Flu Recommendations: 2017-2018 Season

With the flu season approaching, we wanted to let our patients know that we now have flu shots available in our office. The Centers for Disease Control (CDC) has published its recommendations on influenza vaccination for the 2017–18 season, and they continue to recommend vaccination for all people aged 6 months and older with only rare exceptions. People who should either NOT have or should WAIT to have the flu vaccine include:

1. Individuals who have had a severe allergic reaction (e.g., anaphylaxis) after previous dose of RIV or to a vaccine component.

2. Individuals with moderate to severe acute illnesses (with or without fever). However, after resolution of the illness, the flu vaccine can be given.

3. Patients with significant egg allergy (i.e. experience more than just hives) should have the vaccine administered by a clinician with significant experience managing allergic reactions (typically Allergist / Immunologist).

Of interest to our patients older than 65, the CDC states that EITHER standard-dose OR high-dose vaccine is acceptable.

The CDC is again recommending against use of the live attenuated influenza vaccine (FluMist), given its low effectiveness against H1N1 during the 2013–14 and 2015–16 seasons. This is particularly bad news for children who would much prefer a nasal mist over a injection.

Flu Prevention and Treatment at Santa Monica Primary Care
At Santa Monica Primary Care we not only seek to prevent flu through administration of the flu vaccine but also treat flu. During flu season (generally October to April), if you experience any of these symptoms, we recommend that you make an appointment by calling us at 310.828.4411 for further evaluation (we keep same day appointments available during this time):

● Fever* or feeling feverish/chills
● Cough
● Sore throat
● Runny or stuffy nose
● Muscle or body aches
● Headaches
● Fatigue (tiredness)
● Some people may have vomiting and diarrhea, though this is more common in children than adults.
* It’s important to note that not everyone with flu will have a fever.

At Santa Monica Primary Care, we have specific testing that can identify the presence of flu virus called Rapid influenza diagnostic tests (RIDTs) yielding results in less than 15 minutes. Flu is most effectively treated when medication is started within 1-2 days of getting sick and antiviral medications are used and can lessen symptoms and shorten the time you are sick. Medication can also prevent serious flu complications such as pneumonia. For some people, treatment with antiviral drugs can mean the difference between milder or more serious illness possibly resulting in a hospital stay. Treatment is generally 5 days in duration and is generally well tolerated. There are particular antivirals recommended for children and pregnant women as specific studies have shown these to be safe in these individuals. At Santa Monica Primary Care, we may also recommend treatment for household members who have yet to exhibit symptoms but may be at risk of developing flu.

Predicting Flu Activity in Los Angeles
Columbia University maintains a website that more accurately predicts the peak timing of flu activity by city. This has been spot on for Los Angeles for the 2014–15 and 2015–16 seasons and reflected flu activity we saw in the office. The current prediction for peak activity for Los Angeles is the week of January 15th, 2018. They predict cases beginning the week of November 27th, 2017 and steadily climbing to that peak level in mid-January 2018 and remaining high through mid-February 2018 before declining. If you are traveling, the website has prediction models for US Cities from Albany to Wichita (not quite A to Z).

Our Recommendations at Santa Monica Primary Care
At Santa Monica Primary Care, we recommend having a flu shot certainly before the end of November if not sooner but will continue to provide vaccines through the entire season. To schedule an appointment with our office to have your flu shot, please call us at 310.828.4411. The visit will be quick with our experienced staff.

For more information on the CDC’s recommendations, click: MMWR article (Free)

For more information on Columbia University’s flu prediction model for Los Angeles, go to:
http://cpid.iri.columbia.edu//?tab=chart&week=71&type=All Types&location=Los Angeles, CA