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March 23, 2019

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  • Influenza activity is at high levels with influenza A H3N2 increasing in addition to previously circulating influenza A H1N1. Influenza circulation may occur for another 4-6 weeks.
  • King County healthcare facilities are operating at or near maximal capacity and reporting patient volumes in excess of 100%, limited to no bed availability, and large numbers of patients boarding in EDs and other locations. EDs are also experiencing excessive patient volumes and wait times. In response, King County healthcare providers are requested to:
    • Please make all available efforts to manage low acuity patients in outpatient settings, including when providing telephone triage messages to patients.
    • Expand office hours, staffing & clinic capacity to accommodate an increase in patients.
    • Use prompt antiviral drug treatment for influenza infection in high-risk patents to minimize complications and need for hospitalization, regardless of immunization status. See link to CDC info on antiviral drug treatment, below.
  • When indicated, antiviral treatment should be started as soon as possible after illness onset, ideally within 48 hours of symptom onset. However, antiviral treatment might have some benefits in patients with severe, complicated or progressive illness, and in hospitalized patients when started after 48 hours of illness onset.
  • Antiviral treatment should not be withheld while awaiting results of influenza testing in persons with ILI at increased risk.
  • A negative rapid test for influenza in a patient with ILI does not rule out influenza infection.
  • Influenza vaccination is the best way to prevent influenza illness. Continue offering influenza vaccine to all persons 6 months of age and older.

During the week ending March 16th, the percent of visits to King County EDs for ILI was above baseline levels and above the 5-year average among all ages. The percent of ED ILI visits reached new peaks for the current season. Among pediatric age groups, the percent of ED ILI visits exceeded peak levels observed during each of the previous 5 influenza seasons.

Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who is hospitalized; has severe, complicated, or progressive illness; or is at higher risk for influenza complications. Clinical benefit is greatest when antiviral treatment is administered within 48 hours of influenza illness onset but has been observed even when treatment is initiated later.