The Centers for Disease Control and Prevention (CDC) released a report summarizing influenza activity in the United States during the 2016-2017 influenza season. See the Morbidity and Mortality Weekly Report.June 2017
Current Flu Situation
Flu activity is winding down in most of the country for this season. It's important to note that flu viruses may continue to circulate at low levels, even during the summer. Providers should continue to encourage annual influenza vaccination, and vaccinate children as long as influenza vaccine is available. With 101 pediatric deaths from influenza reported this flu season, it is wise to be vigilant. Even one preventable death is too many.
AAP Pediatrics Articles
The May 2017 issue of the journal Pediatrics included two studies that may be of interest. The first article, "Pandemic Influenza Preparedness Among Child Care Center Directors in 2008 and 2016", compares data collected from child care center directors prior to the H1N1 pandemic of 2009 with data in 2016. Only 7% of directors had taken actions to prepare their centers for a pandemic influenza outbreak. Recommended actions are included to help child care center directors increase preparedness efforts. The American Academy of Pediatrics (AAP) also circulated information in this AAP News article.
The second article, "The Concordance of Parent and Child Immunization", concluded that a child's likelihood of following immunization recommendations is associated with the immunization behavior of their parents. Encouraging parental immunization is a means of increasing children's immunization rates, too. This approach, along with office-based strategies (e.g., reminder recall, provider recommendations, Immunization Information Systems), are also likely to increase vaccination rates.
Updated Guidelines for Responding to Pandemic Flu
In April 2017, the Centers for Disease Control and Prevention (CDC) released a set of updated pre-pandemic planning guidelines titled, "Community Mitigation Guidelines to Prevent Pandemic Influenza - United States, 2017." These guidelines replaced the 2007 "Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States – Early, Targeted, Layered Use of Nonpharmaceutical Interventions (NPIs)." The 2017 updated guidelines summarize key lessons learned from the 2009 H1N1 pandemic response, describe new or updated pandemic assessment and planning tools, and incorporate the latest scientific findings on the use of non-pharmaceutical interventions.
Ready Wrigley Preparedness for Flu Season
The AAP worked with the CDC to develop and endorse a new Ready Wrigley Activity Booklet on influenza. Each book aims to build capacity in children's preparedness by inspiring youth readiness and promoting individual resilience. The books are designed for children 2 through 8 years of age. The Ready Wrigley Activity Book series is produced by the CDC Children's Preparedness Unit and CDC health communication specialists. To request up to 200 complimentary print copies of the influenza book (while supplies last), email DisasterReady@aap.org.
Prepare for the Next Flu Season!
To prepare for next flu season, practitioners can meet with office staff to:
- Share what worked or didn't work in the office this past season and what improvements might be made to increase influenza immunization rates.
- Review the recommendations and guidance from the AAP and the CDC Advisory Committee on Immunization Practices (ACIP) for the 2017-18 influenza season once published later this summer (i.e., mid-August through early September). The ACIP reiterated that the quadrivalent live attenuated influenza vaccine (LAIV4), which is given by nasal spray, not be used in any setting during the upcoming flu season. See the AAP News article for additional details.
- Discuss the importance of implementing infection control measures in the office.
- Work together to determine office protocols for minimizing transmission of influenza and other infectious diseases.
- Train staff annually on standard precautions, infection control, seasonal and pandemic influenza, and the importance of immunization.
- For more information, see section 9 in the AAP Preparedness Checklist for Pediatric Practices.
- Learn more about assisting child care programs to reduce influenza by becoming a Pediatric Preparedness Ambassador.
Now is a good time to lay the groundwork for requiring that health care personnel get vaccinated for the flu next season. Take steps to implement a mandatory influenza immunization policy for your clinic staff. The following strategies can maximize the success of implementing a mandatory policy:
- Create a clear policy for management of the small number of employees who qualify for medical exemption.
- Ensure the full support of health care leadership.
- Make the influenza vaccine free to all health care personnel.
- Publicize the program to health care personnel at all levels by communicating expectations and incentives.
- Offer convenient times and locations for education and immunization administration, preferably onsite.
See the AAP policy statement "Influenza Immunization for All Health Care Personnel: Keep It Mandatory" for more information.
Update on H7N9
There has been a substantial increase in the number of human infections with avian influenza A (H7N9) reported in China, making the current epidemic the largest to date since this virus emerged in 2013. Human infections continue to be associated with exposure to poultry and there has not been any sustained person-to-person spread of this virus. However, there have been some changes in recently identified H7N9 viruses that are concerning. While the current risk to the public from this virus remains low, the CDC is watching the situation carefully and is taking routine preparedness measures. See a summary of the candidate vaccine viruses H7N9.
For more information, see the AAP Red Book Online Influenza Resource page and CDC FluView. All AAP "What's the Latest with the Flu" messages are archived. Members of the AAP also have access to Flu Vaccine Recommendations and Key Speaking Points. Also see "What's the Latest with the Flu" messages for child care providers in English and Spanish.
This will be the last "What's the Latest with the Flu" message for the 2016-2017 influenza season. The AAP Disaster Preparedness Advisory Council and the AAP Committee on Infectious Diseases would like to thank everyone for their influenza prevention and control efforts. Please keep an eye out for the return of the messages prior to the 2017-2018 influenza season. For more information, e-mail DisasterReady@aap.org.