City Health Information
September 2012 New York City Department of Health and Mental Hygiene Vol.31(4):25-32
 

IN THIS ISSUE

Influenza Prevention and Control, 2012-2013
  • Vaccinate everyone aged 6 months and older against influenza.

  • Vaccinate day care and school-aged children, who are key transmitters of disease, as early as possible.

  • Give inactivated vaccine to all pregnant women in any trimester.

  • Vaccinate all health care workers against influenza.

  • New health care worker vaccination reporting requirements for acute-care facilities will take effect in January 2013.

Image of boy receiving flu shot

On average, more than 200,000 people in the United States (US) are hospitalized each year for influenza-related respiratory and circulatory conditions (1). In 2011-2012, in New York State as well as nationwide, hospitalization rates were highest in adults aged 65 years and older and children younger than 5 years old (2,3). During that period, the number of emergency department visits in New York City (NYC) due to influenza-like illness was highest in children younger than 5 years old (4). Most of the 1,654 influenza- and pneumonia-related deaths in NYC were in people older than 65 years (5).

Influenza activity remained relatively mild throughout the 2011-2012 season, with lower rates of hospitalization and fewer deaths due to influenza and pneumonia than in recent years. Influenza activity began to rise in February and transiently peaked only in mid-March, demonstrating the unpredictability of influenza activity. Severity of illness can also vary from year to year (3). Global surveillance data indicate changes in the pattern of circulating influenza viruses; as a result, the vaccine for the 2012-2013 season includes 2 new strains (3). Increased influenza activity was noted in several Southern Hemisphere nations in July; providers should be prepared for potential increases in local activity later this season.

Vaccination remains a critical preventive measure against influenza and its potentially severe complications. Everyone aged 6 months and older, particularly those in higher-risk groups, such as older adults, young children, pregnant women, people of any age with underlying chronic conditions (eg, chronic lung and cardiovascular disease or a metabolic or endocrine disorder such as diabetes), and health care workers, should be routinely immunized each year (Boxes 1 and 2) (6). Every available tool to increase vaccination rates in the community should be used. Strategies such as comprehensive health care worker vaccination programs and increased vaccination of day care and school-aged children can potentially reduce influenza transmission (7-10). Pharmacies that offer influenza vaccine also play an important role in improving vaccination coverage in adults.

BOX 1. IMPORTANT GROUPS FOR INFLUENZA VACCINATION
  • Children aged 6 through 59 months, especially those <2 years
  • People aged ≥50 years, especially those ≥65 years
  • People with certain high-risk medical conditions (Box 2)
  • Women who are pregnant or plan to be pregnant
  • Health care workers
  • Residents of long-term care facilities (aged ≥6 months)
  • American Indians/Alaskan Natives
  • People with body mass index ≥40 kg/m2
  • Household contacts and caregivers of:
    • Children aged <5 years, especially those <6 months
    • Adults aged ≥50 years, especially those ≥65 years
    • People with certain medical conditions (Box 2)

PDF version of Box 1

BOX 2. MEDICAL CONDITIONS THAT INCREASE RISK FOR SEVERE INFLUENZA COMPLICATIONS (11)
  • Chronic pulmonary disorders (including asthma)
  • Cardiovascular diseases (except hypertension)
  • Renal, hepatic, neurologic/ neurodevelopmental, hematologic, metabolic, or endocrine disorders (including diabetes mellitus)
  • Weakened immune system due to disease such as HIV or AIDS, medications such as chronic steroids, or cancer treatment (ie, radiation or chemotherapy)
  • Long-term aspirin therapy in children and adolescents <19 years of age because risk for Reye syndrome after influenza infection

PDF version of Box 2