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Alaska swine flu cases increase

Sean Doogan
The H1N1, or "swine flu" virus, seen here colorized under an electron microscope, has infected nearly 200 Alaskans this month despite the fact that it is contained in this year's flu vaccine. C.S. Goldsmith and A. Balish / CDC

Coughing, sneezing, and hacking their way through the holidays, Alaskans are getting the flu. And more are likely to get ill. The epidemiology section of the Alaska Division of Public Health said it saw a December rise in the number of confirmed cases of influenza in Alaska.

The culprit: a majority of confirmed flu cases in Alaska so far this season are of the H1N1 strain -- the so-called “swine flu.” And this year’s strain of swine flu is acting much differently than the disease did when it swept across 214 countries in 2009-2010 and killed more than 18,000, becoming a global pandemic. The 2009 H1N1 flu most affected the young and the old. This year, the Centers for Disease Control and Prevention said young and middle-aged adults are most at risk to develop symptoms severe enough to require hospitalization.

The CDC issued a flu alert the day before Christmas. The agency said it has received numerous reports of hospitalizations requiring ICU care, and even some deaths among young and middle-aged adults. The emergence of the flu, though, is far from unexpected. It appears throughout the seasons each year, but most often it is seen from November through February. This year, in Alaska, December has seen a big uptick in the number of cases reported -- almost 200, compared to just 47 in November. But the 2013-2014 flu season is just getting started.

“We do know the trend is increasing and we don’t know when it is going to peak,” said Dr. Joe McLaughlin, the director of the state’s epidemiology section. “We have widespread illness already throughout Alaska.”

McLaughlin said he is not aware of any deaths that resulted from people getting the flu this year in Alaska, but that doesn’t mean there weren’t any. That’s because the state does not currently require doctors and hospitals to report flu related deaths among adults -- only for children. But that will soon be changing. New regulations are going into effect Dec. 29 that will track adult flu deaths as well as those among children.

At the Anchorage Neighborhood Health Center -- a public health clinic that serves mostly low-income and uninsured patients -- doctors have yet to see a big increase in the number of people coming in with the flu. But doctors there are familiar with the sometimes fatal effects of the disease. Dr. Marin Granholm came to the clinic about a year ago from Bethel, where she said she got a flu “wake-up call” in 2012.

“We had an 18-year-old Alaska Native girl come in who was otherwise healthy. She tested positive for the flu and eventually died from it,” Granholm said.

According to the state, Alaska Natives have a higher risk of suffering severe symptoms because of the flu. So are young children and the elderly. And even though this year’s strain of the flu seems to be more virulent among adults, it is a good idea for everyone to get vaccinated, according to Granholm.

“People have told me they got the flu vaccine shot in the past and it made them sick, so they don’t want to get vaccinated anymore,” Granholm said.  “But they should get the shot because it is their loved ones they are ultimately protecting from the flu.”

Colds often mimic the flu, but Granholm said the flu often comes with a fever and body aches -- symptoms not often associated with a common cold. Flu symptoms usually appear between one and four days after infection. Doctors warn people showing symptoms of the flu not to return to work until they have been free of fever for at least 24 hours. And if you do get sick, it is important to make sure no one else does.

“Practice good respiratory hygiene -- cough or sneeze into your elbow if you are wearing a long-sleeve shirt and wash hands as soon as possible,” Dr. McLaughlin said.

McLaughlin urges everyone over the age of 6 months to get the flu vaccine as soon as possible. Vaccines are available at most doctors’ offices and the state has waived the fee for anyone who does not have insurance or might not be able to pay for it. And while the flu comes in many varieties, McLaughlin said this year’s vaccine -- actually a cocktail of immunization against at least four flu types -- seems to be working well. But, as with many things, the flu remains difficult to pin down, and that could mean more misery is yet to come for ill Alaskans.

It is about average for the timing to usually start to see influenza activity pick up around the holidays, when people congregate together, McLaughlin said. “But it can actually peak as early as November or as late as February (or) March. We just don’t know when the peak will be.”

Contact Sean Doogan at sean(at)alaskadispatch.com.