463. Factors Associated with Antiviral Treatment among Hospitalized Influenza Patients in California During Pandemic (2009-2010) and Post Pandemic (2010-2012) Seasons
Session: Poster Abstract Session: Prevention and Treatment of Viral Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • IDweekPosterFluBMSN_FINALIDWK.pdf (523.9 kB)
  • Background: During the 2009-2010 pandemic and 2010-2012 post-pandemic influenza seasons, antiviral treatment was recommended for all persons hospitalized with suspect or confirmed influenza.  Treatment was particularly recommended for high risk groups including children <2, adults 65+, and persons with underlying medical conditions.  Disparities in receiving antiviral treatment are a public health concern since previous studies have demonstrated a reduction in severe outcomes associated with treatment.

    Methods: Active, population based surveillance was conducted in Alameda, Contra Costa, and San Francisco counties in California from April 2009 to April 2012 as part of the Centers for Disease Control and Prevention (CDC) FluSurv-Net surveillance system.  A case was defined as a resident hospitalized with laboratory-confirmed influenza.  Medical charts were reviewed for demographic and clinical information.  Associations between risk factors and antiviral treatment were evaluated using chi-square and p-trend tests.

    Results: There were 2192 cases identified and 1755 (80.9%) received antiviral treatment.  Females were more likely to receive antivirals than males (83.0% vs. 78.7%; p=.01).  More patients with any underlying condition received treatment (83.4% vs. 72.3%; p<.01), specifically those with asthma (84.0% vs. 79.7%; p=.02) or immunosuppressive conditions (86.3% vs. 80.1%; p=.01).  In total, 59.1% aged <2, 66.4% aged 2-17, 87.3% aged 18-64, and 83.7% aged 65+ received treatment.  When all ages were combined there was no significant trend in antiviral treatment from pandemic to post pandemic seasons (p-trend =.36); however, there was a significant trend in declining treatment in those aged 2-17 (p-trend <.01).  In those aged <2, treatment was consistently lower than other age groups at 62.7% in 2009-2010, 53.1% in 2010-2011, and 55.6% in 2011-2012.

    Conclusion: Despite recommendations for antiviral treatment of all hospitalized influenza patients, there was significant variability depending on gender, age, underlying conditions, and season.  Most notably, those aged <2 were treated less overall and there was a decline in treatment of patients aged 2-17 during the post pandemic seasons.

    Sarah New, MPH and Brittany Martin, MPH, California Emerging Infections Program, Oakland, CA


    S. New, None

    B. Martin, None

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