With January coming to a close, we're heading into peak flu season in Frisco.
We all remember 2018 as a particularly rough flu year and we're hoping for a healthier 2019. Although flu season is inevitable, we can be informed and proactive in keeping our families healthy.
To get an update on Frisco’s fight against the flu, we visited with Dr. Shane Cole, CEO and Medical Director of iCare ER and Urgent Care. Dr. Cole shared valuable information and advice to keep in mind this flu season.
The 2017-2018 flu season was reported to be the worst flu season in almost a decade. How is this year by comparison?
Statistically and anecdotally, we appear to be having a much better year in 2019. (Although that probably doesn’t make you feel better if you or your family has already been hit with the flu!)
According to Dr. Cole, the Frisco flu season started later and, so far, has been much less severe than in 2018. Dr. Cole says last year’s the flu season started in October and stretched through March. This year, he saw his very first flu case in December and has seen only a handful since then.
Dr. Cole says it is difficult for experts to pinpoint exactly what causes one flu season to be more severe than another, as there are a lot of factors at work and multiple strains of flu in circulation.
He notes that this year’s flu vaccine was updated to match the current virus in circulation, including an alternative strain of the H3N2 virus. (This particularly nasty strain mutates easily and can be difficult to treat).
As a result of these updates, epidemiologists are hopeful this year’s vaccine will be more effective than flu vaccines delivered last year.
Dr. Cole explained that the severity of any flu is assessed in the following ways: by reviewing the rates of influenza-like illnesses, flu hospitalization rates, and the overall percentage of fatalities from either influenza or pneumonia. Compared with last year’s flu season, the CDC has reported that severity indicators are much lower, with the following statistics:
- Influenza-like illnesses are currently at a rate of 3.5% vs. 7.5% at the same point last year.
- As of January 11, 2019, the hospitalization rates are 9.1/100,000, compared with last years rate of 30.5/100,000.
- Deaths for the flu season this year to date are less than last year. (Tragically, throughout the 2017-2018 flu season, there were approximately 10,000 deaths from influenza and adult pneumonia in Texas alone. Nationally, the figure was closer to 80,000 people.)
What flu trends are you expecting to see in the next few months?
Dr. Cole says we typically see flu season peak at the end of January and February. He notes that we probably haven’t hit the peak, but he doesn’t expect it to get much worse. Last year at this time, almost every patient that came in to see him with a fever had the flu. This year, in contrast, he has seen only a handful of cases.
He noted that the timings of flu seasons are not exact and they vary somewhat from year to year, beginning as early as October and lasting as far out as May. However, given the trends this year, he's hopeful the 2018-2019 flu season will come to a close by March.
What can Frisco residents do to protect their families and minimize the spread of the flu this year?
Dr. Cole advises, first and foremost, to ensure you get your flu vaccine. For anyone who is aged 6 months upward, this is the most important first step. Along with the flu vaccine, other preventative measures include:
- If someone you know is sick, try to stay away from them.
- Always wash your hands to lessen the likelihood of germs spreading.
- If you become sick with the flu, stay at home and away from public places.
These strategies are somewhat common sense but more important than ever as we head into peak flu season. Although the overall flu season is less severe this year, we still don’t want to be complacent. The flu, even in a “lighter” season, remains a serious and dangerous virus. It's important to be vigilant and help keep our community healthy.
What signs and symptoms should we be looking for as flu season moves into full swing?
Dr. Cole says the biggest sign to look for is “rapid onset”. He notes that flu is not insidious, saying “you typically don’t feel a little under the weather with a runny nose for a few days” and then slowly develop flu. He explains most patients “feel ok one day and the next day like a train hit you…”
If you catch the flu, it's possible to develop a range of symptoms, from quite mild to more severe. Because the virus can cause fatalities and come on quite suddenly, knowing the symptoms of the flu is key. Not everyone who develops the flu will get a fever. However, in many cases, this is one of the most prominent signs of the virus. Other signs include:
- Sore throat
- Stuffy or runny nose
- Part or full-body tiredness
- Vomiting or Diarrhea
What steps should a person take if experiencing flu-like symptoms?
Dr. Cole notes that the majority of people who contract the flu will not require medical intervention. For most patients with flu, staying home and out of contact with other people is key. If you're able to go to your doctor within the first day or two of symptoms, Tamiflu can be prescribed to shorten the course of the virus. (The flu typically lasts five days, but with Tamiflu it can be shortened to three or four days.)
Dr. Cole adds that, unfortunately, “viral infections have momentum behind them, and once the train gets rolling it can be hard to stop, especially after a certain point.”
Individuals who have taken the shot may have less severe illnesses, with symptoms feeling more like a common cold and less like being hit by a ton of bricks.
He also emphasizes that if you're classified as being in a high-risk group, or feel very unwell, you should contact a healthcare professional to raise your concerns and discuss your symptoms.
Who is at greatest risk for catching the flu and/or experiencing serious outcomes?
High-risk individuals include pregnant women, those aged 65 or older, nursing home residents, young children, and those who carry certain medical conditions (including asthma, heart disease, chronic lung disease, liver or kidney disorders, blood disorders, endocrine disorders, people with extreme obesity, metabolic disorders, or a weakened immune system.)
Dr. Cole emphasizes that people with chronic lung conditions are hit very hard by the flu and, in some cases, the flu has been known to precipitate heart attacks in people with coronary artery diseases. The full list of medically classified high-risk people can be found on the CDC website.
After a flu diagnosis, what can patients do to minimize the risk for themselves and their families?
First and foremost, people experiencing flu-like symptoms should stay home and avoid public places. Children running a fever shouldn’t be in school. These common sense practices will go a long way in safe guarding the community.
Household contact among families, however, is extremely difficult to protect against. The virus can live on surfaces for several hours (for example, if you sneeze, the live virus can be on your countertop for a few hours).
However, according to Dr. Cole, most people catch the flu from direct respiratory secretions (drinking after an infected person, coughing directly in the face, coughing into a hand and then touching another person). This is because the virus is much more effectively transmitted by wet respiratory excretions (vs. the virus remaining on surfaces).
Interestingly, Dr. Cole says remaining outside of a 6 foot radius from someone who is coughing minimizes the probability of transmission greatly. Although this is not necessarily realistic for families in the same home, this information is good to keep in mind. Being proactive about limiting wet respiratory excretion contact, even among family members to the extent possible, can go a long way in protecting against the flu.
Any other thoughts you would like to share with our readers?
When asked what else he thought was important to know about flu season, Dr. Cole immediately said, “when to know to go to the hospital”. He notes that you don’t necessarily have to go to the doctor because you catch the flu. Tamiflu, as previously mentioned, can shortly the course by a few days if taken early in the illness. However, for an average patient, going to the doctor is not necessarily a “must”.
Dr. Cole says the important “musts” are to stay well-hydrated and monitor for any severe respiratory compromises. For example, in children and toddlers, look for rapid respiratory rate and for “retractions” (when you can see the skin literally pushing between the ribs). Also, watch for “accessory muscle use” (i.e. children using their abdomen to breath, where you can see the belly muscles going up and down).
Even for adults, if you're experiencing any signs of respiratory distress, or rapid heart rate and very high fever, you need to get checked by a medical professional. As the startling hospitalization and fatality statistics illustrate, the flu is more than a miserable illness. It can become very dangerous very quickly, particularly in high-risk individuals and young children. It's critical to stay well-hydrated and monitor closely for any signs that medical intervention is needed.
Stay healthy, Frisco! Here's hoping for a happy and healthy 2019 – and an early end to this year’s flu season. We’d love to hear your family’s strategies for avoiding the flu in the comments below. And thank you to Dr. Shane Cole for lending his time and expertise to this discussion.
About Dr. Shane Cole
Dr. Shane Cole is a board-certified emergency medicine physician and entrepreneur. He currently serves as a managing partner of University Urgent Care, CEO and medical director of iCare ER & Urgent Care in Frisco and Fort Worth, and CEO of Woodbridge Emergency Medical Staffing Group. Dr. Cole has 12 years of clinical experience in major metropolitan hospital emergency rooms. Board certified by the American Board of Emergency Medicine, Dr. Cole has spent his career helping patients involved in accidents, injuries, and trauma. He is a member of the American College of Emergency Physicians and the American Academy of Emergency Medicine.