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Circulating respiratory virus

Wednesday, December 14, 2016

Community news

Here is a picture of bugs that are circulating in the area and causing most colds, December 2016.

  • Three out of every 100 people seen in our ED in November had influenza–like illnesses (or ILI, characterized by fever, cough, runny nose and/or sore throat); flu season is said to have arrived when about 5 to 6 percent of all ED visits can be attributed to ILI.
  • Over the past two weeks, viral causes were identified in four out of every 10 tested patients presenting with ILI, while bacterial causes (mostly strep A) were identified in 20 percent (2 out 10) of samples, and no cause (viral or bacterial) was identified in 40 percent of people with colds (could be allergies, sinusitis, ear infections or other none pathogenic causes).
  • The flu is currently accounting for about 10 percent of all viral ILI, whereas the common cold (human rhinovirus/rhinitis) is causing the majority of illness (35 percent), followed by RSV (30 percent) and human metapneumovirus (25 percent). No parainfluenza, adenoviruses or coronaviruses have thus far been isolated. Differences between these viral infections can be found here, http://www.nutramed.com/Air/respiratory_infections_viruses.htm
  • Of all flu viruses identified/subtyped from this area in November, a majority (65 percent) were flu type B (which tends to causes severe illness in children), followed by (30 percent) of the A/H3N2 (which tends to cause severe illness in the elderly) and very little (~5 percent) AH1N1 is circulating.
  • According to CDC, all circulating flu viruses (known at this time, in this county) appear to match strains included in the quardrivalent flu vaccine that was administered to our employees.
  • In short, there are a lot of colds going around—most are not the flu—it is strep A , rsv and human rhino viruses that is causing most illness.
  • Please consider obtaining an NP swab from patients you suspect to have the flu so we can test them and forward samples to the state lab for further characterization of circulating strains. Sequencing local viruses (esp. flu) can help with treatment options and gives us a sense of antiviral resistance and how well the current flu vaccine matches circulating strains.

Percentage of ED visits
Persons presenting to the ED with flu-like illness (fever, cough, running nose, cough and/or sore throat) a percentage of all ED visits, this year vs. past three flu seasons (state wide).

People seen with colds as a percentage of all patients seen at the VVRMC ED, July 2016 to November 2016

People with colds seen in ED
As this figure illustrates, only about 3 percent of all ED visits in November were attributable to ILI.

Bugs identified in people with colds, November 21 to December 5, 2016

Bugs identified in people with colds
As shown above, while most colds are viral, a few are bacterial and in some causes no bug is identified.

Viral causes of ILI, based on rt-PCR test sampling from Val Verde County (n=12)

Viral causes of ILI
Most of the viruses from people with ILI tested positive for the common cold and RSV.

Owen Simwale, MPH. PhD
Infection Preventionist
Val Verde Regional Medical Center
801 Bedell Ave.
Del Rio, Tx. 78840
830.778.3676 | 830.778.3661 (fax)
osimwa01@vvrmc.org