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January 10, 2001

Flu cases hitting Hawaii earlier this year

Hawaii’s rapid test program detects trends quickly

Influenza (flu) illnesses are hitting Hawaii earlier than last year, with an increase in cases over the past month, specifically among high school-aged students.

The Department of Health was able to pinpoint these flu cases quickly with its state-of-the-art flu surveillance program nationally recognized as one of the most comprehensive in the United States.

As part of this program, the DOH initiated the use of rapid flu tests with routine virus cultures for the 2001-2002 season in Hawaii. While virus cultures are needed to identify specific flu strains, rapid tests can assist physicians by providing immediate information that can help to reduce complications in high-risk patients. Laboratories can turn around rapid test results in less than 24 hours while routine cultures can take up to 14 days. Hawaii is the first state in the nation to pair these two tests for disease surveillance.

High-risk patients are especially prone to becoming hospitalized and dying from the flu and complications that accompany the flu. Each year, flu illness results in increased numbers of visits to the doctor for treatment. Walk-in clinics and emergency rooms often treat increased numbers of seniors and others with chronic medical conditions such as heart and lung diseases and diabetes during the flu season. Using this new type of rapid testing provides physicians with a ‘real time snap shot’ of influenza among their patients. This type of information answers the questions of who, where, when, and in which age groups influenza is occurring.

Flu epidemics occur nearly every year during the winter months and are associated with an average of 144,000 hospitalizations and 20,000 deaths per year in the United States. Influenza viruses have the ability to mutate and emerge without warning. In addition to annual epidemics, periodic shifts and drifts in flu viruses have caused catastrophic illness on a global scale. The importance of maintaining heightened flu surveillance was underscored by the highly fatal 1997 outbreak of avian influenza in Hong Kong.

One of the real strengths of rapid testing of flu viruses is that it encourages doctors to submit virus culture specimens. Isolation and identification of actual flu strains are the only means of determining whether the strains of flu circulating in the community are the same ones that the flu vaccine provides protection against. The strains currently circulating locally -- the A/Panama/2007/99-like (H3N2) and the B/Sichuan/379/99-like -- are well matched to this year’s flu vaccine.

This is all the more reason to get flu shot now. The flu shot takes about two weeks to become fully effective. Many persons at high risk for flu have Medicare Part B insurance that provides for an annual flu shot with no out-of-pocket expense to the beneficiary. There is sufficient vaccine at clinics throughout Hawaii to handle flu shot requests.

For a list of flu shots clinics call Ask Aloha United Way at 275-2000. Neighbor island calls can be directed to 1-877-275-6569, which is a toll-free call. The DOH Website at http://www.state.hi.us/doh/resource/comm_dis/immunization/resource2001.html provides information about flu clinics.

Additional technical information can be viewed on the web at www.hawaii.gov/health/resource/comm_dis/flu/articles.

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