Still time to prepare for onslaught of flu season
By Marilyn Meyer
So far, the flu season has been mild in Polk County. But that could change quickly.
The virus is lurking everywhere beyond the Florida borders - it moved rapidly in four weeks from no states reporting widespread activity to 21 states with widespread flu, according to the latest report from the national Centers for Disease Control and Prevention.
The good news is it is not too late to get a flu shot, and the formula in this year's vaccine is effective against the most common viruses that have been circulating, the CDC reports. The shot is recommended for everyone 6 months and older.
The latest reports for Polk County show that flu activity was increasing in Polk and six of the 10 counties that touch our county lines, and was flat in the other four neighboring counties.
"It is unpredictable why the virus in one community is worse than another community because the germ itself is unpredictable," said Dr. Daniel Haight, an infectious-disease specialist who is vice president of community health at Lakeland Regional Health.
The spread of the flu is seasonal and expected during the colder months, he said.
Over the holidays, as northerners traveled to Florida tourist destinations and to visit family and Floridians headed north for snow and family time, there was ample opportunity to sit in crowded areas with sniffling, coughing, sneezing people, and to touch doorknobs, banisters, elevator buttons, toilet handles, TV remotes, keyboards and other surfaces previously touched by someone with an infection.
"Most people don't realize the number of times they rub their eyes, scratch their nose or touch their mouth," said Greg Danyluk, who has a doctorate in microbiology and a master's degree in public-health epidemiology and is the epidemiology program manager for the Florida Department of Health in Polk.
That is an issue because, according to the CDC, the two main ways to catch the infection are breathing in droplets from a coughing and sneezing infected person within 6 feet of you or touching an infected surface - studies show the virus can live from two to eight hours on a hard surface - and then touching your own mouth, eyes or nose.
Besides staying away from people who are sick - which often is nearly impossible - frequent handwashing remains the most effective way to prevent spread of the flu, followed by using hand sanitizer.
WHY GET THE SHOT
When healthy people get the flu, they may be miserable for several days to a couple of weeks with sore throat, runny or stuffy nose, body ache, headache, chills, fatigue, fever and sometimes diarrhea and vomiting. But when babies, young children, older people and anyone else with a delicate immune system gets the flu, conditions may be ripe for complications that can lead to hospitalizations and deaths.
Complications can include sinus and ear infections; pneumonia; inflammation of the heart, the brain or muscle tissue; multiple organ failure, such as respiratory or kidney failure; and sepsis, according to the CDC.
In Florida, between 2,200 and 2,800 people died annually of influenza-pneumonia between 2005 and 2015, according to data from the state Department of Health. In Polk County, the number of flu-related deaths over the decade ranged from a low of 92 to a high of 182.
"After the flu hits you, you are so much more susceptible to other diseases, especially bacterial pneumonia," Haight said.
Healthy children, teens and adults who get the flu shot protect not only themselves but their elderly relatives and colleagues and protect vulnerable babies and young children, he explained.
John Hockman, 43, said he got the flu shot this year for the first time in about 10 years, partly because he wants to protect his mother, who has been in and out of the hospital.
"I am a bartender. I work at Wally's Pool Room in downtown Lakeland, and I am in contact with a lot of people. I don't want to spread the flu to other people."
Hockman said he had a bout of the flu last year and "it was enough for me to want to be safe rather than sorry." It was an easy decision when he was offered the opportunity to get the shot during a visit to Central Florida Health Care.
"The elderly population is immune compromised," said Dr. Ruben Adriano, an internist and geriatric-medicine specialist who practices at Lakeland Regional Health's Lake Miriam complex.
Adults 50 and older have increased incidence of chronic lung disease, heart failure, diabetes and obesity, which puts them at higher risk to catch the flu, to be sicker from it and to develop complications.
"Definitely, I ask all my patients to get a flu shot," Adriano said. "Before the visit starts, nurses and support staff alert patients on the need." And, Adriano who is a medical adviser at two nursing homes, said nursing homes ensure all their patients get their shots.
Danyluk said that while nursing homes inoculate all their patients, historically they have struggled to ensure all their staff is vaccinated annually against influenza, since there is no law requiring health-care workers be vaccinated against it.
Haight said that at Lakeland Regional Health, annual vaccination is mandatory for all health-care workers and support workers and the hospital is at a 98 percent vaccination rate, with the remaining 2 percent having valid reasons not to be vaccinated.
At Heart of Florida Regional Medical Center in Haines City, the hospital has been on a campaign to encourage employees to get vaccinated and the percentage has more than doubled this flu season, said Tracey Guerrero, marketing director.
And at Lake Wales Medical Center, the shot, while not mandatory is offered free to all employees, volunteers and physicians and offered at convenient times and places, including in the cafeteria, said Maryemma Bachelder, director of marketing.
"In general, we realize that influenza affects the world throughout cold months," Haight said. "The virus comes in through major ports of entry, so typically, Miami, Los Angeles and Atlanta are at increased risk first in the season.''
And as people go about their business and travel, the virus gets a hold in a community and it spreads.
"When you are looking at flu, when it is going to hit is unpredictable and where it is going to be is unpredictable."
It is not unexpected that Orange County, home to the Orlando International Airport and numerous theme parks, was among the first in Central Florida to move from mild to moderate infection rates, Haight said. "You think of all those hands in theme parks and at the airports with the risk of spreading and catching germs, and you see those areas having more activity sooner in the year. Then, you see the flu activity involve neighboring counties. The employees who service the theme parks and airport bring the virus into their social networks."
And the viruses spread after schools go back in session following the holidays when many children have been traveling. But, Haight said, "we have good folks out in the schools trying to emphasize hand hygiene" in an effort to prevent spread of the germs into homes where younger children and older adults are more susceptible to serious complications.
Danyluk said that as the county epidemiologist, he is most concerned about what is happening locally. Flu itself is not reportable to health authorities, but the CDC and state health departments have developed an extensive monitoring system.
"Florida is unique in that we are subtropical," Danyluk said. "And as large as the state is, we have different waves of flu. The flu in southern Florida is not a mirror image of what is happening in West Central Florida."
And, while we can expect an increase in flu activity locally, it doesn't help a lot to look at what is happening in the rest of the country to determine how the flu will impact Polk County this season, Danyluk said.
"We have to look at look at several weeks' worth of data to get a better picture of what activity is like" because in any county it may go from mild to moderate then back to mild before it may become moderate or widespread.
"Typically we expect the flu to peak in late January or early February, but there have been a few times when it peaked earlier," Danyluk said. And the virus may continue circulating until April or even into May, he said.
That is why there is still time to get a flu shot. The shot should reach full effectiveness in about two weeks and last throughout this flu season.
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