With the colder than normal winter this year, the number of Northsiders who have come down with flu is worse than past years, doctors say.
Although every flu season is different, this year’s vaccine has only been about 30 percent effective, compared to an average of 60 percent effectiveness in other years.
“Each flu season is a little bit different,” Dr. Paul Byers, epidemiologist from the Mississippi Department of Health, said. “There’s quite a bit of variability. It’s difficult to pinpoint why a particular season is bad.”
This year’s main strain is the H3N2 strain, according to Byers, Dr. Joyce Olutade of the University of Mississippi Medical Center (UMMC) and Dr. Eric McVey of St. Dominic’s.
“This year is a season predominated by H3N2, which has a tendency to cause more severe infection in people over the age of 65, young children and people with underlying medical problems,” Byers said. “In years with this strain, there’s a tendency to see more severe infections or hospitalizations and more complications.”
“What we’ve found is, we had 173 or so cases from October through December of 2016,” Olutade said. “During the comparable period in 2017, we saw 1,500 lab-confirmed cases.”
This year’s vaccine is also not as effective as those in past years.
“The influenza vaccine is not extremely effective against the H3N2 circulating virus. It’s not necessarily going to provide protection from getting ill, but, if you do get infection after vaccination, the vaccination reduces the risk of getting a severe infection.”
Every year, the vaccine administers three or four different strains (trivalent or quadrivalent) of the influenza virus, giving the body a small dosage to fight and recognize in case a person does come in contact with it again in the future.
Although everyone who’s received the vaccine has received the H3N2 strain, Olutade said this particular strain has a way of “tricking” the immune system.
“It can modify itself, so the body can’t fight it,” she said. “When it is grown in egg cells, that particular strain gets modified a little bit, so it’s not as effective in humans… So they’re not fighting the real virus.”
This season’s flu mimics the 2014-2015 season, according to Olutade.
“That year also had a very high rate of H3N2,” she said.
The effectiveness of this year’s vaccine is unknown, since the season is still ongoing. However, a successful vaccine carries anywhere from 40 to 60 percent, according to Olutade, and 70 to 80 percent, according to McVey.
“Many people get the vaccine, but the effectiveness is lower than it should be,” Olutade said. “Forty to 60 percent effectiveness is a good match. The last season we had the H3N2 strain, the vaccine was only 32 percent effective… We have to wait and see what the overall effectiveness of this vaccine will be at the end of the season.”
This year’s peak is occurring earlier than last year, according to McVey.
“Last year, the volume was less, but the peak occurred in late February. It was a much later peak than this year, and we’re hoping we’re seeing it now… The high-volume years peak in January, and the lower-volume years peak later.”
At St. Dominic’s, McVey said an average of 30 people per day come into the hospital’s emergency department to get tested for influenza.
“Ten to 15 are positive and get a diagnosis of influenza, and three to four get admitted to the hospital per day in the last six weeks or so,” he said.
Typically, patients don’t require intensive care, but McVey said there are occasions when a patient must be admitted to the intensive care unit (ICU).
To fight the flu, McVey said the first task is to get the vaccine, which will reduce chances of contracting the virus. If someone does contract the virus after getting the vaccine, the vaccine can help in lessening symptoms.
“Number two is good and frequent hand hygiene,” he said. “Avoid crowds, whether it’s a crowded elevator or a local grocery store. The less you’re out among people, the less likely you are to be exposed. However, it’s not a recommendation to not leave your house.”
Olutade advocates lessening visits with people known to be sick with the flu.
“If you know somebody who’s sick, don’t visit them,” she said.
Hospital patients recovering from other illnesses should also not be exposed.
“Our intent is to try to reduce the chance that a hospitalized patient (at St. Dominic’s) become exposed from an outside visitor,” McVey said. “The fewer the visitors, the less the chance they will become infected.”
Good hygiene and avoiding public places when sick helps prevent the spread of the infection as well.
“Wash your hands frequently. For those who actually get the infection, avoiding going to public places like school or work helps prevent spreading the virus,” Olutade said.
Someone who has symptoms should avoid going to the hospital if they can be treated with over the counter medication.
“Stay home if you can take over-the-counter medication,” McVey said. “The virus can still spread with mild symptoms, and people should avoid going to the hospital or seeing someone who is sick, unless you have to.”
Those with otherwise perfect health should not experience extreme cases of the flu virus, according to McVey.
For those with early symptoms of the flu, it’s best to be tested to ensure the cause of those symptoms. Tamiflu can be effective in treating mild and early symptoms of the virus.
However, McVey warned that the nasal swab test is only 80 percent effective.
“If one is otherwise well and healthy — assuming that their current fever, cough, stuffiness and body aches are flu — they should be safe. In 48 hours, if you’re not feeling somewhat better, it’s a good time to go to the hospital… If you have the flu, feel better within a few days and then start feeling worse again, you could be developing a complication of the flu, such as bacterial pneumonia or other complications.”
When this occurs, McVey said one should be evaluated sooner rather than later.
Furthermore, children 12 years old and younger can be contagious before showing or feeling symptoms of influenza infection. “The contagiousness of influenza in children begins prior to onset of symptoms for some reason,” McVey said. “Contagiousness begins at onset of symptoms in adults. Children may not know they’re sick, so we’re asking that all children under 12 not go to the hospital unless there is a true, compassionate need to do so.”
The Mississippi Department of Health confirmed the first pediatric flu death for the 2017-2018 season at the end of January.
“Including this reported death, there have been a total of 17 pediatric flu deaths reported in Mississippi since pediatric flu deaths became reportable in the 2008-2009 flu season,” the press release states. “Nationwide, there have been 30 pediatric flu deaths reported this season, according to the Centers for Disease Control and Prevention.”
The statement also reads that flu shots are recommended for all those six months and older. Symptoms of seasonal flu include fever, cough and sore throat. Fatigue, headache, muscle aches and a runny or stuffy nose are also often present. More severe symptoms and death can also occur.
