Flu Information for Health Care Professionals

The Flu season is off to an early start in 2012-2013, the earliest since the 2003-2004 season. It is important to note that just because the season is off to an early start, it does not guarantee that it will be a worse than average year. 

Flu strains

Current testing shows that most of the Flu strains now are Influenza A H3N2. These strains appear to match well with the H3N2 component in this year’s vaccine. There are Influenza B strains circulating, and about 2/3 of these match with the strain in the vaccine. We are not seeing any new pandemic-like strains thus far. This means that your patients will still receive benefit from being vaccinated if they have not already received a Flu shot.

Treating patients

Given that testing for Flu is now widespread, we have received many questions about whom to treat. This is particularly true for infants younger than 6 months, where there is no FDA approved indication for using Tamiflu (oseltamivir). The AAP/CDC have put together a very well written information sheet that offers guidance for making decisions on treatment, including dose information for the youngest infants.

In addition to the information provided above, we also suggest reviewing the following reccomendations:

1. First, treating infants with Flu makes a lot of sense as they are at high risk for complications of the infection. However despite the guidance from the AAP and CDC, it is important to discuss with parents that while smaller studies have shown the drug to be safe in infants, using Tamiflu in infants less than 6 months is not FDA approved.  There may be rare side effects that become apparent when many more infants are treated. This should be discussed, parents should agree and this agreement should be documented by the provider.  
2. Second, there is a recently published paper that offers further guidance on dosing of Tamiflu for infants 9-12 months. For these infants, a dose of 3.5 mg/kg BID achieved drug levels likely to be more effective for treating Flu. These results are too new to have made it into official publications so providers need to make a note of this.

For more information...

Please refer to these key links for the most up to date Influenza information:

• CDC Weekly Flu Report (latest national surveillance data)
• North Carolina Flu data