In recent days, national news has reported with urgency the rapid spread of influenza in most states, but not yet California. Inyo-Mono Health Officer Dr. Rick Johnson said it’s just a matter of time for us. He said it’s like a Tsunami wave heading for California. Sierra Wave Media talked to Dr. Johnson the week of January 14th:
BK: Are you gearing up for a serious bout of flu?
Dr. J: Yes, we are. California, Hawaii and Mississippi are currently the states that have not been seriously impacted. We know it’s coming. It’s like a tsunami that’s heading our way. It’s like earthquakes – you don’t know when, where and you don’t know how bad. This year it is bad in the rest of the country and will be bad here in a couple of weeks. We are paying attention to that, watching our surveillance in the local communities. We’re looking at the schools, the clinics, the pharmacies, the hospitals to see how many people and how sick people are in our communities. So, it’s here but not in a serious way yet.
BK: Is it too late to get a flu shot?
Dr. J: No, it’s not too late to get a flu shot. Once you get the flu shot, it takes a couple of weeks to take effect. Now is definitely the time to get it. The caveat is this – back in October we had plenty of flu vaccine. Now, we have vaccine but the supply and demand are about equal. So, it’s day to day. You need to check with your health care provider, your pharmacy or with the health department to see if we have it on any given day. Some places actually do have waiting lists. It’s not too late. The flu shot is still the best thing to do. National statistics say it is 60 some percent effective. There is nothing else that is 60 plus percent effective. It is a safe shot. People are concerned about side effects from the shot. One of the myths is that you can get the flu from the shot. You can not get the flu from a killed vaccine. This vaccine – same technology – has been around since the 1940s. It’s been tried over decades. There really is no serious risk of side effects from the vaccine in spite of what you might read on the blogs on the internet.
BK: So, there is no proven danger but is a proven positive effect?
Dr. J: Exactly. It’s not 100%. One of the issues now is lots of people are sick in our community with other coughs and respiratory illnesses, GI illnesses. The generic term is – I had the flu. But, you did not have influenza. If you truly have influenza, you know it. You don’t want to get out of bed, or you can’t get out of bed. You have high fever, body aches. Primarily respiratory symptoms. A small percentage have GI symptoms. But you’ll know it if you get it.
BK: What should someone do if they do have those symptoms?
Dr. J: Number one – what we all try to do is still go to work or school because we don’t have child care, or we’ve used up our sick days, or our employer doesn’t pay for sick days. So, we take two advil or tylenol and we go to work, right? We expose all of our co-workers. I’ve seen interviews of twenty to thirty percent absentee rates back East in places like New York and Indiana and Boston where they actually have declared public health emergencies in response to this. People also say, well, you know, I’m young and healthy. I don’t have to worry if I get exposed. I read a story last week of a seventeen-year-old, previously well, sick for 48 hours an died from the flu. So, it’s not just the very young or the very old that we often times think of at high risk. Virtually anybody can get the flu. So, remember when we used to expose each other to the chicken pox? Somebody in the neighborhood would get sick and you would take all the kids over to get chicken pox? Well, you don’t do that with the flu. Sure, chances are you will do well, although you will feel bad for a few days. But, you don’t want to do that because you don’t know which person is going to have problems with it. Stay home if you get it, and you’re contagious probably for three to five days after you get sick. The issue is you are also contagious for at least one day before you realize you’re sick. That’s why it spreads so rapidly in our community.
BK: So, other than staying at home, what kinds of things can we do to avoid the flu?
Dr. J: Well, I’m sure your mother told you this many, many times. Get plenty of rest, drink plenty of fluids, eat well. Alcohol does not kill the flu virus. You need to remember that the flu virus stays alive on a dry surface for about eight hours. So, think about that – whenever you touch a grocery cart, a door handle, a microwave, a telephone that’s shared, a computer keyboard, whatever it might be. Someone else could have shed some virus onto that surface without really realizing it and potentially have given it to you because you also, even though you might not think about, still are going to touch your face. You don’t get the flu from just having the virus on your hands. Those hands have to touch a mucous membrane – your mouth, your nose, your eyes – to inoculate yourself, and within a couple of days you could get the flu.
BK: So, keep your hands away from your face?
Dr. J: Exactly. Also, washing the hands is very important because you’ve touched surfaces – it’s not just after using the bathroom or before fixing food – it’s really any time you have touched common surfaces that other people potentially have touched. The alcohol-based, water-free sanitizers are fine, but it’s not just a two second scrub. It’s really fifteen or thirty seconds which would be worthwhile because the abrasiveness of that also is really very helpful in reducing the virus that you actually have on your hands.
BK: It probably would pay to do that several times a day.
Dr. J: Yes. And, some people get so compulsive that their hands are cracked and chaffed in our nice, cold, dry weather, but still it is important to remember that and something that allows you to do that – at home, at your work site or in the classroom wherever you might be.
BK: Are the antiseptic wipes helpful?
Dr. J: Yes, they are very helpful. There are some types of bacteria for which they don’t work, but for the flu they work very well.
BK: Let’s say you get the flu. What can your doctor do for you?
Dr. J: Your doctor will probably recite the same litany that I just gave you. The question always comes up – are there medications – antibiotics, Tamiflu, things like that. The flu is a virus. Antibiotics really do nothing to treat viruses unless you get a complication. So, if you’ve been sick for three to five days and now, you’re getting worse, and your doctor says you have pneumonia and he’s giving you an antibiotic, that’s very appropriate because pneumonia is the most common bacterial complication from the flu. Tamiflu is an anti-viral medication that is available. And, your doctor can prescribe that for you. It is best if it is given within 48 hours of getting sick. So, you need to be talking to your physician. Especially if you are in a high-risk situation. If you have chronic heart and lung disease, if you have diabetes, if you’re pregnant – all of those put you at a higher risk and you should consider talking to your doctor early if you think you have the flu so you don’t end up getting hospitalized or get those complications.
BK: So, it sounds like a lot of self-awareness is required here.
Dr. J: That’s right – self awareness and stay-tuned so you know what is going on in our community – Inyo and Mono counties. All I can say right now is the flu is here, it’s not here with a vengeance yet but it’s coming in a couple of weeks.
Johnson said you shouldn’t even shake hands right now – use the elbow bump for a greeting. “Remember the virus” is the watchword.
LATEST PRESS RELEASE FROM DR. JOHNSON:
Time to Get Serious
Influenza is hitting the nation harder than it did at this point last year, and it could be peaking in some parts of the country, but it has not yet reached its peak in California.
Persons who have not yet gotten vaccinated against seasonal influenza should do so, and sooner rather than later. In addition to just beating the anticipated peak, the supply is barely keeping up with the increased demand. Influenza vaccine makers were expected to supply the US market with some 135 million doses. As of January 4, roughly 128 million doses had been distributed. Given reports of spot shortages, vaccine seekers may have to call more than a single healthcare provider to receive their dose. Try your healthcare provider, a pharmacy, or the health department.
The effectiveness of the current seasonal influenza vaccine is 62%, which means that 38% of us who get vaccinated could still contract influenza. These are still good odds, with this vaccine being a perfect match for circulating strains of the flu virus. The flu vaccine is far from perfect, but it is the best tool by far for preventing the flu. It is well worth the effort, and decades of experience show that it is very safe.
Fear of “Bad Year” Becoming a Reality
In early December 2012, the CDC said that given the early onset of the 2012-2013 influenza season and the particular mix of viruses in circulation, this could be a bad year. The ensuing weeks have proved them right. Patients presenting with influenza-like illness (ILI) have flooded hospital emergency departments in the Northeast, for example — so much so that public health emergencies have been declared in Boston, New York State, and Indiana.
The CDC’s latest weekly surveillance report of influenza activity, covering the first week of 2013 and ending January 5, continues to support the “bad year” outlook. According to the report, 47 states reported widespread geographic influenza activity, which is 6 more than the week before. In comparison, no state reported widespread geographic influenza activity for the first week of 2012. 20 children have died so far in this influenza season. Although California is one of the 3 states only reporting regional activity, emergency department visits in San Diego for influenza-like illness have doubled in the last reporting week, evidence that things are beginning to happen in Southern California. We all recognize that whatever happens in Southern California, happens in Mammoth within a few weeks. We are seeing signs that the flu has reached Mono County, and is expected to continue to increase over the next few weeks.
The CDC also said the ILI trend suggests that influenza is peaking or waning in some states. However, the findings for the last week of 2012 preclude certainty because they can represent an artificial holiday spike. Americans make fewer trips to physician offices in December for routine matters such as check-ups, so the patients who do end up in the waiting room “have a different pattern of illness.” As a result, the ILI rate can swell up. It will take a few more weeks of influenza surveillance and more data points to confirm the trend.
Predominant A(H3N2) Virus Associated With More Severe Flu Season
Of the influenza viruses in circulation as of January 5, the most common is A(H3N2). Influenza seasons tend to be more severe when this virus predominates. The United States has not experienced a major A(H3N2) outbreak since the 2007-2008 season. This may explain why this year’s spread is so extensive. The once dreaded pandemic influenza A(H1N1) virus from 2009, and a Type B virus, are both circulating in small numbers. All 3 of the circulating types are included in this year’s vaccine.
Predicting when, where, and how bad a flu season will become is about like predicting earthquakes. We know that influenza viruses in a given country, city, or region will vary from year to year in unpredictable ways. We just do not know why. Stay tuned, and follow the tips on the next page!
Flu Season is Here–Take Action Now
Do your part to protect yourself and others against the flu.
If you have the flu,
• Stay home
• Follow your health care provider’s recommendations
• Prevent the spread of the flu with these flu-fighting tips.
If you don’t have the flu, it’s not too late to get a flu shot! The best protection against the flu is to get the vaccine. Seasonal flu vaccines have a very good safety record.
Everyone 6 months of age and older should get vaccinated. It is especially important to get the vaccine if you, or someone you live with or care for is at high risk of complications from the flu. Our flu infographic shows you what you need to know about the flu vaccine.
- Video: What is the best protection against the flu?
- Video: How can I prevent the spread of the flu?
Everybody can do their part to help prevent the spread of germs and protect themselves from the flu. For the latest information about this flu season.
National Flu Situation homepage: