This year’s especially grim flu season has been sickening and killing a very high number of people over 65, federal officials report -- even people who consider themselves relatively healthy and not frail.
The latest flu statistics show that while the season is leveling off, it’s still a bad one for seniors.
“The numbers for hospitalizations are extremely high in the elderly. In fact, they are the highest we have had since surveillance began in 2005,” says Dr. Lyn Finelli, a flu expert at the Centers for Disease Control and Prevention. “The deaths are way over the epidemic threshold. We are very concerned about the elderly this year", she added in a telephone interview.
“The elderly rates are many, many times the rates in other age groups.”
Flu statistics show the virus is still widespread in 38 states. Nine percent of reported deaths were due to flu and pneumonia, still above what’s considered an epidemic. And 14 more children died of flu last week, bringing the total this year to 59.
It’s still especially bad in the midwest and west, although infections are beginning to wane in the east. Dr. Jeff Duchin, an epidemiologist and flu expert at the University of Washington in Seattle, says he’s seen the impact.
“We have had a record in long term-care facility outbreaks this year,” Duchin, who is also a spokesman for the Infectious Diseases Society of America, said in a telephone interview.
“County emergency department reports are showing us higher prevalence of disease among older folks compared to what we had seen in recent years.”
CDC said people over 65 need to make sure they see a doctor right away if they get flu-like symptoms. That’s because quick treatment with antivirals can help prevent serious illness.
“We see unnecessary delays in treatment, particularly in the elderly,” Duchin said. “We need to recognize these cases promptly so the medications can be started promptly.”
When to go to the ER with the flu
Antiviral drugs such as Tamiflu only work well when given within a day or two of symptoms starting.
People 65 and older may not consider themselves at higher risk, Finelli says. But they need to: Their immune systems are less robust from those of younger people and they are still more vulnerable.
“Even if they are super-fit maybe they have other underlying conditions that put them at higher risk for the flu, like pulmonary (lung) disease and cardiovascular disease and diabetes,” Finelli said.
A study published earlier this week showed that people over 65 have different types of antibodies from younger people. These immune system proteins recognize and attack invaders like germs and they are stimulated by vaccines.
The study, in the journal Science Translational Medicine, showed that the older people are, the fewer antibodies they have and they have fewer different types.
That may help explain why people have a weaker immune response to vaccines as they get older, and why they get sicker once they are infected.
Flu kills anywhere between 4,000 and 49,000 people a year, CDC says. Every year is different. But this year is shaping up to be at the high end of that scale.
“I do think in years where you have a virus that impacts the older adults particularly hard, the number of total deaths tends to be higher. I would expect that this year we’d be on the high range of deaths,” said Duchin.
“It’s hard to tell because the flu season is not over, but we are having a moderately severe season that is an H3N2 predominant season,” Finelli said.
H3N2 is one of the different strains of flu virus circulating, and for some reason when there is lots of H3N2, more people get seriously ill and die. Ninety percent of these deaths are in people over the age of 65.
That’s not always the case. In 2009-2010, a new strain of H1N1 swine flu emerged and it was the dominant strain that year. People over 65 seemed to have extra protection against that one, perhaps because they’d been infected by an ancestor of the virus in their youths. That year, flu killed more young adults and children.
CDC doesn’t have precise numbers of deaths among adults. “The flu is so common that we don’t have deaths in adults as a reportable condition because states would be overwhelmed by counting them,” Finelli says. The CDC will calculate deaths later, after the season’s over, by comparing mortality rates overall to years past and using death certificate data.
So what can people do? “It’s not too late to get vaccinated,” Finelli advises. “There is still vaccine out there.”
Several strains of flu are circulating, and sometimes a B strain comes along after an A strain like H1N1 or H3N2 and sickens people in a new wave of illness. This year’s vaccine protects against an H1N1 strain, and H3N2 strain and one B strain of influenza.
“Now we are down the the final number of doses that have been distributed,” Finelli added. Manufacturers made about 140 million doses this year.
“We are also telling people to stay home when they are sick, so they are not spreading flu everywhere,” Finelli added. “We are also telling people that if they are elderly, to avoid other people who are sick. If your grandkids are sick, don’t volunteer to mind them.”
People over 65 should also avoid places where sick people may be. “They should also ask that all their caretakers be vaccinated for the flu,” Finelli added.
Studies have shown that if children are vaccinated against disease, it protects the rest of the population. This may be true for flu, too, says Duchin. “By vaccinating children we decrease the amount of pneumoccal pneumonia in older adults, which is a tremendous thing,” Duchin said.
“You can protect older adults in the population by vaccinating the children.”
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