The flu virus has begun to spread earlier than usual this year in several parts of the United States, triggering warnings that there could soon be a large increase in flu cases as many people travel and celebrate family gatherings starting this week for Thanksgiving and the holidays.
The situation is especially worrying because the current strain of the virus, H3N2 subclade K, has already caused major infectious outbreaks in places such as Canada and the United Kingdom.
Noticeable increases in flu cases have been reported in recent weeks, according to Cameron Wolfe, an infectious disease specialist at Duke University in North Carolina. “Typically at this point I see one or two a week, but currently I’ve had two, three and even four a day,” he said.
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The director of the influenza surveillance team at the Centers for Disease Control and Prevention (CDC), Alicia Budd, has also warned that “in the coming weeks we expect to see much greater activity” of infections.
Most flu infections so far in the United States are due to the H3N2 strain, according to the CDC. It is a variety that tends to cause more cases of hospitalization and deaths among older adults, so the increase so early this season could carry greater risks for these vulnerable populations, says Wolfe.
“With such an advanced flu season, there is a risk that nursing homes may not have vaccinated everyone yet, or that in hospitals not all medical staff are already immunized,” Wolfe said, “so the community in general is not as protected as when the virus begins to circulate more around January or around that time.”
The most recent report from the CDC reflects that cases are increasing: at least 650,000 people have been infected this season, of which 7,400 have been hospitalized and about 300 have lost their lives.
The majority of flu emergency room visits have been among minors, according to Budd.
Last year, about 280 children died in the United States from the flu, making it the deadliest flu season for children in the country in decades.
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So far this year, no pediatric deaths from H3N2 have been reported, but last year’s experience has worried doctors who saw how the virus spread through schools, daycare centers and then hospitals.
“It feels like the calm period right before the storm,” said Buddy Creech, a pediatric infectious disease specialist at Vanderbilt University in Nashville, Tennessee. “It does seem that we are approaching a very difficult year in terms of influenza,” he added.
The H3N2 strain is also worrying because it can mutate easily; Its subclade K form began to spread this summer and soon there were several mutations, complicating the development of seasonal vaccines that can prevent more types of flu.
The CDC’s Budd said the agency is still looking at how well this season’s vaccine may work for the current strain, but he urged everyone to get vaccinated anyway to have some measure of protection.
“Even in years in which the strain with which the vaccine was developed is not so similar to those that are circulating, we know that inoculation does prevent the disease from progressing to serious cases,” stressed the specialist.
Doctors across the United States are carefully monitoring the increases seen so far in infections.
“Yes, our antenna has been turned on more,” said Daniel Varga, chief medical officer at the Hackensack Meridian Health center in New Jersey. “We have to be much more attentive in local monitoring,” he said.
Melanie Kitawaga, medical director of the pediatric intensive care unit at Texas Children’s Hospital in Houston, explained that it’s still a good time to get vaccinated if you haven’t already: “The more people get vaccinated before the season gets worse, the better off we’ll all be.”
