Swine flu returns at epidemic, deadly levels

This year’s version of the influenza virus has brought back an old enemy—the so-called “swine flu” of 2009—and it has also reached epidemic levels in California, including Mono County, according to Mono and Inyo County Public Health Officer Rick Johnson.

Johnson calls it an epidemic because 4 percent of the local population has the flu—and has for the past three weeks—compared to the normal about one percent that would have it at this time.

What’s more, the current flu has already been the cause of 45 confirmed deaths in the state, with another potential 50 deaths likely to soon be confirmed as swine flu deaths, Johnson said.

Just as alarmingly, the flu is killing people most think are invulnerable. About 10 percent of those had no underlying medical conditions at all, he said.

Although no one has died in Mono or Inyo county, this current version of the flu is nothing to fool around with, he said.

“These are young people, under 65, and yes, some had medical conditions, such as diabetes, obesity, high blood pressure, but some had no risk factors at all,” he said.

If that sounds counterintuitive—the part about young people with no underlying health conditions dying—it’s because it is.

But the swine flu has a rather diabolical twist to it.

“Younger healthier people have a more robust immune system that simply overreacts (called a cascade) to the virus becoming attached to receptors on cells in the lower respiratory tract—the lungs,” he said. “The body then sends lots of cells and chemicals to that area to fight off the invader. That reaction gets out of hand, and fills the lungs with fluid, and the person dies of overwhelming respiratory failure.

“The more traditional mechanism of death, which usually occurs in those at high risk, is pneumonia, which is a secondary bacterial infection that develops as a complication of the initial flu,” he said.

“This is how the elderly, very young, and those with underlying medical conditions usually die.”

“As anyone who has had the flu will tell you, it’s a terrible several weeks for most people. You feel like you’ve been run over by a truck,” said one local, who did not wish their name to be used. “I am a very healthy person, but this floored me for a week and two weeks later, I’m still not well.”

The swine flu has another diabolical characteristic—it sneaks up on people. One day, the person is healthy and feels fine. The next, they have a sore throat that quickly devolves into a serious sore throat and the whole host of symptoms of the flu—muscle aches, terrible fatigue, a fever that can stay at 103 for days and more.

Flu victims are usually unaware they are contagious for the flu just while they are the most contagious—the days before and during their initial symptoms, Johnson said.

Health officials encourage citizens to get a flu shot.

“All strains tested to date are in the current vaccine, and there has been no resistance detected thus far to the usual antiviral medications,” Johnson said.

It takes two weeks to build immunity after the shot, so for those two weeks, people are still vulnerable. But after that, he said, the person’s chances of getting the flu, or getting a much less severe version of it—drop between 60 and 80 percent.

Unlike past years, there is a good supply of the vaccine locally, he said.

“There is no shortage of influenza vaccine. Vaccination remains the single most effective means of preventing illness, hospitalization, and other complications,” he said.

In Mono County, about 20 percent of the population—about 3,000 people out of 14,000—has received the vaccination so far, he said.

“That’s not great,” he said. “But it’s about the same nationally. Unfortunately, another reason younger people are dying from the flu is that they (young adults) are the group least likely to get the vaccine.”
Another thing that makes the flu problematic is that flu symptoms can mimic the symptoms of other illnesses that are also common at this time of year.

“Many have asked about illnesses that are probably not ‘the flu,’ Johnson said. “For instance, there is a gastrointestinal illness ‘going around’ with vomiting and diarrhea. This is most likely what is known as ‘norovirus’, or the ‘winter vomiting disease.’ True influenza does not present with this picture.

“There are also other respiratory diseases in circulation, characterized by prolonged coughing, without much fever or the body aches that are part of the influenza picture. This is most likely what is known as the metapneumovirus,” he said.

What are the symptoms of the flu?
• A 100 F or higher fever or feeling feverish (not everyone with the flu has a fever)
• A cough and/or sore throat
• A runny or stuffy nose
• Headaches and/or body aches
• Chills
• Fatigue
• Nausea, vomiting, and/or diarrhea (most common in children)

Do I have the flu or a cold?
The flu and the common cold have similar symptoms. It can be difficult to tell the difference between them. Your health care provider can give you a test within the first few days of your illness to determine whether or not you have the flu. In general, the flu is worse than the common cold. Symptoms such as fever, body aches, tiredness, and cough are more common and intense with the flu. People with colds are more likely to have a runny or stuffy nose.

When am I contagious and how is the flu spread?
• Most healthy adults may be able to infect other people beginning one day before symptoms develop and up to five to seven days after becoming sick.
• Children may pass the virus for longer than seven days.
• Symptoms start one to four days after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.
• Some people can be infected with the flu virus but have no symptoms. During this time, those persons may still spread the virus to others.
• People with flu can spread it to others up to about 6 feet away.
• Most experts think that flu viruses are spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
• Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose.

How to avoid the flu
• Get vaccinated
• Stay away from sick people and stay home if sick.
• Wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
• Linens, eating utensils, and dishes belonging to those who are sick should not be shared without washing thoroughly first. Eating utensils can be washed either in a dishwasher or by hand with water and soap.
• Frequently touched surfaces should be cleaned and disinfected at home, work and school, especially if someone is ill.