In the deadliest week yet for the nation's stubborn influenza outbreak, nine more children died of flu-related illness last week, bringing the season's pediatric death toll to 29, as local health officials nationwide continue to take protective measures to stop the spread of the virus.
At the halfway point of the 2012-2013 flu season, the number of child deaths has nearly matched the 34 that died in the mild 2011-2012 flu season, U.S. health officials said Friday.
More than half of the children who have died were not vaccinated and most had underlying health problems that made them more susceptible to the virus, said Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention.
But it's the elderly who continue to bear the brunt of the epidemic. Hospitalization rates for people ages 65 and over with laboratory-confirmed influenza jumped to 82 per 100,000 last week, from 70 per 100,000 the previous week, and about 50 per 100,000 during the last week of 2012. The overall hospitalization rate for the entire U.S. population was 19 per 100,000.
In a conference call with reporters, Frieden said the number of flu cases, as well as hospitalizations and deaths, are expected to rise as the epidemic progresses."It's shaping up to be a worse than average (flu) season and a bad season for the elderly," he said "Seasonal influenza always takes the heaviest toll on seniors when it comes to deaths. . . . In general, we estimate that about 90 percent of flu-related deaths are in people 65 and older."
Making matters worse, Frieden said, health care providers aren't offering the antiviral medications, Tamiflu and Relenza, at appropriate levels to reduce patient suffering.
After vaccination, both medications are viewed as the second line of defense against the flu because they shorten the duration of the virus and can cut the flu death rate by 50 percent to 75 percent when taken within two days of developing symptoms.
"Maybe as many as a third or half of people who are hospitalized with flu aren't getting prompt treatment with antivirals . . . and that can have a big impact on reducing serious illness and death," the CDC director said.
Antivirals should be given to high-risk patients with flu symptoms even if rapid flu tests come back negative for the virus because of the prevalence of false negatives, Frieden said. High-risk patients include the elderly; infants and young children; and people with asthma, diabetes, heart disease, lung disease, neurological disorders and other underlying medical conditions.
While the total number of U.S. flu deaths won't be tallied until the end of the flu season, the virus typically kills thousands and sometimes tens of thousands of Americans each year. Over a 25-year period, the number of U.S. flu deaths has varied annually from 3,000 to 49,000, said Dr. Joseph Bresee, chief of the influenza division of the CDC's Epidemiology and Prevention Branch.
About 129 million doses of flu vaccine already have been distributed nationwide. Roughly 1 million doses are administered every day during flu season, Frieden said.
While reports of spot vaccine shortages continue to crop up, the five companies that make the vaccine for the U.S. have another 10 million doses in the pipeline, so providers should still be able to order it and consumers should still be able to find it with a little checking around.
People having trouble finding the vaccine can use the zip code-based "flu vaccine finder" at www.flu.gov.
The 145 million doses produced for the entire season is twice the supply available several years ago, said Margaret A. Hamburg, commissioner of the U.S. Food and Drug Administration.
After beginning a month earlier than usual, the flu season shows signs of slowing in some areas of the country, while increasing out west.
Besides treating patients, hospitals are taking precautions to protect visitors, as well. As of Friday, 30 states and New York City reported high levels of influenza-like illness among outpatient hospital visitors. That's up from 24 last week.
The Central Georgia Health System in Macon this week required that children be at least age 12 or older to visit patients at three area hospitals in order to protect patients, visitors and staff from possible infection.
"Our policies and actions are designed to protect those at greatest risk during the flu season," said Dr. Delanor Doyle, chief medical information officer at the Medical Center of Central Georgia.
The share of deaths caused by pneumonia and influenza in a weekly CDC analysis of 122 cities reached 8.3 percent last week, up from 7.3 percent the previous week. Both levels top the 7.2 percent threshold for an epidemic.
On the positive side, the share of outpatient hospital visits for influenza-like illness was 4.6 percent last week, down from a recently adjusted figure of 4.8 percent the previous week.
By Tony Pugh
McClatchy Newspapers