Influenza and Pertussis Updates 

Influenza Report

Influenza activity continues to be widespread in California and in Napa County.  In week 8 of 2019, the number of visits related to influenza-like illness (ILI) was at 3.6% at Queen of the Valley Medical Center. There have been two confirmed outbreaks, two ICU cases and one death to date. 

Patients with ILI symptoms who are hospitalized, severely ill, or at higher risk for complications should be treated as soon as possible with a neuraminidase inhibitor antiviral agent (e.g., oseltamivir, zanamivir) as per CDC and CDPH recommendations, regardless of flu test results.   Healthcare providers are also strongly encouraged to continue to vaccinate patients.

For outpatients at lower risk of flu complications, consider testing for influenza using PCR prior to prescribing antiviral treatment. Please note that there will be more false negative rapid influenza tests due to the higher prevalence of influenza in the community.

Healthcare providers should continue to report the following using the Confidential Morbidity Report to the Communicable Diseases Control Program at (707) 299-1499. 

• any influenza or acute respiratory illness outbreaks
• lab-confirmed influenza deaths in patients aged 0-64 years
• lab-confirmed influenza ICU cases in patients aged 0-64 years
• RSV deaths in children <5 years of age

Pertussis Health Update

Since flu activity is widespread in Napa County and we are also having a heavier pertussis season, we are tracking pertussis activity.  Napa County Public Health has received 15 laboratory-confirmed pertussis cases in 2019 in both children and adults.  Most cases reported are from Calistoga. 

• Suspect pertussis in any individual with a progressively worsening cough of greater than one week duration with history of post-tussive vomiting and/or paroxysmal coughing or inspiratory “whoop.”
• If you suspect pertussis, obtain nasopharyngeal swab or aspirate for PCR testing.  Clinicians should strongly consider treating prior to test results if clinical history is strongly suggestive (i.e. known contact to a pertussis case OR coughing paroxysms with post-tussive vomiting or inspiratory whoop) or patient is at risk for severe or complicated disease (i.e., infants). 
• For suggested antibiotic treatment (see table 4):  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5414a1.htm
• Since this is a high volume year for cases, only high-risk contacts should be prioritized for PEP:  Infants <1 year of age, pregnant women in the third trimester, caregivers and household contacts of infants < 1 year of age, immunocompromised contacts.
• Report suspected cases promptly to the Communicable Diseases Control Program at (707) 299-1499.