Flu season came early for the South Bend area this year, with some local health care providers seeing a spike in the number and severity of influenza cases.
The early spread of the flu, reflecting a steady increase at the state and national level since the start of December, has already led to dozens of emergency-room visits and strained some pharmacies’ supplies of medicine.
At Memorial Hospital’s emergency room, the percentage of patients complaining of flu symptoms increased to 4.29 percent this week, compared with just more than 2 percent of all ER patients last week, said Kelly Jolliff, an infection prevention specialist with the hospital. In all, she said, the emergency room sees more than 4,000 people per month.
The number of flu patients is a big increase from the norm in late December, when flu patients typically account for less than 1 percent of all ER visits, Jolliff said.
“This is definitely early influenza activity,” Jolliff said. “It’s hitting us harder earlier this year.”
Experts have linked the rise in flu cases around the United States this year to the H3N2 strain of influenza A.
The H3N2 subtype of the influenza virus is one of the predominant strains of seasonal flu in the United States. A version of the H3N2 virus is included in all flu vaccines, but because of ongoing mutations and changing characteristics of H3N2, the U.S. Centers for Disease Control and Prevention says it’s not possible to predict with certainty if the flu vaccine will be a good match to combat this season’s flu virus. On Dec. 16, the CDC reported that 90.4 percent of influenza positive tests nationwide this season were from the H3N2 subtype.
The H3N2 strain is also among the more severe varieties of influenza. Last year, the flu vaccine was 32 percent effective against the H3N2 strain, the lowest effectiveness the vaccine had among the different flu viruses.
“The H3N2-dominant seasons are usually a little more severe,” said Sara Hallyburton, a respiratory epidemiologist with the Indiana State Department of Health. “There might be more flu-associated deaths and hospitalizations because of H3N2.”
Jolliff, the infection prevention specialist at Memorial Hospital, said more than half of all confirmed flu patients at the emergency room have required hospitalization this month. In some years, fewer than 40 percent of flu cases at the ER are severe enough to require hospitalization, she said.
Through Dec. 16, two people had died from the flu in Indiana this season. One was under the age of 18, and the other was between 50 and 64, according to the health department.
Flu cases have increased sharply across the country since Dec. 9, according to the CDC. As of Dec. 16, Indiana was one of 23 states with “widespread” flu activity. Nine of 10 U.S. regions had an “elevated” number of cases being reported by outpatient health providers, according to the CDC’s weekly report.
In Indiana, public health officials consider the state to have entered flu season once complaints of flu-like illness account for at least 2 percent of visits to hospitals and doctors’ offices.
Last year, the state did not hit the 2 percent baseline until early February. But this year, doctors and hospitals were reporting flu-like symptoms in those numbers by mid-December, according to the most recent data from the state health department.
Data on flu cases was not immediately available Wednesday afternoon from St. Joseph Regional Medical Center, Elkhart General Hospital or Goshen Health Hospital.
But Donald Troyer, a physician at Family Medicine of South Bend, said the practice has also seen an increase in patients coming in with flu-like symptoms.
“The early increase is definitely one thing we’re noting. The number of patients coming in peaked last week,” Troyer said. “Influenza A is the more common one that we’ve been seeing.”
Troyer said he was also aware of pharmacies that were running low on Tamiflu, a prescription drug that treats influenza, but said his patients hadn’t called about having issues getting their prescription filled.
He cautioned that people who have flu symptoms should avoid large gatherings, and those whose professions bring them in contact with a lot of people should get an influenza test before returning to work. People who have tested positive for influenza should stay home for a week, Troyer said, to prevent spreading the virus to others.
Troyer also said those who aren’t sick should frequently wash their hands and make sure they have gotten a flu vaccine.
Allison Mack, a spokesperson for Walgreens, said the pharmacy chain has noticed an “increase in demand for antiviral medications in the area.”
Joe Brown, laboratory manager at St. Joseph Health Mishawaka and employee of the South Bend Medical Foundation, said the lab has triggered its “winter rules” for flu testing after reaching a predetermined threshold of flu cases.
“We certainly have had an increase (in positive influenza tests),” Brown said “In the middle of summer, if you have flu-like symptoms, it’s unlikely that you have the flu. But with the winter rule, if someone is symptomatic, it’s known to be in the community by the providers, they want a solid answer for the reason. So we order a test with a potential reflex test, even if the initial test comes back negative.”
Jason Burghdus, pharmacist at the Ironwood Drive Walgreen’s store, said even if the flu vaccine isn’t as effective this year as it was in the past, individuals who are vaccinated could still see benefits.
“It takes a couple weeks to be effective. But you’ll still have protection for last half of January and February if you get it now,” Burghdus said. “(The vaccine) can still reduce the severity for lots of different types of the flu.”
Hallyburton, the epidemiologist with the state health department, urged those preventive measures, as the season is just beginning.
“It’s been steadily increasing over the past few weeks, and I expect it to continue,” she said. “I don’t think we’ve reached the peak of flu season yet.”