Local flu deaths up, worst may be over

Emergency department technician Kyle Heaston, left, and Alexis Lalande, R.N., work in a tent set up outside the Palomar Medical Center Escondido so that medical staff members can triage flu patients on Jan. 3 /Hayne Palmour IV-TNS

The number of flu deaths reported in San Diego County reached a new high, while at the same time lab-confirmed cases went down again, the County Health and Human Services Agency announced today.

A total of 142 flu deaths have been reported through Jan. 13, 2018, the highest ever since the County began tracking fatalities about 20 years ago. The previous deadliest flu season was in 2014-15, when 97 deaths were reported.

Also the number of lab-confirmed cases dropped for the second week in a row from 3,046 to 2,070, a sign that although flu activity is still elevated, it may have peaked.

“Unfortunately, after a high number of flu cases is reported, deaths typically follow,” said Wilma Wooten M.D., M.P.H., County public health officer. “We continue to monitor flu activity in the region to see if cases and emergency room activity will continue to drop and determine whether the season has peaked.”

The influenza A strain called H3N2 is making people so ill in California that thousands have shown up at hospitals, and some places are treating them in “surge tents” intended for major disasters.

Palomar Medical Center Escondido even pulled out a flu tent this month, but was still so busy that some patients were treated in the hallways, said Gunnett, a nurse who oversees their emergency services.

Now they’re running low on beds because many patients were admitted with severe flu. Gunnett said she has started canceling scheduled surgeries and turning single-patient rooms into doubles to free up space.

Wooten said that the record number of deaths could be because the County is now using electronic reporting systems that make it easier for reporting and for public health staff to identify flu-related deaths. The high number of cases being reported this year, Wooten added, reflects better testing and surveillance systems in the region, as well as a more severe influenza season than in recent years.

For the week ending Jan. 13, 2018, the County Health and Human Services Agency is reporting the following:

  • Emergency department visits for influenza-like illness: 7 percent of all visits (compared to 11 percent the previous week)
  • Lab-confirmed influenza cases for the week: 2,070 (compared to 3,046 the previous week)
  • Total influenza deaths to date: 142 (compared to 14 at this time last season)
  • Total lab-confirmed cases to date: 12,446 (compared to 1,788 last season)

It’s Not Too Late for a Flu Shot

The Centers for Disease Control and Prevention recommends that everyone 6 months and older get vaccinated. The vaccine is safe and effective. It takes two weeks for immunity to develop.

The CDC also recommends that people should prevent the spread of germs and take antivirals when prescribed by a doctor. Some local pharmacies may be out of specific medications, but there is no national shortage of antivirals. Sick people should call around if their local pharmacy is out and send a family member to pick up the medications to avoid exposing others to the virus.

Vaccination is especially important for people who are at high risk of developing serious complications from influenza. They include:

  • People with chronic medical conditions like asthma, diabetes and lung disease, even if symptoms are under control
  • Pregnant women
  • People 65 years and older
  • People who live with or care for others who are at higher risk

In addition to getting vaccinated, people should also do the following to avoid getting sick:

  • Wash hands thoroughly and often
  • Use hand sanitizers
  • Stay away from sick people
  • Avoid touching your eyes, nose, and mouth
  • Clean commonly touched surfaces
  • If you are sick, stay home and avoid contact with others

The flu vaccine is available at doctors’ offices and retail pharmacies. If you don’t have medical insurance, you can go to a County public health center to get vaccinated. For a list of locations, visit www.sdiz.org or call 2-1-1.

Flu may be spread by just breathing

Shot of a young businessman suffering with allergies at work/Palomar Health

In other flu news, Palomar Health said this week that in the midst of an especially tough flu season, researchers say it may be possible to spread the virus simply by breathing.

Until now, it was thought that people picked up a flu virus when they touched contaminated surfaces or inhaled droplets in the air ejected by an infected person’s coughs or sneezes.

But the new study finds coughs and sneezes may not be necessary to saturate the air with flu virus.

In the study, researchers analyzed air around the exhaled breath of 142 people with the flu.

“We found that flu cases contaminated the air around them with infectious virus just by breathing, without coughing or sneezing,” said study author Dr. Donald Milton, a professor of environmental health at the University of Maryland.

“People with flu generate infectious aerosols [tiny droplets that stay suspended in the air for a long time] even when they are not coughing, and especially during the first days of illness,” he explained in a university news release. “So when someone is coming down with influenza, they should go home and not remain in the workplace and infect others.”

In fact, nearly half (48 percent) of the airborne samples captured in the air around flu patients who were just breathing — not coughing or sneezing — contained detectable influenza virus, the researchers noted.

What’s more, when patients did sneeze, that didn’t seem to add much to the viral count in the samples, Milton’s group added.

Of course certain steps — “keeping surfaces clean, washing our hands all the time, and avoiding people who are coughing,” can still help lower your odds of catching influenza, said Sheryl Ehrman, dean of the College of Engineering at San Jose State University, in California.

But if an infected person’s breathing spreads flu virus, even those precautions do “not provide complete protection from getting the flu,” she added.

That means that if you are unlucky enough to get the flu, “staying home and out of public spaces could make a difference,” Ehrman said.

The researchers believe their findings could help improve mathematical models of the risk of airborne flu transmission and could also be used to develop better public health flu prevention measures.

For example, improvements could be made to ventilation systems in places such as offices, school classrooms and subway cars, to reduce the risk of flu transmission, the team said.

The United States is in the middle of a particularly nasty flu season, with nearly all states reporting high levels of severe flu, and hospitals swamped with cases. Experts blame the severity of this year’s flu season on a particularly virulent strain of flu and prolonged periods of very cold weather.

The study was published Jan. 18 in the Proceedings of the National Academy of Sciences.

More information

The U.S. Centers for Disease Control and Prevention has more about flu.

SOURCE: University of Maryland, news release, Jan. 18, 2018


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