The flu vaccine last season was almost completely ineffective at preventing the disease, but it might have helped some people stay out of hospital, researchers reported. Overall, the vaccine failed to match the main circulating strain of influenza A, which in 2014-15 was an H3N2 virus, according to Alicia Fry, MD, of the CDC's influenza division in Atlanta.The genetics of circulating H3N2 began to drift away from the vaccine strain almost as soon as experts decided in late February of 2014 what should go into the vaccine. The vaccine strain of H3N2 was dubbed 3C.1, but starting in March it became clear that more than half of the circulating virus was of the types known as 3C.2a and 3C.3a -- variants that were "low reactors" to the vaccine. And it was the H3N2 virus that was causing disease. There was very little influenza (A) H1N1 (unlike 2013-14, when it predominated) and not much influenza B. The problem with flu is that it is highly variable genetically; when experts pick the vaccine strains -- based essentially on highly educated guesswork -- it takes several months to make the vaccine and get it into the clinic. In the meantime, the pathogen can and often does change.
Boston based non-profit, NICHQ, aims
to reduce unbearable episodes of pain for patients in the ER and other clinical
settings with “Sickle Cell Pain inthe Emergency Department: A Guide to Improving Care,” a step-by-step manual
for anyone on the front lines of acute care, from emergency room (ER)
doctors and nurses, to hematology specialists. Dr. Suzette Oyeku, NICHQ’s
strategic project director said, “Sickle cell disease patients wait in
excruciating pain longer than they have to for treatment. Guidelines do
exist, but many providers are unclear about how to carry them out, particularly
in acute care settings. Our guide was designed to help providers bridge
SCD work, funded by The U.S. Health Resources and Services Administration
(HRSA), yielded many results in improving care. These included a
reduction in the wait time for evaluation by 69 percent and a 29 percent
improvement in the time between triage and receiving pain medication. One
of the most significant outputs of the teams’ extensive work is “Sickle Cell
Pain in the Emergency Department: A Guide to Improving Care.” The online
publication offers best practice findings such as standardized order sets, a
recommendation to consider using intranasal fentanyl and a color-coded, full
body chart, reviewed by patients and doctors, as a standard pain assessment
Project Officer Dr. E. Donnell Ivy, said, “Having just recognized World Sickle
Cell Day and as Sickle Cell Awareness Month approaches in September, the timing
for sharing this comprehensive resource could not be better. We
congratulate NICHQ and all of our Treatment Demonstration and Newborn Screening
grantees on advancing the quality of care. As a result of their work,
thousands of patients, from coast to coast, will receive better treatment in
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People receiving this year's seasonal influenza vaccine are 23% less
likely to seek medical treatment for flu-type symptoms relative to
unvaccinated individuals, according to an interim CDC estimate based on
reports submitted so far for the current season.
That's less than half the "vaccine effectiveness" calculated for the vaccines deployed in recent seasons:
The CDC had previously acknowledged that the current flu vaccine cocktail appeared less effective than usual,
because the most common influenza A strain being detected in
circulation, dubbed A/Switzerland/9715293/2013, was not among those
selected for the 2014-2015 Northern Hemisphere vaccine. The
A/Switzerland strain is included in the vaccines to be used in the
upcoming Southern Hemisphere season, which begins in a few months. But
those stocks are neither ready yet nor would they be large enough to
cover the much more heavily populated Northern Hemisphere.
But the new estimate, published online in Morbidity and Mortality Weekly Report, is the first time the agency has put a number to the reduced effectiveness.
Authors of the report noted that their interim estimate came earlier
than in previous years, because of the early onset of significant flu
cases last fall.
"These early vaccine effectiveness estimates underscore the need for
additional influenza prevention and treatment measures, especially among
persons aged ≥65 years, young children, and other persons at higher
risk for serious influenza associated complications," they wrote.
Last week, the CDC called for immediate treatment with influenza antiviral drugs in all high-risk patients presenting with possible flu, without waiting for confirmatory testing.
A single dose of an investigational influenza drug was able to reduce
the duration of fever and viral shedding, researchers said. In a combined analysis of two randomized placebo-controlled trials, the
neuraminidase inhibitor peramivir (Rapivab), given by injection within
48 hours of symptom onset, also lowered the amount of virus in the
blood, according to Rich Whitley, MD, of the University of Alabama at Birmingham. But while the drug reduced the time to resolution of symptoms - the
primary endpoint of the trials - the difference from placebo was not
Is oral zinc associated with a shorter duration, decreased
severity, and reduced incidence of the common cold compared with placebo?
When initiated within 24 hours of symptom onset, oral zinc is
associated with a shorter duration of the common cold in healthy people.
However, there is no association between oral zinc and symptom
severity, and the prevalence of adverse effects with zinc lozenges is
high. Given the high heterogeneity of data, these results should be
interpreted with caution. Used prophylactically, oral zinc is associated
with a reduced cold incidence in children. Prophylactic use has not
been studied in adults.
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