Flu keeps the heat on

Newly released data from the Centers for Disease Control and Prevention confirm what senior living operators have been reporting anecdotally: The 2017–2018 flu season was severe and, in some ways, record-setting.

“Influenza activity indicators were notable for the volume and intensity of influenza cases that occurred in most of the country at the same time,” said the authors of an article in the agency’s June 8 issue of “Morbidity and Mortality Weekly Report,” which was published Thursday. “Record hospitalization rates … also were reported.”

The CDC defines the latest flu season as beginning Oct. 1 and ending May 19.

The report puts national data behind what operators and real estate investment trusts had been seeing in the communities in their portfolios. Executives at REITs HCP, Ventas and Welltower, as well as operators such as Brookdale Senior Living, said the tough flu season affected move-ins and income. Capital Senior Living launched its first national public health initiative to better protect residents from the effects of the flu and said it saw “significant reductions in infections, hospitalizations and deaths nationwide.”

Highlights from the CDC report:

  • Flu activity began increasing in November, reaching an extended period of high activity during January and February and remaining elevated through March.
  • The 2017–2018 season is the third overall high-severity season since 2003–2004 and the first classified as high severity for all age groups.
  • The peak percentage of outpatient visits for the flu was the third highest recorded since 1997–1998, when the U.S. Outpatient Influenza-like Illness Surveillance Network was implemented.
  • The hospitalization rate was highest among people aged 65 or more years, who accounted for approximately 58% of reported flu-associated hospitalizations. The cumulative hospitalization rate for this age group was 460.9 per 100,000 population.
  • Deaths attributed to pneumonia and the flu remained above epidemic threshold for 16 consecutive weeks, peaking at 10.8%, the highest percentage reported since the 2014–2015 season, when National Center for Health Statistics mortality data first were presented for routine flu surveillance purposes.
  • The cumulative hospitalization rate for laboratory-confirmed flu for all ages combined and for the three adult age groups (18 to 49, 50 to 64 and 65+) was the highest documented since the system expanded to include adults during the 2005–2006 season.
  • Clinical laboratories tested 1,210,053 specimens for the flu virus; 224,113 (18.5%) tested positive. Public health laboratories tested more than 98,446 specimens; 53,790 (54.6%) were positive.
  • Among 47,121 people who tested positive for seasonal flu virus by public health laboratories and for whom age data were available, 16,172 (34.3%) were 65 or older.
  • Influenza A(H3N2) viruses predominated among all age groups but at 70% were highest among those aged 65 or more years.

People older than 65, those with chronic conditions and residents of long-term care facilities are among those at high risk for complications from the flu, the authors said.

“The severity of this influenza season highlights the importance of public health measures to control and prevent influenza,” they wrote. “Annual influenza vaccination remains the most effective way to prevent influenza illness.”

Garten R, Blanton L, Elal AI, et al. Update: Influenza Activity in the United States During the 2017–18 Season and Composition of the 2018–19 Influenza Vaccine. MMWR Morb Mortal Wkly Rep 2018;67:634–642.