US flu epidemic rages on, with more deaths and record hospitalizations

By Kate Randall
6 February 2018

The US Centers for Disease Control and Prevention (CDC) reported Friday that at least 16 more children died of the flu over the previous week, with 42 states reporting high levels of the flu activity, up from 39 states the week before. This brings the number of child deaths this flu season to at least 53.

Typically tragic was the case of 7-year-old Savanna Jessie of Columbus, Indiana, who was sent home from the hospital after testing positive for influenza B, strep throat, and scarlet fever. Her father found her in bed unresponsive the next morning. Medics rushed her to the regional hospital, where she was pronounced dead.

“Hospitalizations are now the highest we’ve seen,” said CDC Acting Director Dr. Anne Schuchat in the Friday briefing. CDC officials expect to see numbers similar to or greater than those from the 2014-2015 flu season, when 710,000 Americans were hospitalized and about 56,000 died, including nearly 150 children.

Hospitalizations are one of the key measures of the severity of an outbreak. The rate currently stands at 51.4 per 100,000 people, already significantly higher than the 43.5 rate for the same period during the 2014-2015 season. In California, hospitalization rates are four times higher than they were two years ago.

Although there are indications that flu activity may be peaking in the Western US, Schuchat cautioned that the disease is continuing to spread in the East and remains largely unchanged in the South.

Under these epidemic conditions, the CDC has been hit by a scandal forcing the head of the agency to resign and the Trump administration is proposing drastic cutbacks to the programs that fight epidemics both domestically and internationally.

Dr. Brenda Fitzgerald, a former OB-GYN doctor and Georgia health commissioner, who was tapped by President Trump last summer to head the CDC, stepped down from the post Wednesday after a report in Politico that she traded in tobacco and health care stocks. These included Japan Tobacco, a multinational that sells Winston and Camel cigarettes around the globe, pharmaceutical giants Merck & Co. and Bayer, and health insurer Humana.

In other words, the top official at the helm of the government agency charged with preventing and fighting disease has been trading in stocks that promote tobacco use, a known carcinogen, and private drug companies and health care insurers that are reaping billions in profits at the expense of the well-being of ordinary Americans.

Due to these egregious conflicts of interest, Fitzgerald was forced to cancel her first scheduled appearance before Congress last fall to discuss the opioid epidemic that is ravaging the nation. Dr. Peter Lurie, president of Center for Science in the Public Interest, was quoted by Reuters: “It takes a certain kind of cluelessness for a director of the Centers for Disease Control and Prevention to purchase stock in a tobacco company a month after assuming the job as the nation’s top public health official.”

The choice of Fitzgerald to head the CDC was no less calculated than Trump’s selection of Tom Price to head the Department of Health and Human Services (HHS). Price, a vehement opponent of women’s reproductive rights and the Medicare and Medicaid programs, was forced to resign in September following revelations that he had used more than $1 million in HHS funds for his own travel on private charter jets and military aircraft.

Meanwhile, doctors’ offices, hospitals, and clinics are bursting at the seams in an effort to accommodate people reporting flu-like symptoms. School districts in Chicago, Florida and elsewhere have been forced to close because so many children and staff are out sick. In California, which has been especially hard hit, officials are describing hospitals as “war zones.”

There is an ongoing shortage of saline IV bags to treat people for hydration and administer medications. The shortage stems from the devastation in Puerto Rico following Hurricane Maria, where a private company manufactures nearly half of the IV bags used in US hospitals.

The Food and Drug Administration is monitoring continuing IV bag shortages, as well as spot shortages of some antivirals used to treat the flu, flu tests, and flu vaccines.

The H3N2 virus is the most prevalent in this year’s flu outbreak, causing an estimated 90 percent of cases. Of the two species of influenza viruses that cause seasonal flu, A and B, H3N2, a strain of the A virus, is the most virulent.

Researchers at the Marshfield Clinic Research Institute in Wisconsin earlier this season found that the vaccine designed for this year was about 33 percent effective. A new study from the journal Eursurveillance found that the flu vaccine was only about 10 percent effective against H3N2 among adults in Canada.

H3N2 is particularly resistant to flu vaccines, as it mutates as it moves through the population at a faster rate than other flu viruses. A vaccine to protect against H3N2 is also more difficult to grow in eggs, where viruses for flu vaccines are generally produced.

The federal National Institutes of Health (NIH) only committed $30 million in funding out of an already inadequate budget of $230 million last year overall for the development of a universal vaccine, which could potentially protect against all strains of the flu over the course of a person’s lifetime.

The CDC estimates total yearly expenditures for flu outbreaks, in both direct and indirect medical costs, amount to $87.1 billion. Last year’s budget provided just $57 million for influenza pandemic planning.

As first reported by the Wall Street Journal, the CDC is discontinuing its work in 39 out of 49 countries where its Center for Global Health helps prevent, detect and respond to dangerous infectious diseases such as Ebola and the Zika virus. CDC personnel were informed over the past two weeks that the cuts were being made because it does not expect any new funding for the program.

According to the Center for Global Health website, the organization monitors 30 to 40 disease outbreaks in countries outside the US every day and has trained more than 10,000 “disease detectives” in more than 70 countries.

The five-year initiative was begun under the tenure of Dr. Tom Frieden, CDC director from 2009 to 2017. Its funding runs out in October 2018 and it is not expected to be refunded. Dr. Nancy Knight, director of the Center for Global Health’s Division of Global Health Protection, said, “We estimate approximately an 80 percent reduction in the staff that are based overseas. This is also going to result in a significant reduction of the staff we have at headquarters.”

Frieden, who is now the president and CEO of the initiative Resolve to Save Lives, told CNN the decision to slash 80 percent of epidemic prevention activities overseas “would significantly increase the chance an epidemic will spread without our knowledge and endanger lives in our country and around the world.”

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