Influenza virus and respiratory syncytial virus (RSV) disease have been increasing in Orange County for the last several weeks. Compared to pre-pandemic epidemiology this is an early start to the season for both these respiratory viruses. Australia’s influenza season often provides a harbinger for our upcoming season; their recently-concluded season was the most severe in five years.

Providers are strongly encouraged to:

• Recommend influenza vaccination to their patients, which can be given at the same time as bivalent COVID-19 booster vaccination for those eligible.
• Assure that high risk infants are given Palivizumab, in accordance with AAP recommendations and the recent California Department of Public Health CAHAN advisory Early Respiratory Syncytial Virus Activity and Use of Palivizumab.

Providers should consider the use of antiviral medications for the treatment and chemoprophylaxis of influenza as detailed in CDC’s Influenza Antiviral Medications: Summary for Clinicians.

Providers should continue to test for SARS-CoV-2; ideally, laboratory testing should be multiplex for both SARS-CoV-2 and influenza. Recommendations on treatment of COVID-19 can be found on our COVID-19 Therapeutic Recommendations page. 

Current COVID-19 vaccination recommendations can be found at CDC’s Interim Clinical Considerations, Use of COVID-19 Vaccines in the United States. This guidance includes recent recommendations on the use of bivalent mRNA COVID-19 vaccine boosters for those 12 years and older. Additional authorizations for the use of bivalent boosters in younger ages are anticipated soon.

The Advisory Committee on Immunization Practices (ACIP) Influenza Vaccine Recommendations provides current recommendations for influenza vaccination. These include the new preferential recommendation for those > 65 years to receive either quadrivalent high-dose inactivated influenza vaccine (HD-IIV4), quadrivalent recombinant influenza vaccine (RIV4), or quadrivalent adjuvanted inactivated influenza vaccine (aIIV4) whenever available.

We will be posting current data on influenza epidemiology on a weekly basis on the OCHCA Influenza page.