Monday, December 26, 2005

Happy New (flu) Year

If you live in the southwest of hte United States you have probably noticed that seasonal influenza is here:
During week 50 (December 11 – December 17, 2005)*, influenza activity continued to increase mostly in the southwestern United States. One hundred sixty-nine (8.9%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories were positive for influenza. The proportion of patient visits to sentinel providers for influenza-like illness (ILI) was above the national baseline. The proportion of deaths attributed to pneumonia and influenza was below the baseline level. One state reported widespread influenza activity; 5 states reported regional influenza activity; 2 states reported local influenza activity; 33 states, New York City and the District of Columbia reported sporadic influenza activity; and 9 states reported no influenza activity. (CDC)
In Maricopa County (Arizona) some Emergency Rooms have wait times as long as 12 hours. Over 80% of the year's flu cases has come in the last two weeks (station KOLD via East Valley Tribune/Scottsdale Tribune). In El Paso, Texas the situation is similar:
The flu season is in full swing, as Luis Calvo, who has the flu noticed while he waited in the packed waiting room at the at the Franklin Medical Clinic for hours to see a doctor.

Doctor Andres Enriquez at the Franklin Medical Clinic says his waiting room was so packed that for most of the day there was standing room only and some people actually had to wait outside of the building.

According to Dr. Enriquez 90 percent of the patients he saw on Christmas Eve had the flu like Luis.
And it is not just Dr Enriquez that is seeing more patients. In fact 24 hour pharmacies like Walgreen's saw longer lines this holiday weekend.

"We have seen an exceptional increase in people with various respiratory complaints the reason why we know it appears to be a flu problem is because there has been an increase of people with prescriptions for Tami-flu," says Allen Hrich, a Walgreen's Pharmacist.

But, flu patients not only lined-up to get Tami-flu, they are also looked for other drugs like Suda-fed which you used to be able to get off the shelf, but because of the meth problem you now have to get it from a pharmacist. (KFOX-TV)
The interaction with the substance abuse problem (Sudafed being made into meth) and the stress on the medical care delivery system with even a mild uptick in flu cases shows once again how the public health and social services infrastructures areinterconnected in ways that don't allow us to "target" discrete areas (like antiviral stockpiling or vaccine production and distribution) as ways to respond to an influenza pandemic. Unfortunately we cannot except consumer protection from that list, either:
It was the kind of event companies hold all the time. ExxonMobil had a health fair for its refinery workers in Baytown, Texas, and offered free flu shots. Only the people hired to administer the shots were not qualified health-care professionals and the vaccines they gave were purified water.


This year in Texas, U.S. Atty. Chuck Rosenberg said a Houston businessman, Iyad Abu El Hawa, and his alleged accomplice, Martha Denise Gonzales, were indicted on charges of giving fake flu shots. The two suspects were charged last month with conspiracy and tampering with consumer products; they had allegedly inoculated about 1,100 ExxonMobil employees as well as 14 nursing home patients. El Hawa and Gonzales have pleaded not guilty.

In Alabama, the state Attorney General's Office announced this month that it had cited a Montgomery physician for giving more than 90 fake vaccines. Dr. Zev-David Nash has surrendered his medical license to authorities and is accused of injecting his patients with a harmless saline solution.

According to The Associated Press, Nash gave investigators a box of syringes and a written statement detailing how he substituted the saline solution for flu vaccines at a flu shot clinic he held at a Montgomery bank.

Rosenberg said the complaint in Texas charges El Hawa with attempting to defraud Medicare by administering flu vaccines when none were given.

El Hawa owns Comfort & Caring Home Health and operates two other home health centers in Houston, Rosenberg said. He does not have a medical license and has no formal training or license to dispense medicine. Neither does Gonzalez, whom Rosenberg said worked in a non-medical position in a physician's office and for El Hawa.

Officials said they were trying to determine how El Hawa received the contract from ExxonMobil to administer flu shots at the health fair. (Chicago Tribune)
So the regular (seasonal) flu season in upon us. It is expected to peak in late January or early February. It's not an avian flu pandemic, but it's an opportunity, as seasonal flu hits your community, to ask yourself what it would be like if it were three, four or five times worse. Then get busy in case that happens later this year, next year or the year after.

A good place to start is The Flu Wiki.