Cases of the flu continued to rise over the past week, with the total number almost double what it was at this time last year and doctors saying this year’s illness could match or even surpass the numbers infected by the H1N1 pandemic of 2009.
The latest report from the New Jersey Department of Health, for the week ending last Saturday, logs almost 3,100 additional cases of influenza statewide compared with the prior week, ending January 27. Since the start of the flu season on October 7, 2017, laboratories have confirmed a total of 10,418 positive tests for the virus. The actual number of cases is likely higher, as not everyone with the flu visits a doctor and not every doctor will conduct a flu test.
That total of confirmed cases of the flu, a respiratory illness, surpasses by 5,000 the number tested last year at this time and exceeds the total logged through the entire 2015-2016 flu season that ended May 21, 2016, by 4,000.
“This week was a little worse; hopefully we are coming into the peak,” said Dr. Christopher Freer, chairman of the emergency department at St. Barnabas Medical Center in Livingston. “It looks like 2009 is the year we are going to be comparing with. These are the most cases we have seen going back to 2009. This year might be bigger, we won’t know until it’s over.”
The 2009 flu pandemic
The 2009 flu was called a pandemic because of its prevalence across the globe. It was also a unique virus, having emerged in the spring of 2009 — far earlier than the usual flu, which typically begins to increase in prevalence in October and ends in April — and continued through May 2010, according to Dr. Christina Tan, the state epidemiologist. Data on the number of cases from the outbreak are not comparable to current reports, so it is impossible to tell whether the current flu is more prevalent.
Comparing data for similar time periods from season to season can also be misleading, as flu activity is difficult to predict.
“It is impossible to say in advance precisely when the 2017-2018 flu season will peak or end, how severe it will be, or what viruses will circulate over the course of the flu season,” said Donna Leusner, a DOH spokeswoman.
The 2009 pandemic was a variation of the H1N1 virus. The U.S. Centers for Disease Control and Prevention estimates that between 43 million and 89 million people got the flu between April 2009 and April 2010, while in a typical year, flu infects between 9 million and 36 million people. The pandemic was also an especially virulent strain, resulting in 42 deaths in New Jersey alone.
So far in New Jersey this year, only one death has been attributed to the flu, that of a 4-year old girl last December. The state is seeing very high levels of emergency room visits for the flu and influenza-like illness, similar to what occurred during the 2009 pandemic.
The Spanish flu of 1918
This year’s flu occurs 100 years after the world’s deadliest flu pandemic, the so-called Spanish flu of 1918, which was also an H1N1 virus that reportedly infected 500 million people worldwide and resulted in the deaths of between 50 million and 100 million, including 670,000 Americans.
“In general, most people are going to be fine with the flu,” said Dr. Judy Wong, an emergency room physician at Englewood Hospital and Medical Center, which has also seen an uptick in cases. “It will last for about five to seven days. You need to stay hydrated, use proper hand hygiene, cover your mouth when coughing, and stay home from work or school.”
The flu can be more serious for young children, those over age 65, pregnant women, and people with certain other illnesses — including chronic lung diseases, heart disease, and immunodeficiency disorders.
Leusner said AH3 is the predominant flu strain this year and seasons in which this virus dominates often are associated with more severe illnesses, especially in young children and those over age 65. The state also has a substantial amount of influenza B. Emergency room visits resulting in hospitalization also tend to be higher with an AH3 strain and this season’s hospital admissions are higher than in 2014-2015 and 2012-2013, two other years in which AH3 dominated.
A large number of influenza outbreaks have occurred in long-term care facilities, with more than half of those reported in the past three weeks, which is similar to what happened in 2014-2015, Leusner added.
Beyond the Garden State
New Jersey is not alone in suffering, with nearly every state and Puerto Rico reporting widespread influenza activity. According to the CDC, 17 children have died across the country.
As the numbers of those suffering with the flu continues to grow, people and institutions are making changes to try to prevent its spread.
For instance, Catholic churches have suspended the distribution of wine, and parishioners are nodding or waving rather than shaking hands, at the exchange of the sign of peace.
CentraState Healthcare System in Freehold is restricting most patient visits to those age 14 and older and asking anyone with respiratory symptoms to not visit patients. Those who do visit are being asked to wash their hands or use hand sanitizer when entering and leaving the facility, wash immediately after coughing or sneezing, and wear a disposable mask if they are sick and must travel through the hospital.
While this year’s flu vaccine is reportedly less than optimally effective against the current flu strains, doctors say getting vaccinated, even now, is still the best way to avoid getting sick. Monmouth County had a free flu clinic in Tinton Falls on Tuesday.
Beyond that, Freer suggested, “Just be germaphobic at this time of year. Wash your hands or use hand sanitizer.”
For those who do get sick and can get to a doctor early enough, antiviral medication taken within the first 48 hours of onset can lessen the length and severity of the flu. Symptoms that distinguish the flu from a common cold are that the flu’s symptoms come on abruptly and usually include fever, chills, and headache and body aches. Anyone in high-risk groups should definitely consult with a physician as soon as possible, but so should anyone else with concerns about their health.
“When in doubt, get checked out,” Wong said. “That’s why we’re here, to help people.”