Child first reported flu death in Florida, state reports

A Florida child was the state’s first to die this season due to flu-related illness during the week ended Oct. 6, according to the state’s Department of Health. The child had not received a flu vaccination.

Florida health officials identified the lethal strain as influenza B, which is less common and generally less severe than Influenza A, though both strains infect humans. The child, who was healthy before getting sick with the flu, had no known health conditions, according to the department of health. Additional information, including the child’s age, was withheld to protect the family’s privacy.

Dr. Richard Webby, a faculty member of the infectious disease department at St. Jude Children’s Research Hospital in Memphis, said “Unfortunately, this is what influenza does. Influenza B can be quite a severe infection for younger children so it’s tragic but, unfortunately, nothing that we don’t expect from flu.”

Florida was not alone in reporting a flu death so early in the season.

‘Not uncommon’

A middle-aged woman living in central Kentucky also died of flu-related illness during the second week of October, according to Beth Fisher, a spokeswoman for the Kentucky Cabinet for Health and Family Services. It is unknown whether the woman had underlying health conditions or whether she’d received a flu shot.

Lynnette Brammer, leader of the US Centers for Disease Control and Protection’s Domestic Influenza Surveillance team, said that “it’s not uncommon to start to see small numbers of deaths around this time of year due to influenza even when activity is low.”

In fact, activity is “really low” now, she said.

“There are predominantly influenza A viruses out there, there are a few influenza Bs,” said Brammer. Among the circulating influenza A viruses, H1N1 strains have been more common than H3N2, she said.

This is good news to Webby’s ears. H3N2, he said, is “the virus that always causes the most disease and it’s the one that the vaccine has the hardest time protecting against.”

While he believes a flu season prediction is “probably less accurate than the guys forecasting weather,” Webby said there are two reassuring signs that the 2018-19 flu season will be milder than last year’s season, with its high number of hospitalizations and a record-breaking 80,000 deaths across the nation.

Two positive signs for 2018-19 season

One positive sign is the fact that “activity in the southern hemisphere has, in general, been very mild,” said Webby.

In its most recent flu surveillance report, the Australian Government Department of Health stated the severity of its season, which already peaked in early September, was “moderate,” with “low” impact on society as a whole. The majority of confirmed cases were influenza A, primarily H1N1, a strain which is known to be more mild than others.

While it may not always be the case that a mild season down under translates to a mild season in the northern hemisphere, the fact remains that last year’s severe season in Australia foreshadowed our own.

A second factor suggesting we’re unlikely to have another big H3N2 season is that “we had a lot of that virus circulating last year,” said Webby. “So there’ll be a good deal of people who are going to have some pumped up immunity to that virus.”

Like Webby, Brammer does not make predictions about the season ahead. Still, she said, “it’s a good time for people to go out and get vaccinated so they’re prepared for this season. Because we know it will come.”

“Basically, everybody 6 months of age and older should get vaccinated,” said Brammer. “If you’re pregnant get vaccinated, because it will protect you and it will help protect your baby when the baby’s born.”

Children who are receiving a flu vaccine for the first time will need two inoculations, so it’s a good time to get the first so the second can be fit in before activity picks up in the winter months, she said.

Several vaccine options have been approved by the CDC this season.

When it comes to the conventional flu shot, the CDC makes no “preferential recommendation” between the vaccine that protects against three flu strains and the vaccine that protects against four flu strains. Both cell-grown and egg-grown vaccines are equally acceptable by CDC standards.

Flumist, a nasal spray vaccine, is a needle-free option available for those between the ages 2 and 49, while two high-pressure jet injector vaccines also do not require needles and can be used by anyone between the ages of 18 and 64.

“We’re happy to have as many options out there as we can get,” said Brammer.

Webby suggested we all keep in mind “the usual stuff your grandmother used to tell you.” This homespun advice includes wash your hands well and if you (or your children) are sick, stay home.

Still, the “biggest message,” said Webby, who is a member of the World Health Organization’s flu vaccine composition group, is vaccination. Even when the vaccine doesn’t prevent sickness, it lessens the severity of illness and so may prevent hospitalization, according to the experts.

“We’re all very open about the fact that the flu vaccine is not the greatest vaccine and we really need to make improvements in it,” he said. “But it’s still an effective tool. Now is the time to get vaccinated.”