Flu News from the CDC and Lay Press

Every year, influenza prevention, treatment, and complications pose challenges to pediatricians. This year, new concerns about antiviral drug resistance and complications secondary to bacterial superinfection have emerged.

The CDC recently published the results of a survey of 730 primary care physicians in Connecticut, Minnesota, New Mexico, and New York about influenza testing and antiviral prescribing practices during the 2006–2007 flu season. Most physicians (69%) used influenza testing during the flu season; of those, 88% ordered rapid antigen tests. Although more than 90% of practitioners prescribed the neuraminidase inhibitors oseltamivir and zanamivir, 26% still prescribed amantadine or rimantadine, even though these agents have not been recommended since January 2006 because they are associated with high viral-resistance rates.

The New York Times and the Associated Press reported that 3.8% of influenza virus isolates in the U.S. have a mutation that confers resistance to oseltamivir. Other countries reporting resistant strains were Norway, Denmark, France, and Britain. The CDC still recommends the use of oseltamivir at this time.

The CDC recently issued a health advisory to request that all pediatric influenza deaths be reported through local or state health departments. The advisory is also intended to heighten awareness about pediatric influenza complicated by methicillin-resistant Staphylococcus aureus (MRSA) superinfection. During the past three influenza seasons, the number of reported pediatric deaths from influenza, as well as the number of pediatric deaths with bacterial coinfection, increased. In the 2006–2007 season, 15 of 22 children with S. aureus superinfection had MRSA infection.