As the flu season kicks into high gear, we thought we
could find additional interesting flu tidbits to share. From posters to
shots, cheek kissing to elbow bumping, some of the simple advice gleaned
from today’s headlines can protect individuals from catching the flu.
Lessons from Mexico’s experiences, for example, include having janitors
at a private school wash doorknobs every two hours. For more on how that
country fought to combat the flu, go to
http://today.msnbc.msn.com/id/32602176/ns/health-swine_flu .
1
U.S. Secretary of Education Arne Duncan and U.S. Secretary of Health and Human Services Kathleen Sebelius appeared in the Sept. 6
Parade magazine to explain “How We’ll Protect Against Swine Flu.” They stress giving children three vaccinations: readily available is the regular yearly flu shot, followed by two shots of the special H1N1 vaccine scheduled for use later this month.
2
The Associated Press reported in late August that flu season will be a “multishot” season for many people, or a “multisquirt” season for those who choose the FluMist nasal-spray version. Doctors first suggested that from one (regular flu shot for older adults) up to four (two doses of regular flu for first-ever youngsters under age 9) shots may be required. Visit
www.msnbc.msn.com/id/32618614/ns/health-swine_flu .
3
Seasonal flu viruses attach to receptors found on cells in the nose, throat, and upper airway, enabling them to infect a person’s respiratory tract. Research published in the Sept. 10 issue of
Nature Biotechnology shows that pandemic H1N1 flu can also attach to a receptor found on cells deep inside the lungs.
www3.imperial.ac.uk.
4
The New York Times reported Sept. 4 that the threat of catching H1N1 flu has changed greeting rituals: handshakes, kisses, embraces. Fist-bumping is safer than a handshake, but worst is a kiss, which puts your mucus membranes closer to someone else’s and increases your risk of contamination. Elbow nudges and saluting are suggested as the best options.
www.msnbc.msn.com/id/32692563/ns/health-the_nw_york_times .
5
In France, the custom of cheek-kissing is being curtailed during the flu season, and while the national government is not calling for a ban, many see this as a threat to the tradition. In Coulaines, spitting in public has been banned to prevent the spread of germs linked to H1N1.
http://www.msnbc.msn.com/id/32723391/ns/world_news-europe .
6
In early September, CNN.com cited the CDC’s announcement that the 2009 H1N1 strain is virtually the only influenza currently circulating in the United States. Perhaps because schools opened earlier in the Southeastern states, Georgia, Alabama, Mississippi, and Florida have been hit hard. As many as 25,000 students from 24 schools were sent home on one early-September day.
www.cnn.com/2009/HEALTH/09/08/swine.flu.antivirals/index.html .
7
According to The Washington Post, the CDC now recommends “watchful waiting” before preventive use of antivirals. High-risk patients should be treated promptly, but most people will not need the drugs if they get the flu. This guidance is aimed at preventing overuse, hoarding, and shortages briefly witnessed during the spring outbreak of H1N1.
8
As the flu spreads, so does the message that plain old everyday hand washing — done properly — is the best way to protect yourself from flu germs.
The
Associated Press offers 10 tips on averting any flu (http://today.msnbc.msn.com/id/32597920/ns/health-swine_flu). One way is to wash your hands often with soap and water as long as it take to sing “Happy Birthday” or “The Alphabet Song.”
9
Eighty percent of infections are spread through hand contact. And where are the germiest places in your world? A list compiled by
Today lists a dozen spots where you can reduce your risk. Had you thought of those ATM buttons? How about your handbag? And if you travel, the hotel-room remote? Carry the list with you:
www.msnbc.msn.com/id/21423163 .
10The secret to proper handwashing, according to a CDC representative, is “the friction and duration” of the process. Use soap. Make sure to wash between your fingers. Use a nail brush. Dry briskly with a towel. Old-fashioned soap dislodges dirt, bacteria, and viruses so they go down the drain. No evidence proves antibacterial soaps are more effective. Most drying methods are about equal in removing bacteria. After washing, use a paper towel to open public facitilies’ doors.
www.usatoday.com/news/health/2009-01-20-handwashing-cold-and-flu_N.htm .
11
U.S. Department of Agriculture Secretary Tom Vilsack asked reporters to seriously consider using “H1N1 flu virus” rather than the term “swine flu.” ProFarmers Editors
says the Secretary noted 38 countries have limited or halted imports of U.S. pork, hurting pork producers as well as related businesses. Vilsack claims the term “swine” flu mislabels and misrepresents the novel flu strain H1N1, which is not the same as swine flu. USDA made a seed virus available to vaccine manufacturers to develop an H1N1 vaccine; the action could shave four to seven months off of the time normally required.
www.agweb.com/get_article.aspx?pageid=153154 .
12
The Soap and Detergent Association and the American Society for Microbiology teamed up to produce hand-hygiene education brochures available in print and online at
www.cleaning101.com/handhygiene (“Have U Washed Your Hands 2Day?”) — also in Spanish — and
www.washup.org (“Don’t Get Caught Dirty Handed”). Washing hands includes before, during, and after preparing food, especially raw meat, poultry, or seafood, and before and after meals and snacks. Posted by
www.sdahq.org .
13
Check out the CDC’s FluLabSurge, a spreadsheet-based program designed to assist laboratory directors forecast demand for specimen testing during the next influenza pandemic and develop response plans. FluLabSurge produces estimates of a) the daily number of specimens that may be delivered to a laboratory for testing; and b) the testing capacity of that laboratory (e.g., how many samples can be tested per day or work shift) per pandemic transitional day found in each of the pandemic stages. FluLabSurge also helps the user produce a one-page plan showing how capacity will be used to meet user-defined testing goals (e.g., surveillance, strain identification, clinical diagnostics). Try it out at
www.cdc.gov/flu/tools/flulabsurge.
14
An H1N1-flu mobile texting pilot has been launched by the CDC. Now you can visit
m.cdc.gov on your mobile phone or PDA for information on seasonal flu, H1N1 flu, public-health emergencies, and more. Designed to be easily read and navigated from mobile devices, the site will soon feature more health and safety tips. To learn more and to sign up for service, visit
www.cdc.gov/mobile .
15
A new iPhone application, “Outbreaks Near Me,” allows users to track and report local outbreaks of infectious disease. The app was developed by researchers at Children’s Hospital Boston and the MIT Media Lab, and combines theiPhone’s GPS system with outbreak-tracking info from HealthMap.org, a Web-prowling system that mines official/unofficial Internet data sources for data on outbreaks of emerging infectious diseases. Learn more at
www.foxnews.com/story/0,2933,518690,00.html .
16
The World Health Organization (WHO) reports on the current status of influenza vaccines around the globe: Regulatory authorities have licensed pandemic vaccines in Australia, China, Hungary, and the United States. At press time, Japan and several European countries were awaiting licensing of vaccines. WHO points out that the approval process depends on each country’s regulatory pathway, the type of vaccine being licensed, and the stage of a manufacturer’s readiness to submit required information to regulatory authorities. To learn how the process works, go to the pandemic vaccine manufacturing process and timeline at
www.who.int/csr/disease/swineflu/notes/h1n1_vaccine_20090806/en/index.html.
Preparing for flu season
Commentary by Drew Hoffman
Everyone — from clinicians and laboratorians to members of
the general public — has been acutely aware of the unusual contours of the
flu season this year, with cases jumping dramatically in late April and May
when influenza usually subsides. In fact, given the data so far, many more
people are likely to be infected in this coming flu season (2009-2010) than
in previous seasons.1 Already, colleges have reported a greater
than 100% increase in the cases of flu-like illness from week to week in the
first half of September, according to The American College Health
Association.2 Emergency-room doctors on the front lines have been
greatly concerned; in response, the Institute for Healthcare Improvement is
publishing much-anticipated guidelines for triaging patients presenting with
flu-like symptoms at acute-care facilities.3
Diagnostic tests are expected to be a major component of
any healthcare response to this flu season, with labs looking primarily at
three variables: performance (clinical sensitivity and specificity compared
to gold standard); cost, and time to results. Rapid tests can deliver
results within 10 minutes, and it has been found that when rapid tests are
used according to procedures, they can demonstrate quite high clinical
sensitivity and specificity.
Offering tests that meet facilities’ needs is paramount.
As such, it is important to step back and look at the broader scope of
services and capabilities manufacturers and innovators can provide. First
and foremost is training. Rapid tests have been engineered to be easy to
use, despite the often-sophisticated technology they embody. Nonetheless,
going back to customers from time-to-time (virtually or in person) to offer
refresher training sessions is worthwhile.
Manufacturers are now making more of an effort to ensure
tests are performed correctly. This past August, we hosted a webinar,
prompted by the desire to reinforce the appropriate use of our flu test and
to encourage clinicians and other practitioners to follow the instructions
provided in the diagnostic package insert. Other companies are doing similar
educational preparations for laboratories with webinars, posters, and
videos. These efforts are particularly important, given recent external
studies, for which researchers generated results with varying flu tests
using influenza specimens that were not tested immediately but instead were
shipped and stored in a manner that might not result in optimal performance.
A very real concern is whether facilities might stock out
of rapid tests altogether; last May, some centers came close. Despite the
fact that manufacturers are ready very early in the traditional flu season
at this point, a surge in demand has already been seen in the Southeast and
elsewhere. When unusually high orders for tests came in beginning late last
April, our company made the commitment then to ensure a ready supply of
tests to every customer who orders. Measures such as just-in-time
manufacturing have been instituted, and shifting to manufacturing product up
to the pouched stage and then supplying labs only when they need product.
This system works for the labs and for manufacturers, and benefits everyone.
In addition, a program we developed two years ago to help
acute-care labs correlate test panels and, perhaps, substitute their
standard tests with rapid flu tests has resulted in some cases with labs
using the panels alone, while others incorporated the panels into current
protocols, comparing the panels to either fresh or frozen samples. This
could be critical in helping labs avoid some of the shortages they
experienced earlier this year.
In sum, manufacturers and laboratories can pursue — and
no doubt are pursuing — a range of activities to prepare for what may be a
difficult flu season. Critical to these efforts is for each side to
understand what the other needs and how they can collaborate to reach a goal
that, otherwise, might be inaccessible.
Drew Hoffman is senior marketing manager at Quidel Corp.
in San Diego, CA.
References
- Ferran L. White House Warns of Massive Swine Flu
Spread. ABC News. August 25, 2009.
http://abcnews.go.com/GMA/story?id=8403214 .
Accessed September 22, 2009. - American College Health Association. ACHA Pandemic
Influenza Surveillance. September 14, 2009.
http://www.acha.org/ILI_Surveillance.cfm . Accessed September 22, 2009. - McKenna, M. ER physicians fear possible fall flood of flu.
September 9, 2009.
http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/sep0909ers.html .
Accessed September 22, 2009.
