The Flu and You!

January 22, 2018

 

What you need to know to be safer this Flu Season

 

Hello, Hello, Today is all about the Flu. This is a bit of a hybrid show. It will combine my solo show with thoughts about this season’s flu in the US along with an abstract  on an article in AJIC about Healthcare workers working with flu like symptoms during the 2014-2015 Flu season, then I’ll wrap things up with some suggestions on what you can do to stay safe and flu free this season.

So let’s get down to it. As you may be well aware this influenza season ramping up to be pretty significant. According to the CDC - As of the week of January 6, 2018, the United States geographic spread of influenza in 49 states was reported as widespread. They have been tracking specimens and Influenza A is way surpassing Influenza B. 82.9% of specimens were found to be Influenza A verses 17.1 percent to be Influenza B.

 

And to further drill down on the Influenza A strains, 89.9% of those specimens tested were found to be H3N2. That is the strain that this year’s flu shot does didn’t match. The other type with 8.8% is H1NI, and 1.3% didn’t have subtyping done.

​OK that is nationwide, and when I say nationwide I’m only speaking to the United States of America, where I’m located. I have not looked at other northern hemisphere countries to see what is happening there.

In California, where I live, the California Department of Health for the week ending January 6th 2018 reported statewide activity to be widespread. All regions of the state are shown to have elevated activity. They are seeing above expected levels of flu from outpatient reports and also above expected levels of hospitalizations from the flu.

California also has Influenza A – H3N2 as the viruses that are predominating this season.

Yikes, It’s her is above expected levels and we know that the flu shot doesn’t match for H3N2, the predominate virus this flu season. The northern hemisphere each flu season will look to see what happened in Australia, in the southern hemisphere, to predict what may occur when it is our flu season.

Well in Australia, the flu vaccine was seen to be only 10% effective. I’ve been reading on this and basically in Australia only the individuals that are at high risk will be prompted to get the flu shot. Her in the US everyone is suggested to get vaccinated and in many counties if you work in a hospital it is mandated that you either get a flu shot or wear a mask while in patient care areas for the entire flu season. That is from October to March in the US. 

In the US due to our vaccination push, the individuals who received the flu shot are estimated to be 30% protected. This is due to the sheer number of individuals who received the vaccine and the herd immunity that goes along with it.

But that means if you didn’t get vaccinated or if you did, then you only have 0-30% chance of being protected from your co-workers, your school mates, your fellow commuters, and your healthcare workers if you need to visit your doctor or go into the hospital for some reason (other than the flu).

Working in infection prevention and control what we do is to stop or prevent healthcare associated infections. Basically we don’t want you to become ill or even more ill if you come to our medical centers. But according to an article in the American Journal of Infection Prevention. They survey’s healthcare workers in hospitals, outpatient settings and long term care facilities to see if they worked while having flu like symptoms. I won’t spoil it for you, but I was a bit shocked when I first read it.

I hope you listen to the podcast to hear the abstract about the 2014-2015 Flu season, the idea is that if you are interested in the topic, you will then go read the full article in AJIC. Today I am using the abstract to enhance my point around this season’s flu activity and what we can do to stay safe, so here goes.

Title: Working with influenza-like illness: Presenteeism among US health care personnel during the 2014-2015 influenza flu season by Sophia Chiu MD, MPH, et, al.

I hope you do go back and read the full article! Yikes, In the 2014-2015 Flu season, pharmacists and physicians are the top culprits of going to work with flu like symptoms, Pharmacists who touch your pill bottles and touch the pill mover tool that pushes the pills into the bottles they reported to work with flu like symptoms in the 2014-20165flu season 67.2% of the time. And physicians who you rely on to know to do the right thing went to work 63.2% of the time with flu like symptoms. And if you read the article you will find that healthcare workers in the hospital were slightly higher then ambulatory setting healthcare workers, 49.3 in the hospital to 45.7 in the ambulatory setting.

Well for those of you who are healthcare workers, you most likely have a policy that restricts you from working while ill. If you are a manager, especially this year, when the flu vaccine is minimally effective, I would hope that you are vigilant in monitoring your staff every shift to make sure no one is coming in to work with flu like symptoms and if they are that you are promptly sending them home.

If individuals have a fever, are coughing or sneezing, have a sore throat, or are unable to control their secretions, they should definitely not be at work in a healthcare setting and they should stay home.

I travel about 25 minutes on a train to work. It is called BART, Bay Area Rapid Transit. It is a network of trains that get individuals into and out of around San Francisco and the San Francisco Bay area. If you have been to the Bay area recently, you know that there is major grid lock on the freeways and it is a very expensive place to live, so many individuals are moving farther and farther outside of the hotspots where many of the jobs are like Silicon Valley, San Francisco, and some parts of the east bay. This means that many of us use the BART to get to work. So picture this every week 433K people ride the BART, and during rush hour it is packed with people. Bodies packed in to the trains. People coughing and sneezing and everyone touching the same safety straps and bars to stabilize during the trip. Ugh, when I get off the train I immediately put hand sanitizer on. But what can we all do to keep safe?

Respiratory Hygiene:

If you have to cough or sneeze, then try to angle away from others and cough or sneeze into you sleeve and not your hands. If you have to use a tissue, throw it out right away and do hand hygiene. Before you put anything into your mouth or touch your around your eye, wash your hands thoroughly.  Also keep yourself safe, move away from some is coughing or sneezing, if you can move away from them do so, keep safe.

 

Also, in your work setting promote respiratory hygiene at work. Offer hand sanitizer in meeting rooms along with a box of tissue. Have a sign that says cover your cough. If you work somewhere where you have to share a safety message, physically go over how to cover your cough or sneeze by doing so into your sleeve and not into the air and not into your hand. My preschooler is being taught how to do this, she knows how to cough and sneeze into her sleeve. As adults we should know how to do this too.

CDC has a cover your cough page with posters in many languages. Please print it and share it.

So that’s it. It is a rough Flu season, I hope you can keep safe and Flu free. If you do have flu like symptoms, please stay home, one less person you have contact with while ill is one less person likely to get sick and get their family sick or their school mates sick, or their patients sick.

 

Be safe and please wash your hands!

 

CDC Cover your Cough page with multiple languages.

 

CDPH - Influenza (Flu) and other Respiratory Disease

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