This Flu Season’s Toll Is Challenging Records

One in 10 deaths linked with flu or pneumonia in latest report

The flu or pneumonia claimed the lives of one out of every 10 Americans who died during the week ending February 3, according to the Centers for Disease Control and Prevention (CDC).

Throughout most of the nation, the flu appears to remain on the rise, Acting CDC Director Anne Schuchat, MD, said at a briefing February 9. “In fact, we may be on track to break some recent records”:

  • Reports of visits to doctors’ offices and emergency rooms for influenza-like illness reached 7.7% for the week, up from 7.1% the previous week and topping a previous high (for a nonpandemic year) of 7.6% in the 2003–2004 season.
  • Hospitalizations are on track to pass the 2014–2015 season’s rate and could go “quite a bit higher,” she said. The rate of hospitalizations for the flu reached 59.9 per 100,000 Americans for the week, up from 51.4 a week earlier.
  • The flu’s impact on nonelderly adults remains unusual and especially severe, with a rate of 63.1 hospitalizations per 100,000 in the 50–65-year-old age group.

While flu or pneumonia was listed on 10.1% of death certificates for the week, Dr. Schuchat said deaths probably have not peaked. Some patients die after lengthy hospitalizations.

Dr. Schuchat reported 10 more flu-related pediatric deaths, bringing this year’s total to 63. About half of the children hospitalized for the flu were previously healthy, with no known underlying illness. Vaccination of children against the flu is a relatively new phenomenon that may help limit the pediatric toll, she said.

Dr. Schuchat warned that the flu remains difficult to predict, that officials don’t know if the “very intense,” 11-week-old season has peaked yet, and that the U.S. could see several more weeks of flu activity. Forty-eight states are still reporting high activity, with Oregon and Hawaii as the exceptions. In past seasons such as this, she said, an estimated 34 million Americans got the flu.

A viruses, often linked to more serious flu illness, continue to dominate. There has also been an increase in B viruses (particularly in Western states), which may be more susceptible to the flu vaccine. The CDC continues to recommend getting a flu shot. The vaccine’s effectiveness against the H3N2 flu strain remains questionable. “However, some protection is better than none,” Dr. Schuchat said. It is possible to come down with both an A-strain and B-strain flu in the same year (and even at the same time).

Dr. Schuchat also recommended avoiding those who are sick, frequent hand-washing, covering the mouth when coughing or sneezing, and staying home from work or school when sick. While that last step is important in limiting the flu’s spread, she acknowledged that it can create a “difficult dilemma” for people without sick time.

Most people who feel sick won’t need to see a doctor, she noted. The exceptions are those at high risk: the very young, the very old, pregnant women, and people with pre-existing medical conditions.

Federal officials have received reports of spot shortages of antivirals, but they say those drugs are available. Consumers may have to shop around or use brand rather than generic antivirals. While the most reliable studies suggest taking antivirals within 48 hours of the onset of symptoms to provide the best results, some studies show some benefit at four to seven days after symptoms appear, she said.

Source: CDC briefing; February 9, 2018.