Influenza Outbreak Spreads to 24 States

The influenza outbreak continues to spread rapidly throughout the country, federal officials said Thursday, with 24 states now widely affected, nearly double the number from last week.

The number of infections has not yet reached epidemic proportions, said Dr. Julie Gerberding, director of the national Centers for Disease Control and Prevention, but “the flu season is far from over.”

The affected states are primarily in the West, but eastern states are feeling the effects as well. On Thursday, at least two schools in Connecticut closed for the rest of the week because more than a third of their students were out with flu-like illnesses.

Colorado has been hardest-hit so far, with more than 7,600 confirmed cases, five adult fatalities and the deaths of nine children. Eleven elderly adults are also known to have died in Utah. In a normal year, 114,000 people on average are hospitalized with flu-related illnesses and 36,000 die. Experts said those numbers could double this year.

Colorado’s situation is unique because most states do not collect numbers of flu cases or deaths -- it is not a “reportable” illness.

The California Department of Health Services said Thursday that 1,872 confirmed flu cases had been reported to the agency so far this year; there are no comparable numbers for last year.

The deaths of an elderly San Luis Obispo resident and a 7-year-old Bakersfield boy are confirmed to be from the flu. A 5-year-old Arizona boy visiting Compton and a 13-year-old San Diego County girl are suspected to have died of flu complications.

Nationwide, 23 children have died so far, according to Associated Press.

On Thursday, the CDC added Arizona, Indiana, Iowa, Mississippi, Missouri, Montana, North Carolina, Oklahoma, Oregon, Rhode Island and Virginia to the list of states with widespread flu activity, meaning that at least half of the states has experienced an outbreak.

Last week, only Alaska, Arkansas, Colorado, Idaho, Nebraska, Nevada, New Mexico, Pennsylvania, Tennessee, Texas, Utah, Washington and Wyoming were similarly listed.

The good news is that “possibly, things may be leveling off in some of the states that were hardest hit, but it is still too early to know,” Gerberding said.

Manufacturers produced 83 million doses of flu vaccine this season, and virtually all have been shipped out, although no one knows how many remain in the distribution pipeline. “We do know that there is no big hoard of vaccine anywhere,” Gerberding said.

Some private physicians in Los Angeles County have exhausted their stocks of the vaccine, county health officials said Thursday, but others still have it.

Supplies of an intra-nasally administered vaccine called FluMist are also still plentiful.

A county program to vaccinate high-risk individuals -- a group that includes young children, the elderly and people with chronic diseases -- is expected to continue for at least another week before supplies are exhausted.

Historically, no more than 80 million people in the U.S. have ever been vaccinated for flu in any year. Last winter, manufacturers produced 95 million doses, but they were forced to throw 12 million away unused. “That’s why they only produced 83 million this year,” Gerberding said.

With supplies growing tight, Health and Human Services Secretary Tommy G. Thompson said Thursday that his department had purchased a quarter of a million doses of flu vaccine from Aventis Pasteur -- the last of its stock for this year -- for distribution throughout the country.

The purchase -- 100,000 doses of adult vaccine and 150,000 of a pediatric version -- will be sent to state health departments for distribution to high-risk individuals.

The CDC is also exploring the importation of 500,000 doses of vaccine manufactured by the Chiron Corp. for European distribution.

However, bringing those doses into the United States will require approval from the Food and Drug Administration. Other European flu vaccines are also available, but none have been licensed for sale in this country.

Gerberding noted that other options were available. Nearly 4 million doses of FluMist are still available from its distributor, Wyeth Laboratories. That vaccine is designed primarily for use in healthy people ages 5 to 49.

FluMist has not been widely accepted, in part because it costs nearly twice as much as a conventional flu vaccine and insurers have been unwilling to pay for it. On Thursday, Cigna HealthCare announced that it would provide the vaccine to its members for the rest of this flu season.

Four antiviral drugs -- amantadine, rimantadine, oseltamivir and zanamivir -- are also available for treating influenza infections and preventing them. If given within 48 hours of the onset of flu, the drugs can reduce its duration by a day or more. They can also prevent infection, but they are generally used only to prevent outbreaks within institutions or for close contacts of people who are already infected.

The U.S. is not suffering alone. According to the World Health Organization, Finland, France, Norway, Spain and Portugal have undergone similar outbreaks. Meanwhile, in parts of Canada and the United Kingdom, where influenza was first noted this season, the number of cases has apparently started to decline.

Influenza activity remains low throughout the rest of Europe, but a rising trend has been observed, WHO said.