Flu Season Hits Marin, Could Pack a Wallop

The virulent strain of influenza that has overwhelmed doctors and hospitals in some East Coast cities has officially arrived in Marin.

For the first week of 2013, Marin recorded 19.8 percent positive influenza tests, crossing the 10 percent threshold that indicates that “it is actively circulating in our community, according to Matthew Willis, the public health officer for the county of Marin. The county recorded 6 percent positive test fo the final week of 2012, Willis said.

Willis said the timing of influenza’s full-bore arrival in Marin is right on schedule, just a few days before it arrived here in 2012. The rate of increase over the past two weeks is also within the norm, said Willis, a San Anselmo resident. 

“This is not an outbreak, per se – it’s an anticipated seasonal event,” he said.

Because California tends to get influenza later, public health officers like Willis have the benefit of being able to look at other regions that are experiencing it earlier to see what our experience will be in terms of the strain of influenza, its virulence and the success of the vaccine against it.

Unlike the unusual H1N1 strain in 2009-02010, this season's dominant strain is H3, a common seasonal strain of flu.  

Willis said this year's vaccine – each year it is tweaked in a guessing game of designing the vaccine to the expected strain – "matches the H3 strain very well. So we’re reassured with that. For those people who have been on the fence, this is a good time to go and get vaccinated because it is the beginning of the season.

"And there is no evidence that we’ll have any shortage of vaccine,” Willis added.

The bad news, Willis said, is that this year's strain may be a more virulent strain among the common seasonal strains. That was evident last Friday when the U.S. Centers for Disease Control and Prevention said that influenza officially reached epidemic proportions in the United States, with 7.3 percent of deaths last week caused by pneumonia and the flu.

The percentage of positive influenza tests are taken from Marin General Hospital and Novato Community Hospital emergency departments and the Sutter Terra Linda Urgent Care Center.

Willis said there a number of other factors his office tracks to monitor the spread of – and response to – influenza. They include whether or not emergency rooms are diverting patients with flu-like illness elsewhere (they’re not), increased use of artificial respirators for flu patients (not yet), and increased hospital admissions for the flu (also not yet).

Willis directed residents to the county's influenza website for detailed info on how to stave off influenza. That messaging is repeated with each arrival of flu season:

• Cough and sneeze into your elbow
• Wash your hands frequently and for at least 30 seconds with soap
• Don’t go to work or school if you are sick
• Get a flu shot

That final point - getting a flu shot - remains critical, Willis said.

But it also can be a tough sell, particularly in the wake of a recent New York Times story that drew from a report from the Center for Infectious Disease Research and Policy at the University of Minnesota. The report concluded that influenza vaccinations provide only modest protection for healthy young and middle-age adults, and little if any protection for those 65 and older, who are most likely to succumb to the illness or its complications. 

“We have overpromoted and overhyped this vaccine,” Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy, as well as its Center of Excellence for Influenza Research and Surveillance, told the Times. “It does not protect as promoted. It’s all a sales job: it’s all public relations.”

Despite the controversy, Willis said the influenza vaccine "is our best line of defense and has been known to reduce the duration and severity of symptoms, as well as to reduce the mortality rate from influenza."

More than one-third of U.S. residents have already been vaccinated against the influenza virus, the Centers for Disease Control and Prevention announced last week.

The Flu

Influenza—more commonly known as simply "the flu"—is a contagious respiratory illness caused by viruses infecting the nose, throat and lungs. It spreads via infected people coughing, sneezing or talking, though people can also get infected by touching something with the flu virus on it before touching their mouth, eyes or nose.

The Centers for Disease Control and Prevention offers the following information:

• Who should get vaccinated
• When to get vaccinated
• Selecting a flu vaccine
• Symptoms, complications and severity
• Treatment if you get the flu
• How flu spreads

Symptoms of the flu include muscle or body aches, headaches, cough, sore throat, fatigue, fever or chills, and vomiting and diarrhea (the latter two are more common in kids). The flu can also worsen chronic medical conditions or cause death.

People are contagious a day before symptoms appear and up to a week after getting sick.

Flu Shot

The CDC recommends getting annual vaccines as early as possible, as it takes a few weeks to reach full immunity. Vaccines often cost $20-$30; however, they are often covered by insurance.

Flu shots are an inactivated vaccine made from killed virus, which means it’s impossible to get the flu from the vaccine, according to Dr. Angela Rasmussen, an infectious disease expert.

There are currently three flu shots being produced in the U.S.: the regular (intramuscular) seasonal flu shot, a high-dose vaccine for people 65 and older, and an intradermal (injected into the skin) vaccine for people ages 18 to 64.

In addition, a nasal-spray flu vaccine made with live, weakened flu viruses (which also do not cause the flu) is available to healthy people ages 2 to 49 years old, except pregnant women.

The most common side effect from a flu shot is soreness at the injection site.

The elderly, young children, pregnant women and nursing home residents are at greater risk for serious complications from the flu. People with chronic medical conditions such as asthma, diabetes, cystic fibrosis and chronic lung disease—as well as those who work with them—are also at risk.

“People at high risk should talk with their doctor about getting a high-dose 
flu shot, as this can provide better protection for people with immune
 systems that have been weakened by age or other medical conditions,” Rasmussen said.

People with severe chicken egg allergies, a history of Guillain-Barré syndrome, and those who have had a severe reaction to a flu vaccine in the past should consult their doctor before getting a flu shot, and those who have a moderate or severe illness with a fever should wait to get vaccinated until they are well. Babies under six months of age should not get a flu shot.

Vaccine Info for Marin Residents

If you're considering getting a flu shot, Willis suggests visiting your health provider. To find the location nearest you, use the Flu Vaccine Finder at the top of this page. You can also use the Clinic Finders on the county's influenza website. Here are some places in Marin to get the vaccine: 

• CVS - 150 Donahue Street, Marin City
• Passport Health - 28 Mitchell Blvd., San Rafael
• CVS - 909 Grand Ave., San Rafael

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