1. Health

Severe flu season puts seniors at particular risk

Doctors say even an imperfect vaccine is better than nothing in fighting the flu.
Doctors say even an imperfect vaccine is better than nothing in fighting the flu.
Published Jan. 13, 2015

Tampa Bay area health officials say they are seeing more cases of flu the this year, and patients with flu are sicker than usual. And that's especially bad news for seniors, many of whom have other health problems that can mean the flu is even more serious.

"We are seeing a significant increase in seniors with the flu, both vaccinated and unvaccinated," said Dr. David Weiland, chief medical officer for Largo Medical Center, speaking for all five HCA facilities in Pinellas County. "Many patients have serious complications associated with influenza, such as pneumonia, many more this year over this time last year. They are sicker than last year, there are more of them, and more are dying as a result of complications of the flu."

At least one nursing home, St. Petersburg's Menorah Manor, was closed to visitors for a day last week to protect residents when 10 flu cases cropped up. Visitors are again welcome, but urged to stay away if they are ill, and wash their hands often.

"We did it in an abundance of caution to prevent a further spread," said Annabelle Locsin, director of nursing for Menorah Manor. "It's something we monitor all year long."

According to the U.S. Centers for Disease Control and Prevention, flu hospitalizations are soaring nationally. Two weeks ago, 52 of every 100,000 hospitalizations were flu-related; last week, it was up to 92 per 100,000.

Though numerous strains of the flu are circulating, the dominant strain of H3N2 virus isn't covered by this year's flu vaccine, likely discouraging some people from getting vaccinated.

The H3N2 virus tends to hit seniors and the very young particularly hard, causing more severe symptoms and complications, CDC director Dr. Tom Frieden said Friday. "It's a nastier flu virus (this year)," said Frieden, resulting in more hospitalizations and more deaths than with other flu strains in the past.

Pediatric flu deaths have been in the news, because the federal government requires immediate reporting of such deaths. The CDC calculates an estimated total number of deaths only after the season has ended.

Dr. Jose Santana, an internal medicine-primary care physician with BayCare Medical Group who specializes in older adult patients, said that on average, 90 percent of those who die of flu are over age 65.

Seniors are at risk for several reasons, he said. "First, the immune system wanes as you age, so seniors are less able to fight off the invading virus," he said. "And, so many seniors have other medical conditions such as heart disease, diabetes and cancer, putting them at greater risk for serious complications that a younger person may not have."

Plus, he noted, older people congregate in places where the virus can be easily exchanged such as hospitals, nursing homes, senior centers and malls.

"All it takes is one person to bring it in," Santana said. "That's why prevention is so important."

Health officials say that even if the flu vaccine isn't ideal, it's still worth getting because it might help decrease the severity of illness. Seniors can opt for a high-dose flu vaccine that produces a stronger immune response. Santana said, however, that it's not yet certain whether the high-dose vaccine is superior.

"Get whatever vaccine you can get, whatever your practitioner has on hand,'' he advised. "Both are highly effective at preventing flu and severity of illness.''

Experts recommend a flu shot for almost everyone over the age of 6 months. "Even in a good year, the influenza vaccine is about 60 to 65 percent effective," Frieden said.

If you have flu symptoms, get medical attention within 48 hours, so prescription antiviral medication can be started.

"That could keep you out of the hospital or out of the intensive care unit and might also save your life," he said.

Friday, Frieden also urged doctors not to wait for results from confirmatory lab tests to start antiviral medication, especially in people with conditions like asthma, diabetes and blood disorders.

HCA's Weiland said practitioners there are checking patients with flulike symptoms using a rapid flu test, a nasal swab that gives results while you wait.

"Those who are positive get the antiviral Tamiflu, not antibiotics,'' he said. "And that's important. Antibiotics don't work against the flu. (Unnecessary use of such drugs) just contributes to antibiotic resistance and may cause harmful side effects.''

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