Influenza Surveillance

Public Health conducts year-round influenza surveillance. Data comes from sentinel health care providers, microbiology labs, hospital emergency departments, schools, long term care facilities, and vital statistics. Since the first week in October, King County sentinel providers have submitted 20 specimens from patients with influenza-like illness ( ILI ); none have been positive for influenza. View regular updates on local influenza activity and surveillance.

Nationally, for the week ending October 20^th, thirteen states, the District of Columbia and Puerto Rico reported sporadic influenza activity and 37 states reported no activity. Find national influenza updates at: www.cdc.gov/flu/weekly

Primary Changes and Updates in the Advisory Committee on Immunization Practices (ACIP) Recommendations on Prevention and Control of Influenza

The 2007 recommendations include six principal changes or updates:

Vaccine recommendations

October and November are good times to vaccinate against influenza, but because flu activity typically peaks after January and continues into spring, it’s worth vaccinating throughout the season.

Trivalent influenza vaccine is available as an injectable, inactivated vaccine (TIV) and a live, attenuated intranasal vaccine (LAIV).

For the 2007-2008 influenza season, vaccination with TIV is recommended for:

• all persons, including school-aged children, who want to reduce the risk of becoming ill with influenza or of transmitting influenza to others;
• all children aged 6–59 months (i.e., 6 months–4 years);
• all persons aged >50 years;
• children and adolescents (aged 6 months–18 years) receiving long-term aspirin therapy who therefore might be at risk for experiencing Reye syndrome after influenza virus infection;
• women who will be pregnant during the influenza season;
• adults and children who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological or metabolic disorders (including diabetes mellitus);
• adults and children who have immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus);
• adults and children who have any condition (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration; and
• residents of nursing homes and other chronic-care facilities.

Vaccination with TIV or LAIV is recommended for the following persons, unless contraindicated:

• healthcare personnel;
• healthy household contacts (including children) and caregivers of children aged <5 years and adults aged >50 years, with particular emphasis on vaccinating contacts of children aged <6 months; and
• healthy household contacts (including children) and caregivers of persons with medical conditions that put them at higher risk for severe complications from influenza.

LAIV is now licensed for healthy people aged 2 through 49 years.

Treatment and Prophylaxis

Two licensed influenza antiviral agents are recommended for use in the United States during the 2007-08 influenza season: oseltamivir and zanamivir.

• Oseltamivir is approved for treatment of persons aged 1 year and older and is licensed for use as chemoprophylaxis in persons aged 1 year and older.
• Zanamivir is approved for treatment of persons aged 7 years and older and is licensed for use as chemoprophylaxis in persons aged 5 years and older.

Note: Due to a high proportion of circulating influenza viruses in the U.S. being resistant to adamantanes, the CDC and ACIP recommend that neither amantadine nor rimantadine be used for treatment or chemoprophylaxis for influenza during the 2007-08 influenza season.

While influenza is not a reportable disease, unusual clusters of illness, illnesses following foreign travel and other cases suspected to be avian or other novel influenza virus infection, outbreaks in long term care facilities or hospitals, pediatric deaths, and deaths due to influenza in otherwise healthy persons should be reported to 206-296-4774.