Flu surge triggers Boston public health emergency

Jan 9, 2013 (CIDRAP News) – Signs of an increasingly severe flu season prompted city officials to declare a public health emergency in Boston, where infections have increased tenfold compared with last season.

So far about 700 cases and four deaths have been reported in Boston, which is experiencing its worst flu season since the 2009 H1N1 pandemic, according to a statement from Mayor Thomas Menino, who urged the city's residents to take the flu threat seriously.

"This is not only a health concern, but also an economic concern for families, and I'm urging residents to get vaccinated if they haven't already," he said. "It's the best thing you can do to protect yourself and your family. If you're sick, please stay home from work or school."

Among flu infections reported in Boston so far this season, 25% have been severe enough to require hospitalization, according to the statement. Flu cases are accounting for 4% of all emergency department visits to Boston hospitals, compared with 1% of visits during non-flu season months.

The mayor's office and the Boston Public Health Commission are working with community health centers to offer free vaccination clinics this weekend and are urging residents to contact their primary care doctor to get vaccinated. The mayor's office is also offering a phone hotline to help Boston residents find where to get vaccinated.

Recent rigorous reviews of the flu vaccine have found that it is only about 60% effective in healthy adults, but until better vaccines are developed, health officials say immunization against flu is still the best tool for preventing the disease.

The dominant flu strain in the United States so far this season has been H3N2, which has been known to cause more severe infections. The most recent surveillance update from the US Centers for Disease Control and Prevention (CDC) showed a national spike in doctor's visit for flulike illness similar to that seen in the 2007-08 season, which the CDC had characterized as moderately severe.

The H3N2 flu strain also dominated the 2007-08 flu season, which peaked in the middle of February and was marked by greater morality and higher hospitalization rates in young children than each of the previous three seasons, according to a background report from the CDC.

Though the CDC has said it's impossible to predict how severe a flu season will be, officials have said the current season might be bad due to its early start and the strong showing so far of the H3N2 strain.

Google Flu Trends, which uses patterns of flu-related search terms as a surrogate for flu activity, shows a dramatic spike in US flu activity that it classifies as intense.

Widespread flu activity in many states has prompted several health facilities to limit visitors and establish special measures to handle the influx of flu patients in emergency departments.

Heavy levels of flu have also led to concerns about the supply of oseltamivir (Tamiflu), both in Canada and the United States. Yesterday the Canadian government released a supply of the drug from its National Emergency Stockpile to address a potential shortage, and a spokeswoman from Roche, the maker of Tamiflu, said yesterday that some parts of the United States may face thin supplies of the liquid suspension of the drug.

Today Sarah Clark-Lynn, with the US Food and Drug Administration (FDA) office of public affairs, told CIDRAP News that recent increased demand has led to some temporary local supply interruptions of Tamiflu oral suspension. She said Genentech, which markets Tamiflu and serves as US headquarters for Roche, is working to increase the supply of the oral suspension and has the capsules available.

She said if the oral suspension isn't available, pharmacists can use the capsules to make a liquid suspension for patients.

"The FDA is continuing to monitor this closely and will post information on our website. We are also working with the company to increase supplies," Clark-Lynn said.

See also:

Jan 9 City of Boston press release

Jan 4 CDC weekly surveillance report chart

Google Flu Trends US flu activity

CDC summary of the 2007-08 flu season

Jan 8 CIDRAP News story "Canada, US brace for potential Tamiflu shortages"

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