LAKE COUNTY, Calif. – California is undergoing a flu season that appears to be one of its worst in the past decade, with the flu starting early and already resulting in the confirmed deaths of more than two dozen people, including one death in Lake County.
The California Department of Public Health, or CDPH, said influenza cases are widespread and increasing across the state, with flu activity currently at levels usually seen at the peak of the influenza season.
“Based on where we are today at this point in time, this appears to be one of the worst seasons we’ve had in the last 10 years,” said Gil Chavez, M.D., the state epidemiologist and deputy director of CDPH’s Center for Infectious Diseases.
At the same time, the Centers for Disease Control reported that influenza activity is widespread across 46 states, with only Hawaii, Maine, New Hampshire and New Jersey reporting regional activity.
CDPH closely tracks influenza, with that information forming the basis of its regular reports, posted on its Web site at www.cdph.ca.gov.
As of the most recent report, for the week ending Dec. 30, 27 influenza-associated deaths in persons under 65 years of age were reported to CDPH.
Only influenza deaths in persons less than 65 years are reported to CDPH so the total number of deaths due to influenza is higher.
Lake County Public Health told Lake County News that one county resident has died so far this flu season, with the Mendocino County Health and Human Services Agency reporting that four people have died from influenza-related illness since Oct. 1.
James Watt, M.D, chief of the Division of Communicable Disease Control at the California Department of Public Health’s Center for Infectious Diseases, said this flu season began earlier than usual, with case numbers ramping up in November.
Even so, “We are still early in the season,’ he said, noting that flu activity can continue as late as May.
The most common flu type circulating this season in California is Influenza A’s H3N2 strain, Watt said.
Watt said H3N2 is a more virulent strain of flu based on its characteristics and how it interacts with the immune system.
Similarly, the Centers for Disease Control reported that, as of Dec. 30, of the nearly 7,800 flu specimens tested nationwide, 87 percent were Influenza A, and of those, 90 percent were H3N2.
Watt said that, usually at this time of year, three to four flu deaths in people under age 65 are reported in California, far below the 27 confirmed by state officials on Tuesday. And the number state officials gave Tuesday may be low, as there is a delay between local public health departments confirming flu-related deaths and CDPH’s updates.
Several factors CDPH monitors such as doctors’ office visit and hospitalization are already at levels seen at the peak of more severe flu seasons, Watt said. “Both of those measures are above what we usually see this time of year.”
He said CDPH measures the percentage of visits. Based on the most recent report, almost 6 percent of people going to the doctor were going in with flu-like symptoms.
Watt said 10.6 percent of hospitalizations were due to pneumonia and influenza, numbers usually seen at a flu season’s peak.
“One thing that is consistent about influenza is that it is very unpredictable,” said Chavez.
As such, he said it’s challenging to predict which flu virus will dominate, and when flu activity will end or peak.
Each year the flu follows a different pattern, Watt explained.
This year, flu season started in Southern California, in San Diego in particular, then spread north throughout the entire state, said Watt.
Added Chavez, “We are early and we are trending up so we might end up having one of the worst seasons in some time.”
So far, however, this flu season hasn’t risen to the level of activity seen in 2009 when the H1N1 pandemic occurred, Chavez said.
He said the term “pandemic” is used by the World Health Organization to signify when flu is a worldwide problem. Health officials don’t feel they’re getting close to such a scenario in California this flu season.
The flu situation in Lake County
Lake County Public Health Nursing Director Carolyn Holladay told Lake County News that Lake County has had one reportable death from flu in a person under age 65 and two positive cases of flu in intensive care units. All three of those cases were reported in the time frame from Dec. 28 to Jan. 2.
Holladay said those three cases were all attributed to Influenza A; however, she did not have information available on the subtypes.
During the 2016-17 flu season, Lake County had one flu death, Holladay said.
At the local hospitals, officials are reporting a spike in activity.
At Sutter Lakeside in Lakeport, 27 percent of patients tested for flu last month came back positive, said spokeswoman Morgen Wells.
At Adventist Health Clear Lake, Colleen Assavapisitkul, RN, the vice president of patient care, noted, “During flu season, we always expect an increase of visits to the emergency department and admissions to the hospital. This year is no exception, and we are seeing many patients suffering from flu symptoms. Thankfully, we are staffed to meet this increased need for our services and our team is ready to serve our community members who are suffering from the flu.”
In neighboring Mendocino County, where four flu deaths have been reported this season, Adventist Health Howard Memorial in Willits has implemented temporary visitor restrictions and is asking young or sick visitors to stay away from the hospital unless necessary. Those restrictions are in effect until further notice.
Wells and Assavapisitkul said there are no plans to implement similar restrictions at Lake County’s two hospitals.
However, Assavapisitkul added, “We do ask that those with colds or those who may have been exposed to the flu virus stay home as to not endanger the health of their hospitalized loved ones and our other patients."
Officials urge vaccination
Health officials – including Chavez and Watt – are continuing to encourage Californians to get vaccinated for the flu if they haven’t already had a flu shot yet this season. It’s not too late, they emphasized; Watt said it takes about two weeks for the shot to take effect.
Chavez added that there is plenty of flu vaccine available in California.
Based on data from previous flu seasons, even when the vaccine isn’t 100-percent effective, Chavez said it offers important protections, including lessening the symptoms and complications, and reducing the number of overall cases.
Watt added that a report done last year showed that the flu vaccine reduces deaths in children.
Of the flu-related deaths so far this year in California, Chavez said 70 percent of those who died were not vaccinated.
Watt said the rate of Californians who are vaccinated for the flu ranges between 40 and 50 percent. “We’d love to see those numbers be higher.”
Chavez said the CDC works with the World Health Organization to understand flu activity as it’s happening across the globe, and to pinpoint what flu strains that may be circulating.
They tend to look at flu patterns in the Southern Hemisphere, which experiences the flu season first because they are going through winter at the opposite time of year. “That’s how they inform what strains end up in the vaccine,” Chavez said.
In Australia and across the rest of the Southern Hemisphere, Chavez said health officials saw flu strains now occurring in California. Those strains were included in this year’s vaccine.
There are usually three to four strains included in the vaccines, which are reviewed annually and updated as needed to match circulating flu viruses, according to the CDC.
“The strains are constantly evolving,” said Watt. “We wouldn't be able to include all the strains because there are new strains coming up all the time.”
Watt said that in February there will be information available from the CDC about the effectiveness of the current vaccine.
For information on the flu vaccine in Lake County, call Lake County Public Health at 707-263-1090.
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State officials report on high number of seasonal flu deaths; one death reported in Lake County
- Elizabeth Larson
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