Wednesday, December 29, 2010

Influenza Vaccine a Good Match for Circulating Strains

We are seeing a quick rise in the number of influenza cases in the office. We are identifying both influenza A and B with our rapid tests. While we have had a few patients test positive for influenza even though they received this year's vaccine, the data from the CDC is so far showing a good match between the strains contained in the vaccine and the strains that are causing illness. The strains are also sensitive to oseltamivir (Tamiflu) so far this season.

Here is an excerpt from the CDC's Influenza Update:

Antigenic Characterization:
CDC has antigenically characterized 89 influenza viruses [13 2009 influenza A (H1N1) viruses, 26 influenza A (H3N2) viruses, and 50 influenza B viruses] collected by U.S. laboratories since October 1, 2010.

2009 Influenza A (H1N1) [13]

All 13 were characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2010-11 influenza vaccine for the Northern Hemisphere.
Influenza A (H3N2) [26]

All 26 were characterized as A/Perth/16/2009-like, the influenza A (H3N2) component of the 2010-11 influenza vaccine for the Northern Hemisphere.
Influenza B [50]

All 50 viruses belong to the B/Victoria lineage of viruses and was characterized as B/Brisbane/60/2008-like, the recommended influenza B component for the 2010-11 Northern Hemisphere influenza vaccine.
Antiviral Resistance:
Testing of 2009 influenza A (H1N1), influenza A (H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) is performed at CDC using a functional assay. Additional 2009 influenza A (H1N1) clinical samples are tested for a single known mutation in the neuraminidase protein of the virus that confers oseltamivir resistance (H275Y). The data summarized below combine the results of both test methods and includes samples that were tested as part of routine surveillance purposes; it does not include diagnostic testing specifically done because of clinical suspicion of antiviral resistance.

High levels of resistance to the adamantanes (amantadine and rimantadine) persist among 2009 influenza A (H1N1) and A (H3N2) viruses (the adamantanes are not effective against influenza B viruses) circulating globally. As a result of the sustained high levels of resistance, data from adamantane resistance testing are not presented weekly in the table below.

To prevent the spread of antiviral resistant virus strains, CDC reminds clinicians and the public of the need to continue hand and cough hygiene measures for the duration of any symptoms of influenza, even while taking antiviral medications. Additional information on antiviral recommendations for treatment and chemoprophylaxis of influenza virus infection is available at http://www.cdc.gov/flu/antivirals/index.htm.

Wednesday, December 22, 2010

Flu Clinic Days


Starting in January, we will be scheduling flu clinics on Wednesday's from 2-5 and Friday's from 2-5. If your children haven't received their flu vaccine yet, please call our office and schedule an appointment. We still have flu shots and flu mist for all insurances and VFC.

Thursday, December 16, 2010

Monday, December 6, 2010

Guidelines on Food Allergy Updated

The National Institutes of Health's National Institute of Allergy and Infectious Diseases (NIAID) has released updated guidelines on diagnosis and treatment of food allergies. The summary page for parents and patients can be found HERE.

Highlights:

--Most children with allergies to milk, egg, soy, and wheat will eventually be able to tolerate these allergens, while tree nut and peanut allergies are less likely to resolve with time. Likewise, food allergies that begin in adulthood are likely to persist.

--Food allergies tend to coexist with asthma, atopic dermatitis, eosinophilic esophagitis, and exercise-induced asthma. Eliminating food allergens can improve symptoms of some of these comorbid conditions.

--The guidelines do not recommend restricting maternal diet during pregnancy or lactation to prevent the development or clinical course of food allergies, but they do recommend exclusive breast-feeding of all infants until age 4 to 6 months, unless medical reasons contraindicate breast-feeding.

According to Dr. Hugh Sampson, the guidelines concur with current American Academy of Pediatrics guidelines. "There is no evidence that delaying certain foods, even foods that are considered allergenic, (is) going to have any significant effect on the development of allergy," he said.

-Food allergies should be confirmed, because studies indicate that 50% to 90% of presumed food allergies are, in fact, not allergies.