State

Flu hits epidemic threshold

Sue Carroll, head of the microbiology section in the laboratory at Advocate BroMenn Regional Medical Center, drops a sample of patient fluids into a test tube before assessing the presence of flu virus. Seasonal flu is making an earlier appearance this year, and the most dominant strain seen in lab results is one that causes more severe illness.
Sue Carroll, head of the microbiology section in the laboratory at Advocate BroMenn Regional Medical Center, drops a sample of patient fluids into a test tube before assessing the presence of flu virus. Seasonal flu is making an earlier appearance this year, and the most dominant strain seen in lab results is one that causes more severe illness. File photo

The flu has officially reached an epidemic threshold, according to the Centers for Disease Control and Prevention.

At least 15 children have died from flu-related deaths across the country, according to the CDC.

The flu season is in full swing with the flu widespread in much of the country. State data suggest flu season may have peaked earlier this year than last.

Kansas City is experiencing its most widespread flu season in years.

It’s filling hospital beds and packing emergency rooms throughout the metro area.

“I’ve been here eight years and I’ve never it seen it at this level,” Lee A. Norman, the University of Kansas Hospital’s chief medical officer, said Tuesday. “Clinics and urgent care centers are glutted.”

Nationwide, we’re on track for a nasty flu season, with both a large number of cases and many severe ones that require hospitalizations, according to the Centers for Disease Control and Prevention. It declared an influenza epidemic this week, a status achieved at some point nearly every year, although not usually this early in the season. Twenty-two states and Puerto Rico are reporting high flu intensity. In some parts of the country, flu infections have outpaced those from each of the past few years, according to data from the CDC.

The worrisome outlook is the result of a confluence of factors: an early start to the flu season, with more people sick in December than usual; a strain that tends to make people sicker; a relatively low vaccination rate; and a mismatch between this year’s flu vaccine and the virus that’s making people sick.

“We’re already above the peak that we saw last year, and we’re increasing,” said Michael Jhung, a medical officer at the Influenza Division of the CDC who predicts it will be several more weeks before flu infections peak.

The CDC tracks flu deaths, hospitalizations and the percentage of doctors’ visits for flulike illness. The detailed, public data make it easy to watch the flu take off this year. Google Flu Trends, which has been validated by epidemiologists and published in medical journals, tells a similar story, and a new Google flu tool allows you to look at the misery down to the level of the city. Columbia, South Carolina, for example, is suffering one doozy of a season, according to the Google data. Helmut Albrecht, the chief of infectious disease at the University of South Carolina, confirms as much.

“We call it a bad flu season when 5 to 6 percent of our emergency room visits are for flulike illness,” he said. “We are between 17 and 20 percent.”

Georgia health department spokeswoman Nancy Nydam said at this time last year, flu activity was low and intensity was 4 (on a scale of 1-10, 10 being the highest). This year flu activity is widespread and intensity is 10 – and has been for the past two to three weeks. There have been 459 people hospitalized this year in for flu-related illness in metro Atlanta area. (Last year, there were 296 hospitalizations in metro Atlanta during this same time period.)

Vaccine less effective

One reason for the bad flu season is this year’s vaccine is not considered as effective. The dominant flu strain this year – H3N2 – has mutated, and only about half of the cases match the vaccine, according to the CDC.

Flu viruses are constantly changing and they mutate all the time – from one season to the next or they can even change within the course of the same season. This kind of gradual change is called “drifting.”

The CDC said flu shots may still offer some protection against drifted viruses, which could help lessen the severity of the symptoms and reduce the risk of complications, such as hospitalization and death. Flu shots also will still protect against flu strains that have not mutated, such as the influenza A (H1N1) virus and the B viruses contained in the vaccine.

Facing a nasty flu season, getting a vaccine that provides even partial protection may be more important than ever, according to the CDC.

Doctors know more than ever about where the flu is and how fast it is spreading, but Jhung said the medical system still had not made much headway in reducing the toll. Although the CDC recommends vaccination for everyone older than 6 months, vaccinations remain at less than 50 percent of the population. With so few people protected, it’s still relatively easy for the virus to spread each year; there are lots of susceptible people, and the airborne virus moves around quickly.

The CDC is also urging people with flulike symptoms to seek treatment as soon as possible. Tamiflu and Relenza, a class of drugs called neuraminidase inhibitors, are designed to block replication of the flu virus in the body.

They work best when taken within a day or two of getting sick, and experts say these antiviral medications seem to be particularly effective with this year’s virus circulating.

With a severe flu season and less-effective vaccine, Nydam said it’s key to rely on the basics, including:

▪ Wash your hands.

▪ Cover your cough.

▪ Stay home from work or school whenever you think you might be sick.

▪ Get a flu shot.

“It’s still very important to tell people it is not too late to get a flu shot,” she said. “Typically, flu doesn’t peak until the end of January or first of February, and often circulates into late March or longer. It takes a couple of weeks for the flu vaccine to be fully effective, so there is still plenty of time to be immunized and be protected.”

Kansas City hit hard

“I’ve been here eight years and I’ve never it seen it at this level,” Norman, of the University of Kansas Hospital, said Tuesday. “Clinics and urgent care centers are glutted.”

KU Hospital has admitted 36 flu patients for treatment so far this season. Two of its patients have died of complications of the flu.

Tracking data from the Kansas City Health Department show that the number of newly confirmed flu cases spiked sharply the week before Christmas to levels higher than at any time during the three previous flu seasons.

Right now, the flu is spreading fastest in the Southeast and the Midwest. Dayton, Ohio, and Knoxville, Tenn., are some of the places experiencing intense flu seasons, ccording to the Google data. But because the flu tends to move around the country, places that have been spared so far may just end up with more sick people next year.

Data from the CDC show that flu and pneumonia deaths crossed the epidemic threshold for the first time this flu season during the week ending Dec. 20. So far this season, there have been reports to the CDC of 15 children who have died of flu-related causes. More than 100 children died during the 2013-2014 flu season.

The CDC said flu was widespread through most of the country, except for western states. Doctor visits for flu-like illnesses had reached high levels in Southern and Midwestern states, including Kansas and Missouri.

Flu symptoms that should send an adult to the emergency room include trouble breathing, chest pain, sudden dizziness, confusion and persistent vomiting. Among children, fast breathing, bluish skin color, not drinking enough fluids, irritability and fever with rash are reasons for an emergency room visit.

Contributing: Kansas City Star, Atlanta Journal-Constitution, New York Times

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