Palo Alto Weekly

News - January 11, 2013

'Moderately severe' flu expected in Bay Area

New, more potent vaccine available for the elderly

by Sue Dremann

The influenza virus, which is hammering states in other parts of the country, is slowly moving into Northern California, officials said this week.

One potent strain, Influenza A (H3N2), is causing more people to become severely ill and more people to be hospitalized this season, local health officials and the U.S. Centers for Disease Control (CDC) said.

As of Dec. 29, the strain had not yet made it into Santa Clara County, county public health officials said, but hospitals and health agencies are watching, since the strain has been associated with at least 18 child deaths.

More severe illness is typical with H3N2 viruses, and officials are predicting a "moderately severe" flu season, according to the CDC. But one concern is that the season has started earlier than usual. The flu season typically begins in February, but it started in early January in many states this year, according to the CDC.

The percentage of people nationwide seeing a doctor for flu-like illness is more than double last season's peak of 2.2 percent. In the past four weeks, the percentage has jumped sharply from 2.8 to 5.6 percent, according to the CDC, which tracks the flu's progression nationwide.

Although 29 states have reported high levels of influenza-like illness, with another nine states reporting moderate levels, California has not yet seen many cases, according to Santa Clara County officials.

Dr. Cornelia Dekker, medical director of the Stanford-Lucile Packard Children's Hospital Vaccine Program, said so far only 15 confirmed cases of influenza have been reported by the Stanford lab, which tests suspected cases coming into Stanford's main hospital, clinics, emergency room and children's hospital.

"We're nowhere near what the other states are experiencing, but I'm sure our time is coming," she said.

Dr. Joe Bresee of the CDC's Influenza Division said in a statement that the number of hospitalizations is also high for this time of year.

"While we can't say for certain how severe this season will be, we can say that a lot of people are getting sick with influenza. ... Anyone who has not already been vaccinated should do so now," he said.

Dekker said that flu sets its own pace, and although it does tend to go from east to west, no one can really predict which states will be hardest hit.

"Strains also mutate over time, so we're always dealing with a new set of characters," she said.

This year's flu started with Influenza B infections, but now the predominant strain is the Influenza A (H3N2), she said. The old pandemic H1N1 strain from 2009 is going around this year, but is occurring relatively infrequently, she said.

Dekker said there is still time to get a flu shot. It takes about two weeks to build up antibodies for protection. Three strains of influenza are in the vaccine, which uses only dead viruses. "Fortunately, the vaccine choice was a good match for what we're seeing right now," she said.

Only about 50 percent of children and adults were immunized last year, she said. The more people who are vaccinated, the smaller the potential pool of infected people who can spread the germ, she said.

People who are concerned about vaccines containing preservative can obtain preservative-free flu shots, and now new micro-needles are available for people ages 18 to 64 who fear injections, she said.

Another new influenza vaccine that has four times as much antigen is available for seniors to give them added protection. The alternatives are available through many pharmacies and doctors, she said.

Staff Writer Sue Dremann can be emailed at sdremann@paweekly.com.

Comments

Posted by Paul Losch, a resident of Community Center
on Jan 10, 2013 at 7:16 pm

In addition to the flu described in the article there also is an intestinal virus going around, and it is nasty. I am getting over it, but I went to Stanford Hospital over the weekend and spent several hours there getting re-hydrated and tested to make sure it wasn't something else. It wasn't. The doctor who saw me told me that she had it herself a few weeks back, and they are seeing many people right now with it. The main indicator is diarrhea, which leads to de-hydration.


Posted by Not an issue, a resident of Community Center
on Jan 10, 2013 at 7:22 pm

Probably was norovirus, Paul. But not related to the flu virus. Could have been from fecal contaminated food/ drink.


Posted by Mom of 3, a resident of Palo Alto High School
on Jan 10, 2013 at 10:33 pm

Our entire family gets the flu shot every year. Getting sick is just a waste of time and if we can prevent becoming sick, it's completely worth it because the flu can last days - days of missing class or work. The flu shot is dead virus so people are not contagious after but the flumist is live virus so people are contagious for awhile. Palo Alto Medical Center had a flu shot clinic on Sunday, September 30 from 8AM-4PM that we went to this year. The last few years, the PAMF flu shot clinic (have to be a member of PAMF) has been easy as pie, facilitated so well that we were in and out in a jiffy. They have people directing where to go from the minute you get into the elevator.


Posted by Social Butterfly, a resident of Green Acres
on Jan 10, 2013 at 11:02 pm

What exactly are the symptoms of this horrendous flu that is spreading across the states???


Posted by Mom of 3, a resident of Palo Alto High School
on Jan 11, 2013 at 12:35 am

Here are the symptoms as described on the CDC website: Web Link

Apparently, if you fall ill to the flu and then seem like you are recovering and then fall very ill again, it could be a bacterial infection and antibiotics are needed immediately. Here's a heartbreaking story of a Texa 17-year old who died from what began as the flu: Web Link)


Posted by Anonymous, a resident of Community Center
on Jan 11, 2013 at 12:10 pm

Sometimes flu shots do not work, they are only 70% effective. But if you do get the flu, you will have a milder case.

Sometimes, the CDC predicts that the wrong viruses will be the dominant ones in the flu season, so the vaccine then has the wrong killed virus in it, and no one is protected from the dominant virus of the season. This happened a lot in the nineties. The CDc really has to make an educated guess about what killed viruses to put in the annual vaccine, and they do not always get it right.


Posted by Mom of 3, a resident of Palo Alto High School
on Jan 11, 2013 at 2:09 pm

Anonymous, the CDC predicted the correct viruses to place in the vaccine this year. I read it online but don't have time to find the link. To those who catch the flu even though they had the vaccine, it's possible to catch a different flu virus. Only 3 viruses are in the vaccine but again, they did choose the right ones this year.


Posted by medical question, a resident of Another Palo Alto neighborhood
on Jan 14, 2013 at 2:05 pm

This is a serious question. I appreciate the vaccine, but I worry about long-term protection. If you get a vaccination for a viral strain, does it confer the same long-term immunity as if you just got the illness and fought it off? I wonder sometimes if it might be better for our herd immunity if only the most vulnerable among us vaccinated against diseases that are not typically lethal to the most healthy, unless a strain shapes up to be a deadly one in the healthy like H1N1 (and then we need to vaccinate EVERYONE, fast). I guess the big question here for me is: Do our immune systems need a normal workout, basically, to work well over time, when the most healthy become vulnerable themselves?

I saw a documentary about the 1912 flu epidemic which was so deadly, and yet it did not strike the weakest, it hit the strongest hardest. The working theory seems to be that there was a milder illness the previous year that mostly struck only the young and elderly, and they were thus immune. But the healthiest, who didn't catch that weaker virus, weren't then immune to the 1912 flu. So, projecting to today, if we vaccinated for what turned out to be that weaker disease, and the more serious mutation went around 5,6, 10 years later, would the vaccine confer the same long-term immunity as would be the case for those who caught and fought off the disease?

I'm not suggesting people not vaccinate, but I'd like more information about these issues. There's so much money to be made in vaccinations, it's always a concern that it colors the direction of the public health efforts.


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