January 16, 2013

Early Flu Season Has Hospitals Gearing Up

Flu season has arrived early this year but it’s not too late to get vaccinated. That’s the advice of Dr. David Herman, Chief of the Section of Infectious Diseases at the University Medical Center at Princeton.

“Nationally there has been a marked increase this year in the number of cases and it has started earlier than usual,” said Mr. Herman in a phone interview, Monday.

Noting the city emergency in Boston and the high levels of flu cases being reported in New York City, Mr. Herman said: “Hospitals in our area are gearing up for it. The number of cases is increasing every week and the best thing to do is to get vaccinated. While it would have been better to have done so earlier than now, it’s not too late,” he added.

One hundred and twenty people received flu shots during the first two hours of a free clinic held on Witherspoon Street this past Sunday. The shots were given out by registered nurses courtesy of Princeton HealthCare System (PHCS) at the Neighborhood Information Center, 281 Witherspoon Street. Nurses commented that even though this amounted to a rate of one influenza shot per minute, they had expected an even greater turn out because most local pharmacies had run out of vaccine.

Prompted by the lack of vaccine in his local pharmacy, one Plainsboro resident had urged his wife to come along. He had received a shot through his place of work and warned his wife that she might suffer a mild headache but that was nothing compared to the flu. Side effects of the vaccine, which takes two weeks to take full effect so that exposure during that period can result in flu in spite of vaccination, can include a sore shoulder, a few aches, a low grade fever. It’s a misconception that the vaccination can give you the flu because the vaccine is not live.

“Stay away from crowds,” said Mary Hays RN as she administered a shot to this reporter.

Commonly called “flu,” influenza is a contagious viral infection affecting the respiratory system. Symptoms can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea.

Flu season can last from November to April, with most cases occurring in February, so there’s a good chance of exposure. Princeton’s schools have taken the precautionary measure of informing parents of the signs to watch for.

According to the Centers for Disease Control and Prevention (CDC), the current vaccine is approximately 62 percent effective. In a report released last Friday, January 11, “Early Estimates of Seasonal Influenza Vaccine Effectiveness,” the CDC described the vaccine as “moderately effective.”

Since the flu season of 2004–05, the CDC has been giving out annual estimates of the effectiveness of seasonal influenza vaccine. Data from 1,155 children and adults with acute respiratory illness between December 3, 2012 and January 2, 2013, at five study sites with outpatient medical facilities was used to make the determination.

The CDC report notes that 24 states and New York City were reporting high levels of influenza-like illness, 16 states were reporting moderate levels, five states were reporting low levels, and one state was reporting minimal levels.

The CDC recommends annual vaccination for all persons over 6 months of age. Since influenza activity is likely to continue for several more weeks, it recommends that vaccination efforts should continue.

“The vaccine protects you against most of the strains now circulating,” said Mr. Herman “The pharmaceutical companies seem to have done a good job of matching the vaccine to what is out there, but we won’t know for sure until later in the year. Sometime they guess well, sometimes not, but this year it seems to be good,” he said.

As of January 4, more than 128 million doses of influenza vaccine had been distributed in the United States for the current 2012–13 flu season, from approximately 135 million doses that were anticipated to be available for the U.S. market. At this point some vaccine providers might have exhausted their supplies so if you are looking for a flu shot you many need to call more than one provider (pharmacy, health department, or doctor).

Because the vaccine is not 100 percent effective, some of those vaccinated will become infected with influenza. If you do get the flu, antiviral medications can reduce the duration of the illness as well as complications associated with it. Early antiviral treatment is recommended for individuals with severe or progressive illness (e.g., people in hospital) and those at high risk for complications from influenza. Antiviral treatment should be started as early as possible, preferably within 48 hours after illness onset.

According to CDC reports, this flu season is shaping up to be one of the more difficult the nation has seen in several years. The last week of 2012, saw more than twice the reported number of emergency room visits attributable to influenza as there were during the same week in 2011. In New Jersey, the deaths of two children have been reported: a 14-year-old boy in Ocean County in November, and an 8-month-old boy in Camden County in December. According to Mary O’Dowd, the state’s health commissioner, both boys had underlying medical conditions.

About 24,000 Americans die each flu season, according to the CDC. This winter has been worse because of a new strain of influenza to which few people have built up immunity.

While there’s no reason to panic, there is reason to take precautions such as washing your hands often and staying away from close contact with sick people, said Mr. Herman. And if you get it, you should stay at home. The virus can be spread from a distance of six feet and a day before symptoms become apparent.

Superintendent of Schools Judy Wilson noted that so far Princeton schools had been spared. “We have certainly had students and employees ill but have not had a huge wave of absenteeism as yet and our school nurses have provided parents with additional information on prevention and care,” she said.

Nurse coordinator Holly Javick noted that an information sheet had been distributed to parents warning them that the flu is highly contagious and though it’s often confused with the common cold, its symptoms are usually more severe than the typical sneezing and stuffiness of a cold. The information sheet suggests reducing the spread of the virus by keeping students with influenza-like symptoms at home for at least 24 hours after they no longer have a fever (100 degrees Fahrenheit or 37.8 degrees Celsius, measured by mouth) or signs of a fever (chills, feeling very warm, flushed appearance, or sweating) without the use of fever-reducing medicine.

More information for Princeton parents is provided on the website at: www.cdc.gov/flu/pdf/freeresources/updated/a_flu_guide_for_parents.pdf.