States from coast to coast are reporting their first cases of seasonal influenza, but the flu trackers at the US Centers for Disease Control and Prevention (CDC) remain sidelined by the government shutdown, leaving state authorities blind to the national picture and likely delaying future preparedness efforts.
Maryland had its first confirmed case of influenza in the first week of October, according to Laura Herrera, MD, the deputy secretary for public health services at Maryland’s Department of Health and Mental Hygiene. News reports have documented the first seasonal influenza cases of the season in numerous other states, including New Jersey, Minnesota, South Dakota, Utah, Texas, California, and Arizona. But this year, states are working without the assistance of national flu data typically collected by the CDC.
“It hasn’t impacted us yet, but as cases keep coming in, it will be important to have a national picture of influenza,” Herrera said. Knowing the national and regional trends helps Herrera and her colleagues in other states develop appropriate public health messages and target resources, she explained.
The US Department of Veterans Affairs (VA) also confirmed 20 cases of influenza at VA health facilities across the country but had no hospitalizations, according to an October 11 report. The VA’s public health report, which classified the flu activity to date as low, again lacked national flu data that could be compared with previous seasons. In previous years, however, the VA’s national flu surveillance data tracked closely with the CDC’s national flu data.
So far, the flu season appears to be off to a slow start, said Greg Poland, MD, head of the Vaccine Research Group at the Mayo Clinic, but he cautioned that situation could change very quickly. He noted, for example, that the 2009 pandemic influenza outbreak began in rural Mexico and very quickly spread to Texas and the rest of the United States but that the CDC was able to identify the strain quickly, track its spread, and provide public health authorities with valuable information about the strain.
“We don’t have national health security the way we need to have it,” Poland said. “The situation can change in an instant.”
The lack of national flu tracking data could hinder public health officials’ influenza response this year and next. Poland said that in addition to tracking flu season trends, the CDC usually collects influenza samples and sequences them to assess the strains circulating and determine whether one might pose a pandemic threat. Barbara Reynolds, PhD, director of the CDC’s Division of Public Affairs, said in an e-mail the samples are still being collected during the shutdown but not analyzed. These analyses are used to determine whether antiviral drugs work against circulating strains and whether the flu vaccine is a good match.
The delay in analyzing these samples may also delay the process of determining which strains will be included in next year’s vaccine. “We’re already 2 weeks behind,” Poland said. He said if the shutdown extends beyond next week it could affect next year’s vaccine.