The term “epidemic" is often tossed around to describe major health emergencies: The opioid epidemic that killed 42,000 Americans in 2016. The West African Ebola epidemic that killed more than 11,000 between 2014 and 2016.
But an epidemic, as defined by the Centers for Disease Control and Prevention, is “an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area” and, by that definition, every flu season is an epidemic, according to Carroll County Deputy Health Officer Dr. Henry Taylor.
That can complicate messaging around more severe seasons, such as the 2017-2018 flu season is turning out to be — Carroll Hospital has had to change its visitors policy, and the Health Department scheduled additional vaccine clinics in order to cope.
“This is a serious flu, but it is actually a typical H3N2 epidemic,” Taylor said, noting the particular strain of the flu virus predominate at the moment. “Flu every year kills people.”
More than 100 children died from the flu in the 2016-2017 season, according to the CDC, for instance.
And so it is not entirely novel that flu cases seem to be rising in Maryland in recent weeks, Taylor said, but in order to minimize the severity and protect those most vulnerable — children, the elderly and those with compromised immune systems — it’s important to get the word out.
“Basically, there is a lot of flu around and people are spreading it to other people, and a lot of people are getting sick and going to emergency rooms,” Taylor said. “In that situation, what you want to do is whatever you can to interrupt transmission.”
That’s what led Carroll Hospital to issue a media release on Wednesday announcing a change in visitor rules, the first time it has done so since 2015, according to Stephanie Reid, vice president of patient care services and chief nursing officer at Carroll Hospital.
“And as we watched the number of cases climb this season, it was pretty remarkable,” Reid said. “We were extremely busy in our emergency department. The urgent cares surrounding us in Maryland were extremely busy, and whenever that happens, we have to look from an infection prevention lens: Is there something else we need to do to keep our community and our patients safe?”
Carroll Hospital has seen almost 300 confirmed cases of flu since the beginning of the season, Reid said. In order to minimize the risk to other patients, only two visitors will be allowed to see patients at a time, visitors will not be admitted with a fever or cough, and children ages 14 and younger will be prohibited.
This is an important measure, Taylor said, because much of the increase in reported cases of flu-like illness in Maryland are coming from institutional settings where people are often gathered together, such as hospitals, schools and nursing homes.
“It is serious,” Reid said. “You don’t want to scare people, but it is not something to take lightly.”
Individuals can help interrupt transmission of the flu by many of the frequently recommended hygienic methods, according to Taylor, including covering coughs and sneezes, frequent hand washing and keeping one’s distance from people who are sick.
But another key thing people can do is to make sure they stay away from others when they are sick, Taylor said, calling out from school or work, and letting those they have been around recently know they have come down with the flu.
“People will be contagious for 24 hours before they start feeling sick,” he said. “If you become sick, and you were with your family yesterday, you should give a heads up to your family that they should take care of themselves.”
When it comes to recovery, Taylor said, the official standard is a person should be fever-free for 24 hours before returning to school or work. In practice, however, he said since a fever is typically at its worst in the evening, a person who goes to bed without a fever above 100 degrees can probably attend work safely the following morning.
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“If they are going to have a fever, it’s going to be at night time,” he said.
The other thing people can do to stop the spread of flu is to get their flu shot. The Health Department has scheduled brand-new clinics throughout the month of February, offering the vaccine to children ages 6 months through 18 for free and to adults on a sliding scale.
“The Health Department received several calls from parents in the county stating that they were having difficulty obtaining flu vaccine for their younger children, especially age 6 months to 4 years old,” said Maria Carr, maternal child health program supervisor. “Some were reporting that their primary care providers were out of vaccine. Although there are numerous pharmacies and some urgent care facilities in the county offering vaccine, many only offer the vaccine to children [ages] 9 and up.”
The vaccine being offering is the quadrivalent formula, which protects against four different strains of the flu.
This is important, Taylor said, because while the H3N2 strain of flu is the one currently making the most people sick, that strain appears to be nearing its peak.
“What we’re seeing now is influenza A, but influenza B is going to be unfolding over the next week to month,” he said. “That is better covered by the quadrivalent vaccine.”
For more information on the flu or where to get a flu shot, visit www.cchd.maryland.gov/flu.