Nursing News

Flu Cases Continue Climbing; At Epidemic Level

Flu Cases Increase to Epidemic Level

By Jennifer Larson, contributor
 
Seasonal influenza cases in the United States continue to increase, and have now reached epidemic levels. In fact, flu activity is now considered “widespread” across 40 states as of January 28, 2017, up from 37 states the previous week.
 
The current hot spots include New York City and 15 states -- Alabama, Arkansas, Georgia, Indiana, Kansas, Kentucky, Louisiana, Missouri, New Jersey, New York, Oklahoma, Pennsylvania, South Carolina, Tennessee, and Wyoming – where they have experienced high influenza-like illness (ILI) activity, according the Centers for Disease Control and Prevention (CDC).
 
The CDC also reported, “The proportion of deaths attributed to pneumonia and influenza (P&I) was above the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.”  A total of 15 pediatric deaths related to the flu have been reported so far this season (starting October 1, 2016), including seven in the week ending January 28, 2017.
 
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“Flu has just hit widespread status here in Minnesota. And, it’s increasing in numbers across the country,” said Gwen Verchota, PhD, APRN-BC, care delivery manager and lead nurse practitioner for virtuwell.com, which offers an online clinic to patients in all 50 states.
 
Amesh Adalja, MD, an infectious disease physician at the University of Pittsburgh, has also noticed an uptick in flu cases on varying severities in the last few weeks. “This reflects the fact that the flu season typically peaks in February,” said Adalja. 
 
Most of the flu cases reported so far this year are from a different strain of the virus than those during the 2015-2016 season. 
 
“Last season was dominated by the H1N1 strain of influenza A, while this one is H3N2-dominated,” said Adalja.
 
Interrupting the chain of infection
 
As the influenza virus becomes more widespread, health care providers are reminded that everyone’s chances of exposure increase, both on and off the job.
 
“It is very important to understand that the flu can be transmitted one day prior to the onset of symptoms,” noted Sarah Wiley, BSN, RN, a clinical nurse at Abington-Lansdale Hospital in Pennsylvania. “A person can be infected and not realize it, and will pass it along to someone else.”
 
Even when people do know they have the flu, some don’t take the proper precautions to keep from spreading the infection to others. In a recent poll of workers in the New York metro area, a third of them admitted to continuing to go to work when they had the flu. 
 
That’s why experts continue to urge people to get the flu vaccine. That way, even if they’re exposed, they’re less likely to contract the disease and possibly spread it to others. 
 
“It interrupts that chain of infection,” said Wiley.
 
 
And while the flu vaccine is never 100 percent effective, this year’s vaccine is proving effective in most cases.
 
“Most of the flu viruses that are circulating across the U.S. appear to be covered by this season’s flu vaccine,” said Verchota. Another change this season is that the nasal spray version of the flu vaccine is no longer recommended for pediatric patients because of its ineffectiveness last year.
 
Amid the excuses, nurses can be role models
 
Chances are, you’ve heard excuses from patients who are reluctant to get a flu vaccine. 
Kimberly Jenkins, a medical assistant in a family practice office in Richmond, Va., feels like she’s heard them all.
 
“I don’t get flu shots. The last time I got one, I got sick,” patients have told Jenkins. Also popular is this excuse: “I never get the flu, so I don’t need the shot. I don’t like taking medicine if I don’t absolutely have to.”
 
But even some health care professionals are reluctant to roll up their sleeves. Don’t be one of them, experts say. It’s not just about staying well. It’s also about protecting your patients. 
 
“When you’re in contact with vulnerable patients, this poses a huge threat to their health and safety,” said Wiley, who authored “Nurses’ Most Important Role This Flu Season: Get Vaccinated,” published in the October issue of Nursing2016
 
By getting vaccinated, nurses can decrease the chances that they’ll unintentionally expose their patients to the flu. The CDC reports early vaccine coverage by nurses was at 80.7 percent at the end of November, compared to 82.8 percent for nurse practitioners and physician assistants, and 83.0 percent for physicians.
 
Depending on where you work, you might not have much of a choice. 
 
“My facility, a large teaching hospital, requires an annual flu vaccination for every employee who is able to receive it,” said Brooke Wallace, BSN, RN, who works in Phoenix. 
 
Some institutions do offer an “opt out” option, but it can vary. Jenkins noted that her employer will allow some employees to opt out of the vaccine, but they must sign a waiver and agree to wear a face mask during flu season. 
 
The CDC recommends that everyone over 6 months of age receive a flu vaccination by the end of October, but notes that vaccinations can carry on through the winter.  Even now, it’s still worthwhile to get a flu shot if you haven’t already, said Wiley. 
 
 
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