Influenza struck hard and early this year, hitting healthy and at-risk patients alike, and keeping RTs hopping.
As of this writing, in late January, the flu season continues to pack a wallop around the country after having begun earlier than usual. Although the Centers for Disease Control and Prevention is cautiously optimistic that the season has reached its peak, at least in some parts of the country,1 this notoriously unpredictable illness precludes simple conclusions or forecasts. To further muddy matters, most cases in the 2003-2004 season were caused by the Fujian strain, a new variant not covered by the vaccinewhich itself, unlike in previous years, ran short, leaving many people unable to get vaccinated.2
Practitioners from coast to coast and points between have shared accounts of deaths, long lines for vaccines, crowded hospitals, and related disasters stemming from the flu season. In North Carolina, an RT at Duke University told me that last December, clinics ran out of the vaccine within 2 hours of opening, even when it was limited to high-risk people. Of the nine children who had died of the flu thus far, fewer than half were high-risk cases. Some died of secondary infections after short-lived periods of improvement, and some had had flu shots.
In New York, physician and frequent RT writer John Zoidis said, We are experiencing the highest flu incidence in the past 30 years with the shortage of standard vaccine, a lot of clinicians are concerned. Even supplies of the intranasal influenza vaccine are dwindling. (An article on the topic by Zoidis and Phyllis Braun is on page 12.)
Reports of closed schools, many flu cases in hospitals, and patients plagued by other upper respiratory tract infections came to me from Colorado, northeast Ohio, and Southern California.
A practitioner at a Michigan sleep center noted serious related consequences to this years flu season. For weeks, patients have been canceling and rescheduling, playing havoc with efforts to staff facilities appropriately. Reports went out late because transcriptionistsand backup transcriptionistswere sick. This week, she said in early January, almost our entire maintenance department is sick, so unless we are in desperate need, any fix-it-up request will go in the do-it-later pile. It all adds up to a breakdown of the systems that keep us running smoothly.
The flu epidemic of 2003-2004 is a sober reflection of growing concerns about vaccine resistance and the quickly adapting viruses that have historically plagued humankind. b
1. Centers for Disease Control and Prevention. Available at: www.cdc.gov/od/oc/ media/transcripts/t040108.htm. Accessed January 12, 2004.
2. Altman LK, Pollack A. New York Times. Available at: www.nytimes.com. Accessed January 8, 2004.