Flu Season Has Kicked In… Here’s How to Protect Yourself

The flu season is well under way across the United States, with 24 states reporting widespread influenza activity.
Although there are fewer cases of influenza than this time last year, experts say rates of influenza are generally above-average levels across the country.
“At the end of 2018, flu activity was high in New York City and 19 states, including most of the American southwest and New Jersey. It’s still low in Washington, D.C., Puerto Rico, and 22 of our 50 states, but that will change as the season progresses,” Stephen Morse, PhD, a professor of epidemiology at the Columbia University Medical Center in New York, told Healthline.
H1N1 has been the most common strain of the virus seen so far this season, which experts anticipate will be milder than last year’s strain.
The 2017/2018 influenza season was considered one of high severity by the Centers for Disease Control and Prevention (CDC), with high rates of emergency department visits and widespread flu activity over an extended period.
By the end of October 2018, 185 pediatric deaths from flu complications were reported to the CDC, with 80 percent of deaths occurring in children who hadn’t been vaccinated against influenza.
The number of deaths due to pneumonia and influenza were at or above epidemic levels for 16 straight weeks during the 2017/18 flu season.
But after the Southern Hemisphere experienced a much milder flu season about six months ago, health experts are hopeful this year won’t be as bad.
“The dominant virus is different from last year, which is excellent. The H1N1 virus generally produces milder infections like Australia had last season. We are hoping for a milder season than we had last year, which was a doozy,” Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Tennessee, told Healthline.
“All of the fluologists have their own crystal ball, but flu is fickle so we’re always very cautious about predicting, but I will say so far so good, not bad,” he said.
Two main strains
Since the 1970s, two major Type A flu varieties have coexisted: H3N2 and H1N1.
Each season typically sees one of the strains dominate and H3N2 historically has been considered the nastier of the two strains.
But experts still keep a careful eye on the H1N1 strain, which in 1918 infected 500 million people worldwide and killed 50 million in one of the worst disease outbreaks in recorded history.
“In 1918, the situation was very unusual as a high proportion of the fatalities were in young healthy adults and death often occurred quickly,” Schaffner said.
“There is still discussion about how this happened, but many scientists think that the infection somehow overstimulated the immune system, causing an effect similar to septic shock or a hemorrhagic fever. In cases with longer duration, the infection can also open up the body to a secondary bacterial pneumonia. Although that was, thankfully, unique, we want never to see it repeated.”
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Not too late for a flu shot
So far this season there have been 13 pediatric deaths associated with influenza and experts are urging both adults and children to get vaccinated.
“Influenza can take a perfectly healthy person and put them in the emergency room within 24 hours. Influenza is always dangerous,” Schaffner said.
“Vaccination — although not perfect — still prevents many infections completely, and even if you get influenza having received the vaccine, your illness is much more likely to be milder, and you’re less likely to get the complications of pneumonia and having to be hospitalized.”
Since 2010, the CDC has advised that everyone over the age of 6 months should be vaccinated against influenza.
Those who are particularly vulnerable to complications from influenza include children younger than 5, adults older than 65, pregnant women, residents in nursing homes or other care facilities, and those with an underlying illness.
Although the season has already begun, there is still time to get the flu shot.
“Don’t linger. Run, do not walk, and get your influenza vaccine because it does take 10 days to 2 weeks for the body to build up its maximum protection,” said Schaffner. “There is influenza virus circulating in all of our communities so if you haven’t been vaccinated, you really should get with the program. There’s plenty of vaccines out there, most doctor’s offices have some and if not you can go to any pharmacy to receive one.”
Flu season peak is near
Experts say the United States is likely in the early weeks of the flu season.
It can be hard to predict, but so far it appears the 2018/19 season will peak in late January and early February.
Although not a perfect vaccine, Morse says the average person may not realize just how important a role the influenza vaccine plays in public health.
“We can calculate that if about half the people exposed to the flu couldn’t get infected and pass it on because they’re immune, for example, the virus wouldn’t be able to spread and the epidemic would stop. This is called ‘herd immunity,’” he explained.
The vaccine you get may also help to protect others. So even if the vaccine is only 50 percent effective, it could essentially stop the epidemic in a community if everyone got a flu shot, Morse said.
“We also have good evidence that having a flu shot greatly reduces the risk of hospitalization or death even for those who do get the flu anyway,” he added.

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