Flu season hits Philadelphia early

The images are the same every year — coughing and sneezing, fever and chills and overflowing hospital rooms — but this year has been worse.

Although the number of influenza-like illness cases usually peaks in mid-January, according to Division Chief of Penn Infectious Disease Ebbing Lautenbach, this year’s national and local ILI incidence peaked five weeks earlier than usual.

Prevention at Penn

Student Health Service vaccinated 22 percent of the student population thus far, excluding additional students who have been vaccinated elsewhere.

“We’ve got plenty of flu vaccines at SHS and lots of appointments available,” said Sharon McMullen, director of SHS Campus Health Initiatives.

While flu numbers rose uniquely early this season — both nationally and in Philadelphia — Penn hasn’t seen an abnormal number of cases yet. However, McMullen simply attributes this to the break between semesters. She said it is “probably going to get epidemic on campus,” as Penn has historically reflected both the Philadelphia and national numbers of ILI incidences.

So far, SHS has seen 75 ILI cases, which is more than last year but nowhere near the 1,100 cases they saw during the H1N1 swine flu pandemic in 2009.

Students who have gotten wind about this year’s flu prevalence have taken to health centers to be vaccinated.

“I’ve heard there have been a lot of deaths already in Pennsylvania. I’m trying to prevent that and stay healthy,” College freshman Matt Wolfen said, moments before receiving his flu shot at the CVS at 3925 Walnut Street.

College freshman Nathan Platnick, who was there to support his friends after getting his shot earlier in the season, said, “I’ve had the flu in the past, and it was really awful, so I’m trying to avoid it for the future.”

During a press conference on Friday, Philadelphia Health Commissioner and Deputy Mayor Donald Schwarz urged the public to avoid close contact with others, wash their hands frequently and cover coughs and sneezes with an elbow or a tissue, in addition to getting a flu shot.

If any students exhibit flu symptoms, SHS advises them to stay home to avoid spreading the illness.

Unless the symptoms are particularly severe, those who are sick should not go to the hospital, in order to preserve space for those who need it most, said Mark Ross, Southeastern regional emergency preparedness manager for the Hospital Association of Pennsylvania.

While flu incidents on campus remain relatively low, McMullen said SHS is seeing many cases of norovirus, an illness often referred to as the “stomach flu.” Norovirus causes severe vomiting and diarrhea. As it is not vaccine-preventable, McMullen said this makes hand-washing all the more important.

Contagious and unpredictable

Influenza is a widespread and highly contagious infectious disease, the symptoms of which commonly include fever, coughing and sore throat, among others.

Schwarz said influenza circulation in Philadelphia is already declining, though there remains a possibility that it will peak again before the season ends.

“One of the important things to remember about influenza is that it’s unpredictable,” Schwarz said.

While the Philadelphia Department of Public Health called this year’s flu in the city an epidemic, Schwarz said a disease is deemed epidemic when there is unusual incidence, and “the only thing surprising is how early it happened this year.”

Schwarz added that Philadelphia citizens were concerned after hearing of this year’s outbreak “because we had so little influenza activity over the last two years after the major H1N1 [swine flu] epidemic that we had in 2009.” He also claimed that the vast majority of flu circulating in Philadelphia is preventable, estimating the figure at 98 percent.

According to Schwarz, as of Friday, there were 281 hospitalizations and four deaths in Philadelphia from the flu.

‘How good is the vaccine?’

Health officials agree that immunization is the number one way to prevent the disease.

The vaccine is uniformly distributed across the Northern Hemisphere. It is trivalent, meaning it is intended to protect against three strains of flu. The strain that is responsible for the seasonal outbreak differs greatly from year to year. Consequently, the seasonally distributed flu shot changes every year and is the result of a best guess by health officials as to what strains will be most prevalent during the season.

This year’s flu shot contained influenza A strains H3N2 and H1N1 and one influenza B strain, according to Lautenbach.

“This year, [the vaccine makers] guessed reasonably well,” he said. “The vast majority of influenza A that’s circulating in the community right now, the vaccine seems to be very well matched to those.”

He added that this is good news, as the bulk of influenza cases are A strains.

The B strain is “less of a good match,” he said. The vaccine only covers about 66 percent of the circulating B strains.

On Friday, the Centers for Disease Control and Prevention released its Early Estimates of Seasonal Influenza Vaccine Effectiveness and determined with data from 1,155 children and adults that “the estimated vaccine effectiveness was 62 percent.”

Lautenbach explained the figure as follows: “Of all people who get the vaccine and then get exposed to influenza, how good is the vaccine at preventing influenza?”

He said the 62 percent figure answers this question. However, due to immune problems and other health concerns of some individuals, he added that he estimates a much higher percentage of effectiveness for the average healthy Penn student.

Schwarz cautioned that the vaccine may not work or may be given too late.

Lautenbach added people can still catch influenza if they have been vaccinated, depending on the immune response they develop, though he said that this often results in a milder case of the flu.

“No vaccine is 100 percent effective,” McMullen said. She advised against students becoming complacent after getting vaccinated.

Immunizing HUP

Many hospitals, including the Hospital of the University of Pennsylvania, have made flu shots mandatory for their workers who do not have certain religious beliefs or allergies that exempt them. This has resulted in controversy regarding personal freedoms, but former Penn professor of medical ethics Art Caplan said the measures are necessary.

Caplan said it is “morally unconscionable” for someone to work in a health care setting and not get vaccinated.

“You can’t be around sick people, and you can’t be around newborn babies, and you can’t be around the elderly without getting a flu shot,” he added.

Lautenbach said there has not been resistance to mandatory flu shots at HUP from hospital personnel, as there is so much data behind the policy.

“Ultimately, people are in health care for a reason,” he said. “It’s because they want to take care of people, and you don’t want to do something that’s going to unnecessarily put patients at risk.”

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