Communities seeing rapid increase in flu activity across the U.S.

The Washington State Department of Health (DOH) wants the public to know flu cases are rising quickly in Washington state and nationwide. Flu hospitalizations are at the highest rates seen in 10 years for this point in the year. In the last two weeks, DOH is reporting high cases of flu-like illnesses in Washington.

Flu illness can have serious health consequences, especially for people who are under five years old, age 65 or older, pregnant, immunocompromised, or have chronic health conditions.

In addition to the flu, other respiratory illnesses, such as COVID-19 and RSV, are combining to push our hospitals to emergency capacity. Help keep yourself and your community healthy by getting a flu vaccine and taking other measures to prevent illness.

“Our state’s pediatric healthcare system is overloaded with extremely high numbers of children with respiratory infections,” said Tao Sheng Kwan-Gett, MD, MPH, chief science officer for DOH. “Families urgently need to do everything they can to keep everyone healthy and avoid the need for healthcare, and flu vaccination is one of the most important prevention tools.”

Following the proper prevention and hygiene practices can halt the spread of respiratory illnesses. Washington State Department of Health recommends:

  • Get vaccinated. Vaccination is your best defense against flu and COVID-19.
  • Wash your hands frequently with soap and water. Use hand sanitizer when soap is not available, and hands are not visibly soiled.
  • Consider wearing a mask in crowded settings.
  • If you are sneezing or coughing, wear a mask or use the crook of your arm or a tissue to avoid getting germs onto your hands or spreading virus in the air.
  • Avoid close contact with sick individuals.
  • If you feel sick, stay home.

The most common strain so far is influenza A (H3N2). This strain typically causes more severe disease. All available flu vaccines provide protection against H3N2.

DOH strongly recommends everyone aged 6 months and older get the flu vaccine as soon as possible. It takes two weeks for the flu vaccine to be effective making it a key time to get vaccinated before people get together for the December holidays. If you get the flu when you are vaccinated, it’s typically milder and the vaccine can prevent serious complications including hospital care.

The flu vaccine is available at most pharmacies, health care providers’ offices, and clinics. State employees are eligible to receive SmartHealth points for receiving a flu vaccine. The flu vaccine can be received on the same day as the updated COVID-19 updated booster and other vaccines.

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Pediatric Shared Decision-Making: Creating Better Communication for Your Child’s Care

Shared decision-making (SDM) is a set of processes where health care decisions are made through respectful collaboration between doctors, patients, and their parents or guardians. The American Academy of Pediatrics (AAP) and many other medical care groups see SDM as a key part of family-centered care. However, SDM may not be used as often as it should be. There are many reasons for this, such as:

  • Doctors have not learned how to do SDM.
  • There is not enough time.
  • There can be an imbalance of power between the medical care team and the family.
  • There is an existing lack of understanding of what SDM is and how to participate in SDM.

In this month’s Pediatrics, “Pediatric Shared Decision-Making for Simple and Complex Decisions: Findings from a Delphi Panel”, Eaton et al (10.1542/peds.2022-057978) explore the SDM process to look at what SDM is and how it is best implemented.

What did the authors find in the study?
The processes of SDM refer to the activities, in the short and long term, involved in making decisions. For example, an initial process could be to:

  • Establish a relationship with the family
  • Discuss research treatment options
  • Ask if the family understands the clinical issue and the decision that needs to be made.

The main findings of the study show the need to personalize this decision-making process to each family’s unique situation and preferences. Examples of ways to personalize the process can include:

  • Determine information preferences- such as language, amount, type, method and with whom the information is to be shared. For example, how can the information be given in a way that is accessible, useful, and meaningful to the family?
  • Discuss the role of the child and parent/guardian in the SDM process. For example, does the child want to be a part of the process? Are they old enough? Are they mature enough?
  • Explore family values and what matters most to them. For example, is a family willing to discuss these topics with the rest of the care team and/or with the child?
  • Discuss guidance from the medical team about the child’s care. For example, what type of information does the family want from the doctors and nurses providing the care?

The authors introduce a framework that suggests different ways to help with the SDM process. Developed based on learnings from the study, the framework aims to provide a range of strategies to help personalize the process to unique needs of the child, family and clinical situation. The framework provides guidance to be used in all types of decisions, as well as additional guidance for more complex decisions.

The study also highlights areas where the panel did not agree. For example, the panel did not agree on topics such as:

  • Should “personalized” or another word replace “shared” in this process?
  • How do you decide what the child’s role in the process should be?
  • Should a family be asked if they want a recommendation before a doctor gives one?

The full article is available from the American Academy of Pediatrics.

Remember Summer Safety Precautions Ahead of Expected Weekend Heatwave

The Washington State Department of Health (DOH) is urging people to take precautions, stay cool, and protect themselves ahead of a record-breaking heatwave expected this weekend.

Stay indoors and in an air-conditioned environment as much as possible. Visit friends, family or neighbors with air conditioning or spend time in air-conditioned public places. If you are not fully vaccinated against COVID-19, make sure to wear a mask whenever you’re indoors with people who don’t live with you.

If air conditioning is not available to you, pulling window shades closed throughout the day when the sun is on the windows will help keep the inside cooler. Do not rely on a fan as your only cooling source. While fans might provide some comfort, they won’t prevent heat-related illness when temperatures are very hot. Use your stove and oven less to maintain a cooler temperature in your home.

Stay hydrated. Drink plenty of fluids but avoid beverages that contain alcohol, caffeine or a lot of sugar. Carry water with you and don’t wait until you’re thirsty to drink.

Help those who are vulnerable or at higher risk. Check in frequently with family, friends and neighbors who are elderly, ill or may need help. Avoid dressing babies and children in heavy clothing or wrapping them in warm blankets. Keep outdoor pets safe in the heat, make sure they have protection from heat and sun and access to cold, fresh water. Asphalt gets very hot and can burn your pet’s paws, walk on grass if possible. Never leave any person or pet in a parked vehicle.

If you do go outside, protect yourself from heat and sun. Sunburn slows the skin’s ability to cool itself, so make sure to use sunscreen with a high SPF rating. Wear a wide-brimmed hat and light-colored, loose-fitting clothes. Seek shade in parks and greenspaces where it will be cooler than in paved areas.

If you are working outside, try to plan strenuous activities for early or late in the day when temperatures are cooler. Take frequent breaks and hydrate regularly. Employers should take steps to protect people who work outdoors, including adjusting work schedules and activities, providing access to water and monitoring workers for illness.

If you notice symptoms of heat illness (dizziness, nausea, headaches, muscle cramps), act immediately. Move to a cooler location to rest for a few minutes and seek medical attention immediately if you do not feel better.  

Avoid extreme temperature changes. Taking a cold shower right after coming in from the heat or jumping into cold water when swimming outside can cause rapid changes in your breathing, heart rate and blood pressure and even cause hypothermia.

Follow water safety tips if you go swimming or boating. Remember that swimming in open water is very different from swimming in a pool and make sure to wear a life jacket that fits you.

Before lighting any outdoor fires, check for restrictions or warnings in your area. High temperatures and dry conditions increase wildfire risk.

“Hot weather and high temperatures can quickly go from uncomfortable to life-threatening,” said Umair A. Shah, MD, MPH, Secretary of Health. “We can all take steps to reduce our risk of heat exhaustion or heat stroke and help others stay safe.”