This is a bad one, folks. For over a week, flu-like illnesses have been climbing across the U.S. Hospitals in my area are filling up, leaving patients waiting for hours in emergency rooms and in “virtual beds” (i.e., a hallway with a curtain). This is right on the heels of a recent spike in norovirus-like illnesses (so-called ‘stomach flu’, unrelated to the influenza virus). It’s been a busy time in doctor land.
People with the flu look like absolute crap: sweaty, shivering, pale. They are coughing, and complaining that everything hurts, even their hair. It’s misery. Thankfully, samples being tested are showing that this year’s vaccine is a good match to the circulating viruses (especially the influenza A viruses). That doesn’t mean that vaccinated people can’t get the flu, but they are less likely to, and if they do get sick, they are likely to be a bit less ill than unvaccinated people.
There’s been significant controversy over the last year especially about mass influenza vaccination policies, with experts disagreeing publicly about how big the impact of mass vaccination really is. These arguments are more about policy than medicine, about who to target, cost-effectiveness, and degree of benefit. Clinicians and scientists working with influenza are still recommending vaccination, and it’s not too late.
Just for fun, I cracked open the notebook where we keep the records of flu tests we run in the office. A definition of an “influenza-like illness” (ILI) has been developed for reporting purposes. It’s pretty basic: a fever of 100 deg F or above, cough or sore throat, and no other cause for the illness.
At our office, we don’t use CDC surveillance methods. We do tend to test for flu in people whom we suspect of having the real thing. Guidelines for testing are pretty loose and subjective, so I tend to check people in whom I strongly suspect flu and in whom a diagnosis would make a difference. For the sake of this discussion, I’m defining all my patients tested as having an ILI.
From the beginning of December until today, here’s the data I’ve put together:
And here’s a similar graph from the CDC:
My graph shows cases rather than percentages, but the percentages are close. We are seeing more ILIs, and more and more of them are testing positive for influenza (usually influenza A). I’m going to keep tracking this, since it’s really, really interesting to medicine geeks like me.
The take home message though is more basic: it’s an early and bad flu season. Wash your hands, sneeze and cough into the crook of your elbow. Get vaccinated. And if you do get sick, the current flu viruses are susceptible to the anti-flu drugs. They’re not for everyone, but it’s worth asking your doctor. The quicker you start the meds, the more likely they are to help.