March 12, 2018 – Above you’ll see the most recent North Carolina state flu numbers – 3 straight weeks showing a steady drop in likely cases of influenza.
That’s good news. How about more good news?
A Big Drop in Flu Cases at Raleigh Children & Adolescents Medicine Too
And at our office, we’ve seen a similar trend of fewer cases of flu.
Only seven (7) positive flu tests last week – that is only one per day which is a lot less than most weeks during the month of February.
Yeah March! That is more good news.
Sports and Summer Camp Physicals
The sudden drop in flu cases has created an unexpected and atypical wellness opportunity in March.
If your child needs a physical for summer camp or for school next year, don’t go to Urgent Care or (ugh) Minute Clinic.
Give your pediatrician a call.
Why see your regular pediatrician?
- This is the doctor who is an expert in pediatrics who already knows your child
- This is the doctor who has all your child’s medical records and who knows which vaccines they’ve had and which vaccines they need
- The doctor who has seen them before with illness and will be there to see them if they get sick later
Whenever possible, keep your child’s healthcare in one place – at your pediatric medical home – Raleigh Children & Adolescents Medicine
Give us a call 919-781-7490 and get that taken care of now.
February 27, 2018 – At the end of last week, the North Carolina Department of Health and Human Services updated this years Influenza Surveillance reports.
Picture is Worth a Thousand Words
We’ve been watching this graph for a few weeks, and the most recent trend deserves more focus – how about a crop with some enlargement:
The report shows that there were fewer flu-like cases reported last week when compared to the previous week. That’s good news.
A Welcomed Downward Trend But Still Lots of Flu
Keep in mind – we are still seeing a lot of cases of flu – a significant drop in the number of cases is a good thing but it doesn’t mean flu season is over.
Is It Too Late to Get My Child a Flu Vaccine?
This question still comes up and here are a few points about flu vaccine:
- I have to begin with this: The best time to get the flu vaccine is before flu season (duh) but not so early that it loses its effectiveness before the end of flu season. October is an ideal month for getting your flu vaccine (I always think holidays are a good way to remember so try to get your flu vaccine before Halloween).
- We seem to be on the other side of the peak but there are still weeks to months left of this flu season – if you can find someone who still has flu vaccine – there is little downside and still some potential upside to getting a flu vaccine even though its almost March.
- Note: RCAM still has flu vaccine for all children 6 months to under 3 years old.
How Effective is This Year’s Flu Vaccine?
- There has been much talk of the effectiveness of this year’s flu vaccine and this is what the CDC is reporting as of February 3, 2018: “overall the seasonal flu vaccine [given for the 2017-2018 flu season] reduced the risk of getting sick and having to go to the doctor from flu by about one third.”
- The flu vaccine experts try to shoot higher than one third, but when the choice is depending on one’s own natural immunity vs. that natural immunity plus 33% – most would take the latter.
- So there you go: 1 in 3 people helped by the flu vaccine – not a great year but still a significant tangible benefit.
February 21, 2018 – For those interested, here are some updates about influenza:
Flu Peaking? (Fingers Crossed)
Above is a graphic showing North Carolina Flu Statistics up to the week of February 10, 2018. It includes the current flu season (red line), last year (dark gray line) and two years ago (light gray line).
Interestingly, both of the previous flu seasons per this graphic peaked on the same week – the week of February 24th.
That thick, ever-growing, red line shows how this flu season has surpassed the previous two. Some recent national reports suggest that the number of new influenza cases are slowing down (leveling off). It is hard to conclude that from the above information but keep in mind that is North Carolina data only and includes numbers only through February 10th.
RCAM Flu Numbers Leveling Off? (Two Conflicting Opinions)
Our information is a bit limited – however, flu numbers from our Duraleigh office presented above show that both the number of flu tests RCAM performed and the number of tests positive for influenza have remained similar for the last two weeks.
- Glass-half-full analysis: Flu is leveling off and soon should begin to decline. You may make plans now to come out of your house.
- Glass-half-empty analysis: The Pediatricians at RCAM have been made aware that we have a limited number of flu test kits and so the “leveling off” is simply not testing the more obvious cases or situations where a positive test wouldn’t change what you would do (a viewpoint that justifies the actions of those who continue to “double wipe down” your shopping carts).
Either way you look at it – you probably don’t want to share a glass – half-full or half-empty – with anyone just yet.
Influenza Summary as of February 21, 2018
- There is still a lot of flu active nationally as well as here in our community. This pediatrician is not smart enough to know if it is slowing down but there are some signs to suggest it could be.
- Most people are doing very well, but stay on the lookout for signs of complications from the flu. Here is a good summary about what to look for from The New York Times.
- RCAM is being careful to follow the CDC recommendations for the use of Tamiflu. In short, Tamiflu is not recommended for everyone who gets the flu – only those at high risk for complications from the flu – like the very young (under 2), the elderly, or patients with underlying conditions like asthma and diabetes.
- Call our office with questions: 919-781-7490
- Get your child seen if they seem particularly sick – both those who fall into a high risk group as described here by the CDC as well as anyone – both healthy children and children considered high risk – who are showing signs that their illness could be getting severe.
February 2, 2018 – Some important updates about flu season this year:
There is a lot of influenza out there
I am tired of writing about flu. I am sure you are tired of reading about.
But – for visual learners – I present the graph above that shows new cases of flu over time for the past 3 flu seasons. This year’s flu season is the brightly colored red line that stops at the week ending 1/27. You can see there are more cases of flu than at the same time compared to the previous two years.
What this means to me is we likely haven’t reached this flu season’s peak yet.
What is being reported nationally and statewide also fits what we are seeing at RCAM
Here is a snapshot of the rise in positive flu tests in our Duraleigh office so far for this flu season:
With lots of flu cases we are starting to see some shortages
- We have already run out of privately-supplied flu vaccine for patients 3 years old and up (our current supply is described here). We are hearing reports of pharmacies running low with flu vaccine as well. Here are other places you can call to check on their availability of flu vaccine. At this late juncture in the flu season, it is pretty unlikely that more flu vaccine will become available. (NOTE: put it in your calendar for next year – flu vaccine is generally plentiful every October).
- We anticipate running out of tests for influenza. At this point in time, we are testing for flu only when necessary (a patient doesn’t have to be tested to be diagnosed with flu; at the end of the day, the doctor seeing you makes a clinical judgement).
- We anticipate shortages of Tamiflu – one antiviral medicine that can in some cases lighten the symptoms and / or duration of flu illness
A few things about Tamiflu
Tamiflu is essentially the only medicine (Tamiflu) that might help in the fight against flu (other than the flu vaccine – which again is plentiful in the fall). Compare that number to the choices we have for something like ear infections where we can choose from 6-8 different antibiotics.
Having just one option for flu sets up the potential for problems with supply as well as increases the likelihood of resistance.
Therefore, the Centers for Disease Control (CDC) has come out with recommendations for physicians regarding the use of Tamiflu.
In short, they recommend using Tamiflu only with patients who are at high risk for complications from the flu. High risk tends to mean the very young (under 2 years old), the very old and those with underlying conditions (like asthma or diabetes).
As pediatricians, we feel it is our responsibility to follow the CDC recommendations as closely as possible.
January 26, 2018 – Some Influenza updates:
Flu Vaccine availability at RCAM:
State-supplied flu vaccine (Medicaid insurance):
- 6 months old to under 3 years old – in stock and available
- 3 years and up – in stock and available
Privately-supplied flu vaccine (Private insurance):
- 6 months old to under 3 years old – in stock and available
- 3 years and up – NO LONGER AVAILABLE AT RCAM
Flu Vaccine Elsewhere:
It is unlikely that we will be able to acquire any more privately-supplied flu vaccine. If you would still like to get it – we would still recommend it – and – if you can’t get it at RCAM – here are some places that may still offer flu vaccine.
Influenza at RCAM so far:
You can see – we are seeing more cases of influenza in our office – and we are expecting that number of “Positive [Flu] Tests” to continue to rise.
December 12, 2017 – Hello, Raleigh. Welcome to cold and flu season.
Today’s RCAM Flu Update:
We are seeing lots of colds, and – fortunately – so far not a lot of flu. You can see from the table above that our suspicion of flu has risen as we are performing more flu tests but we are not getting many positives.
This matches how the Center for Disease Control (CDC) characterizes influenza in North Carolina as only “local activity“.
We know it’s coming – typically January and February are our more active flu months (this graphic from the NC Division of Public Health shows the last 2 years case of influenza peaked around February 24th).
Therefore, it is important to point out that it is not too late to get your flu shot – the best known flu prevention.
We still have plenty of flu vaccine at RCAM. If for some reason you can’t make it in to see us, here are places where you can still get your flu shot.
Today’s Holiday Card Update:
It is not too late to send us your holiday cards!
November 3, 2017 – A belated update about flu vaccine availability at RCAM:
We have flu vaccine available for all patients.
Our most recent update reported that we had not received much of our state-supplied flu vaccine yet.
The package did arrive (its been about 2 weeks – I apologize for the delay in posting the news here on the website) and we have plenty of both state-supplied and private-supplied flu vaccine.
How to get the flu vaccine for your child:
- If you happen to be in our office for an appointment, mention to your nurse that you would like your child to get the flu vaccine (as well as any other of your children with you that day who need the flu vaccine). Typically we can squeeze that need into our regular office hours schedule (NOTE: we typically can’t give flu vaccine during a visit to our after-hours sick clinic that occurs in the evenings and on the weekends)
- Call 919-781-7490 and schedule your child to come to an RCAM flu vaccine clinic. Right now we have limited appointment slots available but we continue to add new slots.
- The flu vaccine is also available at most pharmacies as well as the health department. It is not important to us where you get the flu vaccine, but we generally recommend all of our patients get it.
September 25, 2017 – Friday was the official first day of autumn, so we officially said “Goodbye” to summer with its summer vacation and children who need to find things to do – and with that as our tradition here dictates we said “Goodbye” to our summer website banner picture of ‘Three Children at the Pool with a Pink Floaty‘.
I am sure those three children are now back in school and caught up in the purposeful rhythm of the academic cycle.
Today – also part of our tradition – we say “Hello” to autumn and to a new autumn website banner picture: ‘Mother, Daughter and Many Mini Pumpkins’.
Some things coming up at RCAM:
#1-Flu season is right around the corner – it is time to get your flu vaccine
- Flu vaccine clinics – Dr. Meares provided details about getting your flu vaccine at RCAM here. Like most years, in the early going we have plenty of private-supplied flu vaccine but are still awaiting our shipment of state-supplied flu vaccine. We will update here as we get more state-supplied vaccine.
- We continue to recommend the flu vaccine for almost everyone – particularly the very young, the very old, and those with conditions that would make having the flu much worse like asthma or diabetes.
- The American Academy of Pediatrics (AAP) has listed 10 things you should know about this year’s flu vaccine here.
- If you are looking for a lot of information about the upcoming flu season and about the flu vaccine itself, the Center for Disease Control (CDC) has compiled quite a bit here.
#2-Some New Faces at RCAM
- In August we announced the arrival of Dr. Emily Ross. We have been very happy to have her join us. We are learning a lot from her as she learns a lot from us. She is working four days a week mostly in our Duraleigh office.
- This month we welcomed a new nurse – Wendy B. – to RCAM. Along with being our newest nurse she is also our second ‘Wendy’ (to go with Wendy T.). That should not be confusing at all since we already have three nurses named Shannon.
- You may also notice some new faces up front and new voices answering the phone. In the last 2 months, we have welcomed Jenny, Teresa (not to be confused with Front Office Manager Theresa), Denzlo and Allison. Such a large influx to our front office staff reflects only minimal turnover; rather, we have added some new positions in an effort to more completely cover the ever-growing list of front office responsibilities.
#3-Dr. Lehan’s Last Flu Season at RCAM
- Next summer a true giant in our office – Dr. Leigh S. Lehan – will retire after 34 years of pediatrics at Raleigh Children & Adolescents Medicine.
- That seems like a long way off – but it seemed like Kobe Bryant’s last season with the Lakers just flew by – so we all need to start preparations for ‘Life After Lehan.’ That means the rest of us are going to have to get a lot more patient and a lot more gentle to make up for that loss – we better start now.
Biggest difference: She does not put her hands over her head as much now when she is placed in front of a huge pink cake – although now as I write this I am doubting myself – time to put that theory to a test.
September 20, 2017 – “As of September 20th, RCAM Flu Vaccine Clinics are open for those with private insurance.”
Private-Supplied Flu Vaccine:
For those patients who have private insurance, we have received our shipment of flu vaccine and can begin giving those shots. (Private insurance is through a company such as BCBS, United Healthcare, Cigna, etc.)
State-Supplied Flu Vaccine:
For the following groups, the flu vaccine is supplied by the State of North Carolina:
- Insured by Medicaid
- Native Americans or Native Alaskans
- Insured by a medical cost sharing plan
We have NOT yet received an adequate supply of these State-funded flu vaccines, so we CANNOT begin vaccinating patients in this group yet. We have no control over this and have no way to predict when we will receive it. We will start as soon as we can get our supply of vaccines, so stay tuned.
While we dislike separating these two groups, we simply must get started using the vaccine we have.
Also Important to Note:
Again this year, FluMist will not be available. As you may have heard in the news, FluMist has not been as effective recently. We hope to have it by next year, but for now, FluMist is not recommended and is not available. This year, we are again “stuck” with the shot!
December 14, 2016 – Beneath the RCAM Official Image for Flu Season 2016-2017, we make the following announcement:
RCAM now has enough both state and private flu vaccine to cover our flu vaccine clinics for all our patients. If you haven’t already done so, call today and set up an appointment for your child to get their flu vaccine.
- It is not too late: So far – and this is similar to most years – we have seen very few cases of influenza (flu) in our office. We are in the single digits at RCAM for total flu cases …so far. January and February are typically when we see the most patients with flu. For this reason, there is still time to get your child the best protection that we know of against the flu.
- Yes, it is later than usual for us to begin widely offering state flu vaccine (but see #1; not too late): By report, the flooding in the east greatly delayed the shipment of state flu vaccine – at Raleigh Childrens and throughout North Carolina. Our allotments came in small numbers – only enough to keep up with patients who happened to be here for a checkup or similar. Yesterday we finally received a more typical volume of state flu vaccine and therefore today we make this announcement.
Unfortunately, there are unpleasant things about the winter that we can’t do much to prevent. Things like ‘cold’ viruses, ice storms, the fact that every morning your bed feels so much better than wherever you need to be – these are things that just can’t be stopped.
Flu vaccine is the best thing we know to limit your chance of catching a difficult if not dangerous respiratory illness. Get your child vaccinated.