Flu cases spike, but is it just an early peak?

Figures from the Centers for Disease Control and state health officials confirm what many fever-ridden, stuffy-nosed people in the Philadelphia area know: Flu and flu-like cases rose sharply over the past month.

But some believe it might just be a case of the flu peaking early, or just seem worse than usual because last winter was so mild.

"Influenza activity continues to increase in the United States with most of the country now experiencing high levels of influenza-like-illness," the CDC stated in a recent report. The federal agency goes on to say that current levels of flu are already near the peak of "moderately severe" past seasons – even though there is still plenty of time left in the season.

The proportion of people with flu-like symptoms seeking medical attention by the end of 2012 was 5.6 percent, which is higher than usual for that time of year, the CDC said. Last year, the flu peaked at 2.2 percent of the population reporting symptons.

Records show both Pennsylvania and New Jersey are among 41 states reporting high levels of activity regarding influenza, or flu-like symptoms. New Jersey and Pennsylvania were recently listed as "high" in the latest CDC map, and Delaware was listed as "moderate." Both influenza A and B types are being reported.

The problem has been significant enough in some areas to prompt health care facilities to take extra measures. Lehigh Valley Hospital set up a "mobile surge tent" on Tuesday after cases piled up at the Salisbury Township hospital.

Jeremy Walter, a spokesman for Temple Health system, said health care workers have seen a rise, but it's too early to say if it signifies a real increase over previous years, or just an early peak.

"We have, over the last few weeks, seen a spike in our Philly cases, but nothing out of the ordinary for this time of year," Walter said. "The numbers we're seeing now are more in line with what we'd be seeing later in January or February. So the normal spike came earlier this year, and it's not really that extreme of a spike."

The CDC said Friday, however, that "based on past experience it's likely that flu activity will continue for some time." It also notes that the current, predominant flu virus striking now is influenza A (H3N2), which often marks "more severe" seasons with higher numbers of hospitalizations and deaths.

Dr. Marci Drees, the health prevention officer for Christiana Care Health System, said it is probably the earliest flu season she's seen in 10 years. Physicians started seeing patients with symptoms in mid-November with cases growing in December. In all, she said, the flu got rolling in Delaware probably a month earlier than normal.

"I know that we've already had more cases reported in the state, than all of last year," Drees said.

At the least, Drees said, it will likely be a moderate flu season, but could be severe since so much time is left for the virus to run its course. Normally, she said, flu season really doesn't pick up full steam until later in January.

"The only thing that's predictable about the flu is that it's unpredictable," Drees said.

To cope with the influx of patients, Drees said the emergency department at Christiana Hospital has been expanded to provide beds and other equipment in a nearby conference room. She cautioned that otherwise healthy people normally don't need to go to an emergency room since over-the-counter fever reducers are effective for most.

Peggy Leone, a spokeswoman for Virtua, a South Jersey health care system, said the number of flu-like cases its providers are seeing is definitely higher than last year at this time, though she did not have specific figures.

"We have, of course, seen increased volume like everyone else," Leone said.

As a result,Virtua has put in place a temporary policy that requests that only parents, grandparents, or guardians visit in the neonatal intensive care unit in Voorhees. A similar policy is in place in a nursing unit at Virtua Memorial in Mount Holly.

Leone reminds people that it's not too late to get flu shots with much of the season still ahead.

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The following flu Q&A is provided by Christiana Care Health System

Q:  If I think I have the flu, do I need to go to my doctor or the Emergency Department?

A:  You should only go to the Emergency Department if you need emergency care – such as if you're having difficulty breathing, are confused, dizzy or lightheaded, or having chest pain. If you have questions or concerns about the flu or any underlying medical problems, you should call your doctor for further instructions.

Q: Should everybody who gets the flu be treated with antiviral medication?

A:  No.  If you are otherwise healthy, you will likely recover almost as quickly just with over-the-counter treatment for your symptoms (such as Tylenol for fever/body aches, etc.).  Because of concerns about having enough supply of antivirals and of increasing resistance to Tamiflu if a lot of medicine is used, current recommendations are to treat only those severe enough to be hospitalized, or who are at high risk of having severe flu (such as pregnant women, children under 2 years, and those with chronic medical illnesses).