Here are some things to know about the once-a-year rite of flu vaccination. (Baltimore Sun video)
Nobody likes the flu but the party spoiler of respiratory diseases shows up every year anyway. This year, the flu virus is turning out to be a particularly aggressive unwelcome guest and Maryland is a hot spot.
State and federal health officials say influenza seems to be sickening more people.
State health officials, who keep a partial tally of residents who go to the doctor and the emergency room with influenza symptoms, report that activity spiked in mid-December and got worse by year’s end.
“It’s a significant flu season,” said Dr. Howard Haft, Maryland’s deputy secretary for public health. “We are in the midst of the peak flu season. How long it will last is a little difficult to predict.”
It’s still too early to tell if this flu season, which could run until May, will be worse than usual, Haft said.
The high number of reported cases suggests that it may be and that could partially be a result of a vaccine issued this season that is less effective than past seasons though the strains included in the doses match those circulating.
According to the latest state Department of Health report that runs through Jan. 6, there were 1,531 visits to doctors who voluntarily report suspected flu cases and more than 12,700 emergency room visits since the flu season started Oct. 1.
Most people who get sick with the flu, however, are not tested for the flu virus and don’t even visit a medical provider, instead they stay home and ride out the aches, sniffles and fever by resting and drinking extra fluids.
Maryland is among 26 states now reporting high numbers of flu cases, according to federal health officials.
The U.S. Centers for Disease Control and Prevention, which bases vaccines on flu strains on those found in the Southern Hemisphere, reported at the start of the season that Australia in particular had a rough season and the United State could follow suit.
Dr. Kathleen M. Neuzil, director of the University of Maryland School of Medicine’s Center for Vaccine Development, said vaccines are developed by growing flu strains in eggs and they can change slightly. She said the method was a “trade off” between producing a vaccine that is an exact match and one that is timely and cost effective. She said, however, it’s the best defense against a potentially dangerous and certainly miserable virus.
“In terms of the extent and severity of flu, we are definitely seeing widespread infection with influenza in Maryland and through the South and West and more severe illness,” Neuzil said.
The University of Maryland Medical Center “is not seeing a lot of severe illness yet,” she said. “So my prediction is we’re still on an upswing.”
She said she just recently got over a cold and did not want to get sick again. She has had the flu before and “it’s not fun.”
Gilden-Weiner said he has never had the flu but got the shot “just to be sure” to keep it that way.
Dr. Neil Roy, chief of the department of emergency medicine at Sinai Hospital of Baltimore, said he has seen more flu cases there than in recent years and more admissions particularly among older people who have virulent strains. The virus can be especially risky for those with lung disorders such as asthma or chronic obstructive pulmonary disease, he said.
Normally, Roy said, he would not even confirm most patients had the flu with a test. He usually would just send them home to recover. But he has been testing people who are particularly sick. He said those who have shortness of breath or can’t hold down liquids need continuing medical attention and possibly the antiviral medication Tamiflu.
“The level of flu each year can vary, but the vaccine, unfortunately, I think is why we’re getting tagged this year more than usual,” Roy said.
Last season, Maryland reported an early rise in cases, beginning in mid-November, peaking in mid-January and re-emerging in late February.
The CDC reported in December that up to 646,000 people die worldwide from seasonal flu-related respiratory illnesses annually, above the high of 500,000 in previous estimates. The estimates could be low because official records often list a complication such as pneumonia or an underlying health condition that was exacerbated by the flu virus as the cause of death.
“These findings remind us of the seriousness of flu and that flu prevention should really be a global priority,” said a statement from Dr. Joe Bresee, an associate director for global health in the CDC’s influenza division who helped conduct the review.
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The one group the CDC does track closely is children. The CDC reported Friday that there have been 20 pediatric deaths across the United States so far this season, and that there are an elevated number of flu cases in every region of the country.
Haft said there have been no children's deaths in Maryland so far this season. There was one last season. Flu is still widespread in Maryland but cases appear to have moderated since last week.
Public health officials say people do need to take the flu seriously and that even previously healthy, young people can suffer fatal complications. The CDC recommends nearly everyone six months and older get a flu shot.
The doctors all said prevention can go a long way. They reminded people to wash their hands frequently, to avoid touching their faces in case they have touched contaminated surfaces and to sneeze and cough into their elbows rather than their hands. Also, infected people should stay home from work and school.
Dr. Leana Wen, Baltimore’s health commissioner, said there is still time to get vaccinated.