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More flu deaths hit state as cases become widespread

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Dr. Keith Ramsey


By Michael Abramowitz
The Daily Reflector

Saturday, January 13, 2018

North Carolina health officials reported four new influenza-associated deaths on Friday, bringing to 26 the total deaths so far for a season that national and state public health experts are expecting to be nasty and deadly.

The Department of Health and Human Services reported the deaths occurred between Dec. 31 and Jan. 6. It began monitoring flu death on Oct. 1. Information was unavailable from the Pitt County Health Department on whether any of the latest deaths occurred in the county.

The numbers are based on reports submitted by providers to the North Carolina Division of Public Health. The deaths were from compatible illnesses confirmed to be influenza by laboratory or rapid diagnostic tests.

There were four deaths statewide during the same weekly period in 2017, but 14 total deaths through Jan. 14, 2017. That’s 12 fewer than reported so far this year. 

In all, 218 people died during the 2016-17 flu season, most occurring from mid-February through mid-April. The recording period ends in May.

Flu has been considered widespread in the state since last week, according to Dr. Keith Ramsey, medical director for infection control at Vidant Medical Center and chairman of the Pitt County Board of Health. It is hard to tell this early into the flu season if elevated numbers of flu cases are the result of unvaccinated population or changes in the virus that causes flu, Ramsey said.

“This flu strain (H3N2) is the same that has predominated for the last several years, so it may have mutated a little, which could account for problems with the effectiveness of the vaccine,” Ramsey said. “We call that an antigenic drift. The good news is that the vaccine produced here can be tweaked as we watch what goes on in Australia, which gets hit with the flu before we do.” 

Perhaps the greatest challenge to keeping ahead of flu infection is for vaccine manufacturers who try to catch up when a new strain appears, Ramsey said. 

“We’ve got to get away from cultivating vaccine in eggs and expand the use of tissue cultures, but only one manufacturer has made that investment right now,” he said. “If the whole industry does that, they could make needed changes to the vaccine more quickly.”

Cases appearing so far at Vidant Medical Center are fewer than statewide levels, but cases found through testing usually represent the tip of the iceberg, Ramsey said.

“Many people are diagnosed by their doctors based on the appearance of flu-like symptoms and without a test,” he said. “If it looks and acts like the flu, they treat them for that, normally with Tamiflu antiviral medicine and antibiotics.”

The flu season started early, which is never a good sign, and the flu is already widespread throughout the country, the latest report from the U.S. Centers for Disease Control and Prevention shows. Half of states are reporting especially intense flu activity.

"We are currently in the midst of a very active flu season with much of the nation experiencing widespread and intense activity," CDC Director Brenda Fitzgerald told reporters during a briefing.

Based on the latest available data, the United States could be experiencing one of the most severe flu seasons in years, possibly similar to the severe 2014-15 flu season, officials said.

"Flu is everywhere in the U.S. right now. There's lots of flu in lots of places," said Dan Jernigan, director of CDC's influenza division.

But the most recent data show that the proportion of people rushing to their doctors to get treated for the flu has already hit 5.8 percent, which is as high as that number gets during the peak of a really bad flu season, the CDC says.

In addition, the rate at which Americans are being hospitalized for the flu almost doubled in the last week, to 22.7 for every 100,000 hospitalizations, according to the CDC. Those are two of the key ways the CDC monitors the severity of a flu season.

In addition to flu, this year seems to be producing more cases of generally severe colds and respiratory syncytial virus (RSV), which led Vidant to restrict visits to the children’s hospital in December, Ramsey said.

Precautionary steps are about the same for both types of illness, Ramsey said, including frequent hand washing and staying away from others when sick or carrying a fever, especially children.

“Even when the match isn’t perfect, vaccination still is the best way to fight the flu,” Pitt County Health Director Dr. John Morrow said.

Contact Michael Abramowitz at mabramowitz@reflector.com or 252-329-9507.