12/29/09 — Tayloe focusing on flu death rate

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Tayloe focusing on flu death rate

By Phyllis Moore
Published in News on December 29, 2009 1:46 PM

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Dr. Dave Tayloe

Dr. Dave Tayloe wrapped up a whirlwind year as president of the American Academy of Pediatrics in October, but his crusades for the youngest segment of the population will continue.

Tayloe has returned to the practice he founded in Wayne County in 1977, Goldsboro Pediatrics, but will still travel for the AAP one week a month.

His latest challenge is H1N1, especially as it pertains to "so many deaths" of babies in the first year of life.

Data from the recent influenza season has been alarming, Tayloe said. Between May and July of this year, an estimated 251 children were hospitalized with 2009 H1N1 influenza, double the rate for 2008.

The death rate is a particular concern for health officials. According to a retrospective case series involving children diagnosed with H1N1 this year, death rates were 10 times that of seasonal flu in previous years.

"The thing about H1N1 is it's such an unpredictable virus and it's kind of cycled in and out, where you think the epidemic is over, another month or two later you have another surge," Tayloe said.

This is typical of a pandemic, he added. Just when it appears the "season" is over, another round presents itself.

"We don't plan to let our guard down at this point," he cautioned. "What we were faced with in the office was we were not getting enough vaccine to meet the need."

The government has continued to send quantities of the vaccine, he said, which means there is still time to be inoculated.

"We want anyone who missed a chance to be vaccinated during the surge in October and November to come on in and get vaccinated even though it appears to be late in the season because we don't know what's going to happen this winter and spring," Tayloe said.

The advice particularly applies to those considered most at-risk -- pregnant women, anyone living with or providing care for infants younger than 6 months old, health care and emergency medical service personnel, children and young adults from age 6 months to 24 years old, and those 25-64 years old with chronic health disorders or compromised immune systems.

There should be enough vaccine for everyone who wants it, he said, with an emphasis on anyone coming in contact with small children.

"We can't immunize babies under 6 months of age so we have to do everything we can to reduce risk of exposure," Tayloe said. In addition to day care and preschool staffs, that means parents and grandparents, aunts and uncles, even brothers and sisters.

The vaccine is considered effective for a year. And in all likelihood, next year the issue will not be as confused by the choice of two different flu vaccines -- seasonal flu and H1N1.

"We think they'll probably incorporate H1N1 into the seasonal flu vaccine next year," Tayloe said.

He also addressed some of the debate about the live virus and the recent recall of the flu mist.

While there has been some controversy over the "live virus," he maintained the vaccines appear to be extremely safe, and said it is "extraordinarily rare" that someone would become deathly ill from any of the vaccines.

"I have no reservations whatsoever of getting those vaccines," he said.

Last week, the U.S. Centers for Disease Control and Prevention announced the voluntary recall of the nasal mist form of the H1N1 vaccine. But according to the CDC and MedImmune, manufacturer of the vaccine, there were no safety issues involved.

"The (Food and Drug Administration) has standards for potency," Tayloe explained. "(The vaccines) weren't quite up to the FDA standards, so we had to pull the lot. It wasn't anything wrong with the lot -- we were told we did not need to re-vaccinate people that had gotten the lots.

"It was more of a cautionary thing, a slap on the wrist, 'You didn't quite get it right.'"

That should actually come as no surprise, Tayloe noted, since "it was such a rush job" to respond to the anticipated pandemic.

"Your cup is either half full or half empty, (when you're) getting them ready so fast," he said.

Goldsboro Pediatrics had received some of the recalled lot, Tayloe said, but no longer had any on hand at the time of the recall.

"The message we received was, 'OK, you gave it, just don't give any more,'" he said.

His office continues to work closely with public health to create ongoing awareness about the importance of prevention, which includes getting vaccinated if that has not already happened.

Adults are advised to contact the Health Department, or their primary care physicians, to be immunized, Tayloe said.

North Carolina, meanwhile, anticipates receiving as many as 100,000 new doses of nasal mist vaccine, which have been approved for distribution by the Immunization Branch of the state Division of Public Health.

There is one stipulation for the mist, however. Officials say it is not recommended for people with asthma, those with a history of Guillain-Barre syndrome, a weakened immune system, or such long-term conditions as lung, kidney or metabolic diseases, such as diabetes.

For more information on the voluntary recall, visit cdc.gov/h1n1flu/vaccin ation/sprayrecall_qa.htm. For more information on flu vaccine availability in North Carolina, visit flu.nc.gov.