The Delaware Division of Public Health (DPH) is issuing this health advisory to advise health care providers of increased influenza (flu) activity in Delaware, what precautions can be taken and recommendations that can be made for patients experiencing flu-like symptoms.

The level of influenza activity in Delaware is at record levels in the state. DPH urges providers to continue to vaccinate their patients against the flu and to start patients who have a clinical picture consistent with influenza on neuraminidase inhibitor antivirals (such as oseltamivir) as soon as possible and without waiting for results of laboratory testing.

Due to the ongoing strain on the hospitals, providers are encouraged to direct to the emergency room (ER) only those patients experiencing serious or life-threatening symptoms. Patients with less serious symptoms related to influenza can be cared for by primary care providers or at walk-in clinics.
Providers should also consider calling in prescriptions for antivirals for patients with flu like symptoms without waiting for an office visit, and communicate to patients the importance of staying home from work, or in the case of children – school, while sick to prevent further spread of the disease.

Influenza activity remains high

The number of Delaware laboratory-confirmed flu cases for the 2017-2018 season are at record high levels. Total laboratory-confirmed flu cases have now surpassed 4,100. The total for the entire 2016-2017 season was 4,590 laboratory-confirmed cases, which was a record high for the time. Additionally, for the week of Feb. 4 to Feb. 10, 2018, single week totals have exceeded 1,200 lab-confirmed cases, which is almost double the previous single week total record of 671 during the 2009-2010 flu season.

As of February 15, 2018, Delaware has seen 11 flu-related deaths for the 2017-2018 season, most of whom have been patients over 60 with chronic underlying health conditions. The latest reported death was to a 47-year old individual who had no underlying health conditions, and had not been vaccinated. To date, eight of the 11 deaths have been New Castle County residents and three have been Sussex County residents. There have not been any flu-related deaths in Kent County reported.

The age groups hit hardest with the flu this year have been persons aged 5 to 24 (875) – most of them in the 5 to 13 age range, as well as infants and children birth to 4 (461). To date, persons age 65 and older comprise 62.6 percent of the hospitalizations. 513 have been hospitalized this season due to flu complications – more than double the 199 at this time last year.

While there are signs that flu activity may be declining along the West coast, overall, influenza-like-illness increased again nationally. This is highest level of influenza-like illness recorded since the 2009 H1N1 pandemic

While H3N2 viruses continue to be predominant this season, the nation is seeing the proportion of H3N2 viruses begin to decline and an increase in the proportion of influenza B viruses and, to a lesser extent, H1N1 viruses as well.

Health Alert Notice: Seasonal Influenza Activity and Treatment of Patients with Influenza in Delaware