Posted on January 30, 2018
With tens of thousands of patients flocking to hospitals and at least 37 children dead, this year’s flu season is shaping up to be the worst in nearly a decade—and it’s not over yet.
It appears that children returning to school after the winter holidays are sharing more than just their new toys. They’re driving influenza infections to levels not seen since the swine flu pandemic of 2009, public health officials say. By the time this flu season is over, experts estimate more than 50,000 Americans will be dead.
The Centers for Disease Control and Prevention (CDC) explain that the year’s flu activity is starting to cool in some regions, but remains high across most of the country and is actually gaining in other areas. Mortality rates have spiked sharply, with seven additional children dying from the infection in just the past week, said CDC Director Brenda Fitzgerald. So far, 37 children have died as a resistant strain of the virus dominates the season. Government officials say that number may double before the season is over.
Why is 2018 So Deadly?
This year’s flu season is particularly harsh because of a nasty predominant strain: H3N2, which is a form of influenza A. This flu strain is associated with more severe illness, especially among children and the elderly. H3N3 is included in this year’s flu vaccine, but viruses can change and this particular strain tends to mutate more than other strains. The strain also circulated during the 2014-2015 season, another severe season for flu.
The CDC’s Dr. Daniel B. Jernigan told the public last week that more people fell ill during the 2009 “swine flu” pandemic, but that was a new virus. This year’s dominant virus, H3N2, has been circulating for 50 years (it emerged as the “Hong Kong flu” in 1968), but it is usually the most lethal of the seasonal strains. He says H3N2 was also was responsible for bad seasonal flu years in 1997-1998 and 2003-2004.
Why are So Many People Dying?
The flu virus causes damage all by itself, but the immune response it triggers—especially among young, healthy adults—also makes people sick and can lead to death. After entering the body (often inhaled through the nose or mouth), the virus begins hijacking human cells in the nose and throat to make copies of itself. The virus implants in the mucous membranes at the back of the throat and upper part of the bronchial tubes. In doing so, it weakens or destroys the feather-like protective cells in the bronchial tubes that push out bacteria and other material, “like many little oars,” explains William Schaffner, an infectious disease expert at Vanderbilt University.
Without that protection, bacteria, including the kind that causes pneumonia, can work their way down the bronchial tube and into the lungs, causing complicating bacterial pneumonia, he says.
Influenza virus can also trigger such a massive immune response, especially in adolescents and younger adults with robust immune systems, that these otherwise healthy people are basically drowning in their own immune cells and proteins, says Patsy Stinchfield, senior director of infection prevention and control, Children’s Hospitals and Clinics of Minnesota. Or, as she puts it, the overwhelming immune response “can make the whole body’s metabolism go awry. It’s like an army set off bombs and killed all the good stuff while targeting the virus.”
Those over 65 are usually the ones with the highest hospitalization rates, with the second most affected group being children under 4. But officials have been shocked in recent weeks to see that individuals with the second-highest hospitalization rate are between 50 to 64 years old.
“Baby boomers have higher rates of hospitalization than their grandchildren right now,” Dr. Jernigan noted.
It’s not clear why this is happening, but officials think one possibility may be the mix of viruses circulating this season and the different levels of immunity people have developed to those viruses over time.
What to Watch For
Flu symptoms vary from person to person. In general, people who have the flu often feel some or all of these symptoms, according to the CDC:
- Fever or feeling feverish/chills (not everyone with flu will have fever);
- Sore throat;
- Runny or stuffy nose;
- Muscle or body aches;
- Fatigue (tiredness); and
- Vomiting and diarrhea, (more common in children than adults).
Most who get the flu get better in several days to less than two weeks. But some can develop serious complications caused by viral infection of the nasal passages and throat and lungs. Young children, adults ages 65 years and older, pregnant women, and people with certain chronic medical conditions are among those groups who are at high risk of serious flu complications, possibly requiring hospitalization and sometimes resulting in death.
What to Do
If you haven’t already done so, GET A FLU SHOT! It’s not too late. “Even if you get the flu, having received the flu vaccine may help you in terms of not having as serious a course or as devastating a course,” notes Dr. Patricia Whitley-Williams with Rutgers Robert Wood Johnson Medical School. “It may prevent you from being hospitalized if you have received a vaccine, so there is still that benefit in some cases.”
If you do get sick and think you may have the flu, contact your health care provider right away, particularly if you or family members belong to a high-risk group. Even young, healthy adults should call a doctor if symptoms don’t improve or get worse after three to four days of illness. Antivirals such as Tamiflu or Relenza can help treat the flu, but the medication needs to be taken within 48 hours of the onset of symptoms to be effective.
It’s Not Over Yet
Flu is very unpredictable. The exact timing and duration can vary, but influenza activity often begins to increase in October. Most of the time, flu activity peaks between December and February, although activity can last as late as May.
Experts aren’t sure when this season will peak. Officials were hoping the season had peaked in the first week of January, but the latest data shows activity continued to increase into the third week. Even if flu activity peaks soon, there will probably be many more weeks of flu activity based on patterns of similar seasons when this particular strain has dominated. In those seasons, flu season lasted for at least 11 to 13 more weeks after activity hit the peak.
For more information about the flu or the influenza vaccination, visit www.cchchealthcare.com or contact one of Coastal Carolina Health Care’s family practices: CCHC New Bern Family Practice, at (252) 633-1678, or CCHC Twin Rivers Family Practice, at (252) 636-2664.
(Sources: The New York Times; Vanderbilt University; NOLA Media Group; Atlanta Journal Constitution; CNN; The Washington Post; and Bloomberg LP.)