Flu Update and Outlook for 2019

flu-virus

The Flu virus is spreading, and the CDC reports 19 states and New York City with high flu activity relative to the average cross the country.  Those states include: Alabama, Arizona, Colorado, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Mississippi, Nevada, New Jersey, New Mexico, Oklahoma, South Carolina, Texas, Utah, and Virginia. Another nine states have moderate activity.

"The season is really starting to pick up," said Lynnette Brammer, the lead of CDC's domestic influenza surveillance team.

The A strains of the flu virus are the most common so far, in particular H1N1. "There's still a lot more flu season to come," Brammer said. "I expect activity to continue for several more weeks."

Last year’s flu season was one of the worst on record, with the highest death toll in over 20 years. U.S. Surgeon General Jerome Adams, MD, said an estimated 80,000 Americans died of flu in 2018 and its complications and about 900,000 landed in the hospital.

Since 2010, the flu has affected about 9 million to 35 million annually.

What are the latest stats on the flu season?

Brammer said it's too early to tell how severe this season will be or what the mix of viruses will be. The hospitalization rate is still relatively low compared with last year, and deaths are still below epidemic levels, she said.

The CDC says 13 children have died related to flu this season. Most are associated with the A H1N1 strain of the virus. 

How Effective is this Year's Flu Vaccine?

It is impossible to predict how well the updated vaccine will work.There are many strains of the two types of flu viruses, A and B, that infect humans. In order to have flu shots ready for flu season, experts have to decide, many months in advance, which strains to include in the vaccine. Because strains of the virus can rapidly mutate, the vaccine is not always a perfect immunization. Even when the vaccine is a good match, the way it is produced can also affect its efficacy. In addition, most flu shots are grown in eggs, which may change the viruses and affect how effective they are.

Where Can I Get a Vaccine?

It's offered at doctors' offices, clinics, health departments, college health centers, pharmacies, and at many offices and some schools. Many insurance plans pay for the annual vaccination, and older adults covered under Medicare Part B can get the vaccine free, with no copay or deductible. For more information about where to get a flu vaccination, go to the Vaccine Locator.

How Are Flu Vaccines Produced?

During flu season, experts study samples of the viruses circulating to evaluate how well the vaccine protected against those viruses. They use that information to help make their decision for the next one. This year, the vaccine will protect against two A strains -- H1N1 and H3N2 -- and a B strain. The quadrivalent vaccine will protect against an additional B strain.

Like all other vaccines, the one for flu isn't perfect, but it cuts the risk of illness from 30% to 60% in the general population, the CDC says. In general, vaccines work better against influenza B and influenza A (H1N1) viruses than they do against influenza A (H3N2) viruses, the CDC says.

Who Gets Hit the Hardest?

Seniors always get hit the hardest, but the Flu is also hard on children. Thousands of U.S. children had been hospitalized and 180 children had died of flu-related causes in the past 12 months. Among the children who died, about 80% had not had a flu shot, according to the CDC. Children younger than 2 are especially vulnerable. Those ages 6 months and under are also much more likely to get complications, but they're too young to be vaccinated, so the best idea is to be sure everyone in contact with them is vaccinated. Adults ages 65 years and above are at greater risk than younger, healthy adults due to weakened immune systems. Typically, these older adults account for most flu-related deaths and more than half of flu-related hospitalizations. Pregnant women, as well as those who have delivered a baby in the previous 2 weeks, are more likely to have a severe illness than women who aren't pregnant.

Anyone with a chronic medical condition is more likely to have complications. These conditions include:

  • Asthma
  • Diabetes
  • Heart disease
  • Obesity
  • A compromised immune system due to cancer, HIV, or other conditions

When Does Flu Season End?

Although you can get the flu anytime, flu season generally starts in October and extends into March or April. But ''it usually peaks in the U.S. in February, says William Schaffner, MD, medical director of the National Foundation for Infectious Diseases. 

What Types of Flu shots are Available this year?

For the 2018-2019 season, there are several vaccines:

  • Trivalent vaccines, which protect against three flu strains: two A and one B
  • Quadrivalent vaccines, which protect against two A and two B strains
  • A high-dose vaccine that protects against two A and one B strain, meant for adults 65 and above, who usually have weaker immune systems
  • An adjuvanted vaccine, made using an ingredient that helps trigger a stronger immune response, is also an option for older adults. It protects against two A strains and one B.
  • A nasal spray vaccine for people ages 2 to 49 that protects against four strains: two A and two B. It is not for pregnant women and people with weakened immunity, among other conditions.

Children who have never been vaccinated against influenza will need two doses, spaced at least 4 weeks apart.

Which Vaccines Work Best?

While the quadrivalent vaccine protects against more viruses, the CDC says there is no preference among the recommended and approved vaccines. Ask your doctor which is best for you. Different vaccines are approved for different age groups.

Up to 166 million doses of the flu vaccine are expected to be produced for this flu season, including 119 quadrivalent. However, if it is not available, it is better to get another flu vaccine than to wait for it, the CDC says.

Any flu shot is better than none. Don’t delay getting one if you can't get your first choice.

Who Should Get a Flu Shot and When?

In general, everyone over 6 months of age should get vaccinated, and the earlier the better. Late September or early October are ideal, according to the CDC.The AAP says that all children 6 months and older should get the shot to help cut the risk of severe illness and death as soon as possible, but preferably by the end of October. 

Who Should Not get a Flu Shot?

Anyone who got Guillain-Barre syndrome within 6 weeks of a previous flu vaccination should not get vaccinated, the CDC says. Nor should anyone with a known severe, life-threatening allergy to any ingredients in a vaccine.

Does the Nasal Flu Vaccine Work?

The nasal spray vaccine, FluMist, is once again being recommended by the CDC. Although it didn’t work well against H1N1 viruses, it did against some B viruses and H3N2 viruses. It’s available for children 2 and older who don’t have a compromised immune system.

What are Common Flu symptoms?

They usually come more suddenly than cold symptoms. They include fever, feeling feverish, the chills, having a cough, sore throat, runny nose, muscle or body aches, headache, and fatigue. Less common are vomiting and diarrhea. Children are more likely to have vomiting and diarrhea than adults are, the CDC says. Not everyone with the flu has a fever.

What Can I Do I if I Think I Have the Flu?

Stay home, rest, and avoid contact with others except to get medical care if needed, experts say. Avoid contact with others for at least 24 hours after the fever subsides to avoid spreading the flu. Be on the lookout for emergency warning signs that you may be getting serious flu-related complications, the CDC says.

In children, these include:

  • Fast or troubled breathing
  • Bluish skin color
  • Severe irritability
  • Fever plus a rash
  • Lack of interaction
  • Not drinking fluids
  • Symptoms that improve then return with fever and a worse cough

In adults, they include:

  • Breathing trouble
  • Pain or pressure in the chest or abdomen
  • Dizziness or confusion
  • Severe or persistent vomiting

Symptoms that improve but then return with a fever and worsening cough.

What are Flu Treatments?

The FDA in October approved the first new flu treatment in nearly 20 years: baloxavir marboxil (Xofluza). The new treatment joins the other three approved antivirals for flu, including oseltamivir (generic or Tamiflu), peramivir (Rapivab), and zanamivir (Relenza). Antiviral drugs can lessen your symptoms and shorten sick time by 1 or 2 days, according to the CDC. These are prescription medicines in various forms, such as pills, liquid, an inhaled powder, or an IV solution. Ask your doctor if they are right for you. They may also have side effects. Tamiflu may cause nausea and vomiting, and it may make headaches and psychiatric effects more likely. And in a recent study, it didn’t lessen complications. It's important to start the drugs early, as studies show they work best when started within 2 days of getting sick. But your doctor may decide they can still be helpful if started later than that.

What Are Alternative Flu Treatments?

Elderberry has received a lot of buzz, but health experts say the jury is out. This natural remedy may help treat flu and cold symptoms by cutting congestion and perhaps by making you sweat more, experts at the University of Maryland say. In one study, an elderberry extract called Sambucol helped shorten how long the flu lasts by about 3 days. But the product also has other herbs, plus vitamin C, so it's unclear whether the elderberry alone helped. In another study, a lozenge with elderberry extract helped ease flu symptoms if taken within a day of when the symptoms started. And in the lab, some researchers found elderberry could kill the H1N1 flu virus -- but that was in test tubes, not people. According to the National Center for Complementary and Integrative Health: "Although some preliminary research indicates that elderberry may relieve flu symptoms, the evidence is not strong enough to support its use for this purpose."

Aside from getting a Flu shot,  what more can I do help lower the chance of getting the of Flu?

Wash your hands, wash your hands and wash you hands some more. Everyday preventive actions are important. Avoid people who are ill, practice good hygiene, cover your cough with your arm, and clean off your mobile device. Stay at home if you are sick, and wash your hands again.

 

 

 

 

 

 

 

by Girard Cseh