By Tim Gardner
Influenza (the flu) is starting to reach high levels in many parts of the United States, and North Carolina has eight confirmed deaths from it this flu season. While one death from influenza is one too many, the over-all flu season still may not be as bad nationally, regionally and locally as in previous years, according to health care professionals.
The National Center for Diseases Control and Prevention (CDC) confirmed that the death rate in North Carolina so far this flu season is at the mid-to-higher end of the scale for this time frame compared with the previous five flu seasons.
Of the flu-related death so far in the state for the 2018-19 season, seven of the victims were ages 65 and older, while one was in the 25-to-49 age group.
The N.C. Division of Public Health has said it will not release victims’ hometown, county, age and gender for privacy reasons.
The 2017-18 flu season was the deadliest in modern-day North Carolina history, with 391 deaths.
Those totals were broken down as: 290 deaths among people 65 or older; 71 among ages 50 to 64; 19 among ages 25 to 49; six among ages 5 to 17; four among ages 18 to 24; and one child under 4.
The 2016-17 and 2014-15 seasons each had 218 confirmed flu-related deaths.
Nationwide, the CDC said there were more than 80,000 flu-related deaths last flu season— the highest level since the 1976-77 season. The death total had ranged in recent years from 12,000 to 56,000.
But health care professionals are not anticipating there will be as many flu cases as in the 2017-18 season. And that may especially hold true locally.
“The flu is not expected to be as bad or worse in this area than in previous years,” said Jessica Farley, Public Information Officer for the Toe River Health District, which covers Avery, Mitchell and Yancey counties. “Although there are no indications that this flu season will turn out to be more severe than normal, it doesn’t usually peak for another month or so. That makes it difficult to exactly pinpoint how it will be. But fortunately doctors and other health care expects don’t expect it to be as bad. We won’t know for sure until it peaks though.”
Dr. Daniel Jernigan, with the Centers for Disease Control and Prevention, also said that despite the number of flu deaths equaling the same time from the exact time frame a year ago, the most common flu strain found so far is considered somewhat milder than last season’s and the flu season may not be as bad as last season’s.
One of the challenges in fighting flu is that the viruses can change their genetic make-up rapidly — not only between flu seasons, but also during the course of a single season. As a result, the seasonal influenza needs to be evaluated annually to see whether their composition needs to be adjusted. And because it generally takes several months for influenza vaccines to be produced, flu strains for the next season have to be selected months in advance to ensure there’s an adequate supply of vaccines when flu season hits.
“Early signs are that the vaccines we have to treat the flu this season are good matches,” Jernigan said.
And there are no reported shortages of vaccines in the state this flu season, according to the CDC.
The federal Food and Drug Administration (FDA) and CDC targeted four different strains with this season’s flu vaccines– two influenza A types (H1N1 and H3N2) and one to two types of influenza B. That includes replacing the influenza A H3N2 strain used in 2017-2018 with a new strain (A Singapore) that is projected to be more effective in treating the circulating strains in 2018-2019.
Additionally, one of the 2017-2018 influenza B strains (B/Brisbane) has been replaced for 2018-2019 with another strain (B/Colorado).
Those who are most vulnerable to flu complications are the very old and the very young. The most numerous flu deaths strike the elderly. Besides the elderly, other vulnerable groups are children younger than 5, pregnant women and those with pre-existing medical conditions. Added this year is the category of residents of nursing homes and other long-term care facilities.
Every year, about 100 children die from the flu nationwide, according to national pediatric statistics. But nearly half the children who die from the flu have no known medical condition that puts them at higher risk.
Flu season typically begins Oct. 1 and lasts through March 31, although there have been recent seasons in which the flu and flu-related deaths lingered for several additional weeks.
Health care officials have said that there is not a lot that can be done for someone with the flu who otherwise is in good health. The prescription medicines usually are given to people who also suffer other illnesses or are at much more risk of the flu causing them additional physical problems. The medical treatments can lessen the flu’s severity, but it still has to run its course to get out of your body.”
Farley added that the exact number of flu cases is sometimes hard to statistically obtain as some people treat themselves with over-the-counter medicines without seeing a doctor, nurse or another health care professional to be checked and treated.
Recognizable flu symptoms include: fever, cough, sore throat, body aches, chills, fatigue, runny or stuffy nose, headache, diarrhea and vomiting. But anyone who thinks he or she or a family member may have the flu and are experiencing more severe symptoms such as difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion and/or severe or persistent vomiting should seek immediate emergency care.
Flu complications can lead to pneumonia, bronchitis and sinus infections, as well as exacerbations of asthma and congestive heart disease. Pneumonia happens when fluids accumulate in the lungs and interfere with a patient’s ability to breathe. If severe enough, like the flu, pneumonia can lead to death.
Antiviral drugs such as Tamiflu typically are reserved for use on patients whose age or underlying conditions – such as respiratory illness or heart trouble – put them at risk of serious complications from the flu virus. That means patients with no other problems may be sent home when visiting a doctor’s office or health care clinic with a recommendation for plenty of rest and over-the-counter medicines. But those with worse cases of the flu or that it’s caused patients to have other complications may be hospitalized and treated intravenously or through other methods.
Fortunately, most people recover from flu after about a week or two without lasting effects.
Medical experts urge flu vaccinations for everyone 6 months and older who haven’t already received the shot. Even though vaccinations are never 100 percent effective, they reduce the risk of the flu spreading. Some people can carry the infection without showing symptoms, so they don’t know they are transmitting the virus.
Doctors recommend injections over nasal sprays because of higher effectiveness, and to wear face masks. Many health care treatment facilities also mandate that only immediate family and no young children be allowed to visit those hospitalized until the level of flu cases decrease. And all area hospitals are asking anyone showing symptoms of the flu or respiratory illness to stay away from visiting patients and that those not sick should avoid close contact with sick people.
Flu viruses spread mainly from person to person through coughing or sneezing. Sometimes an individual may catch flu by touching an object infected with the virus and then touching the eyes, mouth, or nose. So health care experts highly recommend to avoid touching your eyes, nose or mouth as germs spread those ways. They also urge everybody to wash their hands often with soap and water or alcohol-based hand cleaners, especially after coughing or sneezing.
Additionally, doctors want everyone to cover their nose and mouth with a tissue when coughing or sneezing, and then throwing the tissue in the trash. Also if tissues are not available to cough or sneeze into, people should cough or sneeze into their upper sleeves, not into their hands. If you get sick with the flu, stay home from work or school and limit contact with others to help keep from making them sick.
Flu vaccines typically are available in doctor’s offices, health-care clinics, county health departments, pharmacies and college health centers, as well as from many employers and schools. Individuals can use the FluFinder at www.flu.nc.gov to find a clinic near them.
The shots typically are free for individuals with private insurance and Medicare and Medicaid recipients.