Feeling awful? Could be the flu.
Influenza activity has been climbing across Maryland in recent weeks, and several Baltimore-area hospitals report emergency rooms crowded with patients complaining of fever, headache, coughs and body aches.
"We've been extremely busy. We noticed it cropping up a week or so ago," said Dr. Neal Frankel, assistant chairman of the emergency department at St. Joseph Medical Center in Towson. "We're in the thick of it right now."
Two miles south, at Greater Baltimore Medical Center, emergency department Chairman Dr. Jeffrey Sternlicht said his staff sees 20 to 30 cases a day - a bigger surge of cases than he remembers from the past three or four years. Doctors are also seeing an increase in their private practices.
"I don't think people are any more sick than in the past," Sternlicht said. "Most people can go home, drink fluids and take Tylenol and they'll be OK."
On the other hand, he added, "We've admitted [to the hospital] three times the number we did at this time last year. And that's proportional to what we're seeing in the emergency room."
The Maryland Department of Health and Mental Hygiene confirmed that flu activity has grown in the past four weeks.
Doctors are ordering more diagnostic tests, and the proportion of results positive for flu has grown from 13.8 percent two weeks ago to 20.2 percent Monday, according to Dr. Rene Najera, the agency's influenza surveillance coordinator.
"We won't recognize the peak until we're done with it," he said. But it's not past yet. "We still have influenza on the way."
The flu strains being identified most in Maryland include two kinds of Type A virus. A very few Type B cases have also turned up. All three are covered by this year's vaccine. And there's still time to get protected.
"It's never too late," Najera said.
The surge has come earlier than in the past two years, when the season peaked in mid-March, Dr. Najera said. It looks more like the activity in 2004-2005, when the peak came in early February. But the flu does not appear to be striking all parts of the region with equal intensity.
Representatives for the University of Maryland Medical System downtown, Anne Arundel Medical Center to the south and Franklin Square Hospital Center in eastern Baltimore County say they're seeing flu in volumes normal for this time of year.
Dr. Joshua M. Sharfstein, the Baltimore health commissioner, said there have not been an unusual number of "yellow alerts" - episodes when crowded hospitals divert ambulances to other facilities. Nor have fire officials reported critical volumes of calls for ambulances.
"Our tracking shows there's a ... great amount of flu right now in Baltimore, but we have not heard about a critical situation with respect to hospitals," Sharfstein said.
Mortality data is similar to prior years, and the city has not had to issue a severe flu warning.
Baltimore County school spokesman Charles Herndon said six schools reported more than 10 percent absenteeism yesterday, "a little bit of an uptick" from the norm.
He said he did not know the names of the schools and was unaware of any geographic trend. The highest absentee rate seen so far was 20 percent.
In addition to the normal flu symptoms of cough, fever, headaches, muscle aches and "malaise," Frankel said, "people are having a lot of nausea, vomiting and diarrhea."
"It's different than what you normally expect from the flu ... a definite mix of symptomology," he said.
Not every flu-like illness circulating in Maryland this winter is actually the flu, hospital officials said.
"There's clearly some other viral syndrome causing the same [symptoms], because some people are not testing positive for the flu. They're viral URIs [upper respiratory tract infections] and even stomach bugs," Frankel said.
Doctors say they are also seeing bacterial pneumonia and other secondary infections developing on top of the flu. Most seriously endangered, and most likely to be hospitalized, are the elderly, the very young and anyone with a weakened immune system.
If you still hope to keep yourself and your family from getting sick, Sharfstein said, "it's really important for people to practice good hygiene. Cough into your sleeve, stay home if you're sick ... and do a lot of hand washing."
Finally, if you feel yourself coming down with the flu - or something like it - ask your doctor about an antiviral medication such as Tamiflu. If you take it within 48 hours of developing symptoms, Frankel said, it can ease the course of the illness.