By Pete McQuaid
Flu season usually doesn't kick into high gear until late January. But if November and December are any indication, we're in for a long, sick winter.
According to the Massachusetts Department of Public Health, incidences of influenza and influenza-like illness are much higher than usual for this time of year -- and they continue to increase.
"From what I understand, it's been a high rate," said Frank Singleton, director of the Lowell Health Department. "It looks like one of the worst seasons in a few years."
The national Centers for Disease Control compiles FluView, a weekly flu-surveillance report, with information from 145 laboratories and 2,700 outpatient health-care providers across the country. For the week of Dec. 21 to Dec. 28, the percentage of Massachusetts hospital visits reported as flu or flu-like (defined as a fever of 100 degrees with either cough or sore throat) was 2.7 percent; it was less than 1.5 percent for the same week in each of the past two years.
"The volume is definitely greater overall, and earlier, than last year," said Dr. David Sidebottom, an infectious-disease specialist at Lowell General Hospital.
The CDC designated Massachusetts as one of 31 states where flu is widespread, which means that outbreaks of flu were reported in at least half the regions in the state. Massachusetts' flu-like activity (the percentage of visits that are termed flu-like as compared to the average percentage in the spring and fall) was listed as moderate.
Fitchburg, however, has seen very little flu activity so far this year. Stephen Curry, director of the Fitchburg Health Department, noted some cases in Weston and Gardner, but said flu season so far has been similar to last year's lighter one.
"There's no explanation for it," Curry said. "But it'll come through here eventually."
Dr. Joseph Bergen, chairman of emergency medicine at Emerson Hospital in Concord, said Emerson's overall volume of emergency-room visits was 8 percent higher this past December than the last. He said the malaise is even spreading to the staff, despite a hospital requirement that all staff members either get the flu vaccine or wear a mask.
Bergen said "a lot of people working here have stayed home" because of flu-like illness.
"CDC says the current vaccine is well matched, but it is surprising that many people who have gotten the vaccine are still getting ill," he said.
The CDC develops the vaccine each year by anticipating potential flu strains through early testing. The majority of confirmed cases of flu have turned out to be one of the three strains (H1N1, H2N3 and Influenza B) present in the vaccine, which doesn't always happen.
"The virus changes continuously, so you have to do a guessing game," Lowell's Singleton said. "The problem is that it's like a moving target you have to try to hit every year."
But the vaccine isn't flu-proof. People may still get infected before the two-week period it takes for the body to gain protection. The vaccine doesn't prevent the common cold (flu yields more severe symptoms, including a fever), and it doesn't protect against the possible mutations the virus may undergo over the course of the winter.
"Clearly, when flu is based from birds or other animals that are out there that genetically mix and match with human ones, we have trouble," said Richard Day, director of the Chelmsford Health Department. "We don't deal well with viruses from other sources."
Rest, fluids will shoo flu
The treatment for flu mostly entails rest, which Emerson's Bergen said most can do at home.
Bob Audet, owner of Pawtucket Pharmacy in Lowell, said he has seen more people than usual come in with flu symptoms, but that their symptoms don't seem to last too long.
"Someone with influenza basically needs plenty of fluids, maybe some aspirin or Tylenol for the pain," Audet said. "Bottom line: You feel awful, but most people can fend it off."
Some people can't, though. The state Department of Public Health estimates that up to 800 people die each year in Massachusetts from flu-related complications. People with pre-existing conditions, such as diabetes, heart disease, lung disease and cancer, are particularly at risk for complications, as are people either extremely young or extremely old.
"If your immune system isn't doing very well, whether you have HIV, are using a steroid or are undergoing chemotherapy, you can get much sicker," Singleton said. "Usually, the people affected are either very young or very old, because their immune systems are not great."
LGH's Sidebottom said it's tough to pigeonhole flu patients into one group, since many that might get infected may fight through it without reporting it.
"The problem you have is that you're probably getting more older folks and people with medical problems because kids may not even report it," he said. "Same with young adults who feel they have to get to work."
Follow Pete McQuaid on Twitter @sweetestpete.