Flu Season's Early Start Signals It Could Be Severe

Flu season has kicked off early, a sign it could be more severe than in the past couple of years, federal health officials said Monday.

In the earliest start to flu season in nearly a decade, five Southern states have reported higher-than-normal levels of doctor visits for flulike illnesses in late November, according to the Centers for Disease Control and Prevention. That is a month or two earlier than the typical surge of the seasonal flu, CDC Director Thomas Frieden said in a teleconference with reporters.

Moreover, the dominant flu strain circulating, known as H3N2, tends to prompt particularly severe flu, Dr. Frieden said. "The early nature of the cases, as well as the specific strains we're seeing, suggest this could be a bad flu year," he said.

On the bright side, this year's flu vaccine represents about a 90% match with the dominant seasonal flu strain, meaning it should offer a high level of protection, Dr. Frieden said.

The last time flu season arrived this early was 2003-04, but the flu vaccine was an inaccurate match for that year's dominant strain. About 48,600 people died from influenza that season, more than double the average seasonal total of 23,600 deaths, according to CDC data.

This season, two children with flulike symptoms have died.

About 37% of the U.S. population has received a flu shot, according to preliminary survey data, said Melinda Wharton, a director in the CDC's National Center for Immunization and Respiratory Diseases. The CDC recommends that everyone six months or older get a flu shot.

It is unclear why flu cases are already surging, Dr. Frieden said, though flu season tends to start early in years when the H3N2 strain is dominant. The early start is a departure from the past two winters, when the flu season was mild and peaked late. But flu is unpredictable, CDC officials cautioned.

Indeed, the two mild seasons came after the 2009 H1N1 "swine-flu" pandemic, in which an estimated 12,470 people died in the U.S., according to CDC estimates.

This year, five states—Texas, Mississippi, Alabama, Louisiana and Tennessee—have already reported high levels of influenza, defined as about double the national average of outpatient visits for flulike symptoms. Missouri and Georgia have reported moderate levels, which signal a percentage slightly above the national average. Nationwide, about 2.2% of outpatient visits in late November were for flulike symptoms.

About 112 million flu shots have been administered, about the same level as this time last year, the CDC said. Manufacturers have produced 123 million shots. There have been no reports of tight supply or patients having problems getting vaccinated, a CDC spokesman said.

The seasonal flu leads to more than 200,000 hospitalizations a year, the CDC estimates, and between 3,300 and 49,000 deaths, depending on the severity of the dominant strains.

Written by: Timothy W. Martin, Wall Street Journal
Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP


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