Both states saw sharp increase in flu activity as of end of last week
BUCKS COUNTY, Pa. — A wave of influenza activity has swept up from the South in recent weeks, and doctors are warning that it’s about to hit hard in the Delaware Valley.
So far this season, Dr. Al Sacchetti has seen only a handful of flu patients come into the emergency department at Our Lady of Lourdes Medical Center, where he is chief of emergency medicine. But over the course of this week, there have been more and more.
“With the flu, the emergency department [is] kind of the canary in the coal mine. We’re usually going to pick it up before anyone else starts to see it,” he said. “In my estimate, the floodgates have opened.”
States like Louisiana have been seeing it since the official start of the season in October, but now 46 states, including Pennsylvania and New Jersey, are reporting widespread flu activity — the highest level used to describe the geographic spread of the illness.
Both Pennsylvania and New Jersey saw a sharp increase in flu activity as of the end of last week, the most recent data from the state health departments show. Bucks County had 349 laboratory-confirmed cases of the flu, Montgomery County had 374 and Burlington County had 94.
But the departments note that those are only a fraction of actual cases since most people don’t go to the doctor or get tested, and both states also saw a sharp increase in cases of influenza-like illness, which is a clinical diagnosis based on symptoms such as fever, cough and/or sore throat.
In its most recent flu report, the U.S. Centers for Disease Control and Prevention said activity indicators are “similar to what was seen at the peak of the 2014-2015 season, which was the most severe season in recent years.” However, severity indicators like hospitalizations usually lag behind activity, according to the federal agency.
Hospitalizations increase for all kinds of reasons during flu season, particularly among people who have other illnesses and complications or among older adults and young children who are more vulnerable to severe cases, said Dr. John Russell, director of Abington-Jefferson Health’s Family Medicine Residency Program.
The flu can be fatal. So far this season, there have been 18 flu-associated deaths in Pennsylvania, with 12 occurring during the week that ended Dec. 30. Pennsylvania and New Jersey each have reported one pediatric death.
There are about 30,000 flu-associated deaths in the United States in a typical season, Russell noted, but the numbers were much higher before there were antiviral medications and a flu vaccine — particularly during the 1918-19 flu pandemic, which killed more than 500,000 in the United States and approximately 50 million people worldwide. The 2018-19 season will mark 100 years since the pandemic.
Dr. Paul Spiro of Buckingham Family Medicine and the medical director for Doylestown Healthcare Partnership said this season is far from over and people still should get a flu vaccine even though it’s not believed to be as effective this year.
Estimates for the most recent season in Australia showed the vaccine was only about 10 percent effective against the H3N2 strain. The CDC has not yet released estimates for this season, but based on last year, it expects the vaccine to be about 30 to 40 percent effective. The agency has said it is conducting multiple studies this season on the effectiveness of flu shots.
Vaccines are developed at the beginning of the year, so it’s difficult to predict exactly what strains will be circulating at the end, Spiro explained.
“This time it looks on paper like a good match but … you don’t really know until you start getting people vaccinated,” he said.
Most of the flu cases Spiro, Sacchetti and Russell have seen were in patients who didn’t get the vaccine. But even if people get flu, they still might get some benefit from the vaccine, Sacchetti added.
“If [the CDC] take their best guess and miss, there sometimes is still some resistance so that you get a milder case of it,” he said.
Spiro recommends such patients take acetaminophen like Tylenol for fevers and expectorants like Mucinex to help with congestion, in addition to drinking plenty of fluids. But patients with severe cases should seek medical attention and may need antivirals and other treatments, he said.
Russell said patients should rest and avoid spreading the flu to others. He added that everyone should remember to wash their hands.
Sacchetti agreed. It sounds old-fashioned, he said, but homemade chicken soup does help combat the “big inflammatory response” caused by the flu.
“So your grandmother was right,” he said.
Jenny Wagner is a reporter for the Bucks County (Pa.) Courier Times.