We’re already seeing influenza in our ED. The people coming in with it are really sick, too.
I went to a couple of sites to see how quickly influenza is spreading. The CDC site for influenza is at www.cdc.gov/flu.
A map to track influenza activity across the US is here (update usually delayed by a couple of weeks).
Good news is that so far on what has been submitted to the CDC, 27 of the 30 isolates are related to the 2008-2009 influenza vaccine — so this year’s vaccine appears to be a good match to the circulating virus. If you haven’t gotten your influenza shots yet, you can potentially save yourself and your family from getting very sick by immunizing yourselves as soon as possible. Remember, influenza is not a harmless disease. It is estimated to cause 36,000 deaths per year in the United States alone.
For those of you that don’t want to vaccinate because you will just “take the pills” if you get the flu, I have some bad news for you.
According to this “Influenza Activity Update” which notes influenza activity through November 29, 2008, two thirds of all isolates obtained were H1N1 strain and 96% of the influenza H1N1 isolates tested were resistant to Tamiflu. In other words, you can hoard all of the Tamiflu pills you want – they won’t do a thing when you catch this strain of the flu.
Just like antibiotic overuse, all of our Tamiflu use is now beginning to render Tamiflu useless. When we’re really sick and we really count on Tamiflu to help us get better from this strain of influenza, it will no longer be there for us. The bugs have already learned how to beat the drug.
Fortunately, the isolates resistant to Tamiflu were all sensitive to amantadine – a drug that previously was regarded as ineffective against influenza due to resistance. In addition, all of the isolates are still sensitive to Relenza, but Relenza is not indicated for treatment of children less than 7 years old and isn’t indicated for preventing influenza in children less than 5 years old. Twenty thousand children younger than 5 years old are hospitalized for influenza each year. Also, Relenza isn’t recommended for use in those with underlying lung problems — the same people who are more likely to have worse outcomes when they catch influenza.
I give it about five years until influenza is resistant to all of our medications.
Let’s just hope the pandemic flu is sensitive to something.





