eDocTalk article

Healthy, unvaccinated adults getting flu this season

February 2014

The H1N1 strain is the primary flu type circulating, the same virus as seen in the 2009 pandemic.This year, however, mostly young, healthy adults under age 65 are being infected. In 2009 the virus mainly affected children, pregnant women and the elderly. As of mid-January 2014, about 60 percent of those hospitalized nationally with the flu are between the ages of 18 and 64.

Legacy hospitals are seeing patients that have serious pneumonias and are in respiratory failure. More than a dozen have been treated with extracorporeal membrane oxygenation (ECMO) since the start of the flu season. Legacy has received transfers from throughout the region, including Washington state and Nevada. Four patients have died in Legacy hospitals.

More severe than 2009?

“The H1N1 flu epidemic this year seems to be even more severe than in 2009,” said Andrew Michaels, M.D., medical director of the Legacy adult ECMO program. “We have had referrals Michaels, Andrewfrom more than 19 medical centers for adults with refractory hypoxemia due to influenza A/H1N1. We have cared for 14 of these with ECMO. None of them had received a flu shot.” 

For severe cases, timely referral is critical. “The earlier the patient is referred, the better their chance of survival. If a patient has “severe ARDS” (a Pa02:Fi02 ratio of less than 100) on a Fi02 of > 80%, please call the ECMO service at Legacy Emanuel for a referral,” said Dr. Michaels. 

A flu vaccine is the most important step in protecting against flu viruses, especially for people at high risk of serious complications and those living with or caring for high-risk people.

A new report by the Trust for America's Health finds that only about 36 percent of adults ages 18 to 64 got their flu shot during the 2012–2013 influenza season, and health experts say that a similar percentage is likely getting vaccinated this year.

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