A diagram of the Influenza Virus structure
A diagram of the Influenza Virus structure
… The annual Flu season challenges patients and medical professionals across the United States …

How is the annual Flu season unfolding throughout the United States?

John G. Baresky

The Centers for Disease Control ( CDC ) plus other government healthcare agencies and medical professionals are closely monitoring what is shaping up to be a formidable Flu season.

  • The predominant Flu virus strain varies by region
  • Age groups are another variable in profiling specific Flu virus strains
  • Nationwide, influenza B/Victoria virus has been the most frequently reported Flu strain thus far; the second most frequently occurring is A(H1N1)
  • Influenza B/Victoria viruses are most commonly reported in children aged 0–4 years ( 46% of reported viruses) and persons aged 5–24 years ( 57% of reported viruses)
  • A(H1N1) pdm09 viruses are most commonly identified in persons aged 25–64 years (41% of reported viruses)
  • For adults 65 years of age and older almost equal proportions of influenza A(H1N1) pdm09 ( 38% ) and A(H3N2) viruses ( 37% ) have been reported
  • Current hospitalization rate has been 6.6 cases per 100,000 ( similar to previous Flu season trends at this calendar interval but on the increase )
  • Overall the CDC estimates there have been 4.6 million Flu cases so far this year resulting in about 39,000 hospitalizations and over 2,100 fatalities

The National Foundation For Infectious Disease ( NFID ) estimates the Flu season annually burdens the U.S. with just over $10.4 billion in expenses for hospitalizations and outpatient visits for grownups. This figure does not include the costs of treating infants, children and young, non-adult teens or the cost of absenteeism ( work and / or school-related ) in the U.S. population.

Individuals spanning infants to the elderly are susceptible to the Flu virus. Expectant mothers, seniors and persons with chronic conditions such as asthma, an airway abnormality or other respiratory issues, diabetes, hypertension, heart disease, neurological or neurodevelopmental disease, kidney, liver or blood disease could be more vulnerable to Flu and severe Flu symptoms. Persons ill with pneumonia, measles, strep and other sicknesses would experience exacerbated symptoms by contracting the Flu as well.

The largest Flu vaccine manufacturers include:

  • AstraZeneca ( NYSE: AZN )
  • GlaxoSmithKline ( NYSE: GSK )
  • Sanofi ( NASDAQ: SNY )
  • Seqirus / CSL ( ASX: CSL )

Most Flu vaccine formulations are administered via a single injection although an inhaled nasal spray Flu vaccine is available ( FluMist Quadrivalent manufactured by AstraZeneca ). Healthcare professionals determine and prescribe which Flu immunization option, injection or inhaled formulation, is most appropriate for each patient.

Dr. Jonas Salk and Dr. Thomas Francis, working as researchers at the University of Michigan in Ann Arbor, developed the first Flu vaccine in 1938. They collaborated with the United States Army through their work as the U.S. government wanted to prevent Flu outbreaks from reoccurring such as the Flu epidemic which was triggered during World War I.

Depending on the consumer or “patient” and their access to healthcare products, there is an array of over-the-counter medications available that treat Flu symptoms ( but do not “cure” or prevent the Flu ) that do not require a prescription.

There are several companies manufacturing Flu antivirus pharmaceutical products that require a prescription which can be administered to patients with confirmed Flu diagnosis including:

  • Rapivab ( peramivir; injection ) — manufactured by CSL
  • Relenza ( zanamivir; dry powder for inhalation ) — manufactured by GSK
  • Tamiflu ( oseltamivir phosphate; oral ) — manufactured by Roche but also available as a generic
  • Xofluza (baloxavir marboxil; oral) — manufactured by Genentech / Roche ( OTCMKTS: RHHBY )

Flu outbreaks are not confined to the United States and can be triggered almost anywhere around the world. Historical data and medical researchers link the origin of most Flu viruses to parts of Asia where swine, birds, humans and other hosts can transmit Flu virus as well as enable it to mutate into new forms.

Flu is highly contagious and usually transmitted via droplets created when people speak, cough or sneeze and those airborne droplets land in the mouths, noses and eyes of others; to a lesser extent, it is contracted from touching surfaces where droplets have landed.

The context of how Flu can spread so rapidly is easily explained. As a Flu virus emerges, it can be quickly spread between individuals and multiplied further as persons carrying the Flu virus go about their daily routines. This includes being in close quarters with family, friends, business associates, classmates and others while transiting to various destinations:

  • airplanes, buses, cabs, rideshares, trains
  • casinos, theaters, sports arenas and stadiums, other entertainment venues
  • grocery stores, other places of retail trade
  • gyms, fitness centers, dance studios
  • places of worship
  • restaurants
  • schools
  • workplaces

In the United States, the National Institutes of Health ( NIH ) are heavily involved in numerous public healthcare challenges including the Flu. Around the world, individual governments have various medical and regulatory agencies which parallel the CDC and NIH in terms of monitoring Flu-related events and other healthcare matters. On a global basis, The World Health Organization ( WHO ), a division of the United Nations based in Geneva, Switzerland, has operated a unit dedicated to Flu illnesses, the Global Influenza Surveillance and Response System ( GISRS ), since 1952.

  • It is not too late to get the Flu shot ( or FluMist if appropriate ); there are ample supplies presently available
  • Avoid persons who are sick
  • Avoid directly touching eyes, nose, mouth; cover nose and mouth with a tissue when coughing or sneezing; properly dispose of the tissue quickly
  • Wash hands with soap and water frequently and clean / disinfect surfaces where hand contact is frequent ( desks, counters, tabletops, cell phones, keyboards, tablets, door handles, remote controls, appliance handles, etc. )
  • If diagnosed with the Flu and prescribed Flu antivirus medication, patients should be certain to complete the entire course of therapy and limit close contact with others

In the United States, the Flu season typically begins in October. Over the last 3 decades, it has peaked at various times and depending on the trajectory of regional outbreaks, it can steeply ramp up in October or steadily climb through February. Following February Flu season usually tapers out by April with some cases still being reported in May.

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