FastMed North Carolina Health Advisory - NC Flu Deaths Reported

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Influenza

As you may have heard, as of December 3rd, NC had its first 3 flu-associated deaths this season. Locally, in the past couple of weeks, we have begun to see an increase in the numbers of lab-confirmed influenza, mainly influenza A (H1N1).

  1. All 3 were middle-aged persons with underlying medical conditions who were unvaccinated.
  2. They had tested positive for influenza A, and were from Eastern NC, the Triad and the Charlotte area, respectively.
The most important thing you can do right now is get your patients vaccinated. We highly recommend receiving the vaccination immediately if you have not received this year’s vaccine.

 

FastMed Prevention, Testing and Treatment

Influenza vaccination recommendations

Annual flu vaccination is recommended for everyone 6 months of age and older who does not have a contraindication. You should be vaccinated as early in the flu season as possible. It takes about 2 weeks after vaccination for a person to develop peak protective antibody levels so waiting until flu is spreading in the community may be too late. Vaccination will last the entire flu season.

Allergies to Vaccination

People with a history of egg allergy who report only hives after exposure to egg can receive the flu shot. (The flu mist is not recommended for those with egg allergies) If the person's egg allergy involved a more severe reaction (like angioedema, respiratory distress, lightheadedness or recurrent emesis), they can get the recombinant hemagglutinin vaccine, which is indicated for persons aged 18 through 49 years. 

High Risk Individuals

It's especially important that the following people at high risk of serious complications from the flu - and their close contacts - be vaccinated:

  • Children younger than 5 years (especially those younger than 2 years old)
  • Adults 65 years of age and older
  • Pregnant women and women up to 2 weeks postpartum
  • People with chronic pulmonary or cardiovascular (except isolated hypertension), renal, hepatic, neurological, hematologic, or metabolic conditions
  • People who are immunosuppressed (including immunosuppression cause by medications or HIV infection)
  • People who have a BMI  over 40
  • People less than 19 years of age who are receiving long-term aspirin therapy
  • Residents of nursing homes and other long-term care facilities
  • American Indians and Alaskan Natives
  • Health-care personnel
  • Those living with or caring for persons at high risk of severe influenza-related complications

Diagnostic Testing for Influenza

Rapid Influenza Diagnostic Tests produce very quick results, visit your local FastMed Urgent Care immediately if you suspect you have the flu.

Influenza Antiviral Medications

If we perform a rapid influenza test and determine you have the flu, a number of different antiviral medications may be considered for your treatment. Early influenza detection and antiviral treatment can shorten the duration of fever & illness symptoms, and may reduce the risk of complications from influenza & death, and may shorten the duration of hospitalization.

Influenza Antiviral Medications are most effective when treatment is administered early, especially within 48 hours of influenza illness onset.

Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who:

  • Is hospitalized;
  • Has severe, complicated, or progressive illness (regardless of prior health status); OR
  • Is at higher risk for influenza complications.

Antiviral treatment might still be beneficial in patients with severe, complicated or progressive illness and in hospitalized patients when started after 48 hours of illness onset. Antiviral treatment also can be considered for any previously healthy, symptomatic outpatient not at high risk with confirmed or suspected influenza on the basis of clinical judgment, if treatment can be initiated within 48 hours of illness onset. Antiviral medications are approximately 70-90% effective in preventing influenza and are useful adjuncts to influenza vaccination. Medication must be taken each day for the duration of potential exposure to a person with influenza and continued for 7 days after the last known exposure. For persons taking antiviral chemoprophylaxis after inactivated influenza vaccination, the recommended duration is until immunity after vaccination develops (about two weeks in adults; can take longer in children depending on age and vaccination history).

Infection Control

All persons with suspected or confirmed influenza should stay at home for at least 24 hours after their fever resolves without the use of fever-reducing medication. Even after contracting the flu, correct cough and respiratory hygiene and hand washing can help limit public exposure to the flu.

The Flu Is Contagious

Most healthy adults may be able to infect other people beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Children may pass the virus for longer than 7 days. Symptoms start 1 to 4 days after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Some people can be infected with the flu virus but have no symptoms. During this time, those persons may still spread the virus to others

Flu Reporting

FastMed Urgent Care will report  influenza-like illness in patients with recent swine exposure or any outbreaks of influenza-like illness (fever + cough or sore throat), especially among young children to the local county health department.

Mel G. Lee, MD, CCFP, RMC, RCN (pilot)
Chief Medical Officer North Carolina
FastMed Urgent Care

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