Highlights and Developments From 2019-20 Flu Season

Forecasting localized influenza virus activity could become a lot easier, according to investigators who studied the incorporation of real-time information about influenza-like-illnesses (ILI) from mobile devices. Their study was published in Open Forum Infectious Diseases.

Estimating flu activity is often hampered by delays in reporting because of lags in traditional surveillance sources. In their study, the investigators developed forecasting models of real-time, state-reported ILI that was 2 weeks ahead of published reports. They used more than 12 million temperature readings from 500,000 devices for 3 flu seasons across 46 states.

They found that the data from smart thermometers, like those used in the analysis, can significantly improve influenza forecasting at the state level. Even more importantly, they found that adding thermometer data showed significantly lower errors than a baseline model.

A separate article published in the Harvard Business Review discussed how to motivate busy health care providers to recommend the flu shot to their patients. In an experiment, investigators wanted to see how offering financial incentives compared to creating an inter-health care facility competition in terms of more flu vaccines given.

The first group was financially compensated for all the flu shots they administered if they hit the growth target. A second group were measured the same way, but informed of their own ranking compared to other locations. A third group acted as the control group, and was offered neither the financial incentive nor the relative ranking compared to other centers.

The investigators found that the 2 intervention groups increased flu shot administration by about 6% compared to the control group. The performance ranking facility grew by almost 10%, the investigators said, while the number of vaccines administered by clinics with financial incentives grew by less than 1%.

“This might sound obvious, but most efforts to improve vaccination rates to date have focused on patients, not physicians—even though physicians are in a position to heavily influence patients,” the authors wrote.

Let’s take a look at what else is developing across the flu landscape.

Flu Deaths:

In the last 3 weeks, influenza-related deaths have been reported in the following areas:

• Outside Detroit (male aged 69 years)
• Washington state (male aged in his 90s years)
• Minnesota (unknown gender or age, though officials said it was not a pediatric patient)
• Upstate New York (unknown gender, age 4 years)
• Arkansas, at least 3 deaths at the time of reporting

Flu Research:

National Institute of Allergy and Infectious Diseases (NIAID) investigators are recruiting healthy adults to deliberately become infected with the influenza virus in order to monitor them in carefully-controlled conditions. Volunteers are asked to remain in the clinic for 7 full days after acquiring the virus, typically with a nasal spray with the seasonal flu virus. The volunteers will be followed for about 90 days following the challenge. Preliminary results of this trial are expected in May 2020.

“NIAID investigators have been pioneers in contemporary human influenza challenge trials,” NIAID Director Anthony S. Fauci, MD, said in a statement. “These trials provide a powerful tool to study many aspects of influenza disease progression and also can help to efficiently assess new treatments and vaccine candidates.”

But the buzzworthy headline about this trial: willing participants can reportedly earn north of $3000 for getting sick.

New Tech Tools:

Facebook is getting into the health care sphere by launching its new tool called Preventative Health. The separate app reminds users to get medical checkups, vaccines, and tests. “Facebook will also proactively nudge its users to get flu shots at the time of year when they’re most likely to work, as well as find nearby locations such as grocery stores and pharmacies where they’re available,” according to a CNBC report.

Facebook has an existing tool that already encourages users to give blood when there are shortages, and they have also asked users to share their organ donor status.

Flu Shot Mishaps:

In Oklahoma, 8 residents and 2 employees at the Jacquelyn House—a facility that services developmentally disabled people—were injected by a contractor pharmacist with insulin instead of the flu shot. They were hospitalized.

Future of Flu:

The FDA approved the Fluzone High-Dose Quadrivalent vaccine for adults aged 65 years or older. It is expected to be available in fall 2020 in time for the 2020-21 flu season.

The decision was based on the results of a study that evaluated nearly 32,000 adults aged older than 65 years across 2 flu seasons in the United States and Canada. The results demonstrated that the Fluzone High-Dose prevented 24% more cases of influenza caused by any strain, and 51% more cases caused by strains similar to those contained in the vaccine.

“Influenza is a serious threat, especially for older adults who are more vulnerable to serious complications and even death. For the past 10 years, Fluzone High-Dose has helped protect millions of people 65 years of age and older from seasonal influenza,” John Shiver, PhD, senior vice president, Global Research and Development, Sanofi Pasteur, said in a statement. “We are committed to helping protect as many people as possible from influenza and look forward to introducing this new formulation.”