Annual Influenza Strikes Early

This year’s flu season has struck early, and influenza is now widespread in 47 US states. According to the Center for Disease control, this year’s flu reached levels of an epidemic in the second week in January, meaning that flu was responsible for over 7.2 percent of reported deaths that week.

There is still no conclusive evidence yet that this will be a worse than average year for the flu when all is said and done. While flu activity has been rapidly spreading across the country in the past few weeks, the number of states reporting “high” flu activity actually dropped from 29 to 24 in the second week of January. And despite reports of vaccine and Tamiflu shortages in large cities such as Boston and Chicago, there are still over 10 million flu shots still available, and a stores of Tamiflu still untapped.  The CDC has remained optimistic that this year’s flu season will be nothing worse than an average year.

Even an average year of flu comes with great costs, however. Influenza can be deadly, especially to children, the elderly, and those with compromised immune systems. The annual death toll generally ranges from 3,000 to 49,000, depending on how dangerous that year’s flu virus is and how quickly it is able to spread. The worst year being the 1918 Spanish Influenza pandemic, which killed 21.5 million people, including many otherwise healthy young adults. The flu also costs the United States billions of dollars in economic damage due to the added burden on our health care system as well as lost productivity in the workforce — which amounts to about $90 billion according to some estimates.

The best protection against the flu is the flu vaccine, which offers some protection for some of the season’s most common flu strains. Each year, scientists make their best estimation of what the next year’s most common flu strains will look like. In order to gather information, health workers in over 100 countries collect viral strains from sick patients, which are compiled in five genetics lab around the world — labs in the United States, England, Australia, China, and Japan. These labs convene at a yearly World Health Organization (WHO) meeting, during which scientists debate what the genes of the next year’s most prevalent viral strains look will look like. These decisions are made months before the next year’s flu season, making these predictions even harder to make.

At the WHO meetings, scientists must take into consideration a number of factors when deciding which virus strains will be the next year’s flu bug. They must ask which viruses will cause the most severe infections, which are most contagious, and which have the greatest likelihood for spreading over a wide area. The vaccine that is chosen offers protection from not one but three different kinds of flu virus: two “A strain” flu viruses, which cause upper respiratory infections, and one “B strain” virus, which can be the cause of a milder seasonal flu.

How closely the flu viruses in the vaccine are related to those that are most common in a given flu season is called the “cross-reaction” of the vaccine. Only once since 1990 has the WHO flu shot been deemed a “very poor cross-reaction” to the actual viral strain (in the flu season of 1997-1998). In three other seasons — 1992-93, 2003-04, and 2007-08 — the vaccine has been considered a “poor cross-reaction” to the flu bug. However, the effectiveness of flu vaccinations have by and large held steady over the past few years.

Even in a good year the flu shot is no guarantee that you won’t catch the flu. This usually is either because those who have received the vaccination may be infected by less common variations of the flu virus, or the vaccinated individual’s immune system is not strong enough to fight off the flu even after receiving the shot due to other medical reasons. Estimates of this current season’s vaccine show that those younger than 65 who have been vaccinated are 62% less likely to catch the flu, which is consistent with the historical average. However, the last two decades has not seen much improvement in the vaccine’s effectiveness.

Some have considered the U.S. government’s funding of influenza research underwhelming. In 2011, NIH gave $272 million to researchers studying the influenza virus. The government spent an additional $160 million on influenza planning and response that year through Centers of Disease Control and Prevention around the country. Yet considering the scope of damage done by the flu annually — $90 billion dollars in purely economic terms — research grants represent a much smaller cost than the potential benefit of developing better and more widely distributed vaccines.

Skeptics of the flu shot’s effectiveness even see the current vaccine as being less effective than advertised, or even completely ineffective. And several reports give credit to these arguments. Most recently, a 2010 American Lung Association report stated that influenza-related deaths have not declined over the past several decades despite an increase in the number of vaccinations given out. Since then the pharmaceutical company Roche, producers of Tamiflu, have been accused of hiding data that suggested their drug isn’t effective at fighting influenza. This fed the fire to those who argue that large pharmaceutical producers have immorally promoted their drugs flu vaccines using “bad science” to turn a profit.

But despite these criticisms, the flu shot is undoubtedly the best defence physicians and researchers currently have to control the flu outbreak. While everyone is vulnerable to catching a flu virus, those who have received the vaccine are much less vulnerable than those who have not.

Researchers are making real progress to improve the flu shot and to make it easier to get vaccinated. Starting in the 2013-14 season, the vaccine will contain a total of four flu strains rather than the current three (this new vaccine will protect against two A strains and two B strains). Additionally, ongoing research is being done to find a vaccine that can offer protection for more than one year at a time, so patients will need flu boosters once every four or five years rather than annually. However, for this year, the flu shot currently available from doctors and pharmacies is still the best protection from coming down with this year’s flu strain. Scientists have already confirmed that their prediction of this year’s flu strain was correct (had a good cross-reaction), and there is optimism that the worst of this year’s flu season has already passed.

Worth Health Center has already vaccinated about 400 students, and still has a few shots left for students who have yet to get one. Further steps you can take to avoid getting this year’s flu bug are to get plenty of sleep, eat well, and wash your hands. Visit the Worth Health Center website for more information.

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