Flu WideSpread Over Nearly Half of U.S.

24 States Report Widespread Flu, Deaths Mount

From the WebMD Archives

Dec. 11, 2003 -- This year's nasty flu bug is now widespread in 24 states, the CDC's latest figures show. That's up from 13 states just one week ago.

Deaths are mounting. In the week ending Dec. 6, an estimated 7% of all U.S. deaths were caused by pneumonia and influenza. That's still below CDC's "epidemic threshold" of 7.6% for that week.

CDC uses the term epidemic when an illness causes far more deaths than would normally be expected for that time of year. Last year's flu season never passed the epidemic threshold; but it happened for nine weeks in the 2001-2002 season and for 10 weeks during the 2000-2001 season.

It may not yet be a national epidemic, but some areas are particularly hard hit. One is Pittsburgh, says Lawrence D. Ellis, MD, director of the University of Pittsburgh Medical Center.

"Our children's hospital is overwhelmed. It's seeing more cases this year than in the last several years combined," Ellis tells WebMD. "We are seeing a lot more adult cases too."

Ellis, who's been treating flu patients for 39 years, notes that the U.S. has between 20,000 and 40,000 flu deaths every year.

"If this maps out the way people think it will, we will see a lot more than that," he says.

Fujian Flu

This year's flu vaccine offers at least some protection against all of the flu strains causing illness this year. However, there may be somewhat less protection against one of the most predominant strains -- called Fujian variant. It's impossible to tell how much less protection until after the flu season is over.

The flu vaccine also protects against others flu strains that the CDC warns may emerge later this year.

A Little More Vaccine On the Way

It's not too late to get vaccinated. People at risk should get the vaccine -- and yes, vaccine supplies may still exist in your area.

Meanwhile, U.S. Health and Human Services Secretary Tommy Thompson announced today that the government will buy the last remaining 100,000 doses of the adult vaccine from Aventis Pharmaceuticals. It's also buying the last 150,000 doses of pediatric vaccine from that manufacturer, although shipment of the pediatric dosage won't happen until January. Thompson and the FDA also are looking into buying -- and licensing -- some 500,000 doses of a Chiron Corp. flu vaccine approved in Europe but not the U.S.

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States will get allotments of the vaccine according to population. State health departments will then distribute the vaccine according to need. Those deemed to most need the vaccine are people at risk of severe flu complications.

At-risk people include:

If a member of your household is in one of these groups -- or if you're a health-care worker who cares for such people -- you should get vaccinated to help insulate them from the flu.

What about kids age 2 and older?

"Overall, kids have a very low risk of developing severe complications from flu," CDC director Julie Gerberding, MD, MPH, today said in a news conference. "That doesn't mean it will never happen. Sometimes it does, and parents, of course, find that alarming. Fortunately, FluMist [nasal spray] vaccine is available for that group. Parents who are really concerned should contact their doctor and see if FluMist would be helpful for them." FluMist is not recommended in children under 5 because of the increased risk of asthma and wheezing seen in clinical trials.

Those seeking FluMist nasal spray vaccine should act quickly. As of last week, there were nearly 4 million doses available. The CDC encourages healthy people age 5 to 49 years to get this vaccine.

For those who can't get the vaccine, flu drugs can prevent illness if taken soon after exposure. These drugs can also cut flu severity and shorten illness if taken soon after flu symptoms appear. Available flu drugs include Tamiflu and Relenza.

"We wish we had more vaccine, but still there are many steps we can take," Gerberding says. "For healthy people, for the vast majority of us, flu is an annoying illness, it is not fun, but it is not something we won't get over. The treatment is rest, fluids, and the medicines we normally use to treat symptoms. Just remember not to use aspirin in kids." Aspirin in kids can lead to Reye's syndrome, a very rare but serious disease that can cause brain and liver damage in children and teens.

How do you know it's the flu? You can't, until you get a flu test -- and some hospitals are running out of the rapid tests. But if you feel so bad you really have a hard time moving, it's likely the flu. And while colds often start with a sore throat, the flu often begins with the sudden appearance of fever and a dry cough.

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Unusual Deaths

Most flu deaths come from pneumonia, caused either by the flu bug itself or by bacterial infections such as staph and strep. And this year, a drug-resistant staph bug -- CA-MRSA -- is out there.

The CDC reports three deaths from flu patients with CA-MRSA pneumonia, ranging in age from 20 months to 16 years old. It's not yet clear whether these kids had been vaccinated.

Also unusual is one reported death from a flu-related brain condition called encephalpathy. These symptoms are considered highly unusual in the U.S., Joseph R. Dalovisio, MD, tells WebMD. Dalovisio is president of the Infectious Disease Society of American and chief of infectious diseases at New Orleans' Ochsner Clinic.

However, hundreds of such cases -- many but not all fatal -- have, since the mid-1990s, been reported in Japanese children with the flu. The illness usually starts with fever and rapid onset of mental symptoms.

Similar findings are occurring in the U.S., the CDC reports in the Dec. 12 issue of Morbidity and Mortality Weekly Reports.

"Cases have been reported among young children and school-aged children," the MMWR notes. "Patients might report high fevers, seizures, headaches, abnormal mental status, and/or confusion, and do not always exhibit classic influenza symptoms."

Good Flu Manners

Got the flu? After you see your doctor, stay home! If you have a cough and feel bad -- or any fever with respiratory symptoms -- don't spread it around. You'll get better faster, and your friends and co-workers will thank you.

"The most important advice -- and I know we all want to be heroic workers -- is that you really should stay home to protect others from your respiratory secretions," Gerberding says. "All of us should practice good respiratory etiquette. This means to cover the mouth and nose when we sneeze, and to wash our hands before contact with others."

If you haven't got the flu yet, avoid being in enclosed spaces -- such as elevators -- with people who sneeze or cough. Wash your hands often, and consider getting flu drugs if you have an unavoidable close contact with a flu patient.

WebMD Health News

Sources

SOURCES: Morbidity and Mortality Weekly Reports, CDC, Dec. 12, 2003; vol 52: pp 1197-1202 and 1210. Lawrence D. Ellis, MD, director and professor, University of Pittsburgh Medical Center. Joseph R. Dalovisio, MD, president, Infectious Disease Society of America; chief, infectious diseases, Ochsner Clinic, New Orleans. Steven Johnson, MD, professor, infectious diseases, University of Colorado Health Science Center; director, infectious disease clinic, University Hospital, Denver. CDC news conference, Dec. 11, 2003.
© 2003 WebMD, Inc. All rights reserved.

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