Dr. Fred Hayden is an infectious disease specialist at U.Va.’s Health System.

U.Va. well-prepared for flu season

By Katherine Ward

Ah, the flu season. This year, there is bad news, and there is good news. And then there is even better news.

The bad news, of course, is that flu season is here — and it’s leaving the country in a panic over a shortage of vaccines. Chiron Corp., one of the nation’s two vaccine suppliers, reported possible contamination in their plant on Oct. 8, affecting the 48 million doses they were supposed to send to the United States. As a result, the number of doses nationwide has been nearly cut in half, leaving vulnerable Americans desperate to find another means of prevention.

Who can get the flu vaccine

This year, U.Va. will follow the guidelines instituted by the U.S. Centers for Disease Control and Prevention when administering flu vaccines. According to those rules, only those employees and patients who fall into the CDC’s “priority groups” can receive a flu vaccine. Those groups include: • All children aged 6 months to 23 months. • Adults over age 65.  • People aged 2 to 64 with underlying chronic medical conditions. • All women who are or anticipate being pregnant during influenza season. • Residents of nursing homes and long-term care facilities. • Children 6 months to 18 years of age on chronic aspirin therapy. • Health care workers with direct patient care. • Out-of-home caregivers and household contacts of children less than 6 months old. Health care workers prioritized for vaccination include the following groups who will have direct patient care and/or contact from October 2004 through April 2005: A reminder: you must be wearing your employee ID badge to receive a flu vaccination. • Physicians • Registered Nurses • Licensed Practical Nurses • Physicians Assistants • Patient Care Assistants/Technicians • Therapists and Therapy Aides • Radiologic Technologists • Patient Transporters • Phlebotomists Finally, a new group was just approved for vaccination: • Chaplains and Chaplain Residents • Health Unit Coordinators • Office Services Specialists (front desk patient intake/registration personnel) • Pharmacists providing direct patient care (clarify with your supervisor) • Social Workers • Clinical Nutritionists • ‘Catering to You’ Associates • Psychologists • Security Officers with direct patient contact (clarify with your supervisor) • Volunteers with direct patient contact (clarify with your supervisor) Source: U.Va. Health System

The good news is that, especially for the University community, panic is not necessary. The U.Va. Health System got its vaccine supply from Aventis, which was not affected by the withholding. And the better news is that U.Va. has enough vaccinations — for its patients who fall under the high-risk guidelines from the Centers for Disease Control and Prevention, and for its employees who meet similar criteria. According to Abena Trice-Foreman, a spokesperson for the Health System, it is anticipated that once the Health System has vaccinated those who fall
under the guidelines, there will be enough leftover to provide other medical facilities in the area that are in desperate need of the vaccine.

Dr. Fred Hayden, infectious disease specialist, said U.Va. is in a strong position this year in terms of the amount of vaccine and antiviral drugs. Historically, health care workers are at higher risk for the flu and in turn can transmit the virus to their patients, he said. U.Va. will try to ensure that all of those workers who deal with patients closely will be vaccinated. “Eighty percent of health care workers were immunized last year at U.Va., which is a terrific achievement,” Hayden said.

“We don’t know what this flu season is going to be like,” he said. “We have to hope for a mild season but prepare for a harsh one, because the type of flu strain that will appear this year is impossible to predict. If the flu is a return of the Fujian strain, that we experienced last year, this coming season we could see high illness rates and, unfortunately, increased hospitalizations and deaths.”

One of the reasons for U.Va.’s strong position this year is a new intranasal vaccine called FluMist, which many U.Va. employees will receive. Two thousand doses of FluMist have been donated to the University for vaccination of health care workers. This category includes FluMist, which has been approved for use for healthy patients between the ages of 5 and 49.

“Data suggests that [FluMist] is comparable to the injection vaccine for protection in adults,” Hayden said. “In fact, studies in Europe revealed that the intranasal vaccination was superior to the injected vaccine in children.” Hayden is part of a group working on a comparative study of FluMist and injected vaccine for children in the United States.

FluMist is a live vaccine, which raises the question as to whether the workers will be at risk for spreading the disease after they are immunized. Hayden says the risk is negligible — there has only been one report of a possible transmission of the vaccine virus after a FluMist immunization: an exchange that occurred in a day care center between two children.

The vaccine is highly weakened, he said, and limited to upper respiratory passages. Nevertheless, U.Va. is being cautious. They are following all CDC guidelines, and health care workers who receive vaccinations are restricted from working closely with highly immunocompromised patients, such as bone marrow transplant patients, for one week.

As for all other employees and faculty — those who don’t fall into the “high risk” categories and aren’t health care workers — influenza vaccine may not be available so that U.Va. can provide enough vaccinations to the outlying community.

What should you do if you develop influenza during the upcoming season?

Whether or not you have received vaccine, seek treatment as early as possible with one of the available antiviral drugs for influenza. One such drug, called Tamiflu, has been shown to reduce the duration of illness and decrease the risks of respiratory complications, antibiotic use and hospitalizations after influenza.

For additional information about the flu vaccine and who is eligible to receive it, call 924-8461.

What Causes Influenza?

The influenza virus is generally passed from person to person by airborne transmission, such as sneezing or coughing. But the flu virus can also live for a short time on objects — such as doorknobs, pens, pencils, keyboards, telephone receivers and eating or drinking utensils. Therefore, it can be spread by touching something that has been handled by someone infected with the virus and then touching your own mouth, nose or eyes. Influenza is called a respiratory disease, but the whole body seems to suffer when a person is infected. People usually become acutely ill with several, or all, of the following symptoms: • high fever • headache • runny nose • sneezing at times • cough, often becoming severe • severe aches and pains • fatigue for several weeks • sometimes a sore throat • extreme exhaustion Fever and body aches usually last for three to five days, but cough and fatigue may last for two weeks or more. Although nausea, vomiting and diarrhea may accompany the flu, these gastrointestinal symptoms are rarely prominent. “Stomach flu” is an incorrect term sometimes used to describe gastrointestinal illnesses caused by other microorganisms. The symptoms of the flu may resemble other medical conditions. Always consult your physician for a diagnosis. Source: U.Va. Health Services