January 03, 2019
Flu season appears to be picking up – both locally and nationally.
Health officials in Pennsylvania and New Jersey both have declared influenza widespread for the first time this flu season, according to their latest weekly virus surveillance reports, which detailed confirmed flu cases through December 29.
That mirrors national trends tracked by the U.S. Centers for Disease Control and Prevention, which listed 11 states reporting widespread flu activity through December 22, up from six states just one week earlier.
Pennsylvania and New Jersey will be among the states added to that list when the CDC releases its next update.
Those designations indicate that the geographic spread of virus has broadened across the states; flu activity levels may differ in various regions within them.
In Pennsylvania, flu activity remains highest in the Northeast and Southeast regions, according to the latest state report. Through December 29, there have been 6,435 laboratory-confirmed flu cases, including 197 in Philadelphia. Eight deaths – all adults – have been reported, including four in the last week.
In New Jersey, flu activity is considered high in all regions, with 1,668 confirmed cases through December 29. There have not been any pediatric deaths. New Jersey does not include adult death totals in its weekly reports.
Last year, some 80,000 Americans died of influenza and its complications, according to the CDC. That was the most since 1976. Much of that severity was attributed to the flu vaccine being a poor match to active strains.
It remains to be seen how severe this flu season will be or when it will peak. Flu seasons tend to vary widely from year to year.
"It's unpredictable," said Dr. Thomas Fekete, an infectious disease expert at Temple University Health. "Four to six weeks is the typical duration of the main bump of the flu."
Influenza A viruses, which include H1N1 and H3N2, have accounted for nearly 95 percent of all flu viruses since flu season began in October, according to the CDC.
In recent years, Influenza A strains have hit early in the season, accounting for the main bump, Fekete said. Then an Influenza B strain has followed later in the season, usually in late winter or early spring.
"There's no reason it has to be that way," he said. "That's just the way our experience has been lately."
Operationally, Fekete said there is little difference between Influenza A and B viruses. Patients will not recognize a difference.
"Influenza A and B used to have different treatments, but now the treatments are really effective for both so we don't worry about that," Fekete said. "(Influenza) A tends to be a little more severe, but that's not always the case."
The H1N1 strain – responsible for 82 percent of Influenza A cases – is the same virus that caused the 1918 flu pandemic, which killed more than 50 million people worldwide, including 670,000 Americans. But there is little reason to believe the current H1N1 variation would spark an epidemic, Fekete said.
Flu strains mutate from year to year, enabling them to infect populations that have built up immunity through past exposure. H1N1 has appeared in various forms since that historic pandemic, but today's virus is not the same.
"Often times, they tend to mellow out over time," Fekete said. "That will go on for a long time. Then a new one pops up. These things come and they go."
The best way to protect against the flu is to get vaccinated each year. At the very least, it should limit the severity of the virus, he said. People who are particularly vulnerable, including people who are immunosuppressed, may consider limiting their public exposure.
People who develop flu-like symptoms should see a doctor as soon as possible, Fekete said. The earlier treatment can began, the more effective it is.
"If you wait a couple of days, you really have lost that window altogether," he said.
Additionally, a new flu treatment, baloxavir, is available this year. Sold under the brand name Xofluza, the treatment is given in a single dose.
"That's another new thing you may hear from your doctor," Fekete said. "It's a little bit simpler. Instead of twice a day for a number of days, this is something you can take just once."