State public health officials report a decrease in influenza activity for the week ending January 7, 2012. However, the latest NC Division of Public Health (NCDPH) Flu Report cautions that the usual peak of influenza activity is during January or February, noting that we can expect to see consistent increases during the next few weeks. No flu-associated deaths have been reported in the state since the end of the 2010-2011 flu season. 

The World Health Organization (WHO) reports flu activity in the temperate regions of the northern hemisphere remains below seasonal thresholds, though notable increases in activity have been reported in some areas of Canada, Europe, northern Africa and the Middle East. The viruses detected throughout the northern hemisphere temperate zone have been predominately of the A(H3N2) type. Only very small numbers of A(H1N1) have been reported in recent weeks.

More information is available at www.flu.nc.gov and at http://www.cdc.gov/flu.

No flu-associated deaths have been reported in North Carolina since the end of last flu season, according to the latest Influenza Summary from the state Division of Public Health (DPH). Flu activity across the state was sporadic for the week ending December 3, 2011, with none of the 20 samples submitted to the state Laboratory of Public Health testing positive for influenza. The World Health Organization (WHO) reports that influenza activity in the temperate regions of the northern hemisphere remains at low levels, with sporadic influenza activity reported in Canada and some European countries.

For more flu information and guidance visit:

North Carolina: http://www.flu.nc.gov

CDC: http://www.cdc.gov/flu

The North Carolina Division of Public Health (DPH) reports no influenza activity for the week ending 10-15-11. The CDC reports influenza activity is currently low in the Northern Hemisphere, with Australia reporting that its flu season appears to have peaked and is decreasing.

Physicians and practices can go find more information about flu activity in North Carolina at: http://www.flu.nc.gov/flu/.

As the 2011-2012 flu season gets underway, the Hanover-Pender County Medical Society (NHPCMS) is urging area health care professionals to be immunized against influenza. The call comes in a letter that was drafted after Paul Kamitsuka, MD, an infectious disease physician, expressed concerns about the lack of influenza immunization among staff in long-term care centers in the area. The letter was jointly signed by NHPCMS President Philip M. Brown, Jr., MD, and New Hanover County Health Department Director David E. Rice, MPH, MA. It was sent to area health care professionals, agencies, schools and others with direct person-to-person contact with a patient, student or client. Read the letter here.

As the 2011-2012 flu season approaches, the NC Division of Public Health (DPH) is offering some facts that physicians may wish to share with staff and patients:

• The 2011-2012 trivalent season flu vaccine will include pandemic 2009 H1N1 virus. That’s the same virus used in the 2009 H1N1 monovalet vaccine.
• The CDC recommends universal flu vaccination. Everyone six months of age and older should receive a flu vaccine.
• Health care personnel are particularly encouraged to receive flu vaccine, not only to protect themselves from the disease, but also to help prevent transmission of the flu to patients, co-workers, family members and others.

A higher dose formulation of an inactivated seasonal influenza vaccine (Fluzone High-Dose) for use in people age 65 years and older is available. Fluzone High-Dose contains four times the amount of influenza antigen compared to other inactivated seasonal influenza vaccines. The Advisory Committee on Immunization Practices (ACIP) has not expressed a preference for Fluzone High-Dose or any other licensed inactivated influenza vaccine for use in people age 65 and older.

Please, this flu season: protect yourself, protect your patients, protect your family–Get your flu vaccine.

A video is now available on VaccineShop.com® to help physicians and other providers learn more about the Fluzone Intradermal vaccine microinjection system, the clinical profile, and how to administer Fluzone Intradermal vaccine.  The vaccine is licensed for use in patients 18 to 64 and is available for the upcoming flu season.

Vaccine manufacturer sanofi pasteur is offering an unbranded Flashcard that explains the clinical rationale for Fluzone High Dose, for people over 65 years of age. The company reports that it has already started shipping the vaccine and is tracking ahead of schedule for all flu dose shipping.

Click here to read the 2011 Fluzone High-Dose Newsletter.

The NC Division of Public Health is notifying physicians in North Carolina of an ongoing investigation with the US Centers for Disease Control and Prevention (CDC) into a cluster of influenza B viruses from North Carolina that appear to show less responsiveness to the antiviral drug oseltamivir, also known as Tamiflu. Lab tests by the CDC indicate that the drug has slightly less effect on those particular viruses. The reason appears to be a genetic change in the viruses that has not been seen in samples from other states. The CDC is testing more influenza B viruses from North Carolina and surrounding states to determine whether the same genetic change can be found in other influenza B viruses from North Carolina or elsewhere in the country. Thirty-one viruses with this genetic change were collected from 92 samples from North Carolina patients between November 2010 and February 2011.

Unless otherwise noted, please click title for more information.

Influenza Prevention Options for Older Adults, March 23, 2011, 2:00pm, a Web-based educational program on preventing Influenza in older adults, moderated by David Greenburg, MD, Senior Director of Scientific and Medical Affairs, sanofi pasteur, and Corey Robertson, MD, MPH, FACP, Director of Scientific and Medical Affairs, sanofi pasteur. Please sign up for the one one-hour Web-enhanced teleconference by March 22.

How To Facilitate Patient-Centered Medical Home Recognition: A Hands-on Approach and Analysis Through NCQA’s Eyes, April 7-8, Mountain Area Health Education Center (MAHEC), Asheville, a workshop that will include the new 2011 standards for PCMH recognition. This will be the second time the course is offered nationally and the first offered in North Carolina.  The registration fee of $895 will be reduced to $750 for two or more registering from the same organization, and MAHEC recognizes BCMS members as eligible for the reduced fee. Click here  to register or for more information.

New Option for Influenza Prevention: An Influenza Vaccine for Older Adults, Web-Enhanced Audio Conference, featuring Marvin Bittner, MD, Infectious Disease Specialist, Veterans Affairs Medical Center, Omaha, Nebraska. The Web/Audio Conferences will be available (to hear the presentation for all dates, call 1-877-230-9940 and enter participant code):

April 6, 1:00 – 2:00 pm           (49398198)

April 12, 12:30 – 1:30pm        (49398658)

April 14, 12:30 – 1:30pm        (49398662)

April 20, 12:00 – 1:00pm        (49399418)

The weblink for all dates is http://sanofiamericas.adobeconnect.com/fluzonehighdose/. Please RSVP three days prior to the date you select to Jill Blalock, MPH, jill.blalock@sanofipasteur.com.

Health Information in the Cloud: Business Strategy, Security & Deployment, is a workshop on Cloud computing, hosted by the NC Healthcare Information & Communications Alliance, on Monday, March 21, 2011, at the Friday Center in Chapel Hill. The agenda includes two plenary sessions and nine breakout sessions on business strategy, security and deployment topics. For more details, go to http://www.nchica.org/Activities/cloud/agenda.htm. To register, visit http://www.nchica.org/Activities/cloud/register.htm.

The NC MedAssist Program: RX for NC, Wednesday, April 13, 2011, 10:00 – 11:00 am, a Webinar hosted by Care Share Health Alliance and presented by NC MedAssist, Lori Giang, Executive Director; Mike Darrow, Program Director/NCAFC; Med Assist staff. Space is limited so reserve your seat now at https://www1.gotomeeting.com/register/359629153.

Assess Your Knowledge: FREE On-line Learning Activity for Primary Care Physicians re: Lung Cancer Diagnosis and Treatment

Lung cancer kills approximately 160,000 people in the United States each year, more people than breast, colon and prostate cancers combined. Each year approximately 6,670 people from North Carolina are diagnosed with lung cancer. Despite advances in lung cancer treatment over the last decade, delays at various points in the continuum of lung cancer care have been documented.

To increase patient access to stage-appropriate care based on scientific evidence, a free online Learning from Self-Assessment (LSA) activity has been developed specifically for primary care physicians to assess competencies related to:

•  Recognizing symptoms indicative of lung cancer;
• Evaluating patients when lung cancer is suspected;
• Communicating with lung cancer patients;
• Referring patients to appropriate specialists.

Visit http://cme.wisc.edu/LSA/AccessTLC/index.php to assess your competencies related to lung cancer diagnosis and treatment. This activity has been approved for AMA PRA Category 1 Credit^TM through the University of Wisconsin School of Medicine and Public Health, which is accredited by the Accreditation Council for Continuing Education to provide continuing medical education for physicians. This activity is supported by an educational grant from Pfizer.

For more information about this activity contact: North Carolina Lung Cancer Partnership, Sue Dayton, Project Manager, (336) 525-2003 or sdayton@NCLungCancerPartnership.org.

The NC Department of Public Health reported this week that five flu-associated deaths occurred during the influenza surveillance reporting week ending March 5, 2011 (week 9). The victims included a child and four adults. During the period, health officials reported noticeable decreases in both the percentage of outpatient visits as well as emergency department visits due to ILI for the third consecutive week. The geographic spread of influenza in the state was lowered from widespread to regional. For more information, visit http://www.flu.nc.gov/ or http://www.cdc.gov/flu.

The latest weekly influenza surveillance summary (2-24-11) shows influenza remains widespread in North Carolina, although decreases were shown in the percentage of outpatient visits and emergency department visits due to ILI in the weekly period ending February 19, 2011. One pediatric and one adult flu-associated death were reported for the week. For more information and guidance, visit http://www.flu.nc.gov/ or http://www.cdc.gov/flu.

The Fayetteville VA Medical Center and Mission Hospital in Asheville have taken steps to combat an influenza outbreak. Both are restricting visitors because of an increasing number of flu cases. Cape Fear Valley Health System of Fayetteville, FirstHealth Moore Regional Hospital in Pinehurst and Southeastern Regional Medical Center in Lumberton all report an increase in flu patients. They’re urging people with flu symptoms not to visit patients who are hospitalized.

The latest NC Influenza Surveillance Summary issued by DHHS (2-10-11) shows influenza remains widespread across the state.  One pediatric and one adult flu-associated death were reported for the week ending February 5, 2011. A high rate of increase in the percentage of outpatient and emergency department visits due to influenza were also reported during the period. The State Lab identified 88 positive influenza samples, including influenza B, influenza A/H1N1, influenza A/H3, and influenza A (subtype unknown). Public Health Epidemiologists reported 535 positive influenza results: 282 influenza B and 253 influenza A.

State health officials reported Thursday that a 15-year-old died on January 5 of complications from an influenza infection. The child had not received flu vaccine this season. Statewide surveillance shows that flu is now widespread in North Carolina, with the southeastern US having the most flu activity nationwide so far this season.

State Health Director Jeffrey Engel, MD, recommends flu vaccine for anyone over six months of age, including health care workers. “A good vaccine match can reduce the chances of getting influenza by up to 90 percent,” Dr. Levine said, adding that it is particularly important for people at high risk of complications, including pregnant women, people with chronic diseases, very young children and the elderly.

The 2010-2011 influenza season is about to start as the NC DPH Communicable Disease Branch prepares to begin its weekly distribution of the influenza surveillance summary on October 14, 2010. In the meantime, the NC Immunization Branch is urging all physicians and nurses to get a flu shot to protect themselves and to prevent transmission of the flu to patients, coworkers, family members and others.

The 2010-2011 trivalent seasonal influenza vaccine will include pandemic 2009 H1N1 virus. The CDC recommends universal flu vaccination beginning this year, with everyone six months or older urged to receive a flu vaccine.

A higher dose formulation of an inactivated seasonal influenza vaccine (Fluzone High-Dose) for people age 65 and older will be available this season. Fluzone High-Dose contains four times the amount of influenza antigen compared to other inactivated seasonal influenza vaccines. Studies are underway to assess the relative effectiveness of Fluzone High-Dose compared to standard dose inactivated influenza vaccine, but results from those studies will not be available before the 2010-2011 influenza season. The Advisory Committee on Immunization Practices (ACIP) has not expressed a preference for Fluzone High-Dose or any other licensed inactivated influenza vaccine for use in people age 65 and older.

The North Carolina Division of Public Health (NCDPH) confirmed this week two cases of seasonal influenza, the first cases of flu confirmed by the state since last spring. The cases were diagnosed in two children from Durham County. 

State Health Director Jeffrey Engel, MD says the cases are a reminder that influenza is a year-round problem, and that it’s not too early to get immunized against flu.

This year’s flu vaccine includes protection against three strains of influenza, including H1N1. For most people, that means only one flu immunization is necessary. Children under 9 years of age who haven’t been vaccinated against the flu in the past will need two doses of flu vaccine.  The CDC and the NCDPH recommend that everyone over six months of age should get a yearly flu vaccine.

Read the NCDPH news release about seasonal flu.

The NC Division of Public Health has issued an advisory for physicians and other health care providers to help answer questions about changes in recommendations for influenza immunizations. The advisory covers seasonal flu vaccine, use of H1N1 vaccine left over from last season, and high dose flu vaccine.

Click here to read Flu Season 2010-2011: Updated Information for Health Care Providers.

Fluzone® High-Dose Influenza vaccine for patients age 65 and older will be a payable benefit under Medicare Part B, according to the Centers for Medicare and Medicaid Services (CMS) in its July 2010 AWP NDC – HCPCS Crosswalk File. The vaccine contains an increased amount of antigen compared to standard-dose influenza vaccines, and is designed to help generate a strong immune response in older patients. View the CDC’s Advisory Committee on Immunization Practices (ACIP) recommendations for the use of Fluzone High-Dose vaccine.

Click here for more information and links.