Each flu season seems to have some kind of surprise in store for parents and pediatricians.
Last year, the big surprise was that there wasn't any shortage of flu shots. And of course, there was the emergence of swine flu last spring.
The big surprises this year are that we already have widespread flu activity, which is due to the large number of 2009 H1N1 swine flu cases, and that many offices and clinics are already running out of seasonal flu shots.
This Year's Flu Shot
The big question each year is often whether or not the flu shot is going to work. Remember that three strains of the flu are typically chosen each year in advance and are included in that year's flu vaccine. If they don't match the flu strains that are going around that year, the flu shot may be less effective at preventing people from getting sick with the flu.
Last year, it seemed like the seasonal influenza A (H1N1), influenza A (H3N2), and one strain of influenza B was a good match for this year's flu vaccine. Another strain of influenza B that has been going around wasn't in the flu vaccine. We don't know if the seasonal flu vaccine will be a good match for the seasonal flu strains that will go around this year yet, but we do know that it won't cover the H1N1 swine flu strain. So this year, in addition to the seasonal flu vaccine which all children and teens should now get, they should also get the swine flu vaccine as it becomes available.
Getting a seasonal flu shot may be difficult right now, as delivery of any more vaccine has been delayed, so as doctors run out of their initial shipment of flu shots, they may not have any more for a few weeks.
Flu Season
Flu season activity is usually just getting started, but swine flu cases have kept flu season going throughout the spring and summer and with kids going back to school, flu activity has continued to be widespread in most of the U.S. Seasonal flu likely won't start until later this month though.
Whether you are concerned about seasonal flu or swine flu, parents should take some steps to help avoid the flu to keep you and your family from getting sick with the flu. This can include frequently washing your hands, avoiding close contact with people who are sick with the flu, and disinfecting contaminated surfaces, including toys and kitchen counter-tops. A flu medication, such as Tamiflu and Relenza (zanamivir) can also work as a preventative if you take them after being exposed to someone with the flu.
Although reports showing that some strains of the seasonal flu virus had become resistant to Tamiflu last season might be concerning, we will have to see if that continues this flu season. It could mean that if you get the flu, then you might have to stick it out, suffer through the symptoms, and wait for them to go away.
Fortunately, the same report didn't show resistance to Relenza or the older flu medications, amantadine and Flumadine (rimantadine). This year, Tamiflu or Relenza are the treatments of choice for flu infections.
And the swine flu H1N1 A virus is still sensitive to Tamiflu and Relenza, although the use of flu medications is now being limited to high risk children.
Flu Activity Reports
As of early-November, the CDC reports that flu activity 'decreased slightly' in the U.S.
Forty-three states, Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin, are still reporting widespread flu activity.
Seven states, Hawaii, Mississippi, Nebraska, North Dakota, South Carolina, Texas, and Wyoming, and Puerto Rico are now reporting regional flu activity.
The District of Columbia is reporting local flu activity.
The U.S. Virgin Islands and Guam are reporting sporadic flu activity.
No states are reporting no flu activity.
Remember that when it comes to flu activity reports, widespread > regional > local > sporadic > no activity.
And since August 30, the CDC is also reporting 26,315 hospitalizations and 1,049 deaths associated with influenza virus infections.
Google's Flu Trends, which relates flu searches in an area to how many people are actually sick with the flu, is still reporting a high level of flu activity in the United States. That is just under the highest level, intense, on their scale of minimal < low < moderate < high < intense. Remember that Google Flu Trends is supposed to 'estimate flu activity faster than traditional systems,' like the CDC and based on their scale, flu activity has been increasing the past few months.
Knowing where there is flu activity can be helpful, because if you have classic flu symptoms in an area where there are a lot of flu infections, especially widespread or intense flu infections, then you likely have the flu and should see your doctor right away to see if you are a candidate for one of the flu medications, such as Tamiflu or Relenza.
Flu Deaths
Each year, the flu is reported to be responsible for almost 36,000 deaths, including about 46 to 74 deaths in children. Last year (2008-09 flu season), 97 deaths in children were reported to the National Notifiable Diseases Surveillance System. Unfortunately, this is not unusual in a typical flu season.
There have been 171 influenza-associated pediatric deaths from swine flu since April 26, 2009, including 113 since August 30.
Sources:
Prevention & Control of Influenza - Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR July 17, 2008 / 57(Early Release), 1-60.
Update: Influenza Activity --- United States and Worldwide, 2007--08 Season. MMWR Morb Mortal Wkly Rep. 2008 June 27;57(25):692-700
CDC. Key Facts About Seasonal Flu Vaccine
US Flu Activity Reports.
CDC. Questions & Answers about the 2008-2009 Flu Season
