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Michigan Influenza Activity Update

February 7, 2003

Michigan Department of Community Health Chief Medical Executive, David R. Johnson, M.D., today announced the department is continuing to see a recent increase in reports of influenza-like illness, particularly in Southeast Michigan.  This increase is consistent with the usual peak of influenza at this time of year, as both influenza type A and type B have been confirmed in the state. 

Laboratory results indicate that these strains match those in this season’s flu vaccine, indicating that the current vaccine should provide protection against severe disease.  There remains a good supply of influenza vaccine available in Michigan, and persons who wish to protect themselves from influenza may still have time to get vaccinated.  People wishing to receive the flu vaccine should contact their physician or their local health department. 

The Michigan Department of Community Health continues to work closely with hospitals and local health authorities to investigate cases of severe illness or death, possibly linked to influenza.  At this time, the Department is investigating four cases of unexpected deaths in children, aged 5 to 14, in southeast Michigan that have occurred since January 25, 2003.  The Department also continues to investigate five other cases of severe illness in children that may be related to influenza.  Testing for the cause of these illnesses and deaths continues.

“There is no evidence to suggest a direct link between any of the Michigan cases of illness,” said Dr. Johnson.  “We are continuing our investigation and contact with the Centers for Disease Control and Prevention as they assist us in our efforts.”

As Michigan has continued its consultations with the Centers for Disease Control and Prevention (CDC), it was jointly recognized that in order to comprehensively examine the issues of unexplained illnesses and deaths, a great deal of data abstraction is needed from the medical records.  To assist Michigan in this labor-intensive effort, Michigan and the CDC have agreed that it would be helpful to have CDC based personnel available in Michigan to assist state investigators. 

“The fact that the CDC has agreed to assist us in our efforts to obtain and investigate information on these cases of illness and death should not be viewed as anything other than a cooperative effort between the state and its federal partner,” said Johnson.  “We greatly appreciate the assistance these CDC employees will be able to provide the department as we thoroughly review the cases.”
 
Parents are reminded to be alert for signs of severe illness, including high fever, altered mental status, unusual neck soreness or stiffness, bleeding problems, breathing difficulty and severe, sudden and persistent headaches.  If children develop such severe illness, they should be taken in for immediate medical evaluation.  Parents are also reminded to not use aspirin for treatment of fevers in children that might be associated with influenza, due to the association of aspirin and influenza with Reye Syndrome.

Physicians and clinical laboratories are reminded to report to their local health agencies when they encounter severely ill children and adults with confirmed or suspected influenza.  Physicians should consider rapid diagnostic testing to help guide clinical management of patients with suspected influenza.  Physicians are cautioned that there are limitations to rapid testing and in patients with severe illness physicians should obtain specimens for viral culture.  Additional information from the CDC on testing and treatment of influenza can be found at www.cdc.gov/mmwr/PDF/rr/rr5103.pdf.