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AK Public Health Alert Network Summer Influenza Activity

Unusually High Summer Influenza Activity in Alaska

June 17, 2014 - This advisory alerts Alaska health care providers of ongoing confirmed influenza activity in several regions of Alaska, and advises providers to consider influenza when evaluating patients presenting with compatible symptoms, even though we are beyond the traditional 'flu season'.  Recent activity includes continued community spread of influenza viruses, a long-term care facility outbreak, and influenza associated with summer travelers to Alaska on cruise ships and overland tours.

Guidance for providers

Vaccination

  • There is still time for individuals who have not yet been vaccinated this season — two short weeks remain before this vaccine expires, so use it or lose it!

Early antiviral use can save lives 

  • If you suspect influenza and it is within 48 hours of symptom onset, consider treatment with antivirals regardless of rapid influenza test results.  A negative result cannot be used to exclude flu diagnosis.
  • Antiviral treatment may be considered at any time after onset for patients with suspected influenza who
    • are hospitalized;
    • have severe, complicated, or progressive illness;
    • are at higher risk for influenza complications based on age or medical conditions (see below)
    • live or work in a congregate setting

 Reporting

 Individuals at higher risk of flu complications

  • children aged <2 years;
  • adults aged ≥65 years;
  • persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, hematological (including sickle cell disease), metabolic disorders (including diabetes mellitus) or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability [mental retardation], moderate to severe developmental delay, muscular dystrophy, or spinal cord injury);
  • persons with immunosuppression, including that caused by medications or by HIV infection;
  • women who are pregnant or postpartum (within 2 weeks after delivery);
  • persons aged <19 years who are receiving long-term aspirin therapy;
  • American Indians/Alaska Natives;
  • persons who are morbidly obese (i.e., BMI ≥40); and
  • residents of nursing homes and other chronic-care facilities.

References

Alaska Influenza Webpage at http://www.epi.hss.state.ak.us/id/influenza/fluinfo.htm

CDC - Infection Control in Health Care Facilities. Available at: http://www.cdc.gov/flu/professionals/infectioncontrol/index.htm

CDC - Long Term Care Facility Influenza Control Guidance.  Available at:

http://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm 

CDC - Influenza Antiviral Medications: Summary for Clinicians. Available at: http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm

Conditions Reportable to Public Health in Alaska. Available at: http://www.epi.hss.state.ak.us/pubs/conditions/default.stm

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