After two years of mild flu seasons, public health officials say hundreds of Nebraskans have fallen ill from the virus this season. Since the beginning of the year flu has been officially recognized as “widespread” across the state.
In the last week of January more than 1,000 confirmed cases of Influenza A were recorded by doctors across the state in one seven-day period. That spike “indicated it was a pretty bad year” in the opinion of Dr. Tom Safranek, state epidemiologist.
Currently, most other states in the Great Plains have flu outbreaks as bad or worse than Nebraska, according the U.S. Centers for Disease Control (CDC).
The past two years brought milder than average flu outbreaks. “This year the flu season conforms to a more typical pattern,” Safranek said.
In describing how a graph would represent the flu season since it started last fall, Safranek said he “would paint a picture of a small, steady trickle prior to the first of the year and then when January came we saw a rather rapid peak.”
This year’s outbreak was brought on by a strain of the virus, N1 (H3-N2), with a history of targeting senior citizens.
“We know that affects the elderly,” Safranek said. “We saw that this year.”
There have been 15 flu deaths recorded this season. All but one were in the 65-plus age bracket. The number is not considered abnormal in these circumstances.
“Nursing homes had a serious impact of influenza this year,” Safranek said.
The Nebraska Department of Health and Human Services recommended providing nursing home residents with the over-the-counter medication Tamiflu at the earliest sign any resident might have the virus.
The medical staff at the student clinic at the University of Nebraska at Kearney campus saw a steady increase in the number of students reporting flu-like symptoms each week in January.
“We’ve seen more of it, definitely,” said Cindy Hayes, associate director of the clinic, comparing this year’s outbreak to recent winter semesters.
“We always joke that you can almost diagnose influenza without a test because they just look so sick,” Hayes said. The final week of January brought a large wave of cases at the same time students were also presenting symptoms of mononucleosis, strep throat and common colds.
The flu, said Hayes, hit most students the hardest. “You have those horrible body aches where I’ve had patients say 'my hair hurts,' it just hurts that bad. There is really not a lot of relief for it.”
Hayes called the trends in this year’s flu season “really interesting.” “At the beginning of the month we had a surge and we saw a large of number of patients coming in that had the flu-like symptoms, but in the last week it’s actually quieted down a little bit.”
That slight downward trend mirrors the reporting from medical laboratories across the state in the past week. Figures scheduled to be released later this week show the number of positive flu tests for the first full week of February are down by more than 100 cases from the previous week.
Methods to collect data on flu outbreaks used nationally and by Nebraska health officials have been automated to the point that trends can be identified almost in real time.
Safranek refers to it as the “day-to-day, year-in-year-out police work in public health.”
The department's surveillance protocols for tracking flu are in place throughout the year in the event there are unique strains of flu showing up outside the normal calendar for routine winter bugs.
Every year state health officials look for the earliest hint influenza may be getting an early start. One measure used to look ahead is the number of laboratory tests ordered by doctors suspecting patients are displaying flu-like symptoms.
“It may not be influenza but it tells us when we see an increase in the ordering of those tests that doctors are starting to see influenza-like illness," Safranek explained.
There are 93 medical laboratories spread across Nebraska which tap into the state’s Rapid Diagnostic Test Surveillance. Most of the larger labs have established automated computer links with health department computers, allowing test results to be shared instantaneously. It provides close to real-time information for public health specialists about where in the state the flu is spreading and how quickly.
DHHS closely follows which variations of the flu bug are in play and in some cases, according to Safranek “will pursue more in-depth testing to pinpoint the exact strain of influenza.
“We work with CDC to see if the current year's vaccine is going to be protective against the strains that we're seeing show up in people.”
The flu vaccine distributed this season appears to be the correct match in stopping or reducing the symptoms, Safranek said.
Even if flu season is on the wane, DHHS still recommends getting the vaccination. If the number of cases decreases slowly, hundreds of Nebraska residents could still get infected before spring.