Flu Deaths Hit All-Time High; Weekly Case Numbers Continue to Drop

graphic image of woman blowing her nose while text reads "Flu Got You Down. Call Out Sick. Your co-workers Don't want Your Germs."DOVER — The Division of Public Health (DPH) is reporting two more flu-related deaths that occurred during the last two weeks of February, bringing the 2017-2018 season death total to 30. This number breaks the previous single-season record of 28 flu-related deaths, set in 2014-2015. The deceased were both females, 83 and 84 years old, from New Castle and Kent counties, respectively. Both had multiple underlying health conditions.

The total number of flu cases in Delaware for the season is now at 7,071, also breaking the previous record of 4,554, set in the 2016-2017 season. These numbers only include laboratory-confirmed flu cases and the actual number of flu cases in the state is likely much higher. While overall numbers are at an all-time high, the number of weekly cases has dropped for the second week in a row. There were 381 lab-confirmed flu cases for the week ending March 3, the lowest number of confirmed flu cases in a week since the week ending January 20 when there were 375 confirmed cases. Hospitals and walk-in health clinics are also reporting a drop in patients with influenza-like illnesses.

“We are terribly saddened to learn of even more deaths this flu season,” said DPH Director Dr. Karyl Rattay. “We’ve never seen a flu season this severe before and hope to never see one again. It’s important for everyone to remember that flu continues to circulate in Delaware, and to keep practicing vital prevention measures such as social distancing and frequent hand washing.”

Social distancing means that if you are sick, do not go to school, work, or other social functions until you are fever-free (temperature less than 100 degrees F; 37.8 degrees C) for at least 24 hours without fever-reducing medication. You should wash your hands frequently and sneeze or cough into a tissue which you immediately dispose of. If you don’t have a tissue available, cough or sneeze into your inner elbow.

DPH continues to emphasize the importance of calling your primary care provider at the first sign of illness, and taking antivirals if prescribed. Delawareans are reminded to first go to either your physician or a walk-in clinic rather than the emergency room when symptoms are non-life threatening. People who are extremely ill with symptoms such as trouble breathing, bluish skin color, fever with a rash, dizziness, or severe or persistent vomiting should seek out immediate medical help.

Although the overall number of flu cases have gone down, DPH reminds Delawareans that as long as the flu virus is circulating in the community, there is still time to get a flu shot. DPH will be offering free flu vaccines on March 13, 2018, at the Pyle State Service Center, 34314 Pyle Center Road, Frankford, from 9:00 a.m. to 12:00 p.m. and from 1:00 p.m. to 3:30 p.m. DPH also offers ongoing free flu shots at five State Service Centers. For more information about free flu clinics, visit http://dhss.delaware.gov/dhss/dph/fluclinics.html. To shorten your wait time, you can complete the vaccination form found at the bottom of the webpage and bring it with you.

For more information about flu surveillance in Delaware, read the weekly flu report at http://dhss.delaware.gov/dph/epi/influenzawkly.html. For general information about the flu, visit http://flu.Delaware.gov.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


Delaware ED Data Shows Significant Increase in Opioid Overdoses;DPH Announces Forum for First Responders and EDs to Address Overdose Management

Dover – The Centers for Disease Control and Prevention (CDC) on Tuesday, released data from emergency departments (EDs) showing substantial increases in opioid overdose numbers nationwide, including in Delaware. According to the CDC’s Vital Signs report, which examined ED visit data in 45 states, visits for suspected opioid overdoses increased 30 percent nationwide from July 2016 to September 2017. Of 16 states participating in enhanced data surveillance, Delaware reported the second-highest percent change for suspected opioid overdose ED visits during that time period (105 percent).

Of 2,075 suspected overdose-related ED visits during this time, 1,529 (74 percent) were in New Castle County, 355 (17 percent) in Sussex County and 191 (nine percent) in Kent County. Most significantly, the number of ED overdose visits increased most sharply and more than doubled in New Castle County from 189 in the third quarter of 2016 to 464 in the third quarter of 2017. It is important to note, however, that the report does not include the state rates per 100,000 overdose-related deaths, which is a more stable measure of increases and decreases over time.

“Emergency department data can point to alarming increases in opioid overdoses, and clearly we are concerned about the increases here in Delaware,” said Division of Public Health (DPH) Director, Dr. Karyl Rattay. “The report’s findings highlight the need for enhanced prevention and treatment efforts in EDs, including offering overdose prevention education, naloxone and related training for patients, family members, and friends, initiating buprenorphine in the ED and linking patients to treatment and services in the community as needed.”

The Division of Public Health, already recognizing the important role that not only emergency departments, but also first responders have to play in battling the state’s opioid epidemic, is holding the Acute Overdose Management System of Care Forum on Tuesday, March 13, 2018, at Delaware Technical Community College in Dover for these audiences.

DPH hopes to use the System of Care approach that it has successfully used with its Trauma, Pediatric and Stroke programs to address opioid overdoses in the state. The System of Care approach focuses on an organized approach to patient management throughout the continuum of ca

CDC recommendations on what agencies can do
CDC Opioid Overdose Graphic

re statewide. It involves coordination of care from pre-hospital transport through acute-care discharge, multidisciplinary involvement from dispatch, prehospital, hospitals, medical specialists, prevention, the use of documenting system data resulting in improved communication and collaboration among stakeholders to ensure patients receive the same quality of care no matter where in the state they enter the system. A goal of developing the Acute Overdose System of Care includes better connecting individuals in need of treatment to the Centers of Excellence Substance Use Model of Care which is also currently in development.

“Partnerships, organized into a System of Care, will strengthen and expand efforts, providing better patient experience and outcome system-wide,” Dr. Rattay said. “We will also use the opportunity to encourage emergency responders at all levels to provide all-important and extremely critical connections to treatment resources for patients in crisis.”

Data from 16 states in the CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) Program were analyzed for the report, showing quarterly trends by state and rural/urban differences from July 2016 through September 2017. Overall, ED visits for suspected opioid overdoses increased 35 percent in these 16 states hit hard by the epidemic. The data show:

  • Eight states from three U.S. regions report substantial increases—25 percent or greater—in the rate of opioid overdose ED visits.
  • Significant increases in all states reporting in the Midwest, including Wisconsin (109 percent), Illinois (66 percent), Indiana (35 percent), Ohio (28 percent), and Missouri (21 percent).
  • Considerable variation among states in the Northeast and Southeast; some states reported substantial increases and others modest decreases:
    • In the Northeast, large increases were seen in Delaware (105 percent), Pennsylvania (81 percent), and Maine (34 percent), but other states, like Massachusetts, New Hampshire, and Rhode Island, showed nonsignificant decreases (less than 10 percent).
    • In the Southeast, North Carolina reported an increase (31 percent), while Kentucky reported a statistically significant decrease (15 percent).
  • Continued rises in cities and towns of all types. Highest rate increases (54 percent) were in large central metropolitan areas (a population of 1 million or more and covering a principal city).

While Delaware’s ED overdose visits more than doubled during this time period (from 296 in the third quarter of 2016 to 596 at the end of the third quarter of 2017), due to Delaware’s small population, it is possible that our rates of ED overdose visits are still lower than other states’ rates who did not show a percent change (or a negligible one) during this time.

The sharp increases and variation across states and counties indicate the need for better coordination to address overdose outbreaks spreading across county and state borders. Closer coordination between public health and public safety agencies can support identification of changes in supply and use of illicit opioids, further allowing communities to take appropriate action to reduce opioid overdoses.

To learn more about the signs of addiction, prevention and treatment resources, and the availability of naloxone training in the community, visit HelpIsHereDe.com.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


Single-Week Flu Cases Increase Again, DPH Reports Additional Flu Deaths, Including First in Kent County

graphic of the words flu season, a thermometer and aspirinrDOVER — Single week numbers of laboratory-confirmed flu cases increased again in Delaware. The Division of Public Health (DPH) reports that there were 1,268 lab-confirmed flu cases recorded between February 4 to February 10. This brings the season’s total to 4,235. Last season’s final figures of 4,590, were the highest number of seasonal cases since record keeping began in 2004.

Additionally, DPH is announcing eight flu-related deaths; six of them occurred in the last week, and two occurred earlier in the season but were just recently reported. Influenza-related deaths are a reportable condition in Delaware. The most recent deaths bring the season’s total number of flu-related fatalities to 18. All of the six individuals who passed away last week were from New Castle County. The individuals ranged from age 44 to 89 years old, and none had gotten a flu vaccine this year. All but one had underlying health conditions. Of the two deaths that occurred previously, both victims were from Kent County. One, a 66-year old male died in January, and the second, a 71-year old female, died earlier in February. Both had multiple underlying health conditions and neither had been vaccinated.

“This is a terribly difficult flu season, as evidenced not only by the sheer number of flu-cases but also the growing number of flu-related deaths, said DPH Director Dr. Karyl Rattay. “While people may feel helpless and believe there is nothing they can do to make this situation better, every one of us has as active role to play. There are specific things each of us can do to prevent further spread of everyday germs, and in particular, the influenza virus.”

If you are sick, do not go to school or work until you are fever-free for 24 hours without fever-reducing medication. Call your primary care provider, or visit a walk-in center if you don’t have one, as soon as symptoms develop, as they may choose to prescribe antivirals for treatment, without an office visit. Wash your hands frequently – and wipe down frequently touched surfaces with soap and water or disinfecting products. Cough or sneeze into tissues or into your inner elbow, if tissues are not available.

People who are extremely ill with symptoms such as trouble breathing, bluish skin color, fever with a rash, dizziness or severe or persistent vomiting should seek immediate medical help. While there are signs that flu activity may be declining along the West Coast, overall, influenza-like-illness increased again nationally, and we will likely continue to see elevated flu activity for weeks to come. This is highest level of influenza-like illness recorded since the 2009 H1N1 pandemic.

DPH and the Centers for Disease Control and Prevention (CDC) continue to encourage anyone who has not yet gotten the flu vaccine to get one. The vaccine is still the best way to prevent flu illness, serious flu complications, and the spread of the flu in the community by offering greater protection to the overall population. Even with current vaccine effectiveness estimates, vaccination will still prevent influenza illness, including thousands of hospitalizations and deaths.

While some individual medical providers are reporting a shortage of the flu vaccine, this is not widespread. Residents are urged to first contact their primary care provider for a shot, or to visit https://vaccinefinder.org. Children ages 9 and older can get their flu shot at local pharmacies. Additionally, Delawareans can visit flu.delaware.gov/ or call DPH at 1-800-282-8672 for a list of Public Health Clinics within State Service Centers that are providing the vaccine. DPH is increasing opportunities to provide the flu vaccine. The DPH clinics at the Porter and Hudson State Service Centers are now making vaccines available on a walk-in basis instead of by appointment. DPH clinics in Kent and Sussex are also making the vaccine available to clients during WIC or reproductive health visits in addition to accommodating those who make appointments for vaccination at Milford State Service Center, Shipley State Service Center in Seaford, and Williams State Service Center in Dover.

Medical providers and pharmacies who may be having an issue with their vaccine supply should check the influenza vaccine tracking availability system (IVATS) available at: https://www.izsummitpartners.org/ivats/.

The CDC released the results of early vaccine effectiveness studies for the 2017-18 season on Thursday Feb. 15, 2018. Overall vaccine effectiveness was 36 percent. That means a vaccinated person’s risk of having to go to the doctor because of flu was reduced by more than one-third. Effectiveness was 25 percent against A strain – H3N2, 67 percent against A strain – H1N1 and 42 percent against influenza B viruses. These findings are similar to what has been observed in the past. Of note, vaccine effectiveness was much higher in children 6 months through 8 years of age: overall VE against influenza A and B viruses was 59 percent, and it was 51 percent effective specifically against H3N2. This means the risk for A(H3N2) illness that required a doctor’s visit was reduced by more than half among this group of vaccinated children. The interim estimate of 25 percent vaccine effectiveness against A (H3N2) viruses this season indicates that vaccination provided some protection, greater than what was reported in Canada (17 percent) and Australia (10 percent).

The greatest proportion of cases in week six is again in the 5-24 year age group (38.6 percent) followed by ages 0-4 (20.2 percent). The smallest percentage of cases again is in the 50-64 age group (9.9 percent). For the entire season to date, 32.2 percent of cases are in the 5-24 year age group, 19.0 percent of cases are ages 65 and older and 16.9 percent are in the 0-4 year age group. To date, persons age 65 and older comprise 61.7 percent of the hospitalizations. This mirrors the national trend and the CDC is recommending the pneumonia vaccine for those 65 and older as a result.

Flu is difficult to predict. It’s not possible to say in advance precisely when the 2017-2018 flu season will peak or end, or how severe it will be. For more information about flu surveillance in Delaware, read the weekly flu report at dhss.delaware.gov/dph/epi/influenzawkly.html.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


DPH Confirms First Flu Cases in Children for 2017 – 2018 Season

The words Get Flu Shot written on a CalendarDOVER – The Delaware Division of Public Health (DPH) is reporting the state’s first laboratory-confirmed cases of influenza in children, for the 2017-2018 flu season. Both children are under the age of 4. One is a young male from Sussex County, and the other a female from New Castle County. The pediatric cases bring the total number of flu cases this season to 14 for the week ending Nov. 11, 2017. Another eight cases have been preliminarily confirmed for the week ending Nov. 18, with the potential for more to be reported. There are two main types of influenza (flu) virus – types A and B – that routinely spread in people and are responsible for seasonal flu outbreaks each year. Both pediatric cases of lab-confirmed influenza are type A.

DPH urges all Delawareans 6 months of age and older to get vaccinated soon if they have not yet done so. The flu is easy to transmit and you can get it even from seemingly healthy, but unvaccinated, children and adults. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against influenza virus infection, it is important to get the flu shot as early as possible to give your body time to build immunity. The intranasal vaccine (flu mist) is not being recommended this year based on the Centers for Disease Control and Prevention’s analysis, which showed the intramuscular vaccine was better at protecting against certain strains of influenza.

Vaccinations not only prevent people from getting the flu, but they can reduce the severity of flu illness and prevent visits to the doctor, clinic, emergency room, hospitalizations, and serious consequences (including death) from influenza. Vaccinated people have less chance of missing family, school and work events due to influenza illness.

Getting a flu vaccination is easy. They are offered through physician offices, many pharmacies and some grocery stores. DPH is also offering flu vaccines at its Public Health clinics in several State Service Centers including some with evening hours. For more information about the flu and where to get vaccinated, visit www.flu.delaware.gov, call 1-800-282-8672, or Google “CDC flu finder” and enter a ZIP code.

Last flu season, Delaware had 4,590 confirmed flu cases, 15 of which were fatal.

Delawareans can prevent the spread of the flu and other respiratory illness with good hygiene: Wash hands frequently with soap and water or use alcohol-based hand sanitizers, cover coughs and sneezes with a tissue, and dispose of tissues immediately. If a tissue is not available, cough or sneeze into your inner elbow. Droplets from a sneeze can travel up to six feet. Also avoid touching your eyes, nose, or mouth.

Flu symptoms come on suddenly, and include fever, cough, sore throat, runny or stuffy nose, headaches and body aches, chills, and fatigue. Some people get complications including pneumonia, bronchitis, and sinus and ear infections. Those sick with the flu should stay home from work, school, and other gatherings and not return until they have been free of fever – with temperature less than 100◦ F (37.8◦ C), without the use of fever-reducing medications for at least 24 hours.

They should avoid close contact with well people in the household, stay well-hydrated by drinking plenty of water and other clear liquids. Over-the-counter medicines can provide symptom relief but if you suspect you have influenza, call your doctor as they may decide to provide antiviral medications to help hasten recovery and prevent serious complications. This is particularly important for those who feel very sick, are pregnant, or have chronic medical conditions.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


Public Health and CVS Health Make Overdose-Reversal Drug Available Without Prescription at DE CVS Pharmacies

Two boxes of Naloxone above the Help Is Here signDOVER — The Delaware Division of Public Health and CVS Health announced today that the opioid overdose-reversal medication naloxone is now available without an individual prescription at all of the 20 CVS Pharmacy locations in Delaware, including those located inside Target stores. CVS pharmacists will be able to dispense naloxone to patients without an individual prescription under a statewide standing order issued by the Division of Public Health (DPH).

“By making naloxone available to the public without a prescription, CVS Health has taken an important step in helping us combat the opioid epidemic here in Delaware,” said Governor John Carney. “Naloxone can give people a second chance to get medical care and be connected to resources to treat their addiction. We greatly appreciate their partnership.”

“Naloxone is a safe and effective antidote to opioid overdoses and by expanding access to this medication in our pharmacies in Delaware we can help save lives,” said Tom Davis, RPh, Vice President of Pharmacy Professional Services at CVS Pharmacy. “CVS Health is dedicated to helping the communities we serve address and prevent prescription drug abuse and we are expanding access to naloxone to give more people a chance to get the help they need for recovery.”

In July, Governor Carney signed Senate Bill 48, which expanded community access to naloxone by ensuring pharmacists had the same legal protections as doctors, peace officers and good Samaritans. Pharmacists can now dispense the medicine responsibly without potential legal, criminal, or disciplinary actions due to injuries or death sustained in connection with dispensing the drug. Naloxone will be available at the pharmacy counter in participating pharmacies to anyone who is educated on its appropriate use and signs an acknowledgement form. DPH hopes that this measure, in combination with a revised standing order allowing pharmacists to dispense naloxone nasal spray, will increase access for those concerned about someone at risk of an overdose.

“Our first priority is to save lives, and expanding access to this overdose-reversing medication through local pharmacies gives more people in the community the opportunity to help us do that,” said Dr. Rattay. “We see no signs of the opioid epidemic slowing and we need all the tools at our disposal to turn the tide.”

Overdose deaths in Delaware climbed from 172 in 2012 to 228 in 2015, and then jumped to 308 deaths in 2016. There have been approximately 190 suspected drug overdose deaths to date in 2017. First responders administered the life-saving medication naloxone more than 1,535 times in 2016 and 1,280 times in the first half of 2017.

“Addiction is a chronic disease,” said Dr. Kara Odom Walker, Secretary of the Delaware Department of Health and Social Services (DHSS). “As we expand access, we also need to connect Delawareans suffering from addiction to comprehensive and person-centered treatment services so they can begin their recovery.”

For more information about how to access naloxone at the pharmacy and to receive training on how to use it, visit HelpisHereDE.com/Get-Help/Overdose-Response. HelpIsHere.com is DHSS’ one-stop clearinghouse website for information on prevention, treatment and recovery resources in Delaware, and learning about the signs of addiction.

Within three to five minutes after administration, naloxone can counteract the life-threatening respiratory depression of an opioid-related overdose and stabilize a person’s breathing, which buys time for emergency medical help to arrive. DPH recommends calling 9-1-1 immediately if you find someone in the midst of a suspected overdose, starting rescue breathing, and then administering naloxone. Naloxone is not a replacement for emergency medical care and seeking immediate help and follow-up care is still vital.

“ ‘If we had a 911 Good Samaritan law or Narcan law, your son might very well be alive today.’ Those were the words of the detective investigating my son, Greg’s, accidental heroin overdose,” said David Humes, board member of atTAcK addiction. “I’ve lived with those words every day for over five years. With naloxone now being made available over-the-counter, other loved ones won’t have to live with those words. Greater access to naloxone means more lives will be saved. More people will get a second chance.”

For a list of permanent drug collection sites to safely dispose of unused prescription medication, visit permanent collection sites, visit DPH at http://dhss.delaware.gov/dph/hsp/hhdrugtakeback.html.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.