Flu Update 2018

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Influenza has arrived in our area with a thud! That is the sound of

many of our children, spouses and colleagues taking to bed, or the sofa. 

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While the news has been full of reports of flu across the country for

weeks, the rate of influenza infection and “Influenza Like Illnesses” in

our immediate communities had not been quite so high. Nationally,

this season started a little faster and earlier than the past few years.

The southern tier states were first to be hit, then the west. Since early

December the number of states reporting widespread influenza has

steadily increased and crept closer to us. In Maryland more cases

were reported outside of the DC metro area than in our neighborhoods-until now.

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Well DC Metro, here we go. It is our turn.  

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Flu can cause serious or fatal complications. Hospitalizations already stand at 6,486 since the beginning of the season with the highest rate in the 65 years and older age group, the under 5 year old group, and the surprise finding of high admission rates in 54-65 year olds. Last week an additional 7 pediatric deaths were attributed to the flu, bringing the total to 20 for this season. This number will increase as reporting always lags the actual deaths.

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Almost all of the viruses identified by CDC are the strains present in this year’s vaccine. We use the quadrivalent vaccine at The Pediatric Care Center and Young Adult Care Center with all four of these influenza serotypes. Last week about 85% of the cases of flu identified were Type A and 15% Type B.  Nearly three out of four flu cases will be Type A H3N1. This is important because we already know that the performance of the flu vaccine for Type A H3 viruses tends to be lower and spottier than the A H1 and B types. We already have data that suggests this is true for this year, although the overall efficacy won’t be known until after the season. So yes, it is possible to catch the flu even if you got the vaccine. The good news is that it still reduces the severity of illness and the risks of complications in the group that received the vaccine compared to those who didn’t.

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Here are some answers to common questions you may have. 

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What is the flu? The flu is a contagious disease caused by influenza viruses that infect the nose, throat and sometimes the lungs. It can cause mild to severe illness that could lead to death. Symptoms are often abrupt in onset and may include fever, headache, chills, muscle aches, fatigue and nausea. Cough, sore throat, runny nose and congestion usually appear and sometimes vomiting or diarrhea may also be present.

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How do you catch the flu? Flu virus particles have to get to your mucous membranes of the eyes, nose or mouth and throat. This may happen through the air if you are close to someone with the flu while they are coughing, sneezing or even talking. You can also become infected when the particles are on objects you touch or put in your mouth, nose or eyes.

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How can I avoid catching it? The flu vaccine is our best tool to limit the spread and severity of influenza.  The CDC recommends everyone over the age of 6 months who can receive the vaccine should get one every year. Ideally this is done by the end of October or early November, but it is never too late.

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Since you catch the flu when the virus gets into our eyes, nose or mouth, protect yourself and your family by blocking these routes. Avoid very close proximity to someone with the flu if you can. Your hands and the things you place in your mouth must be free of viral particles. That means make sure your hands are clean or sanitized with an alcohol based sanitizer before you eat or touch your food or utensils.  Household surfaces should be cleaned frequently as well, since this is where someone who is carrying the virus will share it. Think of handles, doorknobs, remote controls and shared keyboards, as well as towels and cups in the bathroom. Those who are ill should catch their secretions and coughs with a tissue, or into their sleeve when that isn’t feasible. Don’t forget to clean your hands after you blow! 

 

Here is a video from the CDC that gives some tips.  https://www.youtube.com/watch?v=9APKBBr18Cc

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What do I do if I do get sick? Unfortunately, there are no magic bullets for the flu or its symptoms. Like most viral infections, we need to optimize our body’s infection fighting response with adequate rest, good hydration and nutrition. Acetaminophen or ibuprofen help to reduce fever, headache, sore throat and the muscle aches. Aspirin should not be used in teens or younger. Other over the counter cough and cold medications have minimal effects and may cause side effects in younger children. Combination products particularly increase the risk of side effects. Focus instead on soothing coughs and keeping the secretions flowing with fluids and mist. Tea with honey, lozenges and the like are tried and true.

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Are there any medications? Several flu antiviral medications are available, the most widely known and used of which is oseltamivir (Tamiflu). The strains circulating this year have been susceptible and if started within the first 2 to 3 days it may shorten the severity and duration of the illness. It may also reduce the complications. Anyone who is under 5 years old or at high risk for complications from the flu should see their doctor as soon as possible when they suspect the flu and discuss this treatment which is only available by prescription.

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When do I call the doctor?

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• If you suspect the flu and your child is under 5 years or otherwise at high risk

• If fever is over 104 degrees F, lasts for more than 72 hours or comes back after going away for more than a day

• If you/your child can’t hold down fluids or show signs of dehydration such as infrequent urination, dizziness when standing, or pale or bluish color and rapid heartbeat.

• If you/your child have chest pain, shortness of breath or continuous coughing

• If your child is excessively irritable, sleepy, seems “out of it”

 

Remember, we want to hear from you anytime you are concerned and need advice. For more info visit: https://www.cdc.gov/flu/pdf/freeresources/updated/a-flu-guide-for-parents.pdf

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It is not too late for the flu shot! Call to get in for yours if you missed it so far this winter. While it does take a few weeks to get full coverage, it may start to work before you get exposed to the current strain. And remember, there are 3 other strains out there. We frequently see two different strains cycle through in the same season.  

   

Be Well!

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Dr. Mattey