Boatswain2PA Posted January 29, 2019 Share Posted January 29, 2019 Anyone else getting the feeling that this year's influenza A is especially lethal? I'm seeing young healthy people (from kids to adults) who are critically ill with Flu A positive ARDS, and I know of an influenza related death of a previously healthy young child. I"m also seeing a big difference between those vaccinated (flu positive & feels bad) and unvaccinated (flu positive and looks/feels like got hit by a train). Anyone else seeing this? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted January 29, 2019 Administrator Share Posted January 29, 2019 Sorry, here in Washington we're worried about a spreading measles outbreak. Have seen a smattering of flu, but nothing I've sent people to the ER for. Link to comment Share on other sites More sharing options...
TWR Posted January 29, 2019 Share Posted January 29, 2019 In Houston, I have had one case of Flu A in a immunized lady. The only case this season so far and even that is a late start. Link to comment Share on other sites More sharing options...
sas5814 Posted January 29, 2019 Share Posted January 29, 2019 I had 5 pos flu A's yesterday. Here in East Texas cold season has been on for a while but the flu just started popping up in numbers in the last few weeks. I sent 1 toddler to the ER yesterday because he had flu like symptoms, was grunting when he breathed and looked septic. I didn't delay the transfer for the flu tests which, in our clinic, can take 30-40 minutes. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted January 29, 2019 Share Posted January 29, 2019 Here in "west" East Texas I don't even bother testing now. It's in the community, false negatives are atrocious, I just use the CDC criteria and tell the patient/family that the anti-viral medication is optional (assuming that they can afford it), and that they'll have their answer in a week after symptom onset. If better, probable influenza but they've survived. If still sx., welcome to the winter head/chest cold season. I tell all of them regardless to watch respiratory status and to seek emergent attention for CP with breathing at rest or SOB at rest. I do give week work/school notes for this dx. only so I can protect the "herd". Most of my population deferred on vaccination it seems (free, go figure) but over the past week or so I'm seeing folks vaccinated that have that flu look in their eyes, as well as legit sx. presentation. As an aside, I print the Tamiflu prescription and hand them a GoodRx card so they can price shop. Other prescriptions are sent to their requested pharmacy for sx. relief. Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted January 29, 2019 Share Posted January 29, 2019 Midwest: southwest Ohio, western Indiana. I've only seen a very few cases, flu A only. No one super ill. Had 2 deaths from flu (I believe flu A) last year - both middle aged with some but not extensive respiratory issues. Link to comment Share on other sites More sharing options...
sk732 Posted February 1, 2019 Share Posted February 1, 2019 We've been getting a number of Flu A's and also a pile of sick adults with RSV as well. My flu shot worked quite well this year, as most others seemed to. Link to comment Share on other sites More sharing options...
narcan Posted February 1, 2019 Share Posted February 1, 2019 Have seen a lot of sick, sick people with the flu this year, but also did have a previously healthy 29 yof with Flu A and RSV who ended up on VV-ECMO, so I would agree, it's bad this year. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 1, 2019 Share Posted February 1, 2019 Not even testing since the false negative rate is high. Walk, quack, look like a duck; you’re being treated as a duck. You’ll have your answer in about 5-6 days from sx onset when you begin to improve. If not? Welcome to the world of a head and chest cold. Link to comment Share on other sites More sharing options...
Cideous Posted February 1, 2019 Share Posted February 1, 2019 Lots of positives in DFW with people who got their flu shot. 3 today....which is disappointing. They do seem to be improving quicker then the non-vaccinated. Link to comment Share on other sites More sharing options...
Marinejiujitsu Posted February 3, 2019 Share Posted February 3, 2019 I had a vertebral artery dissection and 3 small cerebellar strokes 1 week after mine of course I think practicing a choke in jiu jitsu triggered the stroke. It was nuts. Then SEMPA released flu predisposing people to it.Sent from my SM-N950U using Tapatalk Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 3, 2019 Author Share Posted February 3, 2019 5 minutes ago, Marinejiujitsu said: I had a vertebral artery dissection and 3 small cerebellar strokes 1 week after mine of course I think practicing a choke in jiu jitsu triggered the stroke. It was nuts. Then SEMPA released flu predisposing people to it. Sent from my SM-N950U using Tapatalk Whoa...you personally? Hope you are recovering quickly! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 3, 2019 Moderator Share Posted February 3, 2019 On 1/28/2019 at 8:49 PM, Boatswain2PA said: Anyone else getting the feeling that this year's influenza A is especially lethal? I'm seeing young healthy people (from kids to adults) who are critically ill with Flu A positive ARDS, and I know of an influenza related death of a previously healthy young child. I"m also seeing a big difference between those vaccinated (flu positive & feels bad) and unvaccinated (flu positive and looks/feels like got hit by a train). Anyone else seeing this? Yup, have seen several now who are very ill with AKI and positive procalcitonins... Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 6, 2019 Share Posted February 6, 2019 For those of you in hospital settings, what type of rapid flu are you obtaining? Antigen based only or PCR/other? Lost a child in my work community, non-vaccinated, seen in UC/ED for fever, treated for flu/temp and sent home, started to improve, and then died from pneumonia a couple days later. IMO it is very important to provide the warning signs that CDC recommends and document same if for no other reason than to have another bullet in your arsenal should someone come calling (attorney). Had a case the other day where on call back mom goes ballistic because a flu test wasn't run (stepmom was with kid). Hx. of RAD, has MDI (no neb at home), treated for flu w/ Tamiflu, pulmonary/sepsis warning precautions given, and out the door. Apparently she took kid to an outside facility for test only which I'm sure they were more than glad to run for her ($$$) and was diagnosed with flu. No change in therapy. Link to comment Share on other sites More sharing options...
thinkertdm Posted February 6, 2019 Share Posted February 6, 2019 12 minutes ago, GetMeOuttaThisMess said: Had a case the other day where on call back mom goes ballistic because a flu test wasn't run (stepmom was with kid). Hx. of RAD, has MDI (no neb at home), treated for flu w/ Tamiflu, pulmonary/sepsis warning precautions given, and out the door. Apparently she took kid to an outside facility for test only which I'm sure they were more than glad to run for her ($$$) and was diagnosed with flu. No change in therapy. This happens a lot, you can explain until you are hoarse and blood runs out of your ears but these people don't understand basic concepts. Even more basic concepts- avoiding large groups of people, covering your damn mouth when you cough/sneeze, and get the flu shot. It's not rocket science. Link to comment Share on other sites More sharing options...
Colorado Posted February 7, 2019 Share Posted February 7, 2019 Colorado. Small mountain town. 2 early season mild cases of influenza in unvaccinated teens. 2 recent mild cases in unvaccinated adults. 1 case of 10yo unvaccinated w/ pneumonia complication responding well to OP treatment. 1 case of elderly vaccinated w/ no complications. 2 vaccinated teens with uncomplicated cases. 5:3 UNvaccinated/vaccinated. Its here in the town but not too many cases, mostly mild. Link to comment Share on other sites More sharing options...
Marinejiujitsu Posted February 9, 2019 Share Posted February 9, 2019 Whoa...you personally? Hope you are recovering quickly!Yep. It's been surreal. The 1st hospital I went to, I had a CTA head and neck which came back as negative. Then I went to my ER where I work because I was convinced I had central vertigo and it was coming from my neck. Had an MRI/MRA and radiologist found a stroke/dissection which was seen better on the CT from the 1st hospital. [emoji17]Sent from my SM-N950U using Tapatalk Link to comment Share on other sites More sharing options...
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