“We’re all worried it’s going to be a very serious flu season,” says William Schaffner, MD, an infectious-disease specialist and a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee. The Centers for Disease Control and Prevention (CDC) reports that all regions of the country are seeing elevated levels of flu-like illness, with the highest levels of activity in Alabama, Arkansas, Georgia, Mississippi, Nebraska, New Mexico, South Carolina, Tennessee, Texas, Virginia, Washington, and Puerto Rico. “At this early point in time, the incidence of influenza is almost double what is normally seen at this time of the year, suggesting an early start to the season,” says Michael Mina, MD, an assistant professor of epidemiology at Harvard T.H. Chan School of Public Health in Boston. Typically, the rate of influenza-like illness due to flu at this time of year is around 1.5 percent to 2 percent, according to Dr. Mina. This year it’s at 3.5 percent. So far this season, the CDC has counted at least 2.6 million flu illnesses, 23,000 hospitalizations, and 1,300 deaths from flu, according to the CDC, and those numbers are expected to climb in the weeks to come. “This is a season when there is a tremendous amount of family gatherings, office parties, and holiday celebrations,” says Dr. Schaffner. “People coming together closely for extended periods of time is ideal for flu transmission.”
An Unusual Type of Flu
Not only has the flu season kicked off early, but the predominant strain circulating throughout the country — influenza B/Victoria — has come as a surprise. Typically, influenza A strains (H1N1 and H3N2) lead the charge, while B strains usually don’t appear until early spring. “Nobody has seen a season start with a B strain like this,” says Dr. Schaffner. “No one knows why — flu is fickle.”
Children May Be More Susceptible
Because B strains tend to be more active among children, parents may want to be extra mindful of their kids’ health this year. The CDC reports that influenza B/Victoria viruses frequently target children 4 years old and younger (48 percent of reported viruses) and between ages 5 and 24 years (56 percent of reported viruses). “In the past, the thinking was that B viruses cause less severe illness and symptoms than A viruses, but this has been disproved based on more recent studies,” says Robert Glatter, MD, a physician in the department of emergency medicine at Lenox Hill Hospital in New York City. Dr. Glatter points to a study published in July 2014 in the journal Clinical Infectious Diseases that found similar rates of illness and mortality in adults with either A or B strains and a study from September 2016 published in the journal Pediatrics that found B strains led to more severe illness in teens compared with A strains.
The Flu Doesn’t Discriminate
Although the flu may affect children more than adults, no one is safe when the virus comes to town. “The flu is not like a cold. It’s very severe,” says Yvonne Maldonado, MD, the chief of the infectious-diseases division at Lucile Packard Children’s Hospital Stanford and Stanford Children’s Health in California. “You feel like you’ve been hit by a truck. You are completely worn out, you can’t get up for days, and your fever is really high.” The virus can lead to serious complications, such as pneumonia, bronchitis, and sinus or ear infections. In addition to children, groups who are particularly vulnerable to the illness include adults older than 65, pregnant women, and people with certain chronic conditions (such as diabetes, asthma, and COPD).
The Vaccine Provides the Best Protection
Although the influenza vaccine is not perfect, CDC research shows that it can reduce the risk of flu illness by between 40 and 60 percent. From what Dr. Maldonado knows about this year’s vaccine, she expects it to be effective against the dominant B strain. “People who get the vaccine typically don’t get the flu, and for those who do, the symptoms are less severe,” she says. “The vaccine is like insurance to make sure you don’t get infected and you don’t infect others. There’s really no downside to getting vaccinated.” Federal health officials at the CDC advise all individuals older than 6 months to get a flu vaccine every season. (Every year the flu virus mutates, so every year you need a new inoculation.) “Parents should have their kids get the influenza vaccine and show their kids how to wash their hands,” says Sherif Mossad, MD, an infectious-disease specialist at the Cleveland Clinic. Viruses that cause colds and the flu are often transmitted on the hands. Dr. Mossad adds that some people wrongly believe they may get the flu from the vaccine. “You cannot get the flu from the flu shot, because the virus is dead or ‘inactivated,’” he says. Even though the flu appears to be spreading quickly, Schaffner emphasizes that it is not too late to get the flu vaccine, and the flu season (which can extend into the spring) is far from over. “Flu is out there everywhere in the country right now. So if you haven’t been vaccinated, run, don’t walk, to your doctor’s office or pharmacy and get your protection,” he says.
