Flu Season - Influenza

Influenza-like illness (ILI) is defined as a temperature of > 100.0?F (> 37.8?C) and either cough or sore throat in the absence of a known cause. Levels of influenza activity are 1) no activity, 2) sporadic-small numbers of laboratory-confirmed influenza cases or a single influenza outbreak reported but no increase in cases of ILI, 3) local-outbreaks of influenza or increases in ILI cases and recent laboratory-confirmed influenza in a single region of a state, 4) regional-outbreaks of influenza or increases in ILI cases and recent laboratory-confirmed influenza in at least two but less than half the regions of a state, and 5) widespread-outbreaks of influenza or increases in ILI cases and recent laboratory-confirmed influenza in at least half the regions of a state.

Influenza incidence exhibits strong seasonal fluctuations in temperate regions throughout the world, concentrating the mortality and morbidity burden of the disease into a few months each year. Influenza is more likely to spread in the winter than the summer. This may be caused by an increased infectiousness of the disease, an increased susceptibility of people, or an increased number contacts with others that might result in transmitting the infection during the winter. For example, people may spend more time indoors.

The reason that more people catch the flu in the winter appears to be that small seasonal changes in flu transmission at the individual level are greatly amplified as the disease spreads through communities. The underlying cause of seasonal fluctuations in transmission may be too small to measure. Large fluctuations in the number of flu cases between winter and other seasons may be caused by very small changes in the number of people infected by a single infectious person. These small changes in transmission rate are amplified by interactions between the evolving virus and the changing level of immunity that people have to specific strains.

The cause of influenza's seasonality has remained elusive. Studies have failed to establish whether these transmission changes are due to direct effects of temperature and humidity on transmission, to changes in mixing patterns [e.g., school terms or simply more time spent indoors], or to other factors, such as increased viral production under winter conditions. In fact, it may be impossible to establish the underlying cause of seasonality in influenza epidemics, since the large observed oscillations in incidence can be generated by seasonal changes in the transmission rate that are too small to measure. The large oscillations in incidence may be caused by undetectably small seasonal changes in the influenza transmission rate that are amplified by dynamical resonance.

Data can be evaluated quantitatively, and graphic representation of this information, known as epidemic curves (epi-curves), may prove especially useful in this endeavor. These visual representations depict case frequency over time, and are initially used to obtain tentative answers to questions concerning origin, propagation, incidence, prevalence, and likely modes of transmission. The nature of the epidemic curve varies with the pathogen. The frequency curve for most infectious diseases resembles a logarithmic normal curve. Epidemics such as infuenza have distinctive patterns of initiation and spread.

Influenza Vaccination Season Begins

The Michigan Department of Community Health (MDCH) is gearing up for the 2007-2008 influenza season by making special efforts to reach out to high-risk patients as well as children in need of a second dose of influenza vaccine. Vaccine manufacturers expect shipments to be made on-time this year and MDCH is urging providers, local health departments, and community vaccinators to begin vaccinating patients.

"As the 2007-2008 flu season approaches, we encourage all of Michigan's residents to be vaccinated against the flu," said Janet Olszewski, MDCH Director. "Ask your doctor if you are at high-risk for influenza-related complications and be sure to get vaccinated. If you are a new parent, a health care professional, and/or have contact with people age 65 and older, protect those high-risk individuals by getting vaccinated."

According to the U.S. Centers for Disease Control and Prevention (CDC), every year in the United States, an average of 5 percent to 20 percent of the population gets the flu, more than 200,000 people are hospitalized from flu complications, and about 36,000 people die from flu. More than 90 percent of those deaths are among persons age 65 or older. Even though last year's flu season was mild, 68 deaths among children were reported to CDC.

"The single best way to prevent the flu is to get vaccinated each year," said Dr. Greg Holzman, State Chief Medical Executive. "Contrary to popular myth, the flu vaccine cannot give you the flu. There are two types of flu vaccinations available: the "flu shot" and the nasal-spray flu vaccine; both are effective in preventing the flu."

Studies show people with flu can infect others up to 1 day before they start having symptoms and, once sick, they can infect others for up to 5 days. About half of all people with influenza infections do not have any symptoms; these people can infect others without knowing they are sick.

Influenza activity most often occurs in January or later, therefore it is important to know that if you do not get vaccinated in October or November, you can still get get vaccinated in December or later. Though it varies, flu season can last until May. For information on receiving the flu vaccine, please contact your doctor's office or your local health department.

Flu Season, When Does It Start?

Flu season starts to peak in November and continues to peak through April. The Centers for Disease Control and Prevention (CDC) recommend getting your 2004 flu vaccine in the months of October and November in order to prevent an outbreak to the flu virus. Every flu season a new batch of the flu vaccine is made. Scientists consider what strains of the virus are going to be a threat that flu season and develop the vaccine accordingly. There are usually 3 deactivated or killed stains of the flu virus in the vaccine each new flu season.

This flu season, due to the vaccination shortages, the CDC is recommending that specific priority groups get their vaccinations first, and then the non-priority group forgoes their vaccination all together this 2004-2005 flu season. The priority group is as follows:

• Children between ages 6-23 months
  
• Adults aged 65+
  
• Individuals with chronic conditions aged 2-64
  
• All women who will be pregnant during the 2004-2005 flu season
  
• Residents of nursing homes/long term facilities
  
• Children between 6 months to 18 years of age on chronic aspirin therapy
  
• Health care workers that work in direct patient care
  
• Household contacts/out-side caregivers of children under 6 months of age
  

People who have severe allergies to chicken eggs or those who have Guillain-Barre syndrome (obtained after a flu vaccine) should not receive get a 2004-2005 flu vaccine.

The best tip for flu prevention for those unable to get a flu vaccination or for those in the priority group to further protect them selves this flu season is to maintain a healthy immune system.

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