Instead of talking about the weather, people are (still) talking about this season's flu. From coast to coast, influenza has affected millions of people, with many lamenting: "I can't seem to get over this."
That would be me. And yes, I got a flu shot in mid-November.
After contracting what I think was the last Dec. 28, I'm still coughing. My viral journey began with coughing, sneezing, and a few days later, a fever. I functioned fairly normally, working and working out most of the time, except for four days total. I thought I was recovered until the coughing returned with a vengeance, especially at night.
This coughing often leaves me gagging. Going to bed means prepping first with cough medicine with codeine and then taking two puffs of my inhaler. Neither curbs the incessant tickling in my throat that keeps me awake for hours and leaves me feeling "below normal" the next day. It drove my partner to go somewhere else to sleep, and I don't blame him.
I've visited urgent care twice, undergone two chest X-rays — nothing there — and taken an antibiotic for a sinus infection. No bronchitis noted. My primary care provider has finally said that I should just ride this out and expect to cough for up to eight weeks. I am over it!.
I wake up every day hopeful that my coughing will subside.
So how bad is it?
"This is one of the worst flu seasons we've had since we started measuring rate of hospitalization," says Litjen "L.J." Tan, M.S., Ph.D., and chief strategy officer at the Immunization Action Coalition. The rate is typically driven by people age 65 and older, as well as children younger than age 4 — as is the case now.
In a phone interview with HealthCentral, Dr. Tan said the 2014 flu season was also "bad." The latest Centers for Disease Control and Prevention (CDC) Situation Update reports that "at 7.1 percent, influenza-like illness (ILI) activity is approaching the 7.7 peak of the 2009 (swine flu) pandemic. So far, pediatric deaths from flu stand at 53."
We're not out of the woods yet, no way. "Flu activity is likely to remain elevated for several more weeks," says the CDC. The typical season is 20 weeks. Seasonal flu activity often begins as early as October and November and can continue to occur as late as May, it says. Flu activity most commonly peaks in the United States between December and February.
Four types of flu viruses make the rounds: A, B, C, and D. Types A and B cause seasonal epidemics like the current one. Type C causes mild respiratory illness, and D affects cattle.
What we know now
A very new Canadian study notes that flu there has included influenza subtypes A(H3N2) and B(Yamagata), that Europe has incurred simultaneous A and B epidemics — mostly B —while here in the United States, our flu bas been predominantly A(H3N2). The Canadian vaccine (same as ours) demonstrated 10 percent effectiveness against H3N2 among Canadians ages 20 to 64, who happened to be the largest age group in the study. Among all age groups, however, the protection rate increased to 17 percent — still not a stellar number.
By now, we all know that protection from this year's vaccine is low. That's because vaccines aren't so tough against H3N2 because of flu virus mutation and because of seemingly antiquated production methodology involving eggs. All told, flu viruses are also complex at best, ever-changing and ever-challenging.
What goes in and when
The decision-making process for formulating the annual vaccine seems to confuse many people who wonder: "Why can't anyone get this completely right?" It begins early in the year with recommendations for the northern hemisphere from the World Health Organization (WHO).
"Manufacturers also make an educated guess and produce 'seed' viruses in anticipation of those recommendations so we'll have enough vaccine to deliver later in the season for back-to-school time," says Dr. Tan. "We urge that the vaccine be given until the season is over, or when vaccine runs out."
If you haven't had a bout of predominant H3N2, please do get vaccinated now, he says, and this goes for anyone age 6 months and older. No, you can't get infected with that strain again, but you can get infected with other strains — sorry.
The vaccine will protect you against type B, which iscirculating now, as well as against H1N1, circulating at a very low level. Remember that the vaccine takes approximately 7 to 10 days to "ramp up," says Dr. Tan.
Additionally, because this season's vaccine wasn't as effective as had been hoped,, you can still get infected if you got the shot. "The vaccine can prevent you from having more severe illness," he says. "What matters is function and quality of life and the vaccine can often make the difference between having serious complications or not. That could be as pronounced as a cardiovascular impact that could affect the rest of someone's life, or it could be recoverable."
In fact, a Jan. 24, 2018 study in The New England Journal of Medicine "found a significant association between respiratory infections, especially influenza, and acute myocardial infarction."
Geography and the flu
The flu "normally" tends to affect the U.S. southeast and southwest first and spread across the country by region, Dr. Tan says. This year, all 48 contiguous states were hit almost at the same time.
Here's some good news: California and Oregon are beginning to report slight decreases in flu activity, he says, but flu is still widespread in the southeast. "(But) that decrease could all disappear in the next two weeks, due to the unpredictability of the flu."
Maybe you wonder whether your flu vaccine from this season — and the fact that you had the flu (or think you had it) — will make you "safer" next fall. Odds are it won't. It's a guessing game to determine whether viruses will change, and how much, and to assess teeny "microchanges" that occur, says Dr. Tan.
"Some people retain what's called residual immunity," he says. "Older adults have less. It's difficult to predict how long that will last, and that is different for everyone."
If you do get flu now, or next season, go to the doctor quickly to be treated with an antiviral medication such as Tamiflu, says Dr. Tan. "It's especially important if you're in an at-risk population — age 65 and older, children 5 and younger, pregnant women, and people with chronic conditions — or if you're already very sick with this virus. Don't wait for the results of a flu test."
Meanwhile, don't get complacent, no matter what reports say. In an email to HealthCentral, Phil Hampton, director of media relations for the University of California, Los Angeles Health/David Geffen School of Medicine, said emergency rooms at its two main campuses continue to experience unusually high volumes of patients with flu-like symptoms such as sneezing coughing, and fever. It may seem logical, but the health system reminds us all to be considerate and to be proactive: Use tissue when sneezing and coughing, dispose of used tissues in the trash, and make liberal use of hand sanitizer.