Flu season erupts in Central Florida Spike in cases puts strain on Tamiflu supplies
Flu activity has spiked across Florida, slamming doctors’ offices and ERs with sick patients, and depleting supplies of the antiviral drug Tamiflu, particularly in liquid form for children, at some local pharmacies.
Nationwide, this is the most widespread flu season since the 2009 swine flu pandemic, according to federal health officials. They characterized this flu season as “tough” and “intense” during a press call on Friday.
Flu activity had a sharp rise in all Florida counties and among all age groups during the third week of the year, leading to closure of the entire school district in Gulf County in Florida’s Panhandle and the death of a 12-year-old boy in Palm Beach this week.
There were also 52 flu outbreaks, mostly in nursing homes and long-term care facilities, last week, “the largest number of outbreaks to be reported in a single week and is indicative of the high influenza activity Florida is currently experiencing,” said the Florida Department of Health in its weekly flu report.
It’s not yet clear if the season has reached its peak in Florida.
“Two weeks ago, I wouldn’t have thought it would be this bad,” said Dr. Timothy Hendrix, medical director of Florida Hospital Centra Care urgent care centers. “Last week we had a sudden spike and then this week it’s still happening.”
In high severity seasons like this, an estimated 34 million people get the flu; 16 million visit doctors and hospitals; and more than 700,000 are hospitalized. As many as 56,000 adults and children could die, according to the Centers for Disease Control.
So far this season, 37 children, including three in Florida, have died from the flu. The numbers are comparable to other severe seasons, according to state and federal officials. But they’re expected to increase as the flu season runs its course.
Although most people who get the flu recover within a few days, some end up in the hospital and thousands die because of the flu and its complications each year.
Dr. Adriana Cadilla, a pediatric infectious disease specialist at Nemours Children’s Hospital, said sometimes healthy individuals who get the flu end up developing a super infection, when they are exposed to other germs. Some “could have an altered reaction to the flu itself,” she said, leading to unfortunate and rapid deaths.
Because of the widespread nature of the flu this year, federal officials have highlighted the importance of vaccination and have recommended antiviral prescriptions like Tamiflu, particularly for young children, older adults, pregnant women and people with underlying conditions ranging from asthma to diabetes to HIV, who are at a high risk of developing complications from the flu.
Federal officials, the drug manufacturer and major pharmacy chains say that Tamiflu is not in short supply, but the increased demand has led some pharmacies to run out of supply.
“I think it’s a matter of supply and demand,” Hendrix said. “It’s analogous to gas shortage during the hurricane.”
The liquid form of the antiviral, which is usually prescribed to kids and adults who have a difficult time swallowing large capsules, is more likely to be out of stock. Pharmacies tend to carry a lower inventory of the liquid form, because it has a shorter shelf life than the pill form, said Dr. Arnold Monto, Thomas Francis Jr. Collegiate Professor at the University of Michigan School of Public Health.
Lake Nona resident Amy Bowen spent the day Thursday hunting for liquid Tamiflu, which was prescribed to her 5-year-old son at a local emergency department the night before.
“This morning we showed up at CVS at Narcoossee and they were out completely,” she said in a phone interview on Thursday. “And every CVS we checked was out. So we tried Walgreens and Publix and they were all out.”
So she ended up circling back to the hospital by the end of the day and got the medication at the hospital pharmacy, where the pharmacist made her the liquid form.
A Walgreens spokeswoman said in a statement that its Orlando pharmacies are experiencing higher demand for antiviral medications because of the spike of flu activity in the Orlando area.
“We are expecting additional inventory at our pharmacies within the coming days, and in the meantime recommend customers call ahead to confirm availability,” she said.
A CVS spokeswoman said that “there may be instances when individual pharmacies could be temporarily out of stock. We recommend that patients call their local CVS Pharmacy in advance since inventory varies day to day.”
Local pediatrician Dr. Jeannie Moorjani advised families “to circle back with the doctor and see if they’ve heard of a pharmacy that has it.”
And if you can’t find liquid Tamiflu nearby, there’s a simple hack: find out if the pharmacist can compound the capsule into liquid, or, get the same dosage in the capsule form and break it open at home in chocolate syrup, mix and serve, said Cadilla of Nemours.
Although Tamiflu is no magic pill, studies have shown that it helps lessen the flu symptoms and shorten its length, especially when it’s taken within the first 48 hours of onset.
The drug’s most common side effect is nausea. Severe side effects, such as hallucinations — which have been shared in alarming posts on Facebook — are extremely rare, said Monto, who has published several studies on Tamiflu.
“If your doctor prescribes it, they know better,” said Monto.
Get the flu shot, wash your hands, cover your cough and stay home to prevent spread of the disease, advised Dr. Dan Jernigan, director of the Influenza Division at the CDC on Friday. “The average duration of the flu season has been 16 weeks, and at longest 20 weeks. We’re halfway there. We have several more weeks to go.”
“Two weeks ago, I wouldn’t have thought it would be this bad. Last week we had a sudden spike and then this week it’s still happening.” Dr. Timothy Hendrix, medical director of Florida Hospital Centra Care urgent care centers