If it's not the flu, it's some ole bug Flu and flu-like ailments having a field day.


If you've got that hacking cough, or you're home in bed feeling as if a truck ran over you, it won't come as news that the flu and other viruses are having a field day in Maryland.

Lab cultures by the state Department of Health and Mental Hygiene have confirmed 11 cases of A-type influenza so far. Of those that have been further studied, all have proven to be the Beijing strain.

But "that would be the tip of the iceberg, since so few cultures are done," said Betsy L. Thompson, a DHMH medical epidemiologist.

There's evidently a lot more flu-like illness out there, too, "all sorts of upper respiratory infections and a host of different viruses," she said. All such infections "do real well in winter months."

Flu, or flu-like illnesses have hit the schools hard and have now been reported in 10 nursing homes across the state.

"Schools have been our hottest spot," Thompson said. "It's not everywhere, but it is spread throughout the state [at a] moderate level of activity."

The flu and other respiratory viral illnesses all share the same general symptoms: fever, sore throat, coughing, aches and pains. With the genuine flu, it's simply worse, with a sudden onset, a dry cough and whole-body aches and pains.

You catch them all mostly by breathing in viruses carried by coughs and sneezes, or by rubbing your eyes after shaking hands with an infected person. The best protection is washing your hands. Once you're sick, doctors say, stay home until you're well so you don't infect others.

When it is the flu, and if you're otherwise healthy, you'll usually recover in two to seven days, with little more than a lot of bed

rest and plenty of fluids.

But "most viral illnesses are not flu," Thompson said. Many are simply common colds. Or, "when there's a lot of nausea, vomiting and diarrhea . . . it may be a virus, but it's not influenza."

Doctors in Maryland have been seeing a lot of people with diarrhea and vomiting, a viral gastroenteritis that often runs its course in 24 hours.

Absenteeism in Maryland schools began climbing right after Thanksgiving, and by Dec. 20, six counties (Allegany, Carroll, Caroline, Harford, Wicomico and Worcester) were reporting at least 10 percent of their students out with flu-like illnesses.

There may have been other school systems with worse absenteeism, Thompson said, but not all of them report in.

Two weeks ago, a Maryland nursing home reported an influenza outbreak among its patients. That was the first. The total has since risen to 10 homes.

That's a special worry because the elderly and infirm, and persons with weakened immune systems, are most endangered by fatal complications of the flu, such as bacterial pneumonia. But "so far, we have seen no excess mortality from influenza or pneumonia," Thompson said.

She said the death rate may low because this year's flu vaccine includes protection from the A/Beijing strain, which first appeared late last flu season. It is the only type found in Maryland so far this season.

"Generally in winter we see an increase in deaths from pneumonia and influenza," Thompson said. "We haven't seen that yet. The vaccine is effective, so I hope we won't see much."

What's more, despite earlier reports of some local vaccine shortages, flu vaccine is still available for Marylanders most at risk.

The vaccine contains a killed influenza virus that can't cause the disease, but will stimulate the body's immune system to produce antibodies. If the person is later exposed to the live virus, those antibodies will attack and kill it.

That immune response takes about two weeks to fully develop, however. So vaccinated people who are exposed to the virus before they are fully immune may still get sick. They may also get sick from another virus with symptoms similar to the flu. The vaccine only works against the flu.

Also, people with weakened immune systems may never get full protection from the vaccine. They may still get sick, but they will be much less likely to develop a potentially fatal pneumonia.

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