Dialysis unit preparedness for novel influenza strains: Are we ready for Swine Flu?

Bill Peckham

The CDC is reporting 8 cases of influenza in San Diego and Texas and the New York Times is reporting swine flu concerns in Queens NY. This is worrisome news because this strain of influenza is novel. Novel means that no one has prior immunity to this strain of H1N1 influenza because it's new. Since it's new it has the potential to get more people sick then would normally get sick in the flu season which in the Northern Hemisphere is from about November to March, but you can get the flu throughout the year and a novel strain can spread rapidly often in waves.

I've written 32 posts categorized "Pandemic" as it relates to dialysis. I've tried to engage at various planning levels - that's me biting my lip behind the guy talking (page three at this PDF link) at a county planning exercise last year. I've been thinking about this for a while (my first pandemic post was almost exactly three years ago) mostly in regard to the H5N1 "bird flu" influenza virus. I don't think we are as prepared as we should be for an influenza pandemic no matter which flavor.

The experts always said that the next pandemic could be any type of influenza the only requirement is for there to be a new genetic form of influenza that passes easily among humans. The H1N1 cases in the US reported to date have not caused any death (deaths have been reported in Mexico but at this point things are not at all certain) so let's hope that what's know as the Case Fatality Rate is very low. The CDC considers a pandemic to be be severe if the CFR is 2%. This will be an important number to watch.

I'll need to go back and read some of my past posts but generally this is a big deal and we can hope that it is just a wake up call and not the event we've been fearing.

Comments

[Karol]

Hey Bill - did you ever get a supply of Tamiflu?

[Bill Peckham]

It would be a good question for your dialysis provider. NKC has taken preparation seriously.

[Rich Berkowitz]

I know that dialyzors have to be extra careful if an actual pandemic breaks out. I already had hypertension when diagnosed with renal cell carcinoma and had a radical nephrectomy. Thus, my semi-rapid deterioration to CKD5 occurred. So I'm immune compromised. But what about the many CKD5ers who have transplants? Are they basically open targets because of all the immunosuppressants they take?