- The Washington Times - Tuesday, January 16, 2018

At least 2,500 people, including 20 children, have died of flu or pneumonia over the past 3 months in a “severe” season that U.S. health experts hope won’t surpass the record number of infections during the 2014/2015 outbreak.

“It’s widespread activity virtually everywhere,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told The Washington Times. “This is the peak. Hopefully, it will turn around and start coming down.”

All four major flu strains are circulating throughout the U.S., but the overwhelming majority of positive tests for influenza have indicated the H3N2 strain, which Dr. Fauci describes as “inherently and intrinsically a bad actor.”

“Right from the get-go means you have one strike here against you, because you’re starting off with a bad virus,” he said.

Hospitals have been overrun with flu cases in California, where ambulances are turned away from overcrowded emergency rooms and patients are evaluated in medical tents in parking lots, the Los Angeles Times reported.

According to the California Department of Health, 27 people under the age of 65 have died of the flu. The agency doesn’t have a complete tally of such deaths, saying it believes actual count to be much higher. Nearly 12,000 people have tested positive for flu, and the state has recorded an outbreak in every county.

California media said that pharmacies have had shortages of anti-viral medications, but Dr. Fauci said that has more to with uneven distribution than a lack of supplies.

“In other words, there was a lot in some hospitals that didn’t need it as much and not as much in some that really did need it,” he said.

Texas and Florida also have experienced higher levels of flu activity, compared to the rest of the nation, health officials said, adding that hospitals are seeing a record-setting number of cases.

“In Florida, we’re seeing more activity across all age groups this year than we’ve seen in the last two flu seasons,” Mara Gambineri, communication director for the Florida Department of Health, said in an email to the Times.

This includes 73 outbreaks across the state, more than any other previous seasons around the same time, according to the Florida agency’s most recent data.

At least 216 people have died from pneumonia or flu in Florida in the past 52 weeks.

At Texas Children’s Hospital in Houston, infection rates have started to decrease slightly over the past two weeks, from 136 to 110. Yet these numbers are stark compared to years previous. Last month, there were 486 cases of flu, compared to 28 in December 2016.

“We’ve been keeping in close contact with hospitals, and they have certainly been seeing a lot of flu activity but to this point, they’ve been able to handle it within the normal operations of the health care system,” Chris Van Deusen, a spokesman for the Texas Department of State Health Services, said in an email. “In Texas, this season has been tracking fairly closely with [2014/15] so far, but that can always change at a moment’s notice.”

H3N2 was the predominant strain during the 2014/2015 flu season, which resulted in 56,000 deaths, 710,000 hospitalizations and 36.5 million symptomatic cases, said Dr. Dan Jernigan, director of the influenza division at the federal Centers for Disease Control and Prevention.

Speaking Tuesday at the CDC’s Grand Rounds lecture in Atlanta, Dr. Jernigan said so far there have been 339,598 visits for flu-like illness and, while the incoming data are similar to the 2014/2015 season, there is hope it won’t pass that threshold.

“We don’t know exactly what’s going to happen — maybe [infection rates] will start to plateau earlier like 2012/13,” he said. “But at this point, in terms of the numbers we’re seeing, it’s certainly not beyond what we had in 2014/15.”

Dr. Fauci said three factors determine the severity of season — the nature of the virus, the population’s previous exposure and the vaccine match.

The H3N2 strain did circulate during the 2016/2017 season, but rates of infection were fewer, resulting in a lower immune response in the population this season.

While flu vaccine effectiveness is about 60 percent in a good year, experts believe it will only be 30 percent effective this year, Dr. Fauci said.Health officials had earlier predicted a bad season because of a possible mismatch between the vaccine — which mutated during its growth — and the dominating strain.

Despite limitations, health experts still recommend getting the flu shot if a person hasn’t already done so. The flu vaccine takes around two weeks to be effective.

Dr Alicia Fry, a medical officer and team leader for the Influenza Prevention and Control Team at the CDC, said that during the 2016/17 season, vaccine coverage helped prevent 84,600 hospitalizations; 2.6 million outpatient visits and 5.3 million illnesses.

“Even with our current vaccines, influenza vaccination averts a substantial burden of illness,” said Dr. Fry, who also presented at the CDC’s Grand Rounds talk on Tuesday.

If you’re already sick, taking anti-viral medications within 48 hours at the onset of symptoms can help reduce the length of illness. Symptoms include fever and chills; sore throat; cough, runny nose or congestion; fatigue and achieves all over; and headache.

“Influenza anti-virals are an important second line of defense, especially with patients with severe illness and those at increased risk for severe disease,” Dr. Fry said.

These medications include Relenza, an inhalant; Rapivab, administered through IV; and Tamiflu, an oral medication. Reactions and side effects to these medications can vary.

In a rare yet serious case, a family in Texas this week said their six-year-old daughter started hallucinating after taking Tamiflu, and that she tried to jump out a second-story window but was pulled back in by her mother.

“I don’t think the 16 hours of symptom relief from the flu is worth the possible side effects that we went through,” the father, who wished to remain anonymous, told CBS-Dallas-Fort Worth.

“Know that side effects are there for a reason. They’re written down for a reason. I guess they can happen, and we got the short end of the stick,” he added.

Dr. Fauci said that while the nation is in the peak of a bad flu season, they’re not seeing any unusual activity.

“It’s what you would call a bad flu season but a typical bad flu season,” he said. “Among bad seasons, there’s nothing unusual about this. It’s just a widespread activity, a lot of cases, a lot of hospitalizations. It’s a tough year for flu.”

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