US flu season starts early, seven states report high activity

The U.S. flu season is off to a very early start and is quickly intensifying, according to the Centers for Disease Control and Prevention.

The CDC posted its latest update on Friday, reporting that seven states were reporting high flu activity last week, up from two states the week before. More than 3% of doctors’ office visits last week were for flu-like illness, signaling that flu season is really underway.

The surge began in the nation’s South and West. The states seeing high flu activity include California, Louisiana, Oregon, South Carolina, Tennessee, Texas and Washington, according to the CDC. Flu is in the moderate category in Colorado, Florida, Hawaii, Idaho, Massachusetts, New Jersey, New Mexico, New York state, and Puerto Rico.

The CDC estimates that at least 2.6 million illnesses, 36,000 hospitalizations, and 2,100 deaths so far this season are tied to flu infections. The flu hospitalization rate in mid-October was the highest seen that early in an autumn in more than 15 years, noted Dr. Anna Durbin of Johns Hopkins University, during a recent media briefing.

The CDC also noted two child deaths from flu this week, for a total of five so far this season. Flu test positivity was 11.3% this week, up from 9.1% the week before, primarily from influenza A.

The early-season flu activity is higher than what is usually seen at this point of the year, though it is not clear that will mean this season will be worse than others, according to the CDC’s update. The CDC said this early-season influenza activity is currently higher than typically observed at this time of year, but an earlier increase in activity does not necessarily lead to a higher seasonal peak or greater overall severity.

It is too early to know what viruses may predominate or to say whether there might be implications on flu vaccine effectiveness this season. This fall, most of the illnesses so far are caused by a version of an A H1N1 flu bug with mutations that have the potential to more easily slip through the immune system’s defenses. However, data so far suggests the current vaccine “can recognize” the circulating virus and work against it, said Andrew Pekosz, a Johns Hopkins University immunology expert, during a recent media briefing. Health officials won’t know for months exactly how effective this year’s vaccine is. But “right now there is no cause for concern,” he said.

Louisiana is seeing the worst of it so far. Flu season “is taking off and it’s taking off in a direction that’s only likely to increase in the next month or two,” said Dr. Fred Lopez, an infectious diseases specialist at the LSU Health Sciences Center in New Orleans. “If you haven’t been vaccinated, you should get vaccinated now,” he added. The surge began in the nation’s South and West. It’s not unusual for Louisiana to be among the first to see flu season surges each year. That is at least partly due to low vaccination rates, high poverty rates and challenges people face in accessing healthcare, Lopez said.

Doctors expect accelerated spread of flu and other respiratory viruses as people travel and gather later this month for Thanksgiving. “As we prepare to gather with family and friends over the upcoming holidays, getting vaccinated is especially important,” said Dr. Nicole Iovine, a University of Florida-affiliated infectious disease specialist, in an emailed statement this week.

People should not get vaccinated if they are currently suffering significant symptoms, because the body’s immune system is otherwise occupied. But people should get a flu shot even if they already had an infection this fall, because the vaccine protects against three kinds of flu virus, and it’s not unusual for more than one strain to circulate each season, Lopez said.

Last winter’s flu season surged in late December and infections were especially intense in some parts of the country. At the time, New York City health officials called it the most intense season in 20 years. The season faded in the following months, and was basically over by late March. But that spring the CDC estimated there had been at least 32 million illnesses, 380,000 hospitalizations and 24,000 deaths that season.

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