Hospitals on ‘high alert’ as flu reaches epidemic proportions

Source: Centers for Disease Control and Prevention
Source: Centers for Disease Control and Prevention

This year’s flu season is shaping up to be a particularly nasty one, and it could get worse before it gets better, federal health officials said on Monday. There are 43 states reporting widespread flu activity, including Maryland and Virginia, and 21 children nationwide have died of the flu so far this season, according to the latest data from the Centers for Disease Control and Prevention.

Elderly adults have been the hardest hit with severe complications like pneumonia and breathing difficulties requiring hospitalizations. About five out of every 10,000 American adults over age 65 has been hospitalized with the flu so far this year compared to one out of 10,000 younger adults.

“We are in the middle of a heavy flu season with emergency room visits and hospitalizations on the rise, but it’s pretty similar right now to what we saw in the 2012-to-2013 flu season,” said Dr. Lucy Wilson, an infectious disease physician at the Maryland Department of Health and Mental Hygiene. The predominant strain circulating this year, as well as two years ago, is a type A virus, which tends to cause more severe symptoms and more deaths.

During the past 30 years, a low of 3,000 to a high of 49,000 people in the United States have died from the flu every year depending on the severity of the flu season, according to the CDC.

“We are six weeks into the flu season right now,” said CDC spokesperson Erin Burns. “The average [season] is 13 weeks so we still have several weeks probably” left to go.

The CDC is continuing to recommend flu vaccination, because even though this season’s vaccine may work less well than usual, it can still protect against serious outcomes like hospitalization and death,” burns said.

This year’s flu has the potential to cause additional trouble because one of the circulating influenza A strains – an H3N2 virus – is a mutation of the one included in the vaccine, which means the flu shot may not protect against it.

“About 90 percent of the infections we’ve seen are the type A virus, and we suspect that many of those are the drifted strain,” Wilson said, “but we’re not sure how much.”

Emergency departments at local hospitals have seen hundreds of patients coming through their doors during the past few weeks with high fevers, chills, severe respiratory symptoms and other signs of the flu.

“We’ve definitely seen much higher volumes this year compared to last year for what we call influenza-like illness,” said Dr. Deena Berkowitz, an attending physician in emergency medicine at Children’s National Medical Center in Washington, D.C. While a large percentage of these cases are flu, many children are also getting sick with other respiratory viruses that cause fever and linger for days.

“We don’t usually test for flu because it doesn’t change how we manage symptoms,” Berkowitz said. Whether sick children are being cared for in the hospital or at home, they need to drink plenty of fluid throughout the day and get plenty of rest.

Caregivers also need to monitor symptoms. Anyone with a suspected case of the flu who develops extreme lethargy, persistent vomiting or diarrhea, or wheezing or other breathing difficulties should be seen by a health-care provider immediately, Berkowitz said.

Hospitals, nursing home facilities and schools have been on high alert over the past few weeks with some taking steps to curtail the spread of influenza. Inova Fairfax Hospital in Falls Church and the University of Maryland Medical Center in Baltimore have restricted children from visiting patients and have limited the number of adult visitors in patient rooms. Arie Crown Hebrew Day School in Skokie, Ill., brought in additional cleaning crews to wipe down doorknobs and desks and to scrub toilets and sinks after experiencing a 20 percent absentee rate during one week in December.

Jewish day schools in the local area have also been harder hit this season. “On the Monday before winter break, about 15 percent of our 700 students were out sick, mostly with flu symptoms, which is very unusual,” said Shoshanah Belgrade, the school nurse at the Melvin J. Berman Hebrew Academy in Rockville. The school provides flu vaccines for its teachers and other staff, and most have gotten the shot.

Prevention measures are key, Belgrade said, and the school advises parents not to send kids back to school until they are fever-free for 24 hours, which is recommended by the CDC. Those with respiratory symptoms are also instructed to wash their hands frequently throughout the day and to cough and sneeze into their elbow instead of their hands.

Public health officials continue to recommend the flu vaccine as the best way to prevent the flu, even if it’s not as well matched this year. “It’s not considered too late to get a flu shot,” Wilson said. “It’s a chance to become immune to the strains in the vaccine, one of which is a type B, which often starts circulating later in the season.”

The website provides a list of stores and pharmacies still stocked with flu shots, including the types of vaccines they carry.

Although yearly flu vaccines are recommended for everyone over age 6 months, fewer than half of Americans were vaccinated last year, according to the CDC.

Deborah Kotz, a former health reporter for the Boston Globe, covers health and science for WJW.

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