CDC Advises on Flu Prevention; Reports on Flu Epidemic Sweeping Nation

Flu Activity Levels by State - Week ending January 5, 2013 - Map from CDCAccording to the latest Seasonal Flu Surveillance (FluView) Report, issued today by the U.S. Centers for Disease Control and Prevention (CDC), “the United States is having an early flu season with most of the country now experiencing high levels of influenza-like-illness (ILI).” In this week’s FluView report, the CDC said that “some key flu activity indicators continued to rise, while others fell.” “It’s too soon to say exactly what this means; but some regions may have peaked, while other parts of the country are still on the upswing,” the CDC concluded.

Along with statistics about the extent of the current flu epidemic, the CDC has provided recommendations about steps you can take to help prevent getting and spreading the flu, along with information about flu symptoms and treatments, and special information for older adults.

People age 65 and older are among those at greatest risk of flu complications, and the CDC’s information and advice targeted to older adults, along with checklists of everyday preventive actions to stop the spread of germs, will be of particular importance to seniors and their family caregivers.

The Latest Flu Statistics

Numbers of Flu Cases & Geographic Spread

According to a summary of the latest data issued by the CDC on January 11 (which is for the week ended January 5, 2013), twenty-four states and New York City are now reporting high levels of flu activity (see the CDC map above). This is down from the previous week, when 29 states reported high flu activity. Sixteen states are now reporting moderate levels of flu activity, which is up from 9 states in the prior week.

The 24 states reporting high influenza-like illness (ILI) activity for the week ending January 5, 2013 include Alabama, Colorado, Delaware, Georgia, Illinois, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Mexico, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, and West Virginia.

The CDC explains that the measure of “ILI activity level” used in these data and reflected in the map above is based on “the proportion of outpatient visits to health care providers for influenza-like illness … within a state.” “ILI Activity Level” as used in these data and in the map, “does not, however, measure the extent of geographic spread of flu within a state,” the CDC states. “Therefore, outbreaks occurring in a single city could cause the state to display high activity levels,” the CDC explains.

States Reporting Geographically Widespread Flu Activity - Week ending January 5, 2013 - Map from CDCIn terms of the geographic spread of flu within each state, the CDC reports that forty-seven U.S. states (all but Hawaii, California, and Mississippi) now report a widespread geographic dispersal of the flu activity that exists within the state. This is up from 41 states reporting widespread geographic dispersal of flu activity the previous week.

This data, for the week ending January 5, 2013, is illustrated in the CDC map above. States shown in brown are reporting geographically widespread flu activity, states in yellow report regional flu activity, and the District of Columbia (shown in green) reports local flu activity.

According to the CDC, “Geographic Spread data are based on assessments made by each state health department and show how many areas within a state or territory are seeing flu activity….,” such as “detection of outbreaks of flu, increases in the percent of people visiting the doctor with flu-like symptoms, and patients with laboratory-confirmed influenza.”

According to the latest CDC report issued January 11, 3,710 people have been hospitalized because of the flu between October 1, 2012 and January 5, 2013, and 1,443 of these hospitalizations occurred within the one week ended January 5, 2013.

However, the CDC also reported on January 11 that “Nationally, the percentage of respiratory specimens testing positive for influenza in the United States during the week ending January 5, 2012 decreased from 35.2% in the previous week to 32.8%.”

Types of Flu this Season and Antiviral drugs that treat them

According to the CDC, “Influenza (the flu) is a contagious respiratory illness caused by influenza viruses.”

“Influenza A (H3N2), 2009 influenza A (H1N1), and influenza B viruses have all been identified in the U.S. this season,” the new CDC report confirms. The report states that “Since October 1, 2012, CDC has tested 70 2009 influenza A (H1N1), 600 influenza A (H3N2), and 230 influenza B virus isolates for resistance to neuraminidase inhibitors this season.” “The tested viruses showed susceptibility to the antiviral drugs oseltamivir and zanamivir,” the CDC reported.

For further information about treatment of the flu, see the CDC’s webpage on Treatment – Antiviral Drugs.

Flu Vaccination

The CDC recommends that most people get vaccinated for flu, as a preventive measure (see below).

However, “Influenza vaccine effectiveness (VE) can vary from year to year and among different age and risk groups,” the CDC explains on it website.

According to a new report released by the CDC on January 11, a new study has found that the estimated vaccine effectiveness (VE) this flu season is 62%. This means that a person who takes the vaccine is 62 percent less likely to require medical treatment for the flu. This data is based on test results from a sample of 1,155 children and adults who reported to doctors with respiratory infections.

In recent years, vaccine effectiveness (VE) has ranged from approximately 60 to 70 percent.

Number of Flu Deaths this Season

The CDC also reported on January 11 that “The proportion of deaths attributed to pneumonia and influenza (P&I) … is now slightly above the epidemic threshold for the first time this season.” Of all deaths that occurred during the week ended January 5, 2013, 7.3 percent were caused by flu or pneumonia.

However, as reported by the New York Times, “Even though deaths stepped into epidemic territory for the first time — barely — the C.D.C. officials expressed no alarm [in a conference call held Friday morning], and said it was possible that new flu infections were peaking in some parts of the country.”

“Flu outbreaks typically reach epidemic level for one or two bad weeks every flu season, and the mortality threshold is a wavy curve that dips down in summer and up in winter. How severe a season is depends on how high deaths climb and for how many weeks they persist,” the New York Times reported.

According to the CDC, “Flu seasons are unpredictable and can be severe. Over a period of 30 years, between 1976 and 2006, estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people.”

Since the U.S. and other parts of the world face a seasonal flu outbreak every year, it behooves people, and especially older adults and family caregivers, to educate themselves about the flu, how to recognize it, and what preventive steps you can take to reduce chances of getting the flu and help to prevent its spread.

Flu Symptoms & Risks of Contagion

According to the CDC, flu symptoms include fever, chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headache, and fatigue (tiredness). Some people may also have vomiting and diarrhea. People may be infected with the flu and have respiratory symptoms without a fever.

For more information on flu symptoms, see the CDC’s webpage on Flu Symptoms & Severity.

“Most experts believe that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk,” the CDC states among Key Facts about Influenza (Flu) stated on its website. “These droplets can land in the mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or possibly their nose.”

When and how long is flu contagious? According to the CDC, “You may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.” “Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick,” the CDC states. “Some people, especially young children and people with weakened immune systems, might be able to infect others for an even longer time.”

How serious is the flu? According to Dr. David Zich, internal medicine and emergency medicine physician at Northwestern Memorial Hospital in Chicago, as reported by CNN, “Most people with the flu don’t have to [go to the emergency room] — they’ll recover on their own in five to seven days with plenty of rest and fluids.” However, he cautions that “you should go to the ER immediately if:

  • You have difficulty breathing or have pain in your chest
  • You can’t keep fluids down because of nausea and vomiting, or
  • Your fever or cough gets better, then worsens.”

According to the CDC, “Certain people are at greater risk for serious complications if they get the flu. This includes older people, young children, pregnant women and people with certain health conditions (such as asthma, diabetes, or heart disease), and persons who live in facilities like nursing homes.”

Special Risks for Seniors

“Influenza-associated hospitalizations are highest among people 65 and older,” the CDC states. “Of the 3,710 influenza-associated hospitalizations that have been reported this season, 46% have been among people 65 and older,” the CDC reported today.

“It has been recognized for many years that people 65 years and older are at greater risk of serious complications from the flu compared with young, healthy adults,” the CDC states on a page of its website entitled “What You Should Know and Do this Flu Season If You Are 65 Years and Older.”

“It’s estimated that 90 percent of seasonal flu-related deaths and more than 60 percent of seasonal flu-related hospitalizations in the United States each year occur in people 65 years and older. This is because human immune defenses become weaker with age. So influenza can be a very serious disease for people 65 and older,” the CDC reports.

Steps to Take this Flu Season

For those Age 65 and Older

Following are the steps that the CDC recommends that people — especially those 65 or older — should take this flu season:

  1. Get Your Flu Shot
    The best way to prevent the flu is with a flu vaccine. CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine as soon as it becomes available in your community. Vaccination is especially important for people 65 years and older because they are at increased risk for complications from flu.

    A flu vaccine protects against three different flu viruses: an H3N2 virus, an influenza B virus and an H1N1 virus. (See Vaccine Virus Selection for the upcoming season’s exact vaccine composition.) The vaccine has been updated for this season and immunity wanes over a year, so you should get vaccinated this year even if you vaccinated last season. Immunity sets in about two weeks after vaccination.

    People 65 years and older have two flu shots available to choose from – a regular dose flu vaccine and a newer flu vaccine designed for people 65 and older with a higher dose. The high dose vaccine is associated with a stronger immune response to vaccination. However, whether the stronger immune response results in greater protection against influenza illness in older adults is not yet known. The CDC and its Advisory Committee on Immunization Practices have not expressed a preference for either vaccine.

  2. Take Everyday Preventive Actions including covering coughs, washing hands often, and avoiding people who are sick.
  3. Seek medical advice quickly if you develop flu symptoms to see whether you might need medical evaluation or treatment with antiviral drugs. It’s very important that antiviral drugs be used early to treat flu in people who are very sick with flu (for example, people who are in the hospital), and people who are sick with flu and have a greater chance of getting serious flu complications, like people 65 and older (see box for full list of high risk persons/conditions).”

For Everyone

Similarly, the CDC website advises the general population to ““Take 3” Actions To Fight The Flu:”

  1. Take time to get a flu vaccine.
    • CDC recommends a yearly flu vaccine as the first and most important step in protecting against flu viruses.
    • While there are many different flu viruses, a flu vaccine protects against the three viruses that research suggests will be most common. (See upcoming season’s Vaccine Virus Selection for this season’s vaccine composition.)
    • Everyone 6 months of age and older should get a flu vaccine as soon as the current season’s vaccines are available.
    • Vaccination of high risk persons is especially important to decrease their risk of severe flu illness.
    • People at high risk of serious flu complications include young children, pregnant women, people with chronic health conditions like asthma, diabetes or heart and lung disease and people 65 years and older.
    • Vaccination also is important for health care workers, and other people who live with or care for high risk people to keep from spreading flu to high risk people.
    • Children younger than 6 months are at high risk of serious flu illness, but are too young to be vaccinated. People who care for them should be vaccinated instead.

  2. Take everyday preventive actions to stop the spread of germs.
    • Try to avoid close contact with sick people.
    • If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
    • While sick, limit contact with others as much as possible to keep from infecting them.
    • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
    • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
    • Avoid touching your eyes, nose and mouth. Germs spread this way.
    • Clean and disinfect surfaces and objects that may be contaminated with germs like the flu.
    • See Everyday Preventive Actions for more information about actions – apart from getting vaccinated and taking medicine – that people and communities can take to help slow the spread of illnesses like influenza (flu).
  3. Take flu antiviral drugs if your doctor prescribes them.
    • If you get the flu, antiviral drugs can treat your illness.
    • Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over-the-counter.
    • Antiviral drugs can make illness milder and shorten the time you are sick. They may also prevent serious flu complications. For people with high risk factors, treatment with an antiviral drug can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay.
    • Studies show that flu antiviral drugs work best for treatment when they are started within 2 days of getting sick, but starting them later can still be helpful, especially if the sick person has a high-risk health or is very sick from the flu. Follow your doctor’s instructions for taking this drug.
    • Flu-like symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people also may have vomiting and diarrhea. People may be infected with the flu, and have respiratory symptoms without a fever.”

More Information

See the CDC’s webpage with questions and answers on What You Should Know for the 2012-2013 Influenza Season.

For the latest statistics on flu in the U.S. this season, see the CDC’s latest FluView report.

For further information about Flu Vaccine, see Preventing Seasonal Flu With Vaccination, on the CDC’s website.

For common sense preventive steps you can take to avoid getting the flu, see the CDC’s pamphlet on Everyday Preventive Actions.

For more information about medical conditions commonly faced by seniors (including what they are, symptoms & diagnosis, prevention, treatment, and caregiving for each), and steps you can take to promote wellness and help prevent diseases, see the HelpingYouCare® resource pages on:


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