NIH & WHO Experts Warn of Severe Flu Season in the United States

Flu activity is now high in at least 3 states, according to the Center for Disease Control and Prevention’s (CDC) weekly FluView report for the week ending November 25, 2017. The report for Week 47 notes that influenza A continues to dominate the 2017-2018 flu season in the United States. The proportion of outpatient visits for influenza-like illness (ILI) climbed above the national baseline of 2.2% for the first time to reach 2.3%, up from the previous week’s rate of 2.0%. Four states—Georgia, Louisiana, Massachusetts, and Oklahoma—are now reporting widespread flu activity, an increase from 2 states last week.

Several flu-related deaths have also been reported. In Arizona, a 20-year-old woman died on November 28, 2017, after being diagnosed with the flu. According to local news reports, the Phoenix area mother of 2 began feeling ill just 1 day before and she visited an urgent care clinic. After returning home with a flu diagnosis and medication, her symptoms worsened and she was taken to the hospital, where she subsequently died. She had no pre-existing health conditions and had not received a flu vaccine this season.

“Adult influenza-related deaths are not reportable in Arizona, but we continue to see increased numbers of flu cases reported in the state,” said the Arizona Department of Health Services in a statement to Contagion^®. “Flu is unpredictable, but this season, we’re seeing more cases earlier in the season than we typically do. The best way to protect yourself against flu is to get vaccinated. This is especially important as we’re entering the holiday season and people are more likely to be spending time with those most vulnerable to complications from flu, such as infants and the elderly. Remember to cover your cough, wash your hands and stay home when sick.”

During the 2016-2017 flu season, Arizona reported 13,850 laboratory-confirmed influenza cases. So far this season, the state has had 671 confirmed cases and reported 1 influenza-associated pediatric death.

As more indicators continue to suggest that this may be a severe flu season in the United States, a new editorial in the New England Journal of Medicine makes the case for the need for a universal flu vaccine to minimize influenza-related morbidity and mortality. The article’s authors—doctors from the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, and the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne—write that the recent severe flu season in the Southern Hemisphere could hint at a what is to come for the Northern Hemisphere this winter.

In Australia, the authors noted that record-high numbers of laboratory-confirmed influenza cases and above average influenza-related hospitalizations and deaths brought their case count to 215,280 by mid-October—more than triple the 59,022 cases reported during the H1N1 influenza pandemic of 2009. The flu vaccine that was administered, the same vaccine being administered now in the Northern Hemisphere, was only 10% effective against the predominating influenza A (H3N2).

The authors also make the case for moving away from egg-based vaccine manufacturing, following recent news that an egg-adapted mutation lowers vaccine effectiveness.

“Given that most of the US influenza-vaccine supply is currently produced in eggs and the composition of the 2017—2018 Northern Hemisphere vaccine is identical to that used in Australia, it is possible that we will experience low vaccine effectiveness against influenza A (H3N2) viruses and a relatively severe influenza season if they predominate,” write the authors. “This possibility underscores the need to strive toward a “universal” influenza vaccine that will protect against seasonal influenza drift variants as well as potential pandemic strains, with better durability than current annual vaccines.”