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Centers For Disease Control and Prevention Urges Rapid Antiviral Treatment for High Risk Patients
Flu season is here again and the Centers for Disease Control and Prevention (CDC) has received reports of severe episodes of the flu. Seasonal flu accounts for substantial morbidity and mortality every year. The CDC estimates that the 2014-2015 season flu accounted for 970,000 hospitalizations. Elders, adults aged 65 years and older, and especially residents living in skilled nursing facilities (SNFs) are considered high-risk for contracting the flu and vaccination is recommended each year. Comorbidities also increase the risk factor. Those comorbidities include:
· Chronic pulmonary disease including asthma;
· Cardiovascular disease;
· Renal disease;
· Hepatic disease;
· Blood and metabolic disorders including diabetes;
· Neurologic and neurodevelopment conditions;
· American Indians/Alaska natives; and
· Morbid obesity (i.e., BMI equal to or greater than 40).
Unfortunately not all residents and not all SNF staff consent to vaccination and the flu is community acquired. With the current survey focus on quality outcomes and avoiding unnecessary rehospitalization, this information from the CDC takes on added significance for SNFs.
Because of the reported severe flu episodes, the CDC has reminded clinicians to treat suspected influenza in all hospitalized patients with antiviral medications as soon as possible regardless of negative diagnostic testing. This is because early antiviral treatment works best and can reduce morbidity and mortality. Additionally, clinicians should continue efforts to vaccinate patients and staff this season for as long as the flu viruses are circulating.
Additional recommendations from the CDC include:
· Encourage all patients who have not yet received the vaccination to be vaccinated;
· Encourage all persons with flu-like symptoms who are at high risk for flu complications to seek prompt medical care;
· Starting antiviral treatment should not wait for laboratory confirmation of the flu; and
· While flu vaccination is the best way to prevent the flu, taking the vaccine does not rule out the flu virus infection in a patient who has clinical signs and symptoms of the flu. Vaccination status should not impede the initiation of prompt antiviral treatment.