According to the CDC's latest report, which includes data through Jan. 18, influenza-like illness (ILI) activity currently is widespread in 41 states, and 13 states are reporting high levels of ILI activity.
FDA notified providers of the saline shortage on Jan. 17, attributing it to an "unusual spike in demand." Saline cannot be stockpiled, so when company reports a shortage, the announcement can trigger shortages from competing manufacturers as hospitals seek out alternative sources of supplies, according to Modern Healthcare.
Moreover, the temporary shutdown of saline solution producer Baxter International's plant in December has complicated the shortage. Considering that Baxter and Hospira produce about 90% of the saline products used in the nation, some pharmacists say the shortage reflects a lack of resiliency in the supply chain.
"All it takes is a few flu admissions and a small recall and not enough forecasting before a year-end closure and all of that together can create a shortage," says Erin Fox, director of the University of Utah Drug Information Service.
"When there is an unexpected spike in demand from those typical patterns, manufacturers have to adjust production levels, which can take time," says Hospira spokesperson Tareta Adams. "[W]e have a limited ability to produce higher volumes, and we are maximizing production to serve as many hospitals as we can."
While not all patients infected with flu require IV bags with saline, more than 50% of those infected during the last season were 65 years old and older—and most required hospitalization and dehydration treatment, according to Bona Benjamin, director of medication use quality improvement for the American Society of Health System Pharmacists.
"Our sense from reports is that this is a very, very serious situation," says Benjamin, adding if saline must be sourced overseas to "help with the situation temporarily, that's something we're definitely exploring."