HEALTH ADVISORY

Summary

October 1^st marks the beginning of influenza season surveillance. The 2019-2020 influenza season included 19 weeks of widespread activity before dropping dramatically in April coinciding with measures that were instituted to combat COVID-19. This flu season will require even more rigorous measures to strengthen surveillance and preventive interventions in our community while battling both seasonal flu and the ongoing COVID-19 pandemic. The convergence of these two circulating viruses will be a challenge for healthcare providers. Because so many of the symptoms of COVID-19 overlap with seasonal respiratory illnesses, we encourage you to be proactive in preparing for these likely events. The most important action you can take is to ensure all your staff AND patients are vaccinated with the influenza vaccine (age 6 months and older).

FCHD reminds providers of the following reporting requirements.

• Healthcare facilities are required to report influenza by number of cases per week to the local health department. Please report weekly case counts of influenza online to FCHD at https://www.fairfaxcounty.gov/health/diseases-conditions/reporting.
• In some circumstances, influenza needs to be reported immediately to the health department to enable urgent public health actions. The following should be immediately reported (24/7) to the Fairfax County Health Department by calling Acute Communicable and Emerging Disease Program at 703-246-2433. 
  • A case of influenza caused by a novel influenza virus 
  • Influenza-associated death of a child <18 years of age 
  • Suspected influenza outbreak

SUGGESTED ACTIONS:

Reporting Influenza Numbers

• Per Virginia Regulations for Disease Reporting and Control, physicians and directors of medical care facilities in Fairfax County should report to the Fairfax County Health Department the aggregate number of influenza cases per week, by influenza type, if known (e.g. “4 cases of influenza A, 2 cases of influenza B, 2 cases of influenza type unknown”). No patient demographics need to be reported for weekly summary counts of influenza. 
• This information will help to strengthen our capacity to monitor influenza activity in our community. Virginia Department of Health (VDH) releases weekly influenza activity reports for the state. These reports are available at: http://www.vdh.virginia.gov/epidemiology/influenza-flu-in-virginia/influenzasurveillance/.

Immediately Reportable Influenza Cases/Outbreaks

• The scenarios listed in the second bullet of the summary above all need to be reported immediately to FCHD per Virginia Regulations.
• Immediate reporting to public health will allow for quicker follow-up testing at the state lab as well as more rapid public health interventions, such as exclusion of ill individuals from work and/or school, earlier notification to those who are high risk for complications, and the recommendation for prophylaxis, as appropriate, further limiting the spread of disease in our community.

Influenza Vaccine

• Optimal influenza vaccination coverage is essential when dealing with the concurrent COVID-19 pandemic. See CDC information that addresses this issue: https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm 
• Healthcare providers are the number one influencer for patients getting the influenza vaccine. A variety of tools are available from CDC (additional links in next section) to assist you in informing and encouraging your patients to get the vaccine – particularly this flu season with COVID-19 co-circulating. Information for your patients: https://www.cdc.gov/flu/prevent/preventing.htm.

ADDITIONAL INFORMATION:

What will flu season be like this year?

It is not possible to predict the severity of the influenza season, but you can stay up to date on what’s circulating, and the timing, severity and length of the season by signing up to receive the Fairfax County Health Department’s weekly influenza update. The first report of the 2020-2021 season will be released in October 2020. To sign-up, please visit https://redcap.vdh.virginia.gov/redcap/surveys/?s=MKDRNXDHT7.

Information on influenza diagnostic testing, infection control and patient education can be found on the Centers for Disease Control and Prevention’s (CDC) “Seasonal Influenza” website: www.cdc.gov/flu.

Influenza Vaccination:

• For the 2020-2021 season and every influenza season, CDC recommends routine annual influenza vaccination for all persons aged ≥6 months who do not have contraindications. See https://www.cdc.gov/flu/season/health-care-professionals.htm. 
• Following two seasons (2016–17 and 2017–18) during which ACIP recommended that LAIV4 not be used, ACIP voted in February 2018 to recommend that for the 2018–19 season, vaccination providers may choose to administer any licensed, age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). Those recommendations are still in place. 
• Vaccination of people at high risk of developing influenza-related complications is especially important to decrease their risk of severe illness from flu, as is vaccination for healthcare workers and those who care for high-risk persons. 
• Health care workers should be vaccinated annually against influenza. The Healthy People 2020 goal is to achieve >90% of influenza vaccine coverage among health care personnel. https://www.cdc.gov/flu/professionals/healthcareworkers.htm. Strategies to achieve high vaccination coverage among health care workers can be found at https://www.cdc.gov/flu/toolkit/long-termcare/strategies.htm. 
• To review the full CDC recommendation, please see “Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2020-21 Influenza Season” MMWR 2020; August 21, 2020 / 69(8);1–24 - https://www.cdc.gov/mmwr/volumes/69/rr/rr6908a1.htm.

Influenza Antiviral Drugs:

Influenza antiviral prescription drugs can be used to treat influenza or as prophylaxis. Current CDC clinical guidance on appropriate antiviral use for influenza - https://www.cdc.gov/flu/professionals/antivirals/summaryclinicians.htm.

2019-2020 Influenza Summary:

In Fairfax, influenza activity peaked at the end of December with 8.8% of emergency department and urgent care center visits for influenza-like illness, which was similar to the state numbers and slightly higher compared with national activity which peaked the same week at 7%. Per CDC, the number of hospitalizations attributed to influenza this season was moderate (67/100,000), and about the same as the previous year. Virginia reported widespread activity level for 19 consecutive weeks, slightly longer than the 16 weeks for the preceding flu season. The Health Department investigated 17 respiratory outbreaks (prior to the COVID-19 pandemic) of which 15 were suspected or confirmed influenza, predominately in school settings. If you have questions, contact the Communicable Disease Unit by phone at 703-246-2433.

 

Influenza Summary Report

Please fax the below, Influenza Summary Report, to the Fairfax County Health Department at 703-653-1347 or report online at: https://www.fairfaxcounty.gov/health/diseases-conditions/reporting.

If you have questions, contact the Communicable Disease Unit by phone at 703-246-2433.