The most common strain of influenza that's circulating this season seems to be hitting young people harder than older people, experts said Friday.
In its report this week, the Iowa Department of Public Health noted that the CDC had received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with H1N1. “Multiple H1N1-associated hospitalizations, including many requiring intensive care unit admission, and some fatalities have been reported,” officials said.
During the 2009 H1N1 outbreak, the strain caused more illness in children and young adults than in older adults. Given the strain's prevalence this year, the U.S. Centers for Disease Control and Prevention warned that this flu season could be similar.
Iowa's own testing has shown this to be the case. "Influenza A (H1N1) is the predominant strain of influenza in Iowa at this time (115/150 laboratory confirmed cases of influenza this season have been H1N1)," Iowa health officials said. "About 2/3 of all laboratory confirmed cases of influenza have occurred in people 5 to 49 years of age, and this age group has accounted for most of the recent reported hospitalizations."
Iowa officials reported Friday that they had upgraded the state's influenza activity level from “local” to “regional” because of increased activity in the central and eastern parts of that state.
In Nebraska, about 94 percent of cases are influenza A 2009 H1N1, the state reported.
“We're definitely seeing H1N1,” said Dr. Tom Safranek, Nebraska's state epidemiologist.
“We're like all the rest of the country. The virus strain that first showed up in mid-April 2009, that pandemic strain that swept through the world, is still with us. That's what's causing this year's cases.”
H1N1 was included in the flu vaccine that is available this year, said Dr. Mark Rupp, chief of the division of infectious diseases at the University of Nebraska Medical Center.
Influenza was widespread in 10 states, including Kansas and Wyoming, the CDC said Friday in its report for the week that ended Dec. 21. Nebraska and Iowa reported “regional” influenza outbreaks or influenza-related illnesses. “Regional” is the level below “widespread.”
“Week by week, we're seeing a steady, incremental increase,” Safranek said.
Still, the number of cases confirmed by a lab — usually a fraction of the cases — is less than half the total at this time last year.
Missouri, Oklahoma and four states along the Gulf Coast were reporting a high percentage of outpatient visits because of flulike illnesses, the CDC said.
Joeanna Jacobs of Bellevue came down with influenza just after Thanksgiving. “I had a horrible, painful cough,” said Jacobs, 28. “Migraines that would never end. Ear pain. Body aches.”
The illness lasted 10 to 12 days, she said. Her husband and 2 ½-year-old daughter also got the flu. They had it longer, Jacobs said, but their symptoms weren't as severe as hers were. Doctors at the UNMC Physicians Clinic in Bellevue prescribed Jacobs the antiviral medicine Tamiflu, which she thinks helped her recover faster.
Jacobs is 35 weeks' pregnant. That, she said, probably made her feel worse than she otherwise would have felt. She and her daughter hadn't gotten a flu shot. Her husband, who is in the military, was required to be vaccinated.
Rupp and Safranek both said the flu shot is the best way to avoid getting influenza.
People who haven't gotten vaccinated, particularly those in high-risk groups, should do so now, Rupp said. It takes about two weeks after the shot for the person to develop immunity, he said.
About 15 percent of people, Rupp said, will develop some sort of complication from influenza — bronchitis, ear or sinus infections or pneumonia.
Sometimes, people who have battled influenza will feel better for a couple of days and then get another fever and cough, said Dr. Anne O'Keefe, senior epidemiologist with the Douglas County Health Department. They may have developed bacterial pneumonia, she said. That can progress rapidly, she said, and antibiotics are needed to combat it.
“A bacterial infection in the lung can be a lot more severe than viral infections,” she said. “It's something you have to be aware of.”
In addition to getting the flu shot, Rupp recommended that people wash their hands frequently; avoid others who are coughing or sneezing; eat a healthy diet; exercise; and get plenty of rest. “Keep your system as healthy as possible,” he said.
Do I have the flu?
You may have influenza if you have some or all of these symptoms:
• Sore throat
• Runny or stuffy nose
• Body aches
• Diarrhea and vomiting (sometimes)
*Not everyone with influenza will have a fever.
Most people with influenza have mild illness and do not need medical care or antiviral drugs. If you have flu symptoms, you should stay home and avoid contact with other people except to get medical care. If, however, you have symptoms of influenza and are in a high-risk group, are very sick or worried about your illness, contact your health care provider.
Source: Centers for Disease Control and Prevention