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Health Care Professionals Warn About Flu

by and on February 12, 2014 9:20 AM

With flu season in full swing, area medical providers stress the importance of the vaccine and warn about a possible uptick in cases over the next few weeks.

As of Jan. 29 flu was considered widespread in Pennsylvania, meaning there are outbreaks of flu or increases in influenza-like illness cases and recent laboratory-confirmed influenza in at least half of the regions in the state, with recent laboratory evidence of influenza in the state, according to the PA Dept. of Health.

From Sept. 29, 2013 through Jan. 25, 2014, 218 cases of flu were reported in Centre County, the PA Dept. of Health states, and as of Jan. 28, 38 influenza-related deaths were reported in Pennsylvania.

Geisinger Health System has documented 61 cases of influenza diagnosed through its medical laboratory as of Jan. 9.

The most prevalent strain appears to be H1N1, and in Pennsylvania this strain makes up 96 percent of the flu that is out there, according to Geisinger. The H1N1 strain affects younger, healthier people.

"Our concern is that this year will be worse than last year," says Dr. Lisa Esolen, medical director of infection prevention, control and health services at Geisinger Health System. "We are seeing a higher incidence of younger adults with serious disease requiring hospitalization."

So far this year, 34 percent of all hospitalizations are in people aged 18 to 49, as compared with only 16 percent last year. The severity of flu season is influenced by the strain of virus that is circulating, Esolen says.

"This year the strain is the H1N1 pandemic strain from 2009-10 which has a tendency to afflict younger adults more severely," she says.

The flu season is expected to get worse. Esolen expects the incidence will dramatically increase over the next six to eight weeks.

Dr. Raymond Nungesser, family practice physician at Geisinger in Lewistown, agrees.

"Flu season is here," he says. "(It's) not yet peaked."

Nungesser saw more flu cases this past week than the previous week, and expects to see even more next week.

This season's virus is causing more than just illness at home. "This particular strain has already killed," Nungesser says, explaining some of those deaths have been in children.

The current flu vaccine covers the H1N1 strain, and it is recommended for all people over the age of 6 months unless they have an allergy or other contraindication.

"Influenza vaccination is not indicated in babies under 6 months of age, anyone who has a life-threatening allergic reaction to eggs, anyone who has a history of a severe neurologic/paralyzing reaction to a prior influenza vaccine, or if you are currently ill with a fever," Esolen says.

Additionally, the intranasal liquid vaccine, which avoids needles, is available. However, it has precautions of its own, and patients should talk with their physicians before receiving it.

Even those who have already had the flu this season should still consider the vaccine, Nungesser says.

"There are multiple strains ... that are still attacking," he says.

All Geisinger employees are required to get the flu vaccine. Those who are unable to must wear a mask.

Nungesser says the vaccination policy isn't just to keep health care workers safe; it's to reduce contagion within the community.

"We're trying to be a good cocoon for the community," he says.

Vaccines are available at all Geisinger clinics.

At Mount Nittany Medical Center, 133 patients had tested positive for influenza as of Jan. 28.

"That's probably just the tip of the iceberg," says Marlene Stetson, infection control coordinator at Mount Nittany Medical Center.

Stetson says many people don't seek care for the flu, many don't get tested for the flu, and many receive a negative test when they really do have the flu, so the numbers likely are higher than reported.

Since the second week of December, cases have really "ramped up," Stetson says, and have been consistent since. However, she doesn't know if flu has spiked yet, or when it will spike.

The typical flu season is November through March. "We can still see flu into April but it will have tapered off by that time," Stetson says.

The bulk of reported cases have been the H1N1 strain, Stetson says, followed by Influenza A. The medical center is seeing a variety of ages affected by flu this season, especially those aged 30 to 50 and those under 10 years of age.

Stetson says it is common to associate the flu with the elderly, but H1N1 seems to affect middle aged and healthy folks.

The vaccine is recommended for anyone over the age of 6 months, Stetson said, especially high risk patients, such as those with underlying health conditions and those who are pregnant. The vaccine can be received through the end of March.

"We're seeing some pretty serious illness with influenza," Stetson says, including hospitalizations and those requiring intensive care treatment. There's plenty of vaccine available and she says it's not too late to vaccinate.

To help protect against the spread of the flu, Mount Nittany Medical Center has established a vaccination campaign for health care workers in which they are given the choice to receive a vaccination or wear a surgical mask within 6 feet of patients. Additionally, the medical center has a variety of hygiene station kiosks which include information about the flu, masks and hand sanitizers.

To help improve accuracy of flu testing and reporting, the medical center has implemented new technology to test for the flu. The test, which is a nasal swab, examines a patient's DNA to detect the virus. The test is nearly 100 percent sensitive and can even detect a dead virus.

The test, which was introduced this year, hopefully will improve the accuracy of testing and help physicians better treat patients.

"(It will help them) hone in on their clinical decision making," Stetson says.

Common symptoms of the flu include a high fever, body aches, and sometimes gastrointestinal symptoms, such as vomiting or diarrhea, most often in children. Whereas a common cold may come on gradually, the flu hits rather suddenly.

"We'd encourage all visitors not to visit if they're ill with influenza symptoms," Stetson says, adding that anyone who is sick should stay home from work and other activities.

People can protect against the flu by practicing frequent hand washing, using alcohol-based hand sanitizer, covering their coughs and receiving the flu vaccine.

Those who suspect they might be ill with influenza should contact their physicians. Vaccines are available at Mount Nittany Physician Group practices.

Based on the Centers for Disease for Disease Control and Prevention projections, the PA Dept. of Health estimates that five to 20 percent of Pennsylvanians get the flu each year and 200 to 2,000 die from complications of influenza. Click HERE for more information from the Pennsylvania Department of Health.

For more information about Geisinger click HERE. and to learn more about Mount Nittany Medical Center click HERE.

Further flu information, provided by the Centers for Disease Control and Prevention:

Most experts believe that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or nose.

Most healthy adjust may be able to infect others beginning one day before symptoms develop, and up to five to seven days after becoming sick.

Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration and worsening of chronic medical conditions.

To see the CDC's flu facts page click HERE.

This story was produced by the staff at the Centre County Gazette. It was re-published with permission. The Centre County Gazette is a weekly publication, available at many locations around Centre County every Thursday morning.

Staff Writer at The Centre County Gazette
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