http://www.newsday.com/news/printedition/longisland/ny-liflu116031440feb11,0,7731075.storyNew York flu cases climb, feds see resistance to meds
BY DELTHIA RICKS |
delthia.ricks@newsday.com February 11, 2009
Flu cases have accelerated significantly on Long Island and throughout New York within the past week to 10 days, state health officials said yesterday as their federal counterparts grappled with the resistance of a key influenza strain to the leading antiviral medication.
State health officials say the number of people with the flu in recent days has increased dramatically compared with previous weeks in the season.
"Over the last two weeks we've gone to widespread flu activity," said Dr. Gary Leonardi of the Nassau University Medical Center, where his virology lab serves as one of the 13 key sentinel sites in the state, testing flu samples from hospitals and doctors' offices throughout Long Island and the city. Positive samples are sent to the state Health Department lab, which then forwards flu data to the Centers for Disease Control and Prevention. The CDC uses the data to help select viruses to be targeted for the following year's vaccine.
"This is the peak in the season, but we are actually seeing the peak a little later this time around, so there is a shift this year," Leonardi said.
Claire Pospisil, state health spokeswoman, said disease detectives never get an accurate head count on the number of people with the flu because most self-treat it at home. However, the state has logged 16 outbreaks in nursing homes, slightly less than last year but worrisome nonetheless because of the residents' vulnerability.
Suffolk health chief Dr. Humayun Chaudhry said even though people think of the flu in the same context as the common cold, it is a far more serious condition. "Last year there were 2,500 deaths attributed to influenza in New York," he said. He strongly recommended vaccination, even this late in the season.
This flu season is complicated by growing signs of drug resistance in one of the major "A" strains of flu, and a vaccine that is not fully protecting against a circulating strain of B influenza. Viruses are showing resistance to a leading flu drug known as oseltamivir and sold as Tamiflu.
Dr. Pascal Imperato, dean of public health at SUNY Downstate, said the resistant A-strain known is H1N1, which circulates widely each flu season. "Influenza viruses tend to undergo frequent genetic change, so it's possible that whatever is causing the resistance might disappear over time in derivative influenza viruses," he said. Tamiflu is often used in nursing homes.
Dr. Anthony Fiore of the CDC said the resistance was first noticed in Norway where Tamiflu is not widely prescribed. The problem served as a signal for how vast the circulation of flu viruses can be. "We don't know why the resistance has occurred. It's probably not driven by overuse of drug," a usual cause of resistance, he said.
The mismatch between the vaccine B strain and the one in circulation will be discussed next week at a meeting in Washington, Fiore said.
AVOIDING THE FLU
Doctors who treat the fever, dry cough and aches associated with the flu say there are ways of avoiding the misery. And if you have the flu - or had it recently - avoid spreading it. You are infectious a day or two before symptoms begin and from five to 10 days after overt symptoms subside. Here are a few tips.
Get vaccinated. It protects against circulating strains. If you have a fear of needles and are between the ages of 5 and 49, try the nasal spray.
Practice hand hygiene. Wash your hands frequently because flu viruses can survive on surfaces, such as keyboards and doorknobs. Touching your eyes, nose or mouth after exposure can result in infection.
Practice cough hygiene. Always cough into your elbow or shoulder to avoid spreading the flu to others.
When you're sick get plenty of rest and fluids. They can help your body mount its strongest defense.
Don't be alarmed if you are prescribed two flu drugs instead of one. The CDC is recommending, in some cases, Tamiflu with an additional antiviral to fight resistant strains. Drug therapy is prescribed for people who are allergic to the vaccine, or who may reside in a nursing home.
