Flu trackers in North Carolina are reporting the highest levels of flu and flu-like illnesses in the state in more than five years, and officials at the U.S. Centers for Disease Control and Prevention have declared a national flu epidemic, suggesting this year’s flu season might be worse than usual.
Across the state, emergency rooms and doctors’ offices are jammed.
“We’ve been slammed for several weeks now,” said Dr. Charles Bregier, a Novant Health medical director who works at urgent care centers in Charlotte and Matthews. “We had kind of hoped that, with Christmas break, the incidence of flu and flu-like illness would drop off because kids were out of school. But that has not happened. ... The flu is upon us, full bore.”
Dr. Umar Bowers, an internist with Mecklenburg Medical Group-Uptown, said he’s surprised by the number of patients in their early to mid-20s who have come to his office with flu-like symptoms. Although that could be related to his central Charlotte location where many young professionals work, he said, “We’re all concerned about how severe this flu season may be and the significance of how effective the vaccination is.”
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The CDC recently announced that, because of an unexpected mutation, this year’s vaccine doesn’t match exactly with the circulating H3N2 strain of influenza A. But officials say the vaccine could still provide some protection against that strain and would still be effective against influenza B and H1N1, the so-called swine flu.
“Although the match is not as much as we would like, it’s not zero,” Bowers said. “There’s still some significant benefit, particularly for those at high risk.” That includes children, pregnant women, those over-65 and anyone with chronic medical conditions, such as asthma or heart disease.
Mecklenburg County Health Director Dr. Marcus Plescia said some people who got the vaccine will contract the flu anyway, but the onset of illness might be less sudden and the disease could be milder. Those people may “mount a better response, and they’re not sick for as long, and they’re less likely to get the complications,” he said. “... It’s still very useful to get a vaccination.”
Getting a vaccination now is not too late, doctors say. “You never know how long the flu season will last,” Bregier said. “It could become severe again in February or later.”
Bregier said the CDC has “liberalized” its recommendation for the use of antiviral drugs, such as Tamiflu, which have in the past typically been reserved for patients whose age or medical conditions put them at high risk of serious complications from the flu.
This year, doctors are urging patients with severe flu symptoms to call their health care providers and ask about a prescription. Antivirals are not a cure, but they can reduce the severity and length of illness. To be effective, they must be taken within two days of the onset of symptoms.
“Most of the time, people will eventually get over the flu,” Bowers said, “but there are times when it can cause catastrophic illness.”
Visitor restrictions at hospitals
To help hold down transmission of the virus, both Charlotte hospital systems have adopted limited, temporary restrictions on visitors.
Carolinas HealthCare System will restrict visitors under the age of 18 starting Friday because of the flu.
The system also is asking visitors who have colds or other viral illnesses to stop at the front desk and get a mask to wear before visiting patients at Levine Children’s Hospital. The system’s hospitals in Morganton and Valdese are banning visitors under the age of 12.
Novant Health is limiting visitors in its neonatal intensive care units at Presbyterian, Matthews and Huntersville hospitals. Only two immediate family members are allowed per patient, and the designated visitors must wear hospital-issued arm bands.
Starting Friday, CaroMont Regional Medical Center in Gastonia will ban visitors under 13 and anyone who is experiencing flu-like symptoms or has a weakened immune system.
Both Carolinas HealthCare and Novant also have instituted requirements that employees get vaccinated against the flu to prevent the spread of illness from employees to patients and vice versa.
At Novant, 99.7 percent of its employees got vaccinated this flu season, officials said. The Winston-Salem-based system has 25,000 employees and about 10,000 physicians, students and volunteers in four states.
This was the first year that Carolinas HealthCare’s 35,000 Charlotte-area employees faced the vaccine requirement. System officials said 97 percent of employees had the vaccine.
Employees who get exemptions, based on medical or religious reasons, are required to wear masks when they’re near patients during flu season. Failure to get vaccinated or get an exemption results in termination. Last year, about 50 Novant system employees were terminated because they refused to get the vaccine.
Statewide, about 90 hospitals require flu vaccinations for employees, according to the North Carolina Hospital Association. Prior to the swine flu epidemic in 2009, only about 40 percent of U.S. health care workers got vaccinated each year. Last season, about 82 percent got vaccinated, according to the CDC.
Tracking the spread
Influenza, the specific illness caused by an influenza virus, usually isn’t documented by a specific blood test. Instead, state health officials track “flu-like illness” by collecting reports of patients with fevers of 100 degrees or higher, and coughs or sore throats. The reports come from doctors’ offices and health centers that agree to be “sentinel” reporting sites.
The most recent statistics, for the week ending Dec. 20, show that about 10 percent of patients at those site reported symptoms consistent with flu. That was a jump from the week before, when about 3 percent of patients had flu-like symptoms.
Eight people have died from complications of the flu, as of Dec. 20, according to state data. State health officials say they’re hoping the number of deaths this year won’t be as bad as last flu season, when the toll exceeded 100.
Nationally, about 200,000 people are hospitalized and about 36,000 die from influenza and its complications each year.
This is the third consecutive year that North Carolina has reported dramatic increases in flu-like illness around Christmas. Flu season is always unpredictable, but this kind of sharp, early escalations typically hasn’t arrived until January or February, said Zack Moore, an epidemiologist with the N.C. Division of Public Health.
“This may be turning into the new normal,” Moore said.
Jay Price of the News & Observer contributed.