Clinical laboratory managers should be planning for a busy flu season this fall

Yesterday the World Health Organization (WHO) officially declared that A/H1N1 influenza (swine flu) is a global pandemic. This is the first such flu pandemic in 41 years. The announcement was not a surprise, since it was know that WHO was prepared to make this declaration weeks ago. But objections from several countries that such a declaration might trigger civil unrest and economic disruption caused WHO to defer this decision until yesterday.

There was little drama to this development, since the new A/H1N1 strain of the influenza virus has not turned out to be especially virulent or lethal. As of Wednesday, WHO released information that 74 countries have reported 27,737 cases of A/H1N1 flu and 141 deaths attributed to this virus. In the United States, the case count has topped 13,000 with at least 27 deaths confirmed to this strain of influenza.

What is notable, particularly for clinical laboratory managers and pathologists, is that the public health establishment is closely monitoring this current influenza pandemic and believes that it is too early to dismiss A/H1N1 influenza as a major health threat. For example, typically flu viruses disappear as the summer season begins. That has not happened with A/H1N1, which continues to spread. Also, about 50% of the deaths attributed to this strain of the flu virus involve young, healthy people—which is not the usual profile people who succumb to an influenza infection.

The need for ongoing surveillance and vigilance was stress by experts interviewed in the June 8, 2009 issue of The Dark Report http:www.darkreport.com, now being distributed to clients. For example, Jeremy Bridge-Cook, Ph.D.,Vice President of of Luminex Molecular Diagnostics, in Toronto, Canada, told the editor of The Dark Report that “It’s impossible to predict what we will see during next winter’s flu season. However, in the United States now, of the samples that test positive for influenza A, roughly 50% are actually the new H1N1 strain. It suggests that the population has poor immunity. In turn, that does not bode well for the coming flu season. This recent H1N1 pandemic hit during a relatively quiet part of the influenza season.”

In a series of separate intelligence briefings about the April-May experience of clinical laboratories in the United States with influenza A/H1N1, The Dark Report assessed:

a) Strategies used by medical laboratories in the United States did to respond to the huge surge in the number of flu specimens submitted for testing;

b) What strengths and weaknesses in the public health laboratory network became obvious it became swamped with influenza specimens for confirmatory testing;

c) Details about how Applied Biosystems  of Carlsbad California, a division of Life Technologies Corporation, created a 24/7 crash program to manufacture, install, and bring up its FDA-cleared molecular testing system, installing more than 100 new systems in public health laboratories across the United States and abroad in a matter of weeks; and,

d) Specific recommendations by experts about how clinical laboratories can best prepare for the flu season which commences this fall.

Dark Daily readers interested in these intelligence briefings will find summaries on The Dark Report Web site.

At a minimum, the WHO announcement of a global A/H1N1 influenza pandemic means that clinical laboratories in the United States and worldwide should be actively developing strategies and contingency plans that anticipate different scenarios for the upcoming flu season. Lots of smart money is betting that the A/H1N1 strain will not be much more troublesome that it’s been this spring. However, because this flu virus can evolve and mutate swiftly into more virulent and lethal forms, the flu season of 2009/2010 might turn into a roller coast ride for the lab testing profession.

Breaking News: Flu Fears Cause Overcrowding at Hospital Emergency Rooms in Salt Lake City

Also yesterday, the Salt Lake City Tribune is reporting that “Many Salt Lake County hospitals are being overrun by people reporting respiratory problems, including ones related to H1N1 swine flu.” The story was headlined “Salt Lake Valley E.R.s overrun with patients reporting flu-like symptoms.”

The Tribune provided an example, writing that “on Monday [June 8], the emergency room at Intermountain Medical Center in Murray was so busy it diverted ambulances to other hospitals. But not everyone showing up to the ER is sick: Some want antiviral drugs because they’ve been exposed to the flu. Some just want to be tested.”

This episode is a reminder to clinical laboratory administrators and pathologists that public fears about influenza in can surface at any time and overburden the system. It reinforces the need for every medical laboratory to have contingency plans to deal influenza within the communities and regions it serves.

Related Information:

WHO: Swine Flue Pandemic Has Begun, First in 41 Years

Swine Flu Evolved Unnoticed for Years

Salt Lake Valley E.R.s overrun with patients reporting flulike symptoms