If it seems like most of your plans have been canceled this winter because someone has the flu, you are not alone. Flu cases earlier this month were double over the number of reported cases last year.
David Cennimo, an infectious disease expert at Rutgers New Jersey Medical School, explains what is driving the worse-than-usual flu season and what you can still do to protect yourself this winter.
Is there any relief in sight from this staggering flu season? Have we seen the peak yet and, if not, when do you expect it?
It is difficult to know if we have peaked, but there are some hopeful signs. Influenza cases in New Jersey and nationally have decreased in the first week of January based on latest reports.
If this downward trend holds, we may be over this peak. We may have other reasons for optimism as our colleagues in Europe are reporting a downturn in cases as well. They experienced the flu season a bit earlier than us, so their drop in cases is more pronounced and may signal the near future trajectory of U.S. cases.
If things are looking up, is there still cause for concern?
In past years, there have been secondary surges of cases caused by a different seasonal influenza. So, when looking at the totality of an influenza season, even as we get over this peak, there could be many more cases ahead.
It seems like every year we hear the flu is worse than last year, but this year the numbers seem particularly dramatic. Why is the flu worse this year-why are we having such a miserable winter?
This year, we have been particularly unlucky. The flu season started early around the world (compared to recent years) which impacted the holiday planning. This is not unprecedented; the flu season has always exhibited some variability and is why we begin vaccination in September. The subclade K virus, which is behind the rise in cases we are seeing this year, emerged after the vaccines were made so the match is not perfect.
However, initial estimates of the current vaccine effectiveness at preventing an illness severe enough to warrant medical attention are around 35% in adults and 73% in children. So, this is not the best and certainly not the worst matched vaccine we have experienced.
Why is it so hard to predict what strain we will be facing each year to develop effective vaccines?
The virus circulates around the world and continually changes. We have some inclinations about what may happen when we watch the flu season in the Southern Hemisphere. But, as we are seeing this year, sometimes newer viruses may emerge. Most of the vaccines are still made with egg-based processes that take months to manufacture. For this reason, they are not able to adjust "on the fly".
The influenza virus continually mutates, demonstrating a process called antigenic drift. In this way, it is constantly adjusting in small ways which may or may not help it survive. Each year's vaccine is an attempt to keep up with these changes.
What trends are you seeing in vaccination rates?
More concerning are the vaccination rates below 50%. People are not availing themselves of the protection the vaccine could afford.
While it is possible to be infected after vaccination, the data strongly points toward protection. Simply stated, vaccinated people tend to be less sick, require less intensive case, and recover faster.
Is it too late to get a flu vaccine if you haven't already?
It is definitely still worth getting a vaccine. If H1N1 comes around, you can get infected with that one or even a second infection. The season can "extend" by switching infections and why vaccine remains important
What should you do if you suspect you have the flu?
If you suspect the flu, try to isolate or at least wear a mask, stay home, and avoid infecting others. Many people will recover with rest, staying hydrated, and general symptomatic care. Patients with risks for severe influenza -- older age, medial comorbidities, heart or lung disease, immunocompromise -- should be evaluated to determine if they have the flu and can take an anti-viral treatment such as Tamiflu, which can speed recovery. For this reason, they should get a medical evaluation ASAP.
Aside from getting vaccinated, what can you do to protect yourself from the flu? What should you do if a member of your household tests positive or if many of your children's classmates are sick?
Remember, the COVID-19 countermeasures effectively stopped flu transmission for a year. Stay home if you are sick, wear a mask. If you are caring for someone with flu or are trying to avoid exposures, wear a mask and wash your hands frequently. Some very high-risk individuals may be offered antiviral mediation as prophylaxis If they are exposed to flu. These could prevent an infection if taken early. This is a strategy often employed in nursing homes.
