Monday, January 20, 2014
At this time last year, there were 5 laboratory confirmed deaths from influenza. This year, there are 45, with 50 more likely to be confirmed shortly. Who are they?
- Under age 65, including children
- Largely unvaccinated
- Many had chronic medical conditions, especially obesity, high blood pressure, and heart disease.
- However, about 10% were previously healthy with no risk factors!
In California, flu activity continues to increase, including reports of hospitalizations, severe disease and the number of deaths. We are clearly in the midst of what appears to be an earlier peaking, severe flu season. Flu is considered widespread throughout California, as it is in 39 other states, with the deaths being reported from 20 California counties. We are not able to predict when the peak will be; however, it is safe to assume that there will be flu activity around for the next several months.
In the Eastern Sierra, we have been fortunate. There has been only one hospitalization due to influenza, no ICU patients, and no deaths. However, clinics in Mammoth have documented epidemic levels of visits with influenza-like illness for the last 3 weeks, so the flu is certainly here!
The majority of currently circulating influenza viruses are influenza Type A, in particular H1N1, which has been around for 4 years, and is also known as the “2009 swine flu”. All strains tested to date are in the current vaccine, and there has been no resistance detected thus far to the usual antiviral medications.
What is the significance of the fact that the predominant strain is the Flu A H1N1 2009? H1N1 does not discriminate across the age spectrum, and as we are seeing, disease is often seen in younger adults that are otherwise healthy, in addition to those more typically affected; the very young, very old, and those with underlying medical conditions. Furthermore, the young adult age group is least likely to be vaccinated. After all, they are invincible!
There is no shortage of influenza vaccine. Vaccination remains the single most effective means of preventing illness, hospitalization, and death. Providers, pharmacies, and the health department have vaccine.
In addition to getting vaccinated, it's important to practice good hand washing and other good health habits. People who are ill should take actions to stop the spread of germs such as:
• While you are sick, limit contact with others – Please stay home from school or work until you are fever free for at least 24 hours without the help of medication.
• Cover your nose and mouth when coughing or sneezing with your elbow or sleeve.
• Wash hands thoroughly with soap and water, or use an alcohol-based rub.
• Avoid touching your eyes, nose and mouth.
Those at highest risk - the elderly, pregnant women, infants, or those with other health conditions - who show flu symptoms should contact their healthcare provider immediately in order to get the most effective treatment. Symptoms include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue.
Many have asked about illnesses that are probably not “the flu”. For instance, there is a gastrointestinal illness “going around” with vomiting and diarrhea. This is most likely what is known as norovirus, or the “winter vomiting disease”. True influenza does not present with this picture.
There are also other respiratory diseases in circulation, characterized by prolonged coughing, without much fever or the body aches that are part of the influenza picture. This is most likely what is known as the metapneumovirus. Fortunately, there is very little respiratory syncytial virus (RSV) in circulation so far this winter, which is dangerous for the very young. We have not recognized any whooping cough in the local area.
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