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From OHSU Doernbecher Children’s Hospital
Dawn Nolt, M.D., M.P.H.
Dr. Nolt specializes in pediatrics and infectious diseases. She has a special interest in infections in children with malignancies, immunodeficiencies and cystic fibrosis. She is the medical director for infection prevention and control, antimicrobial stewardship and transplant/oncologic infectious diseases.
Every year, a wave of the influenza virus circles the globe, bringing with it fevers, coughs, muscle aches and stomach woes. This year, the annual flu season in the United States will likely happen while our community is still coping with the COVID-19 outbreak. As both are respiratory viruses, the differential diagnosis will be challenging. The good news is that we anticipate the flu vaccine for the 2020-2021 season to be delivered on time with a sufficient supply and a good match to the circulating strains.
Forecasting flu for 2020-2021
Here in the Northern Hemisphere, we typically get a preview of the influenza season by tracking the virus as it migrates through the Southern Hemisphere. This year there are lower levels of influenza than expected in the Southern Hemisphere. Out of 302,586 specimens submitted to the World Health Organization, only 45 were positive for flu.
Does this mean the extra precautions in place to lower the curve of the new coronavirus are also dampening flu activity? Or are fewer people accessing medical care due to pandemic fears and thus not getting diagnosed? We don’t have those answers, but either or both may be true.
For the 2020–2021 influenza season, the vaccine has been modified from last year’s strain to better match what is expected in the U.S. Last year, the virus activity in the Southern Hemisphere prompted a mid-course change in vaccine components. There is no such concern this year.
We anticipate the flu to peak during the usual time period of November through January.
In most years, the largest burden of influenza is among school-age children. We also know influenza outbreaks in households often begin with a child. The shift throughout most of the state to online educational learning may effectively reduce the spread of influenza as well as COVID-19. However, it’s hard to predict the outcome if in-person schooling reopens just as flu season peaks.
Where to find the latest guidelines for influenza
Information about this year’s flu season will likely evolve as will guidelines for COVID-19. Stay on top of changes by utilizing these resources:
Differentiating between COVID-19 and influenza
For both viruses, the common symptoms include fever, cough, muscle pain, nausea and/or vomiting, and diarrhea. The symptoms will be similar enough to likely cause confusion and even panic among patients. Patients who might otherwise not go to the doctor for mild symptoms may be more inclined to seek care.
If symptoms develop during flu season with no known exposure to COVID-19, influenza is a quick test and the priority since we have treatment options. We anticipate an increased demand for testing for both flu and COVID-19 to delineate between the two. Right now, COVID-19 is still going strong. We don’t yet know if there will be a further peak in the respiratory virus during winter.
Encourage widespread flu vaccination
Unlike COVID-19, we do have a vaccine to prevent or reduce symptoms of influenza. We need to encourage all patients to get a flu shot this year.
As a medical community, we will need to strategize how best to make the flu vaccine available, whether that is drive-through administration or other special clinics. If we can limit the spread of the flu, we can alleviate the burden on the health care system and the anxiety for us all.
When to refer or consult
In pediatric patients, complications from influenza that benefit from specialist care can include the following:
- Neurologic issues
- Febrile seizures
- Worsening chronic illnesses
New in-patient pediatric unit in Washington County
Pediatric patients with milder inpatient needs may now be able to get their needed care closer to home.
The OHSU Doernbecher Children’s Hospital inpatient pediatric unit located at OHSU Health Hillsboro Medical Center (formerly Tuality Healthcare) is staffed by board certified pediatric physicians and pediatric-trained support staff.
The new four-bed, family-friendly unit has the capability to provide low-flow oxygen, respiratory therapy, IV fluids and medications for conditions such as gastroenteritis, asthma flares, pneumonia and dehydration.