When Ainsley Devoe’s temperature registered 102 degrees on Monday morning, mom Megan Devoe decided it was time to find out whether the 7-year-old had the flu.
Ainsley likes school, and she had been excited to welcome her teacher on her first day back from maternity leave. “When she didn’t feed good enough to go to school, you know there’s something wrong,” Devoe said.
So Devoe took her young daughter to the CHI Health Quick Care Clinic at 156th Street and West Maple Road, where several other parents with sick kids already were in line.
Sure enough, Ainsley tested positive for influenza. Within a short time, Devoe had her daughter started on an antiviral medication and was back home trying to convince her to rest. “I have proof that you’re sick, so you have to,” Devoe told her.
That’s just one of the battles Nebraska and Iowa residents are fighting as flu season continues to grip the nation. While federal health officials several weeks ago hinted this year’s outbreak might be reaching its peak, infection rates still were rising as of late last week. The flu remained widespread in 48 states, including Nebraska and Iowa. Only one state — Oregon — reported an easing of flu from the week before.
“We aren’t out of the woods yet,” Dr. Anne Schuchat, acting director of the federal Centers for Disease Control and Prevention, said in a press briefing Friday at the close of the season’s 10th week.
Locally, health officials encouraged residents not to drop their guard against flu.
“It’s a pretty severe influenza season, probably the worst in 10 years,” said Dr. Tom Safranek, Nebraska’s state epidemiologist.
The strain that has dominated so far, an influenza A type known as H3N2, is associated with rough seasons with higher rates of hospitalizations and even deaths. While that strain continues to hold sway, influenza B and H1N1 also have increased, both nationally and in Nebraska and Iowa.
Nationally, 7.1 percent of visits to doctor’s offices for the week ending Jan. 27 were for what’s known as flu-like symptoms. Given not everyone gets tested for flu, such measures typically are used as a gauge of how much flu is out there. Last week’s number was up from 6.6 percent the week before and was higher than all but two other seasons in the past 15 years. The last one was in 2009-10, when the swine flu was epidemic.
Numbers in Nebraska and Iowa, however, were not as high. In Nebraska, 5.4 percent of doctor’s office visits were for flu-like illness. In Iowa, the figure was just over 3.9 percent. In Douglas County, visits to doctor’s offices and hospitalizations were down slightly from the week before, but the number of children absent from school had increased.
Still, health officials are seeing enough flu to take notice. Nebraska Medicine on Monday began offering walk-in flu clinics at two locations — Chalco and Clarkson Family Medicine — to allow people who suspect they have the flu to come in without making an appointment and get treated quickly.
Hospitalization rates nationally also have been running high. In a few places, including Southern California and Atlanta, hospitals have reported setting up triage tents or mobile emergency rooms.
No such crunches have been reported in Nebraska or Iowa, although both flu-related emergency room visits and hospitalizations have been elevated. Hospital admissions for flu-like illness in Nebraska recently exceeded last year’s peak week.
Some parts of the country also have reported spot shortages of flu test kits and antiviral medications. In Nebraska, Safranek said he hadn’t heard of any shortages that haven’t been solved by simple restocking.
Devoe, a kindergarten teacher in the Elkhorn Public Schools, said she has seen some other sick children. But the bug appears to be hitting adults hardest. She has been doing her best to touch up her classroom.
“Clorox wipes are my best friend,” she said.
Safranek, meantime, noted that the increase in influenza B actually could be a bit of good news.
Influenza B generally is less virulent, particularly when compared to H3N2. And the flu shot tends to be more effective against B strains, especially when compared to H3N2. The vaccine tends to be less effective against H3N2. Most of today’s vaccine is produced by growing flu virus in chicken eggs. Studies indicate the virus changes in order to grow in eggs, with H3N2 more likely to change than other strains.
A small Canadian study released last week indicated that the current vaccine was only 17 percent effective against H3N2. That follows preliminary data from Australia indicating the vaccine worked only 10 percent of the time against that strain.
Public health officials generally expect effectiveness against H3N2 to be in the low 30 percent range. CDC officials said they plan to conduct their own interim analysis in the next several weeks. In past years, the vaccine’s overall effectiveness has run between 40 percent and 60 percent.
Health officials continue to recommend that people get the flu shot, which covers a total of four strains. Not only can getting the vaccine shorten the course of the illness and lower the fever, it also can keep people out of the hospital and prevent deaths. Widespread vaccination also helps protect those who are more vulnerable to the flu, generally the very young, the very old and those who can’t get the shot.
Most healthy adults who do get the flu will recover at home with plenty of rest and fluids, said Dr. Eric Ernest, an emergency room physician with Nebraska Medicine.
Those at greater risk, he said, are the very young, particularly infants under six months, and the elderly, especially those with significant underlying health conditions.
Warning signs that a person should go to the emergency room include shortness of breath, abdominal pain, vomiting over several days, neurological symptoms or symptoms that seem to get better and then suddenly worsen, he said. All can be signs of an underlying bacterial infection.
Meantime, he said, hand-washing is the best thing people can do to prevent catching or spreading the flu. Other steps include avoiding sick people, eating healthfully and getting plenty of rest.