shipments for the US market and that distributors may have available doses, and MedImmune said though the company had met all of its FluMist orders, it had additional doses in reserve.
A spokesman from GlaxoSmithKline told Bloomberg that it was shipping the last of its stock, doesn't have additional supplies, and hasn't received any requests to make more.
The CDC said it is not recommending that health providers prioritize remaining flu vaccine doses. The universal recommendation remains in place for all people age 6 months and older, but the CDC said it is especially important that people at risk for flu complications be vaccinated, including pregnant women, young children, adults older than 65, and people with underlying medical conditions.
It urged providers who are looking to order more vaccine to visit the Influenza Vaccine Availability Tracking System (IVATS) system Web site to locate distributors and manufacturers that have vaccine for sale. The CDC also recommended that health providers who are out of flu vaccine to refer patients to the HealthMap Vaccine Finder Web site and to connect with others in the area, including public health departments, to identify where to refer patients.
See also:
Jan 15 CDC flu update for pediatricians
Jan 15 CDC flu update for pharmacists
CDC 2011-12 flu season Q and A
Jan 15 Bloomberg News story
IVATS Web site
HealthMap Vaccine Finder
Jan 11 CIDRAP New story "US flu activity shifts west as some national markers drop"
