2517. Seasonal Influenza 2017–2018: Epidemiological Review and Experience at a Veterans Affairs Medical Center in New York

Abstract

Background

The 2017–2018 influenza (INF) season started early with widespread activity throughout the country which was covered extensively in the media. The season peaked in February and subsided nationally in March and April. The CDC reported decreased effectiveness of this season’s vaccine. The latter had the B/Brisbane/60/2008-like (B/Victoria lineage) component for INF B. We report our hospital’s experience of seasonal INF activity.

Methods

Retrospective chart review of every Veteran who tested positive for INF A or B at Northport Veterans Medical Center, Long Island New York.

Results

160 Veterans were diagnosed with INF from December 1, 2017 to April 26, 2018. 106 had INF A, 54 INF B. Of the 160 cases, 15 were in DEC, 61 in JAN, 69 in FEB, 13 in MAR, 2 in APRIL 10 INF A isolates subtyped as: 9 H3N2, 1 H1N1pdm09. 5 INF B isolates subtyped as Yamagata lineage. Demographics: Median age: 63 years (23–93); Race: 79% Caucasian, 16% Black, 1% Asian, 1% Pacific Island, 3% Hispanic. 95% men. Medical History: 11% had history of CHF, 12% CAD, 19% HTN, 24% DM, and 12% COPD. The median BMI was 29 (17–51.5). 101 tested in ER; 36 in clinics, 5 in our related adult and nursing homes, and 17 during their hospitalization. 56 (35%) had received the INF vaccine this season. The median duration from vaccination to diagnosis was 100.5 days (2–175 days). 25 required hospitalization with 5 of them in ICU; 40% of the hospitalized patients had received the INF vaccine. The median length of stay was 4.5 days. 139 received oseltamivir (OSE), 13 supportive treatment, 8 antibiotics alone, and 7 OSE+antibiotics. 5 patients expired (3 INF A, 2 INF B) 3 were not vaccinated; one patient developed NSTEMI and survived. Hospitalized patients were older 73 vs. 60, P:0.018, more likely to have COPD ( P = 0.0009), CHF ( P = 0.0066), and history of lung cancer. There was no difference in risk for hospitalization between vaccinated and unvaccinated Veterans, P = 0.649.

Conclusion

The months of JAN and FEB had the highest flu activity, mirroring the INF activity in our nation as reported by the CDC. The majority of our patients were not vaccinated. 5 fatalities were noted. Not surprisingly, the vaccine was not as effective this season; also our INF B cases were Yamagata lineage (not part of this season’s vaccine). Our data show need for improvement of both the efficacy of INF vaccination (universal) and vaccination rate for our Veterans.

Disclosures

All authors: No reported disclosures.