Swine flu: Next flu season could be a busy one

5/25/2009

NEW YORK —While news around the novel H1N1 influenza virus, also known as the swine flu, dominated airwaves earlier this month, U.S. health officials began preparing for a return visit of the virus this fall when the 2009-2010 cough-cold-flu season kicks off in September.

And that should mean a busy season in the coming year, especially as it pertains to the sale of hand sanitizers, N-95 face masks and flu vaccines (at least for the seasonal flu currently in production), as well as more questions for pharmacists and retail clinicians from concerned patients.

It also should mean a busy fall for pharmacists dispensing prescriptions for Tamiflu and Relenza. New antiviral prescriptions dispensed at retail pharmacies totaled 277,000 for the week ended May 1, more than 19 times higher than the earlier week, according to SDI’s Sentinel Laboratory Network. During the season, new prescriptions reached as high as 155,000 during the week ended Feb. 27.

A return of the H1N1 influenza this fall, in conjunction with incidences of typical seasonal influenza, is expected to generate plenty of consternation among the public. Already the CDC has picked up an increase in seasonal flu cases this late in the 2008-2009 season, though mostly as a result of increased testing that is uncovering seasonal flu cases that would have gone unreported otherwise.

“It maybe foreshadows what we have to face next fall, when seasonal strains of influenza are likely to circulate, and we may see this H1N1 strain come back, perhaps, in worse or milder form,” said Anne Schuchat, CDC’s interim deputy director for science and public health.

As of May 12, there were approximately 3,600 probable and confirmed cases of H1N1 influenza across 46 states and the District of Columbia with three deaths and possibly as many as 116 hospitalizations. The median age of those patients remains low, at 15 years, with a range of 1 month to 86 years. Almost two-thirds of confirmed cases fall under the age of 18 years.

Coming into mid-May, however, concern over an H1N1 pandemic began to wane. Even as the CDC’s number of confirmed cases continued to grow, SDI data found that for the week ended May 8, the number of new antiviral prescriptions dispensed at retail pharmacies dropped to 118,578—down 59% compared with the week prior. Tamiflu accounted for 90% of those prescriptions.

Now the CDC is looking ahead. “We’re also preparing for the fall, including exploration of vaccine development and manufacturing discussions,” Schuchat said. One concern is that the novel H1N1 virus that is susceptible to antivirals Tamiflu and Relenza will mutate and resurface as resistant to Tamiflu and Relenza.

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