Health & Medicine

Flu season mild now but could grow worse, doctors say

Flu vaccinations are encouraged for everyone 6 months and up because influenza and related complications rank as the eighth-leading cause of death nationwide. Still, flu vaccines are generally only roughly 60 percent effective. 2009 file photo.
Flu vaccinations are encouraged for everyone 6 months and up because influenza and related complications rank as the eighth-leading cause of death nationwide. Still, flu vaccines are generally only roughly 60 percent effective. 2009 file photo. rpench@sacbee.com

On the nation’s official color-coded map identifying hot spots where this season’s flu is flaring up, California is still green. That’s a good thing.

Southern states, by contrast, are flaming red with active flu cases. The Midwest is crimson bordering on reddish-orange. Soon enough, no doubt, California will turn chartreuse, a yellow-tinged green, and may even tragically progress through the primary-color wheel toward yellowish-orange – possibly even red.

Each year, the Centers for Disease Control and Prevention helps the public track the flu’s severity through the aid of color gradients on its online map charting activity in U.S. states.

As the map shows, the number of reported respiratory distress flu-like cases in Northern California and the Sacramento region is currently low – under 1,000 or so. This signals a mild start to the 2014-15 influenza season. So far, one Californian, in Los Angeles, has died of the flu virus, according to public health experts.

Still, several national health leaders, including the CDC’s chief Tom Frieden, have issued red-flag warnings indicating this may shape up to be a nasty year for the flu. For one thing, the predominant Influenza A H3N2 virus that’s circulating has a history of causing large swaths of illnesses and fatalities. Compounding risks, especially to older people 60 and up, is the discovery by researchers that this year’s vaccines may not protect against surprise mutations of the H3N2 viral strains.

The CDC estimates the current vaccine offers little protection against more than half of influenza A H3N2 viruses.

Even without the threat of mutations, the H3N2 virus is considered a far greater danger to the public than last year’s potent H1N1. That virus was unusually harsh to otherwise healthy, young-to-middle-age adults.

Some of those cases, such as the sudden loss of local television executive Nancy Pinnella – healthy and hiking one day and deathly ill a couple of days later – rattled the Sacramento-area community. Many residents said they’d been shunning flu shots but cases like Pinnella’s converted them into evangelists for immunization. In the four-county Sacramento region last season, the flu killed 108 residents, according to a year-end report by the California Department of Public Health.

Dr. Randy Bergen, an infectious-disease expert for Kaiser Permanente in Northern California, said the flu season in the upper portion of the state is clearly underway.

Bergen analyzes Kaiser data to track the proportion of the health care system’s patients with flu-like respiratory symptoms. So far, specimens from 704 Kaiser patients in Northern California were tested for influenza viruses.

“We start to get worried when the rate of respiratory testing reaches 10 percent or more: We call that the beginning of the influenza season,” Bergen said. “Right now, we’ve reached 10 percent, ” or 70 cases, he said.

Percentages that hit 30 percent to 40 percent would signal the height of the flu season, which typically peaks in late January or February, he said.

With at least 6 million enrollees in California, Kaiser’s data carries enough heft that the health system acts as an official collaborator in the state public health department’s annual influenza surveillance program.

Dr. Ron Chapman is the departing director of the California Department of Public Health. He and state epidemiologists urge Californians to get vaccinated against the flu virus.

“Influenza is much more serious than the common cold and has the potential of causing serious illness and death,” he said.

Chapman said recent flu activity in the state remains low, but he pointed out that, nationwide, thousands of people die from the flu each year. By comparison, so far, the deadly Ebola virus has taken only one life in the U.S. in 2014, that of a Liberian man in Dallas.

Vaccinations are encouraged for everyone 6 months and up because influenza and related complications rank as the eighth-leading cause of death nationwide. Still, flu vaccines are generally only roughly 60 percent effective. Public health officials say this is considered a good outcome, though they admit it falls far short of the efficacy of other vaccines on the market.

This season, the serious hitch to the immunization program is the spinoff of the mutated versions of H3N2. When infectious-disease experts held their annual gathering last January to decide which flu strains to target with the 2014-15 vaccines, evidence led them to the potent H3N2 virus, as well as the H1N1 virus.

But no one counted on the unexpected happening: The prime suspect – the H3H2 virus – split up and about half of the viral strains went rogue.

Researchers call them drift variants of the vaccine-targeted H3N2 virus. These variants result when similar viruses infiltrate H3N2, changing the genetic code, thus creating mutations.

The good news is that the original H3N2 virus that’s referred to in the research community as the Texas strain is still covered by the vaccine. Its mutated cousin, however, which gets its nomenclature halfway around the globe and is known as the Switzerland strain, will be unaffected by the vaccine, experts say.

Furthermore, since last spring and especially during the last three months, researchers have observed that more and more of the tested H3H2 flu viruses were found to be mutated drift variants. Bergen said mutated viruses were discovered in three-fourths or two-thirds of lab-tested specimens.

In laymen’s terms, a change in the genetic code of any living organism alters its appearance, often its shape. But antibodies created by the vaccine only know to fight off the original H3N2 influenza virus, in its original shape.

The CDC’s Melissa Rolfes confirmed that the current vaccine offers little protection against more than half of Influenza A H3N2 viruses, but said that, should people become ill with those rogue variants, anti-viral drugs may be able to treat them successfully.

Regardless, Rolfes, Frieden, Chapman and others say there still are health benefits to getting the 2014-15 influenza vaccine since people could still be exposed to the original H3N2 virus that this season’s vaccine is designed to clobber.

Call The Bee’s Cynthia H. Craft, (916) 321-1270.

Where To Find Flu Vaccines

No-cost community health centers may offer free vaccines. If you are insured, you’ll also find free flu vaccines at your local retail pharmacies.

Obamacare requires health insurance to pick up the entire cost of preventive services like vaccines, so you should not have to pay anything.

Go to www.flu.gov and its “Flu Vaccine Finder” to type in your ZIP code to locate nearby flu shots.

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