While not as severe as last year’s extreme influenza epidemic, the flu continues to take its toll on New Jersey in the current season. And even with the worst of winter behind us, experts caution that the viral outbreak remains a threat to public health.
Their message to the public is it’s not too late to vaccinate.
Flu shots are relatively effective this year and they are the best way to protect individuals and their families — and those who can’t be vaccinated for medical reasons — from the potentially deadly disease, doctors and public health experts note. It’s also important to wash your hands, cover your coughs and sneezes, and stay home from school or work when you are sick, especially with a fever.
“There is high flu activity in the state, so it’s important for those who have not yet gotten a flu shot to get vaccinated, especially children, the elderly, and people with certain health conditions who are at high risk for serious flu complications,” state health commissioner Dr. Shereef Elnahal said last week. “Influenza can cause severe illness and unfortunately can be deadly, especially in these vulnerable populations.”
The state Department of Health announced in late February that an infant from northern New Jersey had died of influenza-related complications; it was the third pediatric flu-related death this season. The baby had several underlying medical conditions that made vaccination inappropriate.
Days earlier, the department confirmed the death of a north Jersey toddler connected to the disease. And a child in central New Jersey died in December as a result of the virus, according to the DOH, which did not release additional information for privacy reasons.
To combat the spread of the virus — which can lead to a contagious respiratory illness with symptoms that include fever, body aches, chills, nausea and more — the DOH launched a multimedia public awareness campaign #fightthefluNJ in October. It continues to encourage people to get vaccinated and take other precautions.
In February, Elnahal joined leaders at Penn Medicine Princeton Medical Center to talk to healthcare workers about the importance of these acts and to celebrate its own staff vaccination rate of 98 percent; the remaining two percent had medical or religious reasons for being exempt, the DOH said.
Dr. Uzma Hasan, the division chief of pediatric infectious diseases for Saint Barnabas Medical Center, part of the RWJ/Barnabas healthcare system, agreed last week that it is still not too late to get a flu shot. “Flu transmission is ongoing and vaccination prevents severe illness, hospitalization and death from influenza. It also protects against other strains of influenza which may circulate later in the season,” she said, urging that all individuals older than six months get a flu shot.
Experts note that, while often associated with winter, flu season technically extends into April or May. Reports in New Jersey show the state had also confirmed three pediatric deaths at this point last year. The 2017-2018 flu season peaked late and was particularly severe, driving high numbers of patients to the emergency room. When the final tally was in, by October 2018, five young patients had died for reasons related to the virus.
The risks of going unvaccinated
While this year may not share all the extreme characteristics seen last year, Hasan and others stress that we have yet to see the full impact of the current flu season; state data show that the disease is still taking a significant toll on public health. “I think cumulative numbers (for pediatric mortality) at end of season will be comparable to other years,” Hasan said, noting that those who are unvaccinated are particularly at risk.
According to the latest weekly flu data for New Jersey, the outbreak appeared to be slackening in the northeast corner of the state, specifically Bergen, Hudson and Essex counties. But the remaining 18 counties all reported “high” influenza activity, a status that had been the norm for months in all areas of the state.
Several thousand people have tested positive for various strains of influenza in recent weeks, but the numbers are down from the 2017-2018 season. Flu-related absences at school are also lower this year, as is the number of cases reported among residents at nursing homes and other long-term care facilities.
At the end of 2018, emergency-room visits were running above the average for the three highest flu seasons, but the rates have since dropped below that trend line. Still, flu-related concerns accounted for more than 5 percent of all ER visits in the middle of February. Hospital admissions tied to influenza, which had been trending close to the three-year average for high-activity seasons, have also dropped, the mid-month report showed. These comprised over 3 percent of total admissions at that point.
Hasan, with Saint Barnabas, said much of the flu-related hospital traffic she has seen this year involves children who have other health issues that put them at greater risk for adverse impacts of the virus. “The majority of children we have seen in our ER who have required inpatient admission are unvaccinated, with secondary bacterial pneumonias, or children with chronic medical issues, who are at risk of overwhelming illness from influenza, particularly when unvaccinated,” she said.
Effects on public health
Since children with compromised immune systems can’t be vaccinated, experts stress that protecting public health depends on other individuals getting their flu shots. Studies by the federal Centers for Disease Control and Prevention suggest this year’s flu virus is effective in reducing respiratory infection in nearly half of those infected and is more than 60 percent effective in children. (Influenza viral strains are constantly evolving, requiring new variants of vaccines each year, and making it essentially impossible to completely guard against all types of the disease.)
Vaccination is “the most important step in protecting against the flu since it can reduce the risk of hospitalization and serious health consequences,” said Dr. Tina Tan, an assistant commissioner at DOH and the state epidemiologist, in a recent public video message. Covering coughs, hand washing and staying home when sick are also key factors, she said.
It’s also important to “dispel the myth” that children get sick from the flu shot, Hasan added. While vaccinated children may get sick, it is likely they are picking this up from somewhere else, she said.
“We need to get the message across: Even if your child gets influenza after receiving the influenza vaccination their illness will be much milder, as the vaccine protects from overwhelming illness and death,” Hasan said.