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Fevers, aches and fatigue

With case numbers high, influenza makes itself felt throughout the county

Fevers, aches and fatigue

The H1N1 virus

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POSTED February 8, 2018 1:42 p.m.

Influenza has been in the headlines, as the numbers of identified cases has continued to rise. That story came close to home with the passing of Fennimore’s Damien Lord, the 33-year-old father whose funeral was held Friday. Lord succumbed to a secondary infection – in his case, pneumonia – the most common risk arising from the illness.

Cases of influenza – marked by the sudden onset of fever, body aches, sore throats, headaches, fatigue, runny or stuffy noses, even vomiting – began a precipitous rise at the end of November across the nation. Wisconsin has not been spared, nor has southwest Wisconsin. The last few weeks have seen area hospitals at their busiest, in terms of influenza cases, according to Brian Simmons, Infection Control Practitioner at Crossing Rivers Health in Prairie du Chien.

“Generally speaking, it’s been one of our busiest seasons in the last ten years,” Simmons said.

The last time there was a similar spike was during the H1N1 pandemic in 2009, he noted. Simmons characterized current levels of influenza activity as medium to high in the region, saying it thus far was similar to the rest of the state.

Grant Regional Health Center has been going through over 50 test kits for influenza per weekend lately, with more than half returning positive results, according to Jennifer Rutkowski, Infection Preventionist at the Lancaster hospital.

Flu by the numbers

According to the Wisconsin Division of Public Health, 8,471 cases have been positively identified this season as of Jan. 27. Numbers are likely higher, as not all people with the virus are seeking medical care or testing. Of the known cases, 3,809 involved hospitalization, with two-thirds of those being patients 65-years-old or older.

In Grant County, the picture is consistent with the state, according to Grant County Public Health Director Jeff Kindrai. He points to influenza-associated hospitalization, citing the 20 cases reported in the county in 2016. For 2017, that number was 35; 22 of those cases were reported since Sept. 2017. Reporting of confirmed influenza cases at the county level is not mandated, Kindrai noted, saying the only numbers the county tracks are pediatric mortalities (none so far this season) and hospitalizations.

The one thing that is being stressed by all three health officials is the importance of hygiene and taking advantage of influenza vaccination.

“One of the things everyone has been talking about is the strain of virus in this year’s vaccination not being effective for prevention,” said Rutkowski. “It may not be as effective at prevention, but where you really see the difference is in duration and severity (of the flu.) It’s the difference of two or three days of missed work and 10 days of missed work. It’s really a significant impact.”

Kindrai and Simmons both echo Rutkowski’s observation, citing plenty of available vaccine. In addition to stocks maintained by the county and hospitals, local clinics and pharmacies offer vaccinations, as well.

Most insurance will cover the cost of vaccination, according to Rutkowski. For those who need to pay out of pocket, she suggested calling around as rates can run on average between $40 and $80.

Prevention is your - and my - best medicine

Practicing good hygiene is both about prevention for self and prevention for others, explained Simmons. Washing your hands frequently is key to reducing your chances of catching influenza, as is being sure to stay well rested and eating well. And if you are sick, he stressed staying home, drinking plenty of fluids, getting plenty of sleep, and eating healthy, nutritious foods as vital to recovering.

If you must go out when you are sick, Simmons said, practicing good cough hygiene reduces your chance of making others sick.

“Cough into the crook of your elbow, and not on your hands,” Simmons suggests.

Rutkowski also suggested using facemasks and making sure to keep your hands clean. Hand washing when you are already ill can help prevent not only the possible transmission of influenza, it may reduce your chances of exposure to secondary infectious diseases, she explained, as can avoiding touching your ears, nose, or mouth.

Reducing the spread of influenza virus is a major effort at hospitals and clinics, Rutkowski added. Area hospital and clinic staffs are constantly cleaning to reduce exposure.

The health officials also stress that in addition to staying home and not going to work or school, notifying your doctor if you think you have influenza is wise.

Some people are more susceptible to flu complications that can result in hospitalization and sometimes death. Pneumonia, bronchitis, sinus infections and ear infections are examples of common secondary complications. Populations of particular concern include all children under 5-years-old and people over 65-years-old, pregnant women, residents of nursing homes, people of Native American and Native Alaskan descent, and people with chronic conditions such as asthma, chronic lung disease, heart disease, endocrine and organ disorders, and impaired auto-immune disorders.

“Your doctor may recommend antivirals, which work particularly well if administered in the first 48 hours,” Kindrai said.

Hospital impacts

The severity of the season has left some hospitals and clinics struggling across the country. Staffing shortages and IV saline solution shortages have both been reported.

So far, southwest Wisconsin has fared well, and is expected to continue to do so, noted both Simmons and Rutkowski.
The shortage of IV saline solution experienced by some hospitals as they respond to influenza hospitalizations resulted from the closure of a primary manufacturing facility when Hurricane Maria hit Puerto Rico.

That sparked Grant Regional to make proactive orders, noted Rutkowski. Grant Regional has received and responded to requests from other regional hospitals experiencing IV saline solution shortages. They remain well stocked and expect to make it through the season without a problem, as is Crossing Rivers.

Rutkowski and Simmons both also noted that while they have experienced some illness, hospitals and clinics associated with the hospitals have remained fully staffed. They attributed that to having all employees get the influenza vaccination.

Vaccination FAQ

Kindrai noted that the Centers for Disease Control and Prevention (CDC) is recommending influenza vaccination injections. The CDC recommendation is to not use the nasal spray flu vaccine (LAIV).

Injected influenza vaccines have been updated to better match circulating viruses, with the influenza A(H1N1) component updated. Additionally, they are recommending high-dose shots and shots made with an adjuvant to trigger a stronger immune reaction for older adults.

Flu vaccines protect against the three or four viruses (depending on vaccine) that research suggests will be most common. For 2017-2018, three-component vaccines are recommended to contain:  A/Michigan/45/2015 (H1N1)pdm09-like virus (updated); an A/Hong Kong/4801/2014 (H3N2)-like virus; and B/Brisbane/60/2008-like (B/Victoria lineage) virus.

Quadrivalent (four-component) vaccines, which protect against a second lineage of B viruses, uses the same viruses recommended for the trivalent vaccines, as well as a B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

While it is recommended to get the vaccination before influenza season starts - it takes about two weeks after vaccination for antibodies to develop in the body that protect against flu – it’s not too late to benefit from the shot now, noted the health officials. There is no way to know when influenza season will peak or end. While influenza spreads every year, the timing, severity, and length of the season varies from one year to the next.

Reducing the severity is the key aspect of the influenza vaccine this year, Kindrai pointed out. Each year, thousands of people die from influenza and influenza-related secondary infections – between 3,000 and 49,000. The vaccine and good hygiene are our best defense against influenza-related mortality.

 

For those who would like to assist Damien Lord's family with expenses, donations can be made via a GoFundMe page. (https://www.gofundme.com/damien-lords-funeral-funds)

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