What You Need to Know About the 2019–2020 Flu Season

Summer may not officially be over yet, but the effects of the 2019–2020 flu season are already being felt.

Seasonal flu activity typically occurs between October and May, but the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) is reporting that 1.2 percent of patient visits in the first week of September were due to influenza-like illness, or ILI. ILI is defined as having a fever of 100 degrees F or higher and a cough or sore throat.

On September 10, 2019, health authorities in California announced the first flu-related death of the flu season — a 4-year-old child from Riverside County. The child reportedly had underlying health issues.

“We should never forget that the flu still kills,” said Cameron Kaiser, MD, Riverside County's public health officer, in a press release. “I always recommend people get their flu shots every year, but a death so early in the flu season suggests this year may be worse than usual.”

How Bad Will This Flu Season Be?

The American Academy of Pediatrics notes that last year’s flu was moderately severe, and was the longest-lasting U.S. influenza season in the past decade. The Centers for Disease Control and Prevention (CDC) points out that the timing, severity, and length of the flu season varies from year to year.

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“We don’t know how bad the flu will be. But we do know the flu is coming, and many people will get it,” says William Schaffner, MD, an infectious disease specialist and a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee.

To get a bead on the U.S. flu season and what flu strain will dominate, scientists look to the Southern Hemisphere, where the season winds down as ours ramps up.

“Australia doesn’t predict what will happen here, but it might give a hint,” says Dr. Schaffner.

The Australian Government’s Department of Health states that the clinical severity of the current season as a whole has been considered low.

“Based on the activity in the Southern Hemisphere, it has not been a heavy season nor a particularly virulent season,” says Alan Taege, MD, an infectious disease specialist at the Cleveland Clinic. “The season there started early, peaked, and appears to be declining.”

But the dominant strain of flu there this season, H3N2, usually leads to more serious symptoms and hospitalization compared with the common H1N1 strain. Last year's U.S. flu season saw the dominant strain flip from H1N1 to H3N2 around March 2019.

During the winter of 2017–2018, when H3N2 prevailed, the CDC reported that more than 80,000 people died of influenza in the United States, making it one of the deadliest flu seasons in decades.

“It looks like H3N2 may be the dominant virus this year in the United States, and that tends to cause more severe illness,” says Schaffner.

No Matter the Strain, Flu Is Serious

The CDC warns that any type of flu can be far worse than the common cold. The illness can come on quickly and produce fever, cough, sore throat, runny or stuffy nose, body aches, headaches, and fatigue.

A bad case of flu can bring on vomiting and diarrhea. Some people develop complications, ranging from mild sinus and ear infections to potentially fatal pneumonia and inflammation of the heart, brain, and muscle tissues.

“The flu is a contagious and serious respiratory illness that can result in serious complications, and death,” says Dr. Taege. “Every year thousands of people, including children, die from the flu. Young children, older adults, pregnant women, and people with certain chronic conditions are the most vulnerable to complications.”

Your Best ‘Shot’ at Protection

The CDC advises that everyone age 6 months and older get a flu vaccine every season. The vaccine — now administered through an injection or nasal spray — is widely available in physician offices, clinics, some workplaces, and pharmacies all over the country.

The vaccine can reduce related sicknesses, doctor's visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations and death.

A 2017 CDC study showed that vaccination can significantly lower a child’s risk of dying from the illness.

The CDC also endorses the vaccine as safe and effective for pregnant women. Some of the protection gained by the mother crosses the placenta and gets passed on to the newborn during the first six months of the baby’s life, before he or she is eligible for vaccination.

“It’s not a perfect vaccine, but it still does a lot of good,” says Schaffner. “Even if you get flu after having had the vaccine, you’re likely to have a less severe infection. You’re less likely to get complications of pneumonia and go to the hospital. That’s been shown year in and year out.”

Taege adds that vaccination helps suppress the dreaded spread of the disease.

“By getting vaccinated, you are not only protecting yourself, but you’re protecting those around you by lessening the amount of flu in the community,” he says.

Despite reports that tens of millions of vaccines may ship late this season, Schaffner does not anticipate that the delays will significantly affect opportunities for immunization.

“If you haven’t been vaccinated by Thanksgiving, run, do not walk, because most of the time flu peaks in the United States in February,” he says. “We can’t predict the severity of the upcoming flu season, but we can predict that there will be flu. So get vaccinated.”

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