Flu Outbreak – Now impacting 46 states. Death toll rising

Image: Photo By: Staff Sgt. Sheila deVera, Public Domain

Cases of influenza have spiked, with 46 states now reporting widespread activity, the Centers for Disease Control and Prevention says. This is in part due to the weakness of the 2017/18 flu vaccine which mis-guessed the dominant strain of flu that would surface during flu season. The strain responsible for the outbreak is H3N2, a particularly deadly variety of influenza.

(Some media reports have speculated that this year’s flu shot will only be about 10% effective for Americans, based on results seen in Australia during its flu season. The US Centers for Disease Control and Prevention (CDC) said it expects this year’s effectiveness rate to be closer to last year’s number, between 32% and 39%.) Want to know how they come up with the vaccine for the year? Go here.

As much as possible, avoid people who are sick. Wash your hands frequently and avoid touching your mouth, nose and eyes. Keep babies, seniors and immune-compromised individuals away from disease-spreading situations. Wave don’t shake at church. Wear gloves shopping. The official line is that masks aren’t particularly effective in keeping you from catching the flu, although they help keep sick people who wear them from spreading their germs. But in Japan, where commuters wear them to prevent spreading diseases they are seen as a net positive.

Here are some of their rules:

  • Wear a facemask when coming within six feet of a sick person.
  • Position the strings to keep the mask firmly in place over the nose, mouth, and chin. Try not to touch the mask again until you remove it.
  • Wear a facemask before going near other people if you have the flu.
  • If you have the flu and need to see the doctor, wear a facemask to protect others in the waiting area.
  • Consider wearing a mask in crowded settings if the flu is widespread in your community or if you are at high risk for flu complications.
  • When you’re done wearing the mask, throw it away and wash your hands. Never reuse a facemask.

Anti-virals like Tamiflu are effective in lessening the symptoms of H3N2 but are most effective if administered within 48 hours of the onset of symptoms.

The CDC recommends individuals presenting with symptoms like fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue seek medical attention as quickly as possible.

Influenza activity increased again in this week’s FluView report. All U.S. states but Hawaii are reporting widespread flu activity. Indicators used to track influenza-like-activity (ILI) are similar to what was seen during the peak of the 2014-2015 season, a season of high severity. The overall hospitalization rate is high also, but still lower than the overall hospitalization rate reported during the same week of the 2014-2015 season. CDC also is reporting an additional 7 flu-related pediatric deaths, bringing the total number of flu-related pediatric deaths to 20 so far. Flu activity is likely to continue for several more weeks.

CDC continues to recommend influenza vaccination for all persons 6 months of age and older as flu viruses are likely to continue circulating for weeks. In addition, in the context of widespread influenza activity, CDC is reminding clinicians and the public about the importance of antiviral medications for treatment of influenza in people who are severely ill and people who are at high risk of serious flu complications.

  • Since October 1, 2017, CDC has tested 164 influenza A(H1N1)pdm09, 555 influenza A(H3N2), and 201 influenza B viruses for resistance to antiviral medications (i.e. oseltamivir, zanamivir, or peramivir). While the majority of the tested viruses showed susceptibility to the antiviral drugs, two (1.2%) H1N1pdm09 viruses were resistant to both oseltamivir and peramivir, but was sensitive to zanamivir.

Below is a summary of the key flu indicators for the week ending January 6, 2018 (week 1):

  • Influenza-like Illness Surveillance: For the week ending January 6, the proportion of people seeing their health care provider for influenza-like illness (ILI) was 5.8%, which is above the national baseline of 2.2%. All 10 regions reported a proportion of outpatient visits for ILI at or above their region-specific baseline levels. ILI has been at or above the national baseline for seven weeks so far this season. During recent seasons, ILI has remained at or above baseline for 13 weeks on average.
  • Influenza-like Illness State Activity Indicator Map: New York City and 26 states experienced high ILI activity (Alabama, Arizona, Arkansas, California, Colorado, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, South Carolina, Texas, Virginia, Washington, West Virginia, and Wyoming). Puerto Rico and 10 states (Idaho, Massachusetts, Michigan, New York, North Carolina, Pennsylvania, Rhode Island, South Dakota, Tennessee, and Wisconsin) experienced moderate ILI activity. The District of Columbia and six states (Alaska, Hawaii, Iowa, Maryland, Minnesota, and Vermont) experienced low ILI activity. Eight states experienced minimal ILI activity (Connecticut, Delaware, Florida, Maine, Montana, New Hampshire, North Dakota, and Utah).
  • Geographic Spread of Influenza Viruses: Widespread influenza activity was reported by 49 states (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming). Regional influenza activity was reported by Guam and 1 state (Hawaii). Local influenza activity was reported by the District of Columbia. Sporadic activity was reported by the U.S. Virgin Islands. Puerto Rico did not report. Geographic spread data show how many areas within a state or territory are seeing flu activity.