Preparing for Influenza with point-of-care testing

LOOKING BACK on 2018-2019 flu season

The moderately severe flu season of 2018-19 peaked in the US during mid-February and lasted 21 weeks, making it the longest season in 10 years.1

During the 2018-19 season, the proportion of flu-related deaths in the US was at or above the epidemic threshold for 10 weeks during a span from January-March, while the same flu season saw 116 flu-related pediatric deaths reported to the CDC.1

Since many flu-related deaths occur from secondary infections and complications from pneumonia and sepsis, it is not surprising that death rates increase during moderate and severe flu seasons.

influenza at a glance
  • From Oct. 1, 2018-May 4, 2019 alone, the CDC estimates that in the US, flu caused:
    • 37.4-42.9 million symptomatic illnesses
    • 17.3-20.1 million medical visits
    • 531,000-647,000 hospitalizations
    • 36,400-61,200 thousand deaths
  • Cardiovascular disease is the most common underlying medical condition in flu-stricken patients.

    Source:  CDC Morbidity and Mortality Weekly Report (MMWR)

    PREPARATION IS PARAMOUNT

    The uncertainty of how severe the upcoming 2019-2020 flu season will be can create challenges for healthcare professionals. For treating patients diagnosed with the flu, preparation is paramount. To address the increased volume of patients, emergency departments should implement risk stratification protocols to triage, diagnose, and treat patients with the flu or flu-like symptoms.

    The flu virus can progress quickly; if untreated, those stricken – no matter what age – are at risk. Underlying medical conditions in patients, such as cardiac and respiratory disorders, are a greater cause for concern as the influenza virus can make things worse. The flu virus, especially as it infects the respiratory tract, can trigger extreme inflammatory responses in the body that can lead to heart attack and/or sepsis, as the body tries to respond to and fight the virus.2,3 Quickly and accurately identifying a myocardial infarction, the onset of sepsis, stable metabolic and pulmonary function, and other complications from the flu can improve risk stratification of patients and identify the best clinical treatment regimens.

    POCT AND THE FLU

    The most commonly reported of these underlying medical conditions are cardiovascular disease, obesity, and metabolic disorders. Of the pediatric hospitalizations, more than half (55%) had an underlying respiratory disorder, including asthma (27%).1  When patients arrive at urgent care or the ED with flu-like symptoms and have these underlying conditions, it is even more critical to perform diagnostic point-of-care tests as soon as possible to drive rapid and accurate clinical decision-making.

    Incorporating a patient stratification strategy including the i-STAT System in the emergency department when time and throughput are critical helps the ED improve key metrics, streamline operations, and reduce costs. During a busy influenza season, point-of-care testing can decrease complexities such as, long wait times, growing patient volumes and the inability to obtain timely test results, all of which can impede the delivery of high-quality care.4

    References

    1. Morbidity and Mortality Weekly Report (MMWR). Update: Influenza Activity in the United States During the 2018–19 Season and Composition of the 2019–20 Influenza Vaccine https://www.cdc.gov/mmwr/volumes/68/wr/mm6824a3.htm?s_cid=mm6824a3_w 
    2. CDC Flu Symptoms & Complications (2018) https://www.cdc.gov/flu/consumer/symptoms.htm 
    3. Kwong et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. January 25, 2018. N Engl J Med 2018; 378:345-353 
    4. Abbott Point Of Care. Flu Flashcard 2019. https://www.pointofcare.abbott/us/en/your-challenges/flu-season-and-point-of-care-testing#solutions

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