February 22, 2008

Hospitals riding out rising wave of flu cases

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Hospitals riding out rising wave of flu cases

Tennessee's influenza activity level was upgraded from regional to widespread by the Centers for Disease Control and Prevention early this week.

Lagging just behind the national trend, Vanderbilt University Medical Center's flu cases appear to be spiking only a few days later.

During the final week of January thru the first week of February, the number of confirmed influenza cases at VUMC nearly tripled.

Last week there were 95 confirmed cases, as the Adult and Pediatric Emergency Departments registered dramatic increases in flu activity, particularly last weekend.

Many patients presenting to the Adult Internal Medicine Clinic are also complaining of flu-like symptoms.

Ian Jones, M.D., assistant professor of Emergency Medicine and medical director of the Adult Emergency Department, described the last few days as “extra busy,” but perhaps beginning to get better.

“Last Sunday we saw more than 200 patients in the Adult ED. We called in a few extra physicians to meet the demand,” said Jones.

“After flu patients have undergone appropriate triage screening to rule out underlying complications, we have been sending many of these patients with flu-like symptoms home as quickly as possible to maintain available beds for sicker patients.”

Along with influenza and flu-like illnesses, VUMC's emergency departments are seeing a high incidence of patients presenting with respiratory illness.

“Our patient volume increase has actually been more like 60 percent over two weeks ago. And it still continues to be high,” said Tom Abramo, M.D., director of Pediatric Emergency Medicine.

“We are advising parents to contact their primary care doctor before coming to the Emergency Department. That would help a lot.”

In addition to increased volume in its emergency departments, each flu season brings the added challenge of maintaining available inpatient bed space and adequate staffing levels due to seasonal illness.

So far there have been no bed closures due to a shortage of available staff, and Vanderbilt University Hospital diversions remain at typical levels.

Compounding challenges to VUMC this flu season is the matter of this year's flu vaccine not providing a perfect match for the flu strains currently making the rounds.

“This year, the dominant flu strain circulating is an exact match with the vaccine,” said William Schaffner, M.D., professor and chairman of the Department of Preventive Medicine.

“However, another strain is somewhat off target, providing partial protection, while the third strain is a mismatch. Fortunately, this third strain is influenza type B.

“These viruses usually produce milder disease and are not often associated with large outbreaks,” Schaffner said.