A New York youth sports club is discouraging high fives for fear of spreading germs. Catholic churches in Rhode Island and Texas are telling congregants celebrating Mass not to shake hands or drink wine from a shared chalice. A Northern Virginia hospital system is advising visitors that they might be screened for flulike symptoms.
One of the deadliest and most severe flu seasons on record has spread to more than 90 percent of the nation. Along with aches and fevers, the problem is depleting vaccine supplies, putting increased pressure on hospital emergency rooms and shuttering businesses and schools, health officials say.
Forty-seven states — including Alaska, which is nearly four hours by plane from the lower 48 border — reported widespread flulike illness, according to data from the Centers for Disease Control and Prevention.
"There's flu all over the country right now," said Dr. Joe Bresee, a medical epidemiologist from the influenza division of the CDC. "There's widespread disease in most states and high levels of disease in most states."
Even Hollywood has suffered from the outbreak. A few seats, including one for actress Meryl Streep, were noticeably empty Sunday at the presentation of the Golden Globe Awards.
"The bottom line, it's flu season," CDC Director Dr. Thomas Frieden said during a conference call Friday. "Most of the country is seeing or has seen a lot of flu, and this may continue for a number of weeks."
The good news, Dr. Frieden said, is that the number of states reporting a "high level" of flu activity declined last week from 29 to 24.
Mississippi, California, Hawaii and the District were the only places in the U.S. to report less than a widespread outbreak, noting only local and regional flu activity.
Liz Sharlot, a spokeswoman for the Mississippi State Department of Health, said although her state is reporting less flu activity than others, officials are seeing higher levels of the illness than normal and are reluctant to predict whether the state might get through the season more easily than some of its neighbors.
"It's too early to count your chickens," she said.
Besides keeping people bedridden, the increase in the number of cases reported this season has had a two-pronged affect. Hospital emergency rooms and urgent-care centers are swelling with patients with flulike symptoms. Some doctor's offices and walk-in clinics are reporting vaccine shortages because of demand from people worried about getting sick and about a diminishing supply of the vaccine.
Brent Burkhardt, a spokesman for CVS Minute Clinics, said that Washington-area clinics were "for all intents and purposes, depleted."
Mr. Burkhardt said the run on injections likely was caused by a combination of people with ailing family members and friends trying to protect themselves, and by a panic generated by news reports about the severity of the flu strain.
"We are treating patients for the flu, that does continue to go on. If a patient comes in to a Minute Clinic within 48 hours of diagnosis, we may be able to get a prescription for Tamiflu, which helps increase recovery," he said. "But it points to the importance of getting shots earlier in the year."
CDC officials said more than 130 million doses of the vaccine were produced for this season and it is a good match for the flu that is wreaking havoc across the country.
Still, with the shots in short supply in some places, "common sense" preventive measures are being trotted out across the country.
Inova, which operates five hospitals in Northern Virginia, has announced that it is restricting visitation policies because of flu concerns and that visitors might be screened for flulike symptoms. Some Catholic churches across the country have omitted parts of the Mass where parishioners shake hands or sip from the same cup during Communion. News outlets in New York reported Tuesday that the Manhattan Soccer Club, which has about 750 children playing soccer throughout the city, advised parents that children should avoid high-fiving and bump elbows instead to help prevent hand-to-hand contact.
Annual flu upticks aren't uncommon, but what makes the 2012-13 season so worrisome among health specialists is that reports started earlier than normal and that the strain making people ill is the same kind that made the 2003-04 season so severe.
The strain H3N2 is considered common but can be fatal for young children and senior citizens. The CDC's most recent report through Jan. 5 showed that 20 people younger than 18 had died this season. About 24,000 people die each year from influenza-type illnesses.
Doctors have warned that even the flu vaccine is not 100 percent effective. That said, this year's vaccine does offer a 60 percent effective rate, meaning that those who have been vaccinated are about 60 percent less likely to get the flu that requires a doctor's visit, Dr. Frieden said.
The vaccine takes several weeks to take effect, CDC officials said, so a vaccinated person can catch the flu by coming into contact with the virus, but their symptoms often are not as severe.
On Tuesday, Laurel Regional Hospital in Prince George's County had a line outside its door for a free flu-shot clinic. The clinic started at 2 p.m., and in an hour 100 people had come in, said Shervon Yancey, the community health manager for the hospital.
"It all kind of happened rapidly," Ms. Yancey said of the rush.
As she straightened her shirt sleeve after receiving an injection, Maria Bitenas, 65, said she came to get her vaccine because "my family was bugging me this year."
"More children are sick, my neighbor's children," the Laurel resident said. "I called CVS, but nobody had any [vaccine] and Target had it for $45."
Patrick Boateng, 23, said he heard about the clinic from his mother.
"I went to the doctor and they ran out," the Beltsville resident said. "I'm traveling in the next couple days, going to different places," Mr. Boateng said of his reason for getting a shot. "Anyone passing through airports, being around people, it's good to have that precaution."
Adjusting her jacket after receiving her first-ever flu shot, Avril Abrahams, 30, said her brother persuaded her to come to the clinic.
"He wanted to come, but I was still a little skeptical," the Hyattsville woman said. "I decided on the spot. It's my first time."
The shot hurt "a little." As for the vaccine itself, "I'm still skeptical," she said.
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