Sacramento County officials Friday reported a rise in flu fatalities to 17, as California public health officials announced a doubling of statewide flu deaths to 45 – with the vast majority of the victims not vaccinated against the flu.
In Sacramento County, an additional 78 people were hospitalized in intensive-care units with severe influenza-like symptoms. Those who died of the flu locally were nine were women and eight men, all ranging in age from 18 to 64, said Dr. Olivia Kasirye, county public health officer.
With several weeks left in the peak flu season, Sacramento County’s death toll from influenza exceeded the 16 who died during the entire 2012-13 season. One person in El Dorado County also died of influenza, state officials said.
Addressing the statewide figures, Dr. Gil Chavez, state epidemiologist, said 80 percent of those who died had not received a flu vaccine. But the remainder had been immunized with the flu shot, which is believed to be 60 percent to 70 percent effective.
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“We know that no vaccine is 100 percent effective,” Chavez said. “We are always going to have some people who get vaccinated and who do not develop full immunity. Unfortunately we can see from the numbers, some of those may end up dying.”
The state reported that three children had died, in Riverside County, Los Angeles County and San Mateo County.
Officials also confirmed for the first time that the virus that’s predominant throughout California is the same H1N1 that caused the 2009 pandemic.
“The virulence of the virus is dictated by the structure of the virus,” Chavez said during a news conference. “As far as we know, there have been no changes genetically to this virus and the one we had seen during the pandemic. We consider this and the 2009 pandemic virus to be the same strain.”
Typically, viral strains mutate from year to year, prompting slight changes in flu vaccines as public health officials try to stay ahead of the mutations. But the Centers for Disease Control and Prevention in Atlanta had warned clinicians to expect this year’s season to mirror 2009, with young adults and otherwise healthy middle-aged people hit hard, as well as those with underlying medical conditions.
At this time last year, nine Californians had died of influenza-like symptoms. Last week, 45 flu deaths had been confirmed by the state, with 50 more flagged for further investigation. Those turned out to be flu-related, Chavez said. This week, another 51 deaths are under investigation and have yet to be confirmed. State flu activity reports run about a week behind local figures.
“The increasing number of influenza-related deaths points to the severity of this flu season,” said Dr. Ron Chapman, who heads the California Department of Public Health. “Vaccination is so important because it continues to be the best defense against the flu.”
People 6 months of age and older, especially pregnant women, are being urged to get vaccinated.
All of the flu vaccines available this season protect against the H1N1 virus, as well as two others, an influenza A and influenza B. One version of the flu shot, known as a quadrivalent, covers another B strain as well.
State officials said they did not notice clusters of the flu, although Sacramento County has consistently reported a high number of fatalities compared with other counties.
California officials also cited a bit of good news: Outpatient visits and hospitalizations for the flu had decreased somewhat from the week before. However, it was too early to tell if the flu may be peaking or is merely going through its regular “ebbs and flows,” Chavez said.
California law requires hospitals and counties to report flu deaths of those under 65 because the demographics present a reliable snapshot of how severe a flu season may become. The CDC said that, of the 3,745 flu-related hospitalizations reported so far, 61 percent have been in people 18 to 64 years old, a pattern also seen during the 2009 H1N1 pandemic.
“Having looked at H1N1, we can tell in fact that it affects younger individuals, and tends to affect the most those with the most severe medical conditions,” Chavez said. He said 80 percent to 90 percent of the cases have been “younger individuals” who also have underlying conditions such as pregnancies, immune-suppressing diseases and obesity.
By far, the most dangerous underlying condition nationwide has been obesity in those hospitalized with the flu, with 45 percent of patients reported obese, said Angela Campbell, with the CDC’s Influenza Division. Other risky medical conditions have been metabolic disorders, cardiovascular disease and asthma, particularly in children, Campbell said.