Influenza

There were four states at the highest level of influenza-like illness (ILI) activity for the week, more than any other week of the 2015-2016 flu season, according to the Centers for Disease Control and Prevention.

Arizona, Kentucky, New Jersey, and New Mexico, along with Puerto Rico, were all at level 10 on the CDC’s 1-10 scale of ILI activity for the week ending March 5, 2016. Other states in the “high” range were Arkansas, Illinois, Nevada, and North Carolina at level 9 and Alabama and Mississippi at level 8, the CDC reported.

The proportion of outpatient visits for ILI was 3.5% for the week, the highest of the season so far and well above the national baseline of 2.1%. In addition to the 10 states and Puerto Rico with ILI levels in the high range, there were 13 states in the “moderate” range (6 or 7 on the 1-10 scale) and 12 states in the “low” range (4 or 5), with a total of 44 states at level 2 or higher, data from the CDC’s Outpatient Influenza-like Illness Surveillance Network (ILINet) show.

Two flu-related pediatric deaths were reported during week 21 of the flu season, although both occurred earlier: one during the week ending Feb. 13 and one during the week ending Feb. 27. There have been a total of 20 pediatric deaths reported for the 2015-2016 season, with Florida (four deaths), California, (three), Arizona (two), and Nevada (two) the only states reporting more than one, the CDC report noted.

The continued rise in ILI activity is somewhat unusual. The only season out of the previous 10 with a peak later than the current one was 2011-2012, which peaked at only 2.4% on the week ending March 17, 2012. The earliest of the bunch came during the 2009-2010 season, which peaked at 7.7% during the week ending Oct. 24, 2009, according to ILINet data.

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There were four states at the highest level of influenza-like illness (ILI) activity for the week, more than any other week of the 2015-2016 flu season, according to the Centers for Disease Control and Prevention.

Arizona, Kentucky, New Jersey, and New Mexico, along with Puerto Rico, were all at level 10 on the CDC’s 1-10 scale of ILI activity for the week ending March 5, 2016. Other states in the “high” range were Arkansas, Illinois, Nevada, and North Carolina at level 9 and Alabama and Mississippi at level 8, the CDC reported.

The proportion of outpatient visits for ILI was 3.5% for the week, the highest of the season so far and well above the national baseline of 2.1%. In addition to the 10 states and Puerto Rico with ILI levels in the high range, there were 13 states in the “moderate” range (6 or 7 on the 1-10 scale) and 12 states in the “low” range (4 or 5), with a total of 44 states at level 2 or higher, data from the CDC’s Outpatient Influenza-like Illness Surveillance Network (ILINet) show.

Two flu-related pediatric deaths were reported during week 21 of the flu season, although both occurred earlier: one during the week ending Feb. 13 and one during the week ending Feb. 27. There have been a total of 20 pediatric deaths reported for the 2015-2016 season, with Florida (four deaths), California, (three), Arizona (two), and Nevada (two) the only states reporting more than one, the CDC report noted.

The continued rise in ILI activity is somewhat unusual. The only season out of the previous 10 with a peak later than the current one was 2011-2012, which peaked at only 2.4% on the week ending March 17, 2012. The earliest of the bunch came during the 2009-2010 season, which peaked at 7.7% during the week ending Oct. 24, 2009, according to ILINet data.

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There were four states at the highest level of influenza-like illness (ILI) activity for the week, more than any other week of the 2015-2016 flu season, according to the Centers for Disease Control and Prevention.

Arizona, Kentucky, New Jersey, and New Mexico, along with Puerto Rico, were all at level 10 on the CDC’s 1-10 scale of ILI activity for the week ending March 5, 2016. Other states in the “high” range were Arkansas, Illinois, Nevada, and North Carolina at level 9 and Alabama and Mississippi at level 8, the CDC reported.

The proportion of outpatient visits for ILI was 3.5% for the week, the highest of the season so far and well above the national baseline of 2.1%. In addition to the 10 states and Puerto Rico with ILI levels in the high range, there were 13 states in the “moderate” range (6 or 7 on the 1-10 scale) and 12 states in the “low” range (4 or 5), with a total of 44 states at level 2 or higher, data from the CDC’s Outpatient Influenza-like Illness Surveillance Network (ILINet) show.

Two flu-related pediatric deaths were reported during week 21 of the flu season, although both occurred earlier: one during the week ending Feb. 13 and one during the week ending Feb. 27. There have been a total of 20 pediatric deaths reported for the 2015-2016 season, with Florida (four deaths), California, (three), Arizona (two), and Nevada (two) the only states reporting more than one, the CDC report noted.

The continued rise in ILI activity is somewhat unusual. The only season out of the previous 10 with a peak later than the current one was 2011-2012, which peaked at only 2.4% on the week ending March 17, 2012. The earliest of the bunch came during the 2009-2010 season, which peaked at 7.7% during the week ending Oct. 24, 2009, according to ILINet data.

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Influenza-like illness (ILI) activity in the 2015-2016 U.S. flu season declined for the first time since early January, according to the Centers for Disease Control and Prevention.

The proportion of outpatient visits for ILI was reported at 3.2% for the week ending Feb. 20, but the CDC has adjusted that figure to 3.3%, which makes the 3.2% reported for this most recent week (week 20 of the season, ending Feb. 27, 2016) a decrease from the week before.

Despite that drop, two states were at level 10 on the CDC’s 1-10 scale of ILI activity for the first time this season. Arizona had already reached level 10, and joining it there last week was North Carolina, moving up from level 8 the week before. Other states in the “high” range of activity were Arkansas, New Mexico, Tennessee, and Utah at level 9, and Illinois and Maryland at level 8, the CDC reported March 4. Puerto Rico, which had been at level 10 for several weeks, moved down to level 8.

States in the “moderate” range of activity for the week ending Feb. 27 were Florida and New Jersey at level 7 and Alabama, California, Hawaii, Kentucky, Mississippi, Oklahoma, and South Carolina at level 6. Altogether, there were 35 states at level 2 or higher, according to data from the CDC’s Outpatient Influenza-like Illness Surveillance Network.

Four pediatric ILI-related deaths were reported to the CDC during week 20, but three actually occurred during week 19. There have been 18 ILI-related deaths so far during the 2015-2016 season, the CDC said.

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Influenza-like illness (ILI) activity in the 2015-2016 U.S. flu season declined for the first time since early January, according to the Centers for Disease Control and Prevention.

The proportion of outpatient visits for ILI was reported at 3.2% for the week ending Feb. 20, but the CDC has adjusted that figure to 3.3%, which makes the 3.2% reported for this most recent week (week 20 of the season, ending Feb. 27, 2016) a decrease from the week before.

Despite that drop, two states were at level 10 on the CDC’s 1-10 scale of ILI activity for the first time this season. Arizona had already reached level 10, and joining it there last week was North Carolina, moving up from level 8 the week before. Other states in the “high” range of activity were Arkansas, New Mexico, Tennessee, and Utah at level 9, and Illinois and Maryland at level 8, the CDC reported March 4. Puerto Rico, which had been at level 10 for several weeks, moved down to level 8.

States in the “moderate” range of activity for the week ending Feb. 27 were Florida and New Jersey at level 7 and Alabama, California, Hawaii, Kentucky, Mississippi, Oklahoma, and South Carolina at level 6. Altogether, there were 35 states at level 2 or higher, according to data from the CDC’s Outpatient Influenza-like Illness Surveillance Network.

Four pediatric ILI-related deaths were reported to the CDC during week 20, but three actually occurred during week 19. There have been 18 ILI-related deaths so far during the 2015-2016 season, the CDC said.

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Influenza-like illness (ILI) activity in the 2015-2016 U.S. flu season declined for the first time since early January, according to the Centers for Disease Control and Prevention.

The proportion of outpatient visits for ILI was reported at 3.2% for the week ending Feb. 20, but the CDC has adjusted that figure to 3.3%, which makes the 3.2% reported for this most recent week (week 20 of the season, ending Feb. 27, 2016) a decrease from the week before.

Despite that drop, two states were at level 10 on the CDC’s 1-10 scale of ILI activity for the first time this season. Arizona had already reached level 10, and joining it there last week was North Carolina, moving up from level 8 the week before. Other states in the “high” range of activity were Arkansas, New Mexico, Tennessee, and Utah at level 9, and Illinois and Maryland at level 8, the CDC reported March 4. Puerto Rico, which had been at level 10 for several weeks, moved down to level 8.

States in the “moderate” range of activity for the week ending Feb. 27 were Florida and New Jersey at level 7 and Alabama, California, Hawaii, Kentucky, Mississippi, Oklahoma, and South Carolina at level 6. Altogether, there were 35 states at level 2 or higher, according to data from the CDC’s Outpatient Influenza-like Illness Surveillance Network.

Four pediatric ILI-related deaths were reported to the CDC during week 20, but three actually occurred during week 19. There have been 18 ILI-related deaths so far during the 2015-2016 season, the CDC said.

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The Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee unanimously approved recommendations regarding the trivalent and quadrivalent influenza vaccines to be distributed during the 2016-2017 flu season.

The 14-member committee voted that the components of the trivalent influenza vaccine for the upcoming flu season should include an A/California/7/2009 (H1N1) pdm09-like virus; an A/Hong Kong/4801/2014 (H3N2)-like virus; and a B/Brisbane/60/2008-like virus of the B/Victoria lineage.

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Additionally, the quadrivalent influenza vaccine should include a B/Phuket/3073/2013-like virus of the B/Yamagata lineage as “the second influenza B strain in the vaccine.”

All four components correspond with the recommendations of the World Health Organization, which announced its proposed components for influenza vaccines in the Northern Hemisphere on Feb. 25.

“I’m comfortable trying to follow the footprint of the virus we’ve seen today, quite elegantly put out in front of us,” said committee member Dr. Sarah Long, professor of pediatrics at Drexel University in Philadelphia, adding that she was “very pleased with what happened in the last year” regarding the predictions of dominant virus strains and the effectiveness of the eventual vaccine.

The proposed vaccine for next season differs from the one distributed during the 2015-16 flu season. While both vaccines contain the identical California strain of influenza A and the Phuket strain of influenza B, the 2015-2016 vaccine included an A/Switzerland/9715293/2013 (H3N2)-like virus in its trivalent form, and a B/Brisbane/60/2008-like virus of the B/Victoria lineage in its quadrivalent form.

“Timely vaccine supply requires close collaboration and communication between multiple stakeholders to ensure sufficient provision of [a] well-matched vaccine,” said Matthew Downham, Ph.D., associate director of biopharmaceutical development, AstraZeneca. Timely strain selection will ensure “vaccine availability and usage” for the most widespread and effective coverage.

While the FDA is not obligated to follow the recommendations of the Vaccines and Related Biological Products Advisory Committee, it generally does.

None of the committee members reported any relevant financial disclosures, nor were there any waivers for conflicts of interest.

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The Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee unanimously approved recommendations regarding the trivalent and quadrivalent influenza vaccines to be distributed during the 2016-2017 flu season.

The 14-member committee voted that the components of the trivalent influenza vaccine for the upcoming flu season should include an A/California/7/2009 (H1N1) pdm09-like virus; an A/Hong Kong/4801/2014 (H3N2)-like virus; and a B/Brisbane/60/2008-like virus of the B/Victoria lineage.

©pressdigital/iStock

Additionally, the quadrivalent influenza vaccine should include a B/Phuket/3073/2013-like virus of the B/Yamagata lineage as “the second influenza B strain in the vaccine.”

All four components correspond with the recommendations of the World Health Organization, which announced its proposed components for influenza vaccines in the Northern Hemisphere on Feb. 25.

“I’m comfortable trying to follow the footprint of the virus we’ve seen today, quite elegantly put out in front of us,” said committee member Dr. Sarah Long, professor of pediatrics at Drexel University in Philadelphia, adding that she was “very pleased with what happened in the last year” regarding the predictions of dominant virus strains and the effectiveness of the eventual vaccine.

The proposed vaccine for next season differs from the one distributed during the 2015-16 flu season. While both vaccines contain the identical California strain of influenza A and the Phuket strain of influenza B, the 2015-2016 vaccine included an A/Switzerland/9715293/2013 (H3N2)-like virus in its trivalent form, and a B/Brisbane/60/2008-like virus of the B/Victoria lineage in its quadrivalent form.

“Timely vaccine supply requires close collaboration and communication between multiple stakeholders to ensure sufficient provision of [a] well-matched vaccine,” said Matthew Downham, Ph.D., associate director of biopharmaceutical development, AstraZeneca. Timely strain selection will ensure “vaccine availability and usage” for the most widespread and effective coverage.

While the FDA is not obligated to follow the recommendations of the Vaccines and Related Biological Products Advisory Committee, it generally does.

None of the committee members reported any relevant financial disclosures, nor were there any waivers for conflicts of interest.

[email protected]

The Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee unanimously approved recommendations regarding the trivalent and quadrivalent influenza vaccines to be distributed during the 2016-2017 flu season.

The 14-member committee voted that the components of the trivalent influenza vaccine for the upcoming flu season should include an A/California/7/2009 (H1N1) pdm09-like virus; an A/Hong Kong/4801/2014 (H3N2)-like virus; and a B/Brisbane/60/2008-like virus of the B/Victoria lineage.

©pressdigital/iStock

Additionally, the quadrivalent influenza vaccine should include a B/Phuket/3073/2013-like virus of the B/Yamagata lineage as “the second influenza B strain in the vaccine.”

All four components correspond with the recommendations of the World Health Organization, which announced its proposed components for influenza vaccines in the Northern Hemisphere on Feb. 25.

“I’m comfortable trying to follow the footprint of the virus we’ve seen today, quite elegantly put out in front of us,” said committee member Dr. Sarah Long, professor of pediatrics at Drexel University in Philadelphia, adding that she was “very pleased with what happened in the last year” regarding the predictions of dominant virus strains and the effectiveness of the eventual vaccine.

The proposed vaccine for next season differs from the one distributed during the 2015-16 flu season. While both vaccines contain the identical California strain of influenza A and the Phuket strain of influenza B, the 2015-2016 vaccine included an A/Switzerland/9715293/2013 (H3N2)-like virus in its trivalent form, and a B/Brisbane/60/2008-like virus of the B/Victoria lineage in its quadrivalent form.

“Timely vaccine supply requires close collaboration and communication between multiple stakeholders to ensure sufficient provision of [a] well-matched vaccine,” said Matthew Downham, Ph.D., associate director of biopharmaceutical development, AstraZeneca. Timely strain selection will ensure “vaccine availability and usage” for the most widespread and effective coverage.

While the FDA is not obligated to follow the recommendations of the Vaccines and Related Biological Products Advisory Committee, it generally does.

None of the committee members reported any relevant financial disclosures, nor were there any waivers for conflicts of interest.

[email protected]

Influenza-like illness (ILI) activity reached a new national high for the 2015-2016 flu season during the week ending Feb. 20, according to the Centers for Disease Control and Prevention.

Nationwide, the proportion of outpatient visits for ILI was 3.2%, up from 3.1% the week before and well over the national baseline of 2.1%. Arizona and Puerto Rico were still at level 10 on the CDC’s 1-10 scale for ILI activity, and they were joined in the “high” range of activity by California, New Mexico, North Carolina, Texas, and Utah, which were all at level 8, the CDC reported Feb. 26.

States in the “moderate” range of activity for week 19 of the 2015-2016 flu season (week 7 of calendar year 2016) were Arkansas, Florida, and New Jersey at level 7 and Connecticut, Illinois, and Oregon at level 6. There were 13 states in the “low” range of activity – five at level 5 and eight states at level 4 – and 24 states in the “minimal” range, of which 13 were at level 1. Colorado and the District of Columbia had insufficient data to determine activity level, according to data from the CDC’s Outpatient Influenza-like Illness Surveillance Network.

For the week, one flu-related pediatric death, associated with an influenza B virus, was reported to the CDC, bringing the total to 14 for the season. The only states reporting more that one death are California (two) and Florida (three), the CDC said. The average number of deaths for the three previous flu seasons is over 143.

During week 19, a total of 18,844 respiratory specimens were tested, 13.8% of which were positive: 76.1% for influenza A and 23.9% for influenza B. Since Oct. 1, 2015, 4.2% of specimens have tested positive for influenza, with a 70% to 30% split between influenza A and B, the CDC report showed.

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Influenza-like illness (ILI) activity reached a new national high for the 2015-2016 flu season during the week ending Feb. 20, according to the Centers for Disease Control and Prevention.

Nationwide, the proportion of outpatient visits for ILI was 3.2%, up from 3.1% the week before and well over the national baseline of 2.1%. Arizona and Puerto Rico were still at level 10 on the CDC’s 1-10 scale for ILI activity, and they were joined in the “high” range of activity by California, New Mexico, North Carolina, Texas, and Utah, which were all at level 8, the CDC reported Feb. 26.

States in the “moderate” range of activity for week 19 of the 2015-2016 flu season (week 7 of calendar year 2016) were Arkansas, Florida, and New Jersey at level 7 and Connecticut, Illinois, and Oregon at level 6. There were 13 states in the “low” range of activity – five at level 5 and eight states at level 4 – and 24 states in the “minimal” range, of which 13 were at level 1. Colorado and the District of Columbia had insufficient data to determine activity level, according to data from the CDC’s Outpatient Influenza-like Illness Surveillance Network.

For the week, one flu-related pediatric death, associated with an influenza B virus, was reported to the CDC, bringing the total to 14 for the season. The only states reporting more that one death are California (two) and Florida (three), the CDC said. The average number of deaths for the three previous flu seasons is over 143.

During week 19, a total of 18,844 respiratory specimens were tested, 13.8% of which were positive: 76.1% for influenza A and 23.9% for influenza B. Since Oct. 1, 2015, 4.2% of specimens have tested positive for influenza, with a 70% to 30% split between influenza A and B, the CDC report showed.

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Influenza-like illness (ILI) activity reached a new national high for the 2015-2016 flu season during the week ending Feb. 20, according to the Centers for Disease Control and Prevention.

Nationwide, the proportion of outpatient visits for ILI was 3.2%, up from 3.1% the week before and well over the national baseline of 2.1%. Arizona and Puerto Rico were still at level 10 on the CDC’s 1-10 scale for ILI activity, and they were joined in the “high” range of activity by California, New Mexico, North Carolina, Texas, and Utah, which were all at level 8, the CDC reported Feb. 26.

States in the “moderate” range of activity for week 19 of the 2015-2016 flu season (week 7 of calendar year 2016) were Arkansas, Florida, and New Jersey at level 7 and Connecticut, Illinois, and Oregon at level 6. There were 13 states in the “low” range of activity – five at level 5 and eight states at level 4 – and 24 states in the “minimal” range, of which 13 were at level 1. Colorado and the District of Columbia had insufficient data to determine activity level, according to data from the CDC’s Outpatient Influenza-like Illness Surveillance Network.

For the week, one flu-related pediatric death, associated with an influenza B virus, was reported to the CDC, bringing the total to 14 for the season. The only states reporting more that one death are California (two) and Florida (three), the CDC said. The average number of deaths for the three previous flu seasons is over 143.

During week 19, a total of 18,844 respiratory specimens were tested, 13.8% of which were positive: 76.1% for influenza A and 23.9% for influenza B. Since Oct. 1, 2015, 4.2% of specimens have tested positive for influenza, with a 70% to 30% split between influenza A and B, the CDC report showed.

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The overall rate of effectiveness for the 2015-2016 season’s influenza vaccine is 59%, according to preliminary data shared at a Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices meeting.

“This means that getting a flu vaccine this season reduced the risk of having to go to the doctor because of flu by nearly 60%,” Dr. Joseph Bresee – who heads the CDC’s Epidemiology and Prevention Branch – stated in a press release. “It’s good news and underscores the importance and the benefit of both annual and ongoing vaccination efforts this season.”

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These findings are based on data collected by the U.S. Flu Vaccine Effectiveness Network between November 2, 2015, and February 12, 2016. A 59% effectiveness rate would be roughly in line with what previous years’ vaccines have rated when similar strains of influenza have been prevalent, according to the CDC.

Against the H1N1 strain, which was “responsible for most flu illness this season,” the influenza vaccine was 51% effective. Dr. Bresee noted that the CDC has received reports of unvaccinated individuals this season dying or falling seriously ill because of infection from the H1N1 strain.

The vaccine was 76% effective against all influenza B virus strains, and 79% effective against the B/Yamagata virus strains. There are not enough data at this time, however, to determine the vaccine’s effectiveness against B/Victoria or H3N2 strains.

The CDC cautions that, because the current influenza season is still weeks away from being over, the final rate of vaccine effectiveness for 2015-2016 may change once all the data are analyzed. On average, influenza seasons last 13 weeks.

“Flu activity this season started a bit later and has been lower so far than we’ve seen during the previous three seasons, but activity is still on the upswing and expected to continue for several weeks,” Dr. Bresee stated.

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The overall rate of effectiveness for the 2015-2016 season’s influenza vaccine is 59%, according to preliminary data shared at a Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices meeting.

“This means that getting a flu vaccine this season reduced the risk of having to go to the doctor because of flu by nearly 60%,” Dr. Joseph Bresee – who heads the CDC’s Epidemiology and Prevention Branch – stated in a press release. “It’s good news and underscores the importance and the benefit of both annual and ongoing vaccination efforts this season.”

Copyright CDC

These findings are based on data collected by the U.S. Flu Vaccine Effectiveness Network between November 2, 2015, and February 12, 2016. A 59% effectiveness rate would be roughly in line with what previous years’ vaccines have rated when similar strains of influenza have been prevalent, according to the CDC.

Against the H1N1 strain, which was “responsible for most flu illness this season,” the influenza vaccine was 51% effective. Dr. Bresee noted that the CDC has received reports of unvaccinated individuals this season dying or falling seriously ill because of infection from the H1N1 strain.

The vaccine was 76% effective against all influenza B virus strains, and 79% effective against the B/Yamagata virus strains. There are not enough data at this time, however, to determine the vaccine’s effectiveness against B/Victoria or H3N2 strains.

The CDC cautions that, because the current influenza season is still weeks away from being over, the final rate of vaccine effectiveness for 2015-2016 may change once all the data are analyzed. On average, influenza seasons last 13 weeks.

“Flu activity this season started a bit later and has been lower so far than we’ve seen during the previous three seasons, but activity is still on the upswing and expected to continue for several weeks,” Dr. Bresee stated.

[email protected]

The overall rate of effectiveness for the 2015-2016 season’s influenza vaccine is 59%, according to preliminary data shared at a Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices meeting.

“This means that getting a flu vaccine this season reduced the risk of having to go to the doctor because of flu by nearly 60%,” Dr. Joseph Bresee – who heads the CDC’s Epidemiology and Prevention Branch – stated in a press release. “It’s good news and underscores the importance and the benefit of both annual and ongoing vaccination efforts this season.”

Copyright CDC

These findings are based on data collected by the U.S. Flu Vaccine Effectiveness Network between November 2, 2015, and February 12, 2016. A 59% effectiveness rate would be roughly in line with what previous years’ vaccines have rated when similar strains of influenza have been prevalent, according to the CDC.

Against the H1N1 strain, which was “responsible for most flu illness this season,” the influenza vaccine was 51% effective. Dr. Bresee noted that the CDC has received reports of unvaccinated individuals this season dying or falling seriously ill because of infection from the H1N1 strain.

The vaccine was 76% effective against all influenza B virus strains, and 79% effective against the B/Yamagata virus strains. There are not enough data at this time, however, to determine the vaccine’s effectiveness against B/Victoria or H3N2 strains.

The CDC cautions that, because the current influenza season is still weeks away from being over, the final rate of vaccine effectiveness for 2015-2016 may change once all the data are analyzed. On average, influenza seasons last 13 weeks.

“Flu activity this season started a bit later and has been lower so far than we’ve seen during the previous three seasons, but activity is still on the upswing and expected to continue for several weeks,” Dr. Bresee stated.

[email protected]

Live attenuated influenza vaccine (LAIV) is likely to be an option for all individuals with egg allergies, regardless of allergy severity, because the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to approve proposed amendments to the existing recommendations regarding administration of LAIV in individuals with egg allergies.

With 11 members voting “yes” and three choosing to abstain, the committee agreed to leave sections 1, 2, and 3 as they currently are, with a slight change to section 1 so that it will now include the latter half of recommendations that were previously placed under section 4. Therefore, section 1 of the recommendations for influenza vaccination of persons with egg allergy – which already states that “Regardless of a recipient’s allergy history, all vaccines should be administered in settings in which personnel and equipment for rapid recognition and treatment of anaphylaxis are available” – will now also include text stating that the vaccine should be administered in a medical setting and supervised by a health care provider with “experience in the recognition and management of severe allergic conditions,” or that such a medical professional should be “immediately available.”

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Sections 2 and 3 will remain the same. Section 2 states that a previous allergic reaction to the influenza vaccine is a contraindication to ever receiving the vaccine again in the future. Section 3 states that individuals with egg allergy who have only experienced hives due to eggs still should be administered the influenza vaccine.

The committee voted to strike section 5 of the existing recommendations, which calls for a 30-minute postvaccination observation period. However, the committee still advises that health care providers monitor all patients, particularly adolescents, for 15 minutes immediately after vaccination, and that individuals should be seated or lying down “to decrease the risk for injury should syncopy occur.”

The CDC generally follows ACIP’s recommendations.

[email protected]

Live attenuated influenza vaccine (LAIV) is likely to be an option for all individuals with egg allergies, regardless of allergy severity, because the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to approve proposed amendments to the existing recommendations regarding administration of LAIV in individuals with egg allergies.

With 11 members voting “yes” and three choosing to abstain, the committee agreed to leave sections 1, 2, and 3 as they currently are, with a slight change to section 1 so that it will now include the latter half of recommendations that were previously placed under section 4. Therefore, section 1 of the recommendations for influenza vaccination of persons with egg allergy – which already states that “Regardless of a recipient’s allergy history, all vaccines should be administered in settings in which personnel and equipment for rapid recognition and treatment of anaphylaxis are available” – will now also include text stating that the vaccine should be administered in a medical setting and supervised by a health care provider with “experience in the recognition and management of severe allergic conditions,” or that such a medical professional should be “immediately available.”

©pressdigital/iStock

Sections 2 and 3 will remain the same. Section 2 states that a previous allergic reaction to the influenza vaccine is a contraindication to ever receiving the vaccine again in the future. Section 3 states that individuals with egg allergy who have only experienced hives due to eggs still should be administered the influenza vaccine.

The committee voted to strike section 5 of the existing recommendations, which calls for a 30-minute postvaccination observation period. However, the committee still advises that health care providers monitor all patients, particularly adolescents, for 15 minutes immediately after vaccination, and that individuals should be seated or lying down “to decrease the risk for injury should syncopy occur.”

The CDC generally follows ACIP’s recommendations.

[email protected]

Live attenuated influenza vaccine (LAIV) is likely to be an option for all individuals with egg allergies, regardless of allergy severity, because the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to approve proposed amendments to the existing recommendations regarding administration of LAIV in individuals with egg allergies.

With 11 members voting “yes” and three choosing to abstain, the committee agreed to leave sections 1, 2, and 3 as they currently are, with a slight change to section 1 so that it will now include the latter half of recommendations that were previously placed under section 4. Therefore, section 1 of the recommendations for influenza vaccination of persons with egg allergy – which already states that “Regardless of a recipient’s allergy history, all vaccines should be administered in settings in which personnel and equipment for rapid recognition and treatment of anaphylaxis are available” – will now also include text stating that the vaccine should be administered in a medical setting and supervised by a health care provider with “experience in the recognition and management of severe allergic conditions,” or that such a medical professional should be “immediately available.”

©pressdigital/iStock

Sections 2 and 3 will remain the same. Section 2 states that a previous allergic reaction to the influenza vaccine is a contraindication to ever receiving the vaccine again in the future. Section 3 states that individuals with egg allergy who have only experienced hives due to eggs still should be administered the influenza vaccine.

The committee voted to strike section 5 of the existing recommendations, which calls for a 30-minute postvaccination observation period. However, the committee still advises that health care providers monitor all patients, particularly adolescents, for 15 minutes immediately after vaccination, and that individuals should be seated or lying down “to decrease the risk for injury should syncopy occur.”

The CDC generally follows ACIP’s recommendations.

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Oseltamivir and zanamivir are competitive inhibitors for the neuraminidase enzyme for the influenza virus. They block the surface receptor enzyme and prevent release of virus from the host cell, thus limiting propagation of the infection. These medications can be given as prophylaxis after exposure to influenza or can be given therapeutically for a suspected or confirmed infection. Oseltamivir is recommended for treatment of suspected or confirmed influenza infection in the special population of pregnant women, as the risk for complications of influenza is increased in this group.

Safety evidence

However, there are limited data on the safety and efficacy of the neuraminidase inhibitors in pregnancy. With respect to safety, there have been seven publications in the literature addressing the risk for major birth defects following treatment or prophylaxis with one or both of these products, with the majority of the published data relating to oseltamivir exposure.

In a review by Tanaka et al. in 2009, 90 pregnancies treated therapeutically with oseltamivir in the first trimester were reported to two teratogen information services in Japan; one major birth defect (1.1%) was reported (CMAJ. 2009 Jul 7;181[1-2]:55-8). A year later, Greer et al. published a retrospective chart review at a Texas hospital between 2003 and 2008. During that period, 137 pregnancies that involved a pharmacy record of dispensing of oseltamivir were identified. Of these, 18 were dispensed in the first trimester, and none were linked to a major birth defect outcome (Obstet Gynecol. 2010 Apr;115[4]:711-6).

A 2011 record linkage study in Sweden identified 86 pregnant women for whom oseltamivir (n=81) or zanamivir had been prescribed. Of these, four were linked to a major birth defect in the infant; however, only one of the four prescriptions had been filled in the first trimester (Pharmacoepidemiol Drug Saf. 2011 Oct;20[10]:1030-4). In 2013, Saito et al. reported on a case series gathered from 157 obstetric facilities in Japan. Among 156 infants born to women exposed to oseltamivir in the first trimester, 2 (1.3%) were reported to have a major congenital anomaly; there were no congenital malformations reported in the 15 first-trimester exposures to zanamivir (Am J Obstet Gynecol. 2013 Aug;209[2[:130.e1-9).

In 2014, a teratogen information service in the United Kingdom reported on eight first-trimester exposures to oseltamivir and 37 to zanamivir, with no major birth defects noted in either group (BJOG. 2014 Jun;121[7]:901-6). Additionally, a French prescription database study identified 49 pregnancies thought to be exposed to oseltamivir in the first trimester with one reported congenital anomaly (BJOG. 2014 Jun;121[7]:895-900).

Finally, the manufacturer of oseltamivir published a summary of pregnancies from global pharmacovigilance data accumulated through spontaneous reports and other studies between 2000 and 2012 (Pharmacoepidemiol Drug Saf. 2014 Oct;23[10]:1035-42). Outcomes were available for 1,875 infants. Among these, 81 (4.3%) had major birth defects. However, following case review, the authors indicated that only 11 of the defects (occurring in 9 infants) were biologically plausible based on the timing of the exposure to oseltamivir.

Efficacy examined

With respect to efficacy, two small studies have addressed the pharmacokinetics of oseltamivir in pregnancy to determine if the recommended dosages for nonpregnant individuals are appropriate for pregnancy.

In the earlier of the two studies, Greer et al. looked at the pharmacokinetics of oseltamivir in 30 pregnant women, 10 in each of the three trimesters, who were taking 75 mg of the drug either once or twice daily. Maternal samples were drawn before and after the first dose of oseltamivir. They found little evidence of differences across the three trimesters and concluded that the parent drug values were in the pharmacologic range for clinical efficacy (Am J Obstet Gynecol. 2011 Jun;204[6 Suppl 1]:S89-93).

In contrast, Pillai et al. enrolled a small sample of women being treated with oseltamivir; they evaluated pharmacokinetics for the active metabolite of oseltamivir following 48 or more hours of treatment in 29 pregnant and 35 nonpregnant women (Br J Clin Pharmacol. 2015 Nov;80[5]:1042-50). Significantly lower levels of the active metabolite were noted in the pregnant women, compared with nonpregnant women. The authors suggested that the physiologic changes of pregnancy, correlated with increased renal clearance, produced an approximate 30% lower exposure to the drug in the pregnant state. While they were not able to relate this to maternal or infant outcomes, this finding suggested that further work is needed to determine if dosing recommendations should be adjusted in pregnancy.

The current recommendation is that pregnant women or women within 2 weeks post partum be given oseltamivir for treatment of suspected or confirmed influenza regardless of trimester of pregnancy. The limited safety data that are currently available have not suggested an increased risk for major birth defects following treatment with this product. However, the data are sparse for oseltamivir and even more so for zanamivir. Larger studies focused on these treatments are needed.

Dr. Chambers is professor of pediatrics and director of clinical research at Rady Children’s Hospital, and associate director of the Clinical and Translational Research Institute at the University of California, San Diego. She is director of MotherToBaby California, past president of the Organization of Teratology Information Specialists, and past president of the Teratology Society. She reported having no financial disclosures relevant to this column, but has received research funding Roche-Genentech and GlaxoSmithKline unrelated to antiviral medications. Email her at [email protected].

Oseltamivir and zanamivir are competitive inhibitors for the neuraminidase enzyme for the influenza virus. They block the surface receptor enzyme and prevent release of virus from the host cell, thus limiting propagation of the infection. These medications can be given as prophylaxis after exposure to influenza or can be given therapeutically for a suspected or confirmed infection. Oseltamivir is recommended for treatment of suspected or confirmed influenza infection in the special population of pregnant women, as the risk for complications of influenza is increased in this group.

Safety evidence

However, there are limited data on the safety and efficacy of the neuraminidase inhibitors in pregnancy. With respect to safety, there have been seven publications in the literature addressing the risk for major birth defects following treatment or prophylaxis with one or both of these products, with the majority of the published data relating to oseltamivir exposure.

In a review by Tanaka et al. in 2009, 90 pregnancies treated therapeutically with oseltamivir in the first trimester were reported to two teratogen information services in Japan; one major birth defect (1.1%) was reported (CMAJ. 2009 Jul 7;181[1-2]:55-8). A year later, Greer et al. published a retrospective chart review at a Texas hospital between 2003 and 2008. During that period, 137 pregnancies that involved a pharmacy record of dispensing of oseltamivir were identified. Of these, 18 were dispensed in the first trimester, and none were linked to a major birth defect outcome (Obstet Gynecol. 2010 Apr;115[4]:711-6).

A 2011 record linkage study in Sweden identified 86 pregnant women for whom oseltamivir (n=81) or zanamivir had been prescribed. Of these, four were linked to a major birth defect in the infant; however, only one of the four prescriptions had been filled in the first trimester (Pharmacoepidemiol Drug Saf. 2011 Oct;20[10]:1030-4). In 2013, Saito et al. reported on a case series gathered from 157 obstetric facilities in Japan. Among 156 infants born to women exposed to oseltamivir in the first trimester, 2 (1.3%) were reported to have a major congenital anomaly; there were no congenital malformations reported in the 15 first-trimester exposures to zanamivir (Am J Obstet Gynecol. 2013 Aug;209[2[:130.e1-9).

In 2014, a teratogen information service in the United Kingdom reported on eight first-trimester exposures to oseltamivir and 37 to zanamivir, with no major birth defects noted in either group (BJOG. 2014 Jun;121[7]:901-6). Additionally, a French prescription database study identified 49 pregnancies thought to be exposed to oseltamivir in the first trimester with one reported congenital anomaly (BJOG. 2014 Jun;121[7]:895-900).

Finally, the manufacturer of oseltamivir published a summary of pregnancies from global pharmacovigilance data accumulated through spontaneous reports and other studies between 2000 and 2012 (Pharmacoepidemiol Drug Saf. 2014 Oct;23[10]:1035-42). Outcomes were available for 1,875 infants. Among these, 81 (4.3%) had major birth defects. However, following case review, the authors indicated that only 11 of the defects (occurring in 9 infants) were biologically plausible based on the timing of the exposure to oseltamivir.

Efficacy examined

With respect to efficacy, two small studies have addressed the pharmacokinetics of oseltamivir in pregnancy to determine if the recommended dosages for nonpregnant individuals are appropriate for pregnancy.

In the earlier of the two studies, Greer et al. looked at the pharmacokinetics of oseltamivir in 30 pregnant women, 10 in each of the three trimesters, who were taking 75 mg of the drug either once or twice daily. Maternal samples were drawn before and after the first dose of oseltamivir. They found little evidence of differences across the three trimesters and concluded that the parent drug values were in the pharmacologic range for clinical efficacy (Am J Obstet Gynecol. 2011 Jun;204[6 Suppl 1]:S89-93).

In contrast, Pillai et al. enrolled a small sample of women being treated with oseltamivir; they evaluated pharmacokinetics for the active metabolite of oseltamivir following 48 or more hours of treatment in 29 pregnant and 35 nonpregnant women (Br J Clin Pharmacol. 2015 Nov;80[5]:1042-50). Significantly lower levels of the active metabolite were noted in the pregnant women, compared with nonpregnant women. The authors suggested that the physiologic changes of pregnancy, correlated with increased renal clearance, produced an approximate 30% lower exposure to the drug in the pregnant state. While they were not able to relate this to maternal or infant outcomes, this finding suggested that further work is needed to determine if dosing recommendations should be adjusted in pregnancy.

The current recommendation is that pregnant women or women within 2 weeks post partum be given oseltamivir for treatment of suspected or confirmed influenza regardless of trimester of pregnancy. The limited safety data that are currently available have not suggested an increased risk for major birth defects following treatment with this product. However, the data are sparse for oseltamivir and even more so for zanamivir. Larger studies focused on these treatments are needed.

Dr. Chambers is professor of pediatrics and director of clinical research at Rady Children’s Hospital, and associate director of the Clinical and Translational Research Institute at the University of California, San Diego. She is director of MotherToBaby California, past president of the Organization of Teratology Information Specialists, and past president of the Teratology Society. She reported having no financial disclosures relevant to this column, but has received research funding Roche-Genentech and GlaxoSmithKline unrelated to antiviral medications. Email her at [email protected].

Oseltamivir and zanamivir are competitive inhibitors for the neuraminidase enzyme for the influenza virus. They block the surface receptor enzyme and prevent release of virus from the host cell, thus limiting propagation of the infection. These medications can be given as prophylaxis after exposure to influenza or can be given therapeutically for a suspected or confirmed infection. Oseltamivir is recommended for treatment of suspected or confirmed influenza infection in the special population of pregnant women, as the risk for complications of influenza is increased in this group.

Safety evidence

However, there are limited data on the safety and efficacy of the neuraminidase inhibitors in pregnancy. With respect to safety, there have been seven publications in the literature addressing the risk for major birth defects following treatment or prophylaxis with one or both of these products, with the majority of the published data relating to oseltamivir exposure.

In a review by Tanaka et al. in 2009, 90 pregnancies treated therapeutically with oseltamivir in the first trimester were reported to two teratogen information services in Japan; one major birth defect (1.1%) was reported (CMAJ. 2009 Jul 7;181[1-2]:55-8). A year later, Greer et al. published a retrospective chart review at a Texas hospital between 2003 and 2008. During that period, 137 pregnancies that involved a pharmacy record of dispensing of oseltamivir were identified. Of these, 18 were dispensed in the first trimester, and none were linked to a major birth defect outcome (Obstet Gynecol. 2010 Apr;115[4]:711-6).

A 2011 record linkage study in Sweden identified 86 pregnant women for whom oseltamivir (n=81) or zanamivir had been prescribed. Of these, four were linked to a major birth defect in the infant; however, only one of the four prescriptions had been filled in the first trimester (Pharmacoepidemiol Drug Saf. 2011 Oct;20[10]:1030-4). In 2013, Saito et al. reported on a case series gathered from 157 obstetric facilities in Japan. Among 156 infants born to women exposed to oseltamivir in the first trimester, 2 (1.3%) were reported to have a major congenital anomaly; there were no congenital malformations reported in the 15 first-trimester exposures to zanamivir (Am J Obstet Gynecol. 2013 Aug;209[2[:130.e1-9).

In 2014, a teratogen information service in the United Kingdom reported on eight first-trimester exposures to oseltamivir and 37 to zanamivir, with no major birth defects noted in either group (BJOG. 2014 Jun;121[7]:901-6). Additionally, a French prescription database study identified 49 pregnancies thought to be exposed to oseltamivir in the first trimester with one reported congenital anomaly (BJOG. 2014 Jun;121[7]:895-900).

Finally, the manufacturer of oseltamivir published a summary of pregnancies from global pharmacovigilance data accumulated through spontaneous reports and other studies between 2000 and 2012 (Pharmacoepidemiol Drug Saf. 2014 Oct;23[10]:1035-42). Outcomes were available for 1,875 infants. Among these, 81 (4.3%) had major birth defects. However, following case review, the authors indicated that only 11 of the defects (occurring in 9 infants) were biologically plausible based on the timing of the exposure to oseltamivir.

Efficacy examined

With respect to efficacy, two small studies have addressed the pharmacokinetics of oseltamivir in pregnancy to determine if the recommended dosages for nonpregnant individuals are appropriate for pregnancy.

In the earlier of the two studies, Greer et al. looked at the pharmacokinetics of oseltamivir in 30 pregnant women, 10 in each of the three trimesters, who were taking 75 mg of the drug either once or twice daily. Maternal samples were drawn before and after the first dose of oseltamivir. They found little evidence of differences across the three trimesters and concluded that the parent drug values were in the pharmacologic range for clinical efficacy (Am J Obstet Gynecol. 2011 Jun;204[6 Suppl 1]:S89-93).

In contrast, Pillai et al. enrolled a small sample of women being treated with oseltamivir; they evaluated pharmacokinetics for the active metabolite of oseltamivir following 48 or more hours of treatment in 29 pregnant and 35 nonpregnant women (Br J Clin Pharmacol. 2015 Nov;80[5]:1042-50). Significantly lower levels of the active metabolite were noted in the pregnant women, compared with nonpregnant women. The authors suggested that the physiologic changes of pregnancy, correlated with increased renal clearance, produced an approximate 30% lower exposure to the drug in the pregnant state. While they were not able to relate this to maternal or infant outcomes, this finding suggested that further work is needed to determine if dosing recommendations should be adjusted in pregnancy.

The current recommendation is that pregnant women or women within 2 weeks post partum be given oseltamivir for treatment of suspected or confirmed influenza regardless of trimester of pregnancy. The limited safety data that are currently available have not suggested an increased risk for major birth defects following treatment with this product. However, the data are sparse for oseltamivir and even more so for zanamivir. Larger studies focused on these treatments are needed.

Dr. Chambers is professor of pediatrics and director of clinical research at Rady Children’s Hospital, and associate director of the Clinical and Translational Research Institute at the University of California, San Diego. She is director of MotherToBaby California, past president of the Organization of Teratology Information Specialists, and past president of the Teratology Society. She reported having no financial disclosures relevant to this column, but has received research funding Roche-Genentech and GlaxoSmithKline unrelated to antiviral medications. Email her at [email protected].

Activity of influenza-like illness (ILI) was at its highest level so far for week 18 of the 2015-2016 flu season, according to the Centers for Disease Control and Prevention.

That increased activity put Arizona and Puerto Rico at level 10 on the CDC’s 1-10 scale of ILI activity for the week ending Feb. 13. Joining them in the “high” range of activity was Oklahoma at level 8, the CDC reported Feb. 19.

The percentage of visits for ILI in week 18 was 3.1%, higher than the national baseline of 2.1% and the highest level of the flu season. For the week, 30 states were at level 2 or higher on the CDC’s 1-10 scale, which is the highest number for the season. States in the “moderate” range were Arkansas, Connecticut, Illinois, and New Mexico at level 7 and Florida, Hawaii, Maryland, Nevada, New Jersey, Texas, and Utah at level 6. California and South Carolina (level 5) and Georgia, Louisiana, Mississippi, and North Carolina (level 4) took their place in the “low” range, data from the CDC’s Outpatient Influenza-like Illness Surveillance Network show.

Two ILI-related pediatric deaths were reported for the week – one of which occurred during the week ending Jan. 16 – bringing the total to 13 for the season. Three of those deaths occurred in Florida and two in California, with Arizona, Illinois, Louisiana, Michigan, Nevada, Puerto Rico, Tennessee, and Washington each reporting one death, the CDC said.

Since Oct. 1, 2015, the overall ILI-related hospitalization rate is 4.1 per 100,000 population, with 1,147 laboratory-confirmed flu hospitalizations reported. Among all hospitalizations, 71.1% were associated with influenza A, 26.4% with influenza B, 1.7% with influenza A and B coinfection, and 0.8% had no virus type information. Hospitalization data come from the Influenza Hospitalization Surveillance Network, which covers more than 70 counties in 10 states as well as 3 additional states.

[email protected]

Activity of influenza-like illness (ILI) was at its highest level so far for week 18 of the 2015-2016 flu season, according to the Centers for Disease Control and Prevention.

That increased activity put Arizona and Puerto Rico at level 10 on the CDC’s 1-10 scale of ILI activity for the week ending Feb. 13. Joining them in the “high” range of activity was Oklahoma at level 8, the CDC reported Feb. 19.

The percentage of visits for ILI in week 18 was 3.1%, higher than the national baseline of 2.1% and the highest level of the flu season. For the week, 30 states were at level 2 or higher on the CDC’s 1-10 scale, which is the highest number for the season. States in the “moderate” range were Arkansas, Connecticut, Illinois, and New Mexico at level 7 and Florida, Hawaii, Maryland, Nevada, New Jersey, Texas, and Utah at level 6. California and South Carolina (level 5) and Georgia, Louisiana, Mississippi, and North Carolina (level 4) took their place in the “low” range, data from the CDC’s Outpatient Influenza-like Illness Surveillance Network show.

Two ILI-related pediatric deaths were reported for the week – one of which occurred during the week ending Jan. 16 – bringing the total to 13 for the season. Three of those deaths occurred in Florida and two in California, with Arizona, Illinois, Louisiana, Michigan, Nevada, Puerto Rico, Tennessee, and Washington each reporting one death, the CDC said.

Since Oct. 1, 2015, the overall ILI-related hospitalization rate is 4.1 per 100,000 population, with 1,147 laboratory-confirmed flu hospitalizations reported. Among all hospitalizations, 71.1% were associated with influenza A, 26.4% with influenza B, 1.7% with influenza A and B coinfection, and 0.8% had no virus type information. Hospitalization data come from the Influenza Hospitalization Surveillance Network, which covers more than 70 counties in 10 states as well as 3 additional states.

[email protected]

Activity of influenza-like illness (ILI) was at its highest level so far for week 18 of the 2015-2016 flu season, according to the Centers for Disease Control and Prevention.

That increased activity put Arizona and Puerto Rico at level 10 on the CDC’s 1-10 scale of ILI activity for the week ending Feb. 13. Joining them in the “high” range of activity was Oklahoma at level 8, the CDC reported Feb. 19.

The percentage of visits for ILI in week 18 was 3.1%, higher than the national baseline of 2.1% and the highest level of the flu season. For the week, 30 states were at level 2 or higher on the CDC’s 1-10 scale, which is the highest number for the season. States in the “moderate” range were Arkansas, Connecticut, Illinois, and New Mexico at level 7 and Florida, Hawaii, Maryland, Nevada, New Jersey, Texas, and Utah at level 6. California and South Carolina (level 5) and Georgia, Louisiana, Mississippi, and North Carolina (level 4) took their place in the “low” range, data from the CDC’s Outpatient Influenza-like Illness Surveillance Network show.

Two ILI-related pediatric deaths were reported for the week – one of which occurred during the week ending Jan. 16 – bringing the total to 13 for the season. Three of those deaths occurred in Florida and two in California, with Arizona, Illinois, Louisiana, Michigan, Nevada, Puerto Rico, Tennessee, and Washington each reporting one death, the CDC said.

Since Oct. 1, 2015, the overall ILI-related hospitalization rate is 4.1 per 100,000 population, with 1,147 laboratory-confirmed flu hospitalizations reported. Among all hospitalizations, 71.1% were associated with influenza A, 26.4% with influenza B, 1.7% with influenza A and B coinfection, and 0.8% had no virus type information. Hospitalization data come from the Influenza Hospitalization Surveillance Network, which covers more than 70 counties in 10 states as well as 3 additional states.

[email protected]

Influenza-related hospitalizations were approximately twice as high among residents of areas where at least 20% of the population lived below the federal poverty level, compared with areas of less poverty, based on data from more than 27 million individuals in the United States.

Census and hospitalization data included 14 states and spanned two flu seasons (2010-2011 and 2011-2012). Overall, the incidence of flu-related hospitalizations was approximately 21 per 100,000 person-years in high-poverty areas, compared with approximately 11 per 100,000 person-years in census areas where less than 5% of the population lived below the poverty level. The data were consistent across all age groups and ethnicities.

Flu vaccination rates were inversely associated with poverty level, ranging from a high of 48% in high-income areas to a low of 35% in areas with the most poverty. This finding, however, was probably caused by lower vaccination rates among adults aged 65 years and older in higher-poverty areas, compared with high-income areas (80% vs. 94%) noted Dr. James L. Hadler of the Yale School of Public Health in New Haven, Conn., and colleagues.

“Enhanced influenza outreach to improve influenza vaccination coverage for persons living in poorer neighborhoods and efforts to increase use of antivirals by clinicians serving these neighborhoods could reduce poverty-related disparities in severe influenza outcomes,” the researchers noted.

The findings were published in the Morbidity and Mortality Weekly Report (MMWR 2016;65[5]:101-5). Read the full article here.

Influenza-related hospitalizations were approximately twice as high among residents of areas where at least 20% of the population lived below the federal poverty level, compared with areas of less poverty, based on data from more than 27 million individuals in the United States.

Census and hospitalization data included 14 states and spanned two flu seasons (2010-2011 and 2011-2012). Overall, the incidence of flu-related hospitalizations was approximately 21 per 100,000 person-years in high-poverty areas, compared with approximately 11 per 100,000 person-years in census areas where less than 5% of the population lived below the poverty level. The data were consistent across all age groups and ethnicities.

Flu vaccination rates were inversely associated with poverty level, ranging from a high of 48% in high-income areas to a low of 35% in areas with the most poverty. This finding, however, was probably caused by lower vaccination rates among adults aged 65 years and older in higher-poverty areas, compared with high-income areas (80% vs. 94%) noted Dr. James L. Hadler of the Yale School of Public Health in New Haven, Conn., and colleagues.

“Enhanced influenza outreach to improve influenza vaccination coverage for persons living in poorer neighborhoods and efforts to increase use of antivirals by clinicians serving these neighborhoods could reduce poverty-related disparities in severe influenza outcomes,” the researchers noted.

The findings were published in the Morbidity and Mortality Weekly Report (MMWR 2016;65[5]:101-5). Read the full article here.

Influenza-related hospitalizations were approximately twice as high among residents of areas where at least 20% of the population lived below the federal poverty level, compared with areas of less poverty, based on data from more than 27 million individuals in the United States.

Census and hospitalization data included 14 states and spanned two flu seasons (2010-2011 and 2011-2012). Overall, the incidence of flu-related hospitalizations was approximately 21 per 100,000 person-years in high-poverty areas, compared with approximately 11 per 100,000 person-years in census areas where less than 5% of the population lived below the poverty level. The data were consistent across all age groups and ethnicities.

Flu vaccination rates were inversely associated with poverty level, ranging from a high of 48% in high-income areas to a low of 35% in areas with the most poverty. This finding, however, was probably caused by lower vaccination rates among adults aged 65 years and older in higher-poverty areas, compared with high-income areas (80% vs. 94%) noted Dr. James L. Hadler of the Yale School of Public Health in New Haven, Conn., and colleagues.

“Enhanced influenza outreach to improve influenza vaccination coverage for persons living in poorer neighborhoods and efforts to increase use of antivirals by clinicians serving these neighborhoods could reduce poverty-related disparities in severe influenza outcomes,” the researchers noted.

The findings were published in the Morbidity and Mortality Weekly Report (MMWR 2016;65[5]:101-5). Read the full article here.

A diagnosis of influenza increased the risk of subsequent atrial fibrillation by about 18%, investigators reported online in Heart Rhythm.

Clinicians therefore should consider atrial fibrillation (AF) in patients with influenza-like symptoms who report palpitations or experience an ischemic stroke, said Dr. Ting-Yung Chang of Taipei Veterans General Hospital in Taiwan and his associates. Influenza vaccination might help prevent AF, and high-risk patients should be encouraged to receive the vaccination annually, they said. However, a large prospective study is needed to clarify whether influenza vaccination reduces the risk of AF and subsequent ischemic stroke and systemic thromboembolic events, they added.

©Graça Victoria/Thinkstockphotos.com

Atrial fibrillation increases the risk of stroke about fivefold, triples the risk of heart failure, and doubles the chances of dementia and death, the researchers noted. Mounting evidence implicates inflammation and sympathetic nervous system dysregulation in the pathogenesis of AF, raising questions about whether influenza might underlie or contribute to some cases of AF. To explore relationships among AF, influenza, and influenza vaccination, the investigators analyzed data for 11,374 patients with AF who were enrolled in the Taiwan National Health Insurance Research Database between 2000 and 2010. They matched each patient with AF to four controls based on age, sex, enrollment date, and the Charlson comorbidity index (

Heart Rhythm. 2016 Feb. doi: 10.1016/j.hrthm.2016.01.026

).

Unvaccinated patients with influenza were 18% more likely to develop AF than unvaccinated patients without influenza (odds ratio, 1.18; 95% confidence interval, 1.01-1.38; P = .032), even after adjusting for demographic factors, medical history, and use of relevant health care services, the researchers reported. In contrast, vaccinated patients who later developed influenza were about as likely to develop AF as unvaccinated patients who did not develop influenza, both in the overall analysis and in subgroups stratified by age, sex, and comorbidities. Moreover, vaccinated patients without influenza were even less likely to develop AF than unvaccinated patients without influenza (OR, 0.88; 95% CI, 0.84-0.93; P less than .001).

The registry database excluded relevant data on smoking history, body mass index, and physical activity level, the researchers said. “Influenza infection was diagnosed using ICD-9 codes with concomitant use of antiviral agents, and was not further confirmed based on the results of viral culture with throat swab,” they added. “The diagnostic accuracy of influenza infection cannot be fully ascertained.”

The National Science Council and the Taipei Veterans General Hospital funded the study. The researchers had no disclosures.

A diagnosis of influenza increased the risk of subsequent atrial fibrillation by about 18%, investigators reported online in Heart Rhythm.

Clinicians therefore should consider atrial fibrillation (AF) in patients with influenza-like symptoms who report palpitations or experience an ischemic stroke, said Dr. Ting-Yung Chang of Taipei Veterans General Hospital in Taiwan and his associates. Influenza vaccination might help prevent AF, and high-risk patients should be encouraged to receive the vaccination annually, they said. However, a large prospective study is needed to clarify whether influenza vaccination reduces the risk of AF and subsequent ischemic stroke and systemic thromboembolic events, they added.

©Graça Victoria/Thinkstockphotos.com

Atrial fibrillation increases the risk of stroke about fivefold, triples the risk of heart failure, and doubles the chances of dementia and death, the researchers noted. Mounting evidence implicates inflammation and sympathetic nervous system dysregulation in the pathogenesis of AF, raising questions about whether influenza might underlie or contribute to some cases of AF. To explore relationships among AF, influenza, and influenza vaccination, the investigators analyzed data for 11,374 patients with AF who were enrolled in the Taiwan National Health Insurance Research Database between 2000 and 2010. They matched each patient with AF to four controls based on age, sex, enrollment date, and the Charlson comorbidity index (

Heart Rhythm. 2016 Feb. doi: 10.1016/j.hrthm.2016.01.026

).

Unvaccinated patients with influenza were 18% more likely to develop AF than unvaccinated patients without influenza (odds ratio, 1.18; 95% confidence interval, 1.01-1.38; P = .032), even after adjusting for demographic factors, medical history, and use of relevant health care services, the researchers reported. In contrast, vaccinated patients who later developed influenza were about as likely to develop AF as unvaccinated patients who did not develop influenza, both in the overall analysis and in subgroups stratified by age, sex, and comorbidities. Moreover, vaccinated patients without influenza were even less likely to develop AF than unvaccinated patients without influenza (OR, 0.88; 95% CI, 0.84-0.93; P less than .001).

The registry database excluded relevant data on smoking history, body mass index, and physical activity level, the researchers said. “Influenza infection was diagnosed using ICD-9 codes with concomitant use of antiviral agents, and was not further confirmed based on the results of viral culture with throat swab,” they added. “The diagnostic accuracy of influenza infection cannot be fully ascertained.”

The National Science Council and the Taipei Veterans General Hospital funded the study. The researchers had no disclosures.

A diagnosis of influenza increased the risk of subsequent atrial fibrillation by about 18%, investigators reported online in Heart Rhythm.

Clinicians therefore should consider atrial fibrillation (AF) in patients with influenza-like symptoms who report palpitations or experience an ischemic stroke, said Dr. Ting-Yung Chang of Taipei Veterans General Hospital in Taiwan and his associates. Influenza vaccination might help prevent AF, and high-risk patients should be encouraged to receive the vaccination annually, they said. However, a large prospective study is needed to clarify whether influenza vaccination reduces the risk of AF and subsequent ischemic stroke and systemic thromboembolic events, they added.

©Graça Victoria/Thinkstockphotos.com

Atrial fibrillation increases the risk of stroke about fivefold, triples the risk of heart failure, and doubles the chances of dementia and death, the researchers noted. Mounting evidence implicates inflammation and sympathetic nervous system dysregulation in the pathogenesis of AF, raising questions about whether influenza might underlie or contribute to some cases of AF. To explore relationships among AF, influenza, and influenza vaccination, the investigators analyzed data for 11,374 patients with AF who were enrolled in the Taiwan National Health Insurance Research Database between 2000 and 2010. They matched each patient with AF to four controls based on age, sex, enrollment date, and the Charlson comorbidity index (

Heart Rhythm. 2016 Feb. doi: 10.1016/j.hrthm.2016.01.026

).

Unvaccinated patients with influenza were 18% more likely to develop AF than unvaccinated patients without influenza (odds ratio, 1.18; 95% confidence interval, 1.01-1.38; P = .032), even after adjusting for demographic factors, medical history, and use of relevant health care services, the researchers reported. In contrast, vaccinated patients who later developed influenza were about as likely to develop AF as unvaccinated patients who did not develop influenza, both in the overall analysis and in subgroups stratified by age, sex, and comorbidities. Moreover, vaccinated patients without influenza were even less likely to develop AF than unvaccinated patients without influenza (OR, 0.88; 95% CI, 0.84-0.93; P less than .001).

The registry database excluded relevant data on smoking history, body mass index, and physical activity level, the researchers said. “Influenza infection was diagnosed using ICD-9 codes with concomitant use of antiviral agents, and was not further confirmed based on the results of viral culture with throat swab,” they added. “The diagnostic accuracy of influenza infection cannot be fully ascertained.”

The National Science Council and the Taipei Veterans General Hospital funded the study. The researchers had no disclosures.