By Sarah Ovaska

While public health officials issue warnings about a newly emerged strain of coronavirus reaching the United States, the country is still battling with another deadly respiratory virus — influenza.

This year’s flu season has hit children particularly hard, with the emergence early on of the influenza B strain that tends to affect children at higher rates than adults, said Zack Moore, state epidemiologist for the N.C. Department of Health and Human Services.

“When we tend to have a season like this, those tend to hit children and young adults harder,” he said.

Adults have lived through more flu seasons, where H1N1 (A) and the B strain make up the two dominant strains of the virus and have built up some resistance to the B strain over time.

As of last week, 105 children had died in the United States from complications of the flu, according to the Centers for Disease Control and Prevention. That death toll makes it the second-highest number of pediatric deaths at this point in the flu season since the CDC began tracking that data in 2004. And nearly 70 percent of this season’s pediatric deaths were linked back to the influenza B strain, according to the CDC.

Three North Carolina children are counted in that death toll, one infant and two older youth. Lacie Rian Fisher, a 15-year-old Haywood County girl and high school cheerleader, died in late December from flu and septic shock just days after the otherwise healthy teenager began to feel unwell.

“You do not think your child could have a cold or the flu and then be gone in just a few hours,” Rosalind Fisher Payne told The Citizen Times in Asheville earlier this year, about her daughter’s death.

While the prevalence of the flu appears to be abating, it still remains a major public health concern in North Carolina. The state has seen 115 deaths from the flu, according to updated numbers released Thursday afternoon by NC DHHS.

“I hope we’re more than midway” through the season, Moore said, acknowledging the predictable unpredictability of influenza that makes it difficult for epidemiologists like him to know for certain.

Flu prevention

  • Avoid close contact with anyone who is sick with a runny nose, sneezing and a cough.
  • Stay home from work or school when you’re sick.
  • Cover your mouth and nose when you sneeze. Avoid touching your face if you’re around someone who is sick.
  • And, according to state health director Elizabeth Cuervo Tilson, “Wash your hands, wash your hands, wash your hands.”

Source: Centers for Disease Control and Prevention.

But Moore had no similar hesitation when asked if people should get vaccinated against the flu if they hadn’t already.

“I’m always going to say yes to that question,” Moore said. “It’s the best way to protect yourself and protect your loved ones.”

Pediatricians’ offices seeing influx 

The pediatricians at Charlotte’s Novant Health Pediatrics in Symphony Park have seen firsthand the effects of this year’s flu on the young.

“We are still seeing so many patients,” said Kasey Scannell, a pediatrician at Novant Health Pediatrics Symphony Park. “We’re seeing more people with (influenza) with really high fevers and body aches.”

Flu cases in N.C. for the 2019-20 season. (Source: NC DHHS)

The Charlotte medical practice treated a large number of young patients early in the season with the influenza B strain, which the practice tests for in-house, and now are starting to see more cases of the A strain emerge. They’ve even had a few patients test positive for both strains at the same time, or families with two run-ins with influenza in a single season, Scannell said.

“You can get both strains,” she said. “If you’ve had one, there’s a chance you can still get the second.”

In most cases, patients can go home and recover by resting. Some families opt for antiviral flu treatments such as Tamiflu, which can help lessen symptoms if taken within 48 hours of the onset of symptoms. But with potential side effects from those treatments that can range from nausea to  vomiting and even hallucinations for some, many families choose to just go home and wait out the virus, she said.

She suggests seeking out immediate medical attention if someone with the flu begins to have issues breathing, or exhibits behavioral changes such as confused speech patterns. Equally worrisome are high fevers beyond the four to five days typical with the flu. That’s a sign that a more serious condition like pneumonia or a secondary infection could be at play.


The flu’s effects so far, in 2019-20 

115: Number of deaths linked to flu, N.C.
3: children’s deaths, N.C.
105: pediatric deaths linked to flu, U.S.
16,000: Estimated deaths linked to flu in the U.S.
280,000: total hospitalizations linked to the flu, U.S.
29,000,000: Total cases of the flu, U.S.

Given the seriousness of the flu, Scannell, like Moore, is still urging families who visit her practice to get flu shots, including babies six months and older.

She knows it can be a tough sell at times for doctors, given that the flu vaccine tends to fluctuate between 40 and 60 percent effectiveness and needs to be given once a season. But having some resistance is much better than none, she said.

This year’s flu vaccine appears to have been moderately effective, with the coverage better for children than in the adult population, according to an analysis released last week by CDC researchers.

The vaccine had an overall effectiveness of 45 percent — 50 percent effective against the influenza B virus strain, and 37 percent effective against influenza Type A.

But the effectiveness went up for children, with an overall effectiveness rate of 55 percent.

Just having the vaccination each year helps the body combat the virus more effectively and can shorten the intensity and duration of the flu, doctors say.

In her Charlotte practice, Scannell said she can tell the difference between influenza patients that have gotten the vaccine and those who skipped it. Those who skipped tend to be worse off.

“The kids who have received the vaccine really do look far better than the kids who don’t receive the vaccine,” she said.

graphic including an image of coronavirus
The seasonal flu vaccine protects against the influenza viruses that research indicates will be most common during the upcoming season. There are several flu vaccine options this flu season. Graphic courtesy: CDC

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Sarah Ovaska is a freelance writer based in Orange County, who has called North Carolina home for well over a decade. She’s reported on criminal justice, education, health and government issues at publications including the News & Observer, N.C. Policy Watch and NC Health News. She can be reached at sovaska AT northcarolinahealthnews DOT org