The 2022 flu season started a month early, severity is highest in 13 years

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The flu is hitting the United States unusually early and hard, causing the most hospitalizations at this time of the season in more than a decade and underscoring the potential for a dangerous winter of respiratory viruses, according to federal health data released Friday.

While the flu season is usually between October and May, peaking in December and January, it came about six weeks earlier this year with unusually high illness. There have already been at least 880,000 cases of influenza illness, 6,900 hospitalizations and 360 influenza-related deaths nationwide, including one child, according to estimates released Friday by the Centers for Disease Control and Prevention.

Since the 2009 H1N1 swine flu pandemic there hasn’t been such a high burden of influenza, a metric used by the CDC to estimate the severity of a season based on laboratory confirmed cases, doctor visits, hospitalizations and deaths.

“It’s unusual, but we’re coming out of an unusual covid pandemic that has really hit the flu and other respiratory viruses that are circulating,” said Lynnette Brammer, an epidemiologist leading the CDC’s national flu surveillance team.

Activity is high in the south and southeastern United States and is starting to move up the Atlantic coast.

The CDC uses a variety of measures to monitor influenza, including estimating the rate of doctor visits for flu-like illnesses. But given the similar symptoms that could include people seeking care for covid-19 or RSV, another respiratory virus with similar symptoms, the laboratory data leaves no doubt.

“The data is disturbing,” said William Schaffner, Medical Director of the Nonprofit National Foundation for Infectious Diseases and Professor of Infectious Diseases at Vanderbilt University School of Medicine. “Not only is the flu precocious, but it also looks very serious. This is not just a preview of the upcoming attractions. We are already starting to see this movie. I would call it a scary movie.”

Adding to his concern, he said, is that his flu shot is delayed than usual at this point in the season. About 128 million doses of the flu vaccine have been distributed so far, up from 139 million at this point last year and 154 million the year before, according to the CDC.

“This makes me doubly worried” Schaffner She said. The high burden of the flu “certainly looks like the start of what could be the worst flu season in the last 13 years.”

RSV, other viruses that make it difficult to find a bed in children’s hospitals

The number of influenza cases this season is already an eighth of last season’s total estimate of 8-13 million cases.

The latest influenza data comes as the nation’s public health system grapples with multiple virus threats. Coronavirus cases are expected to increase as the country moves into colder weather and more people congregate indoors. New covid-19 subvariants with a greater ability to dodge immune defenses now account for 27% of cases, up from 17% a week ago. Children’s hospitals are filling up with a record number of RSV-infected children.

The effectiveness of the flu vaccine in preventing a doctor visit, hospitalization or death is uneven from year to year and has fluctuated between 40 and 60 percent in past years, according to the CDC. But Brammer and others say this season’s vaccine is well matched to circulating strains. This offers a “little ray of sunshine” for what could be a gloomy winter, Schaffner said.

Nationwide, the predominant virus – a particularly harmful strain, H3N2 – causes the worst outbreaks of the two. types of influenza A viruses and two influenza B viruses that circulate among people. The seasons when H3N2 dominates typically cause the most complications, especially for the very young, the elderly, and people with certain chronic health conditions, experts say.

What many people don’t realize is that even after someone has recovered from the flu, the inflammatory response generated by the virus continues to wreak havoc for another four to six weeks in those who are middle-aged and older, increasing the rate. of heart attacks and strokes, Schaffner said.

The flu hasn’t been a serious problem for the past two years, experts and health officials said, due to the masking, social distancing, and other measures people have taken to protect themselves from covid-19.

The omicron variant of covid-19 has morphed into dozens of immune subvariants. Frances Sellers of The Post explains the threat of these new strains. (Video: Jackson Barton, Sarah Parnass / The Washington Post)

Health officials tend to officially consider a flu season as ongoing after consecutive weeks of flu activity by different surveillance systems, including a significant proportion of outpatient visits for flu-like illnesses. Those doctor visits increased for three weeks in a row starting October 22, more than a month earlier than in previous seasons, CDC’s Brammer said.

Biden officials fear that the exhaustion of the pandemic could lead to a bad covid winter

Influenza is notoriously difficult to predict. It’s hard to know how long the season will last, how severe it might be, and whether different parts of the country will experience different levels of respiratory disease at different times. Last season, flu activity peaked in January, “then it dropped like a stone, then it burned just below the epidemic threshold beyond March through April, May and June,” Schaffner said. That “long smoking tail was very unusual”.

“An early start doesn’t always mean serious,” Brammer said.

In the Southern Hemisphere, the flu season was also very different, Brammer said. In Australia, there was “very strong, very fast absorption and then a very rapid decline,” she said. In Argentina, the peak of flu activity occurred in what would be that country’s summer.

“Things haven’t returned to a normal pattern,” Brammer said.

Chile anticipated its bad flu season, which began months before a typical season, by quickly vaccinating 88 percent of its high-risk population before the peak of flu activity, according to a CDC report this week. The flu vaccine used in Chile, which included a match for the dominant H3N2 virus, was about 50% effective in preventing hospitalization. The vaccine used in the Northern Hemisphere includes the same viral composition as the vaccine in the Southern Hemisphere, so experts hope the formulation could be just as effective in preventing serious flu diseases.

The latest CDC data shows that overall respiratory disease activity is “very high” in South Carolina and DC and “high” in 11 states: Alabama, Georgia, Louisiana, Maryland, Mississippi, New Jersey, New York City, North Carolina, Tennessee, Texas and Virginia.

Texas was among the first states to see flu activity in late September. At the Methodist hospital system in Houston, laboratory-confirmed influenza cases rose to 975 as of Oct. 20, up from 561 the week before, officials said.

Officials had been preparing for a more robust flu season this fall and winter because so many people have dropped out of covid protection measures and are reluctant to get vaccinated.

“It was something we expected because we are a hub and a lot of people travel here,” said Cesar Arias, head of infectious diseases in the hospital system. But, he said, “I didn’t expect to see that much [flu] so soon.

Arias said conversations about flu vaccines became related to hesitation about coronavirus vaccines. Conversations in Texas, “as you can imagine, [are] louder and at least more vocal, “he said.” We are struggling with this, trying to spread the message to get vaccinated. “

People need to get a new flu vaccine every year to be protected, and it takes up to two weeks for the protection to kick in and the vaccine to work. The flu is contagious before symptoms begin. The CDC recommends everyone 6 months and older to get a flu shot, ideally by the end of October.

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