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Health Officials Urge More Americans to Get Flu Shots; Nasal Mist Is Option

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Sep. 24--Despite the lingering summer weather in the Pacific Northwest, flu season is fast approaching, and a top health official said yesterday there are some hints that the bug may hit harder this year than during the past few mild seasons.

Predicting how the flu will play out is very tricky, said Nancy Cox, chief of the Influenza Branch for the U.S. Centers for Disease Control and Prevention (CDC). But the flu season that's wrapping up now in Australia and New Zealand was "moderately severe" and could be a harbinger for North America, she said.

The mix of viruses Down Under also included a high percentage of a common strain that's often linked with bad flu years.

"We are very closely monitoring ... for indications these troublesome viruses may predominate during the coming season in the U.S.," Cox said at a news conference announcing a national campaign to increase immunization for a disease that kills more Americans each year than AIDS.

The CDC estimates less than a third of U.S. residents get annual flu shots. The ranks of the unvaccinated include one-third of senior citizens, who are at the highest risk of complications and death from the flu virus, said director Dr. Julie Gerberding.

A CDC study this year revealed that 36,000 people die from influenza and its complications in an average year in the United States, more than twice as many as previously estimated. Nearly 115,000 people a year are hospitalized because of flu.

"That's a horrifyingly high statistic for an illness that is essentially preventable," said Dr. Donald Palmisano, president of the American Medical Association.

The annual AIDS death toll in the United States is about 16,000. In the worst flu years, nearly 70,000 people die. And 90 percent of those killed by flu are age 65 or older.

No shortage this year

The good news is that vaccine is abundant this year.

For the past two years, the drug was in such short supply that health officials urged young, healthy people to delay their shots to make sure high-risk people got immunized first.

In response, manufacturers increased their production, pumping out about 85 million doses. Vaccine is already available in some locations. By early next month, it should be widely distributed, Gerberding said.

A shot next month should offer protection for the entire flu season, which runs through March.

"We want people to get out there and get their vaccinations now. There's no reason to wait," Gerberding said.

Washington state health officials are also urging more vaccinations but are cautious about predicting a bad flu year.

The same basic mix of flu viruses has been circulating around the country for the past three years, said epidemiologist Phyllis Shoemaker of the state Department of Health. That makes it easier to produce a consistently effective vaccine and keeps the severity of outbreaks down.

A serious flu epidemic is certainly possible, Shoemaker said, but impossible to foresee at this point: "We cannot say this year is going to be light, and we can't say it's going to be heavy."

Free vaccine

For the first time, the state will offer free vaccine this year to all children between the ages of 6 months and 23 months. Recent studies have shown a relatively high rate of infection among very young children, said Cindy Gleason, immunization educator for the state Department of Health.

"The elderly and the very young are the most vulnerable," Gleason said.

In previous years, the state has provided free vaccine only to children suffering from asthma, heart disease and other problems that increase their risk of flu and its complications. Nationally, more than 75 percent of children with asthma still don't get regular flu shots, the CDC's Cox said.

The free vaccine is available through private health-care providers and clinics.

Flu immunization may get a boost this year from the introduction of FluMist, a nasal-spray vaccine. Manufacturer MedImmune plans a huge marketing campaign for the spray, which sells for about $50 a dose, compared with $15 to $20 for a shot.

But the nose spray is approved only for healthy people between ages 5 and 49. That's because it's made from a weakened, live virus, which hasn't been tested yet in susceptible populations.

The standard flu shot contains a killed virus and is incapable of causing disease -- though many elderly people mistakenly believe it can, said Dr. William Schaffner of the National Foundation for Infectious Diseases.

Older vaccines caused more pain and swelling and occasional fevers but the newer versions have very few side effects, he said.

In addition to preventing most cases of flu, the vaccine has an added benefit in the elderly: A recent study found that people who got flu shots had a lower risk of hospitalization for heart disease and stroke.

None of the experts at yesterday's news conference could explain what was agreed to be a shocking statistic: Only 38 percent of health-care workers get flu shots, despite the fact that they work with vulnerable patients.

"That's an alarming number," said Palmisano, of the American Medical Association. "Without vaccination, health-care workers can transmit the flu to patients in their care, who are already in fragile health."


-- People 50 and older

-- Anyone with a chronic condition, including asthma, heart and lung disease, immune disorders, diabetes and kidney disease

-- Women in the second or third trimester of pregnancy

-- All health-care workers

-- Household contacts of anyone 65 or older, or anyone with chronic medical problems

-- Healthy children age 6 months to 23 months

-- Anyone who wants to reduce his or her chance of contracting flu


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(c) 2003, The Seattle Times. Distributed by Knight Ridder/Tribune Business News.

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