Posted 11:32 pm Monday, January 07, 2013
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U.S. prepares for rough flu season predicted
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Health care providers are seeing an early spike in flu cases and demand for antiviral medications, as the country prepares for what could be a rough flu season.
Thirty-one states — mostly southern states and the east coast — have been hit hard, with widespread activity. Widespread activity is defined by the Centers for Disease Control and Prevention as “outbreaks of influenza or increases in influenza-like illness cases and recent laboratory-confirmed influenza in at least half the regions of the state with recent laboratory evidence of influenza in the state.”
This is the earliest regular flu season the U.S. has experienced in nearly a decade. Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, said during a telebriefing last month that the last time it came this early was the 2003-2004 season.
“That was an early and severe flu year, and while flu is always unpredictable, the early nature of the cases as well as the specific strains we're seeing suggest that this could be a bad flu year,” Frieden said.
The strains seen this year are Influenza A, or H3N2; the 2009 Influenza A, or H1N1; and Influenza B. In years where H3N2 strains were dominate, there was a severe flu season. H3N2 first appeared in 1968 and the H1N1 virus showed up in the 2010-2010 season.
Both A and B are significant viral strains. This season, at least 52 percent of confirmed cases have been type A.
All strains of the influenza virus change its antigenic properties, or mutate, regularly, which is why scientists have not been able to eradicate the virus.
But health officials are confident that the strains circulating today “match” this year's vaccine.
Thirty-one states — mostly southern states and the east coast — have been hit hard, with widespread activity. Widespread activity is defined by the Centers for Disease Control and Prevention as “outbreaks of influenza or increases in influenza-like illness cases and recent laboratory-confirmed influenza in at least half the regions of the state with recent laboratory evidence of influenza in the state.”
This is the earliest regular flu season the U.S. has experienced in nearly a decade. Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, said during a telebriefing last month that the last time it came this early was the 2003-2004 season.
“That was an early and severe flu year, and while flu is always unpredictable, the early nature of the cases as well as the specific strains we're seeing suggest that this could be a bad flu year,” Frieden said.
The strains seen this year are Influenza A, or H3N2; the 2009 Influenza A, or H1N1; and Influenza B. In years where H3N2 strains were dominate, there was a severe flu season. H3N2 first appeared in 1968 and the H1N1 virus showed up in the 2010-2010 season.
Both A and B are significant viral strains. This season, at least 52 percent of confirmed cases have been type A.
All strains of the influenza virus change its antigenic properties, or mutate, regularly, which is why scientists have not been able to eradicate the virus.
But health officials are confident that the strains circulating today “match” this year's vaccine.
“Of the doctors who are submitting specimens that we look at to see which strains of flu are spreading, about 90 percent are very well matched with this year's flu vaccine,” Frieden said. “That means that we did about as good as we could have done to put the right three strains of flu into the flu vaccines that are available on the market.”
Health care providers reiterate that the flu is a serious disease. The CDC estimates that from the 1976-1977 season to the 2006-2007 flu season, flu-related deaths ranged from a low of about 3,000 to a high of about 49,000 people.
In addition, the flu can create secondary infections, particularly among people who have a suppressed immune system, or those with heart disease, diabetes and asthma.
Between Oct. 1, and Dec. 29, there were 2,257 laboratory-confirmed influenza-associated hospitalizations reported, according to the CDC. That's a rate of 8.1 per 100,000 population. Among all hospitalizations, 85.2 percent were associated with influenza A and 13.8 percent with influenza B.
The flu season began in late September and saw a spike by late November, according to the CDC. Typically, a peak in the season is around January or February.
It's difficult to pinpoint actual numbers locally, because the flu is not a reportable event. However, sentinel providers help to determine the extent of the illness by reporting to local health departments or cooperating with the CDC.
Dr. Jonathan MacClements, Smith County Health Authority and chairman of The University of Texas Health Science Center at Tyler's Department of Family Medicine, said local hospitals have reported high numbers to the Northeast Texas Public Health District and notified medical staff to be aware of the spike.
Health care providers reiterate that the flu is a serious disease. The CDC estimates that from the 1976-1977 season to the 2006-2007 flu season, flu-related deaths ranged from a low of about 3,000 to a high of about 49,000 people.
In addition, the flu can create secondary infections, particularly among people who have a suppressed immune system, or those with heart disease, diabetes and asthma.
Between Oct. 1, and Dec. 29, there were 2,257 laboratory-confirmed influenza-associated hospitalizations reported, according to the CDC. That's a rate of 8.1 per 100,000 population. Among all hospitalizations, 85.2 percent were associated with influenza A and 13.8 percent with influenza B.
The flu season began in late September and saw a spike by late November, according to the CDC. Typically, a peak in the season is around January or February.
It's difficult to pinpoint actual numbers locally, because the flu is not a reportable event. However, sentinel providers help to determine the extent of the illness by reporting to local health departments or cooperating with the CDC.
Dr. Jonathan MacClements, Smith County Health Authority and chairman of The University of Texas Health Science Center at Tyler's Department of Family Medicine, said local hospitals have reported high numbers to the Northeast Texas Public Health District and notified medical staff to be aware of the spike.
Antivirals and prevention
Antiviral medications available for the flu are Tamiflu, a tablet, and Relenza, a powder that is inhaled. The medications work on the virus's ability to replicate.
“They don't treat influenza,” MacClements said. “They shorten the length of the illness and they reduce the effect of the virus. So you'll still have the flu, you'll just have a shorter, less serious form of it.”
In recent weeks, there has been a demand for the medications, but MacClements said there is no shortage.
“There is no manufacturing shortage of Tamiflu,” he said. “What may have occurred in that incidence is a couple of pharmacies may have been out of stock and have to order for their local supply and they would be in the next day. But at this time, what I can see talking to the pharmacies, there is no shortage of Tamiflu. Within our community at the moment there are some facilities that have back orders on some of their vaccines and they're saving the vaccines for those who are at higher risk, but the vaccine is still available and we still encourage everybody who hasn't had their vaccination that they seek out a place where they can get vaccinated.”
By the beginning of December, there were about 123 million doses of vaccines available nationwide and the CDC estimated that 112 million people had been vaccinated up until then.
In addition to getting the vaccine, MacClements said practicing simple, preventive measures is the best way people can protect themselves from the flu.
“It's a preventable disease,” he said. “The vaccine is effective. You don't get the flu from the vaccine. It helps ensure that you don't get an infection.”
Preventive measures includes proper hand washing or use of a hand sanitizer. To help stifle the spread of the flu, MacClements recommends covering coughs and staying home if feeling ill or running a fever.
“They don't treat influenza,” MacClements said. “They shorten the length of the illness and they reduce the effect of the virus. So you'll still have the flu, you'll just have a shorter, less serious form of it.”
In recent weeks, there has been a demand for the medications, but MacClements said there is no shortage.
“There is no manufacturing shortage of Tamiflu,” he said. “What may have occurred in that incidence is a couple of pharmacies may have been out of stock and have to order for their local supply and they would be in the next day. But at this time, what I can see talking to the pharmacies, there is no shortage of Tamiflu. Within our community at the moment there are some facilities that have back orders on some of their vaccines and they're saving the vaccines for those who are at higher risk, but the vaccine is still available and we still encourage everybody who hasn't had their vaccination that they seek out a place where they can get vaccinated.”
By the beginning of December, there were about 123 million doses of vaccines available nationwide and the CDC estimated that 112 million people had been vaccinated up until then.
In addition to getting the vaccine, MacClements said practicing simple, preventive measures is the best way people can protect themselves from the flu.
“It's a preventable disease,” he said. “The vaccine is effective. You don't get the flu from the vaccine. It helps ensure that you don't get an infection.”
Preventive measures includes proper hand washing or use of a hand sanitizer. To help stifle the spread of the flu, MacClements recommends covering coughs and staying home if feeling ill or running a fever.
“Prevention is key,” he said.
Last season, there was a mild flu season that begun relatively late but there are no clear-cut answers as to why the flu season started early this year.
Dr. Dr. Amir Shams, Ph.D., associate professor of microbiology and immunology at The University of Texas Health Science Center at Tyler, believes more vaccinations should have been given three months ago, at the start of the flu season. He also noted that people should also remember to get the shot each year, as virus strains change.
“This is a very important point— that people have lost the sense of priority for vaccination,” he said. “To me, the main part might be that people have not gotten vaccinated early enough or at all. That's why we have very early signs of an endemic of influenza … If you're immune against last year's strain, your body can detect those viruses this year too. The problem is when you have an antigenic shift, a totally different virus is being generated and our immunity cannot conquer it.”
Shams said most flu cases originate in large cities or crowded areas such as places with public transportation systems. Schools and colleges are also hotbeds for flu.
“If I get influenza and get on public transportation I can infect at least 1,000 people with a couple of coughs in the train, in the metro, because it's in a closed area,” Shams said.
He said there is no correlation between the transmission of the flu virus and weather. He did note that as it gets colder, people stay indoors more.
“There's a possibility of sharing all kinds of microbes (indoors), including the influenza virus,” he said.
Shams' team of researchers has been working since 2007 to understand the mechanisms of immunomodulators – chemicals found in the body that regulate the immune system – and how they enhance the body's defense against the flu virus.
He is now waiting for additional grants to continue an expanded project. Shams recently extended his investigation into seeing if boosting the body's innate immunity can also prevent secondary infections such as bacterial pneumonia.
Last season, there was a mild flu season that begun relatively late but there are no clear-cut answers as to why the flu season started early this year.
Dr. Dr. Amir Shams, Ph.D., associate professor of microbiology and immunology at The University of Texas Health Science Center at Tyler, believes more vaccinations should have been given three months ago, at the start of the flu season. He also noted that people should also remember to get the shot each year, as virus strains change.
“This is a very important point— that people have lost the sense of priority for vaccination,” he said. “To me, the main part might be that people have not gotten vaccinated early enough or at all. That's why we have very early signs of an endemic of influenza … If you're immune against last year's strain, your body can detect those viruses this year too. The problem is when you have an antigenic shift, a totally different virus is being generated and our immunity cannot conquer it.”
Shams said most flu cases originate in large cities or crowded areas such as places with public transportation systems. Schools and colleges are also hotbeds for flu.
“If I get influenza and get on public transportation I can infect at least 1,000 people with a couple of coughs in the train, in the metro, because it's in a closed area,” Shams said.
He said there is no correlation between the transmission of the flu virus and weather. He did note that as it gets colder, people stay indoors more.
“There's a possibility of sharing all kinds of microbes (indoors), including the influenza virus,” he said.
Shams' team of researchers has been working since 2007 to understand the mechanisms of immunomodulators – chemicals found in the body that regulate the immune system – and how they enhance the body's defense against the flu virus.
He is now waiting for additional grants to continue an expanded project. Shams recently extended his investigation into seeing if boosting the body's innate immunity can also prevent secondary infections such as bacterial pneumonia.
