Flu Season Could Be Long, Hard, CDC Says

Kate Traynor

BETHESDA, MD 20 October 2009—The Centers for Disease Control and Prevention (CDC) today released new data about people recently hospitalized with 2009 H1N1 influenza virus infections and said the agency is preparing for a long, difficult flu season.

"We expect to be seeing illness from H1N1 for several more months and may see a lot of disease in the spring. And so we're really just at the beginning," said Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases. "We're planning a long response."

Schuchat said surveillance data from nearly 5000 hospitalizations that occurred from September 1 through October 10 confirm earlier reports that H1N1 disproportionately affects young people.

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In all, she said, 53% of hospitalized patients were under 25 years of age, 39% were 25–64 years of age, and 7% were 65 or older. In a typical influenza season, about 60% of hospitalizations occur in those 65 or older.

Schuchat said death rates are also skewed toward younger patients: about 24% of the deaths since September 1 have been among people under age 25 years, 65% in 25–64-year-old patients, and 12% in those 65 or older.

"With seasonal flu, 90% of fatalities occur in people 65 and over," she said. "It's almost completely reversed here. Nearly 90% of our fatalities are occurring in people under 65."

CDC recently updated its recommendations on antiviral treatment for H1N1-infected patients. The agency continues to emphasize the need to promptly administer antivirals to hospitalized patients who have influenza symptoms as well as symptomatic patients who have underlying conditions that increase the risk of influenza-related complications.

"If you suspect flu, it's very important to provide those antiviral medications quickly," Schuchat said. She emphasized that therapy should start before laboratory confirmation of the illness if the clinician suspects influenza infection in a high-risk patient.

Schuchat also said that a negative result on a rapid test for H1N1 infection does not reliably rule out infection and encouraged clinicians to rely on their clinical judgment if a symptomatic patient tests negative.

The federal government this month renewed, for the second time, a declaration that the H1N1 virus presents a public health emergency. As part of the response to the emergency, the Department of Health and Human Services recently released 300,000 courses of pediatric oseltamivir suspension for shipment to state health agencies.

Shcuchat said CDC encourages pharmacies to make provisions to compound oseltamivir suspension to increase the amount of pediatric dosage forms available throughout the country.

Some pharmacy chains, including Wal-Mart, Walgreens, and Publix, have announced that they will compound pediatric oral suspensions of oseltamivir for customers.

Schuchat said she appreciates the efforts of pharmacists and other health care providers on the "public health frontlines."

"They're working together on this response. We are all trying to make sure that we reduce illness and death and spare this country the worst of the pandemic," she said.