Early 2020 Flu Season Statistics and Other Influenza News

January 16, 2020

Fewer Massachusetts health care workers receive influenza vaccines than is required by the state; how to spot the difference between the flu and other illnesses with similar symptoms; and more of the latest flu news as we enter 2020.

The US Centers for Disease Control and Prevention (CDC) said that for the first week of 2020, influenza virus remains high, but indicators for severity—such as hospitalizations and deaths—are not high at this point in the flu season, which can run into the springtime.

The CDC also said that visits to health care providers for influenza-like illness decreased from 7.0% during the holiday week (between Christmas and New Year’s) to 5.8% the first week of January. That number is considered below the “epidemic” threshold. However, all regions remain above their baselines, and there are 46 states plus Puerto Rico that report “widespread” flu activity.

The agency estimates that so far this flu season there have been 9.7 million flu illnesses, 87,000 hospitalizations and 4800 deaths from flu, including 32 pediatric deaths. More than 170 million doses of the flu vaccine have been administered, they added.

If a health care worker experiences fever, cough, or sore throat, they should avoid working until their fever has been gone at least 24 hours, according to CDC recommendations. However, research released over the summer showed that health care workers reported working at least 1 day while symptomatic, Contagion® reported.

“Many health care personnel do stay home when they think they might spread a disease,” study author Brenda Coleman, PhD, of the Infectious Disease Epidemiology Research Unit at Toronto’s Mount Sinai Hospital, told Contagion®. “Unfortunately, most of us cannot distinguish influenza from other upper respiratory infections, or sometimes symptoms that are not infectious from those that are.”

Separately, a Massachusetts state report indicated that during the 2018-19 season, less than 90% of health care workers were vaccinated against the flu virus. The Department of Public Health requires all licensed health care facilities to offer free, annual flu vaccines to all personnel. However, nursing home workers reported only 72% vaccinations, clinics reported 68%, rest homes reported 64%, and day health programs reported 61%, The Boston Globe wrote.

A study from investigators at the University of Arizona explained how a person’s first encounter with the flu—often taking place during childhood—can impact their ability to successfully fight it off into adulthood. Essentially, a person’s past exposure to the virus can determine their individual response to subsequent infections (also called immunological imprinting), the team explained in a press release.

“In other words, if you were a child and had your first bout of flu in 1955, when the H1N1 virus was circulating but not H3N2, an infection with H3N2 was much more likely to land you in the hospital than an infection with H1N1 last year, when both strains were circulating,” said study co-author Michael Worobey, PhD, head of the Department of Ecology and Evolutionary Biology and a member of the BIO5 Institute at the University of Arizona.

The flu can be confused with other illnesses, as evidenced by a Florida toddler. First, the family thought she had the flu (she tested negative). Then, they suspected an ear infection (not that, either). Finally, the 3-year-old girl tested positive for strep throat. Despite their similar symptoms, the biggest difference between strep and the flu, her pediatrician said, are body aches and high fever.

Influenza can also be confused with respiratory syncytial virus (RSV), another illness which is having an early season. Children can be tested for RSV and most cases are typically mild. Some severe cases can develop bronchiolitis, especially in children with comorbidities.

In other flu news:

  • Investigators from Hong Kong believe that “enhanced” flu vaccines can better protect elderly patients compared to standard vaccines, as discussed in a report from Contagion®. “Each of the enhanced vaccines is thought to work better than standard dose vaccines in older adults, based on previous studies,” corresponding author Benjamin J. Cowling, PhD, of Hong Kong University’s School of Public Health said. “Our trial is the first large trial to provide direct comparisons between the vaccines.”
  • The January 6th World Health Organization update on influenza suggested increased activity in North America, Europe, and Central, Western and East Asia with H3N2 accounting for the majority of detections.
  • A study from the American Society from Microbiology found that disinfection effectiveness of ethanolbased disinfectants against the flu decreases drastically in mucus. They also found limitations of antiseptic hand rubbing when examining undried infectious mucus. The study authors hope that their findings contribute to preventing flu outbreaks as well as the advancement of current hygiene practices.
  • Two pieces of flu news out of Nebraska: Late in December, Nebraska was considered the most influenza affected state in the country. Local news said there are increased incidence of the flu as well as different strains compared to the rest of the country. Most of the flu is H1N1, however influenza B was also prominent, according to a health department spokesperson. A flu outbreak (45 cases) at a Nebraska State Penitentiary resulted in the cancellation of Christmas Eve visits to the prison. The facility is providing face masks for staff and inmates, encouraging inmates to get vaccinated and practice good hygiene, providing medication to flu cases that are in the early stages, screening new inmates for symptoms, and increasing disinfection efforts.
  • A man diagnosed was diagnosed with influenza A that progressed into acute respiratory distress syndrome and Burkholderia. The 30year-old father of 3 later required a double lung transplant. From the time he was diagnosed to the time of the transplant, he visited 4 hospitals in a span of 5 months.
  • Google cofounder Larry Page is using his charitable foundation to offer free flu shots to school children in the Oakland, California area, according to The Verge. He reportedly is also working with labs to develop a universal flu vaccine — the holy grail of fighting the flu.

And at the intersection of the flu, sports, and entertainment:

  • LeBron James missed Saturday’s game against the Oklahoma City Thunder with an illness and flulike symptoms, ESPN reported. He played in all but one other game this season through Saturday for the Lakers; they lost both without him.
  • Players from the Green Bay Packers had the flu in the leadup to their Divisional Round matchup against the Seattle Seahawks on Sunday, including cornerback Josh Jackson. Earlier in December, Contagion® wrote that the Seahawks faced the flu. Ultimately, the Packers prevailed, 28-23.