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By Yen Duong

Move over, groundhog. Per the latest data, there are several more weeks of flu season ahead.

Dr. Katie Passaretti of Atrium Health talked to reporters about visitor restrictions due to flu on February 7. Photo credit: Yen Duong

Health department officials set a baseline “high flu activity” rate based on previous years’ data, said North Carolina State Epidemiologist Dr. Zack Moore.

Once you pass it, “you’re going to stay above baseline on average about six or eight weeks,” Moore said.

In response to rising flu rates, 43 hospitals in Charlotte and the central Piedmont started restricting visits from children today at 7 a.m. In press releases, Atrium Health, Novant Health, Cone Health, Wake Forest Baptist Health and Randolph Health asked that children 12 and under and anyone with flu-like symptoms avoid visiting.

“It’s not meant to be that this is a big scare time or anything like that,” said Dr. Katie Passaretti, Atrium’s medical director for infection prevention in a press conference on Thursday. “Children obviously are more often spreaders of germs […] so that’s the rationale behind asking children 12 and under not to visit the hospital right now; we’re kind of at that peak of flu activity.”

Medical staff can screen children for flu-like symptoms for exceptional visits, such as visiting a dying relative or the birth of a new siblings, but in general, they want to “keep kids to a minimum,” Passaretti said.

“This isn’t meant to be a hardship on people, but we really are trying to protect the people that are sick in the hospital,” Passaretti said.

Other North Carolina hospitals started implementing these limitation policies earlier this year. For instance, Mission Health began restrictions on Jan. 3, UNC REX Hospital on Jan. 11, other UNC Hospitals on Jan. 14 and Duke hospitals on Jan. 15.

Passaretti said that the eastern part of the state “tends to get hit with flu earlier,” which explains why those hospitals put restrictions in place before hospitals in the central part of the state did.

For all the providers, the restrictions will stay in place until further notice.

Hospitals ask that anyone with flu-like symptoms postpone visiting patients. Flu symptoms, per the Centers for Disease Control and Prevention, include:
  • A 100 degree F or higher fever or feeling feverish (not everyone with the flu has a fever)
  • A cough and/or sore throat
  • A runny or stuffy nose
  • Headaches and/or body aches
  • Chills
  • Fatigue
  • Nausea, vomiting and/or diarrhea (most common in children)

So far, more mild than last year

Flu season, as recorded by the NC Department of Health and Human Services, lasts from about the beginning of October to the end of May. This year is shaping up to be less severe than last year, with 35 flu-related deaths reported so far.

“Last year we had [391] deaths reported, which is the most we’ve ever had,” Moore said. “We know that’s the tip of the iceberg, because there’s a lot of [times] where deaths occur and they were never diagnosed or if they were, they weren’t reported.”

According to CDC “flu forecasting,” the flu season has probably not peaked yet and cases will continue increasing for the next few weeks. Moore said he prefers to not make predictions.

The proportion of doctor visits because of flu-like illnesses over time. Graphic credit: NC DHHS

“The only thing I can predict is that there’s gonna be flu going around for at least several weeks to come,” Moore said. He explained that “what comes up must come down,” so flu cases don’t disappear after a peak but instead gradually decrease to normal levels.

Two weeks ago almost 3.5 percent of North Carolinians seeking medical treatment at reporting providers had flu-like symptoms, according to NC DHHS. That’s the highest percentage yet this year.

About 150 emergency rooms, doctors’ offices and health departments electronically report the proportion of visits for flu-like symptoms to DHHS through the NC DETECT system, Moore said.

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“That’s been our most time-tested and reliable indicator of the intensity of the flu season,” Moore said.

Last year that number spiked to 10.3 percent at its peak, which fell in mid-February. In 2017, flu season peaked in late February.

Not too late for flu shot

As with other vaccines, getting the flu shot can protect vulnerable people nearby with so-called “herd immunity”. Seniors, children under five, pregnant people and people with certain chronic illnesses are particularly susceptible to complications from the flu. Of the 35 flu-associated deaths so far, 20 people were 65 or older.

Even this late in the season, a flu shot is still worthwhile, Moore said.

You can use https://vaccinefinder.org/ to find flu shots. The CDC recommends vaccinations for everyone older than six months.

“Oftentimes it’s not something people think about until they start seeing a lot of illness in their friends or family members or schools,” Moore said. “Sooner is better than later.”

The CDC estimates that about half of North Carolinians got a flu vaccine last year, which is better than the national average of 37 percent of adults. The federal government’s Healthy People 2020 program aims for 70 percent influenza vaccination rates by next year.

The vaccine, which is reformulated each year, varies between 40 and 60 percent effectiveness. Even without perfect effectiveness, Moore said “if you can cut your risk in half, do it.”

North Carolina is one of many states with high flu rates as of January 26. Graphic credit: CDC

“The flu shot only protects against four different strains of the flu, so it’s important to do what we call good respiratory etiquette and good hand hygiene all the time,” Passaretti said.

That means covering coughs, sneezing into your elbow, throwing away used tissues, and washing hands often.

Moore added that sick people and children should stay home until they’ve been fever-free for 24 hours to limit contagiousness. If you think you have the flu, do not rush to an emergency room or urgent care. Instead, contact your doctor to see if flu medications, such as Tamiflu, are appropriate.

“For some people, particularly people who are at higher risk of complications, that can be a really important second line of defense,” Moore said.

Moore hopes that one day the flu vaccine reaches 100 percent effectiveness.

“I’m hopeful that someday, before I retire, we’ll look back on these seasonal flu epidemics and say ‘I can’t believe we tolerated that,’” Moore said. “This many people getting sick, this many people dying and it was just sort of a normal thing. That’s how people felt about smallpox back in the day.”

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Yen Duong

Yen Duong covers health care in Charlotte and the southern Piedmont for North Carolina Health News.