Tag: flu season

Closing Schools During Flu Outbreaks

Have you heard about schools closing during flu season?

Will that help stop the flu?

Closing Schools During Flu Outbreaks

While it is not uncommon to hear about schools closing at the peak of flu season for a “deep clean,” there is no general recommendation that they close to help combat the flu.

“Studies have shown that the flu virus can live and potentially infect a person for only 2 to 8 hours after being deposited on a surface. Therefore, special sanitizing processes beyond routine cleaning, including closing schools to clean every surface in the building, are not necessary or recommended to slow the spread of flu, even during a flu outbreak.”

Influenza Guidance for School Administrators

So why do schools close?

“We do not recommend closing schools to prevent flu transmission. However, schools may choose to close or dismiss students if a large number of absences prevent normal school functioning.”

Influenza (Flu) in Schools

In general, it is because so many people are sick, that then it becomes harder to keep the school functioning safely.

Why?

Mostly because it is not only students that get sick. Teachers, counselors, and everyone else who works in the school can get sick too.

“The length of time school should be dismissed will vary depending on how severe the flu is and how many people are sick. When the decision is made to dismiss students, CDC recommends doing so for 5-7 calendar days.”

CDC on How long will schools have to stay dismissed?

Still, closing a school should typically be a last resort, as it can be very disruptive for everyone who needs to make arrangements to watch their kids who suddenly aren’t in school.

It is also important to understand that closing the school is not the only option officials have.

Call your local and state health experts before closing your school for the flu.
Call your local and state health experts before closing your school for the flu.

They can instead consider some type of selective dismissal, for example, only sending high risk students home or only specific classes or grades with a lot of flu cases.

What about Tamiflu?

“A mild form of Influenza A H1N1 2009 was confirmed in a secondary school affecting mainly those in the boarding house. Cases identified were treated, but post-exposure prophylaxis with oseltamivir administered to the remaining school population actually halted the outbreak, after social distancing interventions had not succeeded.”

Asiedu-Bekoe on Mass Oseltamivir Prophylaxis Halts Pandemic Influenza A H1N1 2009 Outbreak in a Secondary School in Ashanti Region, Ghana

While Tamiflu can help prevent flu infections when taking prophylactically, there are no recommendations for its use to control outbreaks. Even if it did work, the concern would be that we would quickly see resistance among flu viruses.

Tamiflu can be used if high risk kids and adults are exposed to the flu though.

What to Know About Closing Schools During Flu Season

There is typically no general recommendation to close schools during flu season, but if you do, after consulting with local and state health officials, you should encourage the students to actually stay home! It doesn’t do any good if sick kids aren’t in school, but are still mixing with others in the community.

More on Schools Closing During Flu Season

Is the Flu Deadlier This Year?

Why do people seem to think that the flu is deadlier this year?

Everyone has a prediction about flu season, but it is still too early to tell if this year will be deadlier than others.
Everyone has a prediction about flu season, but it is still too early to tell if this year will be deadlier than others.

It seems like we get these kinds of warnings and predictions every year.

Is the Flu Deadlier This Year?

Is it true this year?

“Levels of outpatient ILI remain elevated; however hospitalization rates and percent of deaths due to pneumonia and influenza remain low. This is likely due to the predominance of influenza B/Victoria and influenza A(H1N1)pdm09 viruses which are more likely to affect children and younger adults than the elderly. Because the majority of hospitalizations and deaths occur among people age 65 and older, with fewer illnesses among that group, we expect, on a population level, to see less impact in flu-related hospitalizations and deaths.”

Weekly U.S. Influenza Surveillance Report, Key Updates for Week 1, ending January 4, 2020

It is certainly true that we are seeing more pediatric flu deaths at this time of year than usual, but we don’t usually have such an early start to the flu season!

“This season so far has been particularly deadly for children, with 27 deaths reported through December 28. That’s the highest number of deaths at this point in the season since the CDC started keeping track 17 years ago.”

Elizabeth Cohen on US on track for one of the worst flu seasons in decades

If flu season also peaks and ends earlier than usual, than it might not end up being an overly severe flu season.

Will it be a deadly flu season?

Of course.

It’s flu season!

“The overall cumulative hospitalization rate was 14.6 per 100,000 population which is similar to what has been seen during recent previous influenza seasons at this time of year.”

Weekly U.S. Influenza Surveillance Report, Key Updates for Week 1, ending January 4, 2020

But there is not yet good evidence that this season is or will be much worse or deadly than others.

Influenza-like Illness numbers don't say anything about the severity of flu illness.
Influenza-like Illness numbers don’t say anything about the severity of flu illness.

Or that this year’s flu vaccine won’t be effective. We won’t get a report on the effectiveness of this year’s flu vaccine until next month.

“Although the V1A.1 and V1A.3 subclades are genetically distinct, sera from previous studies conducted among humans vaccinated with a V1A.1 virus cross-reacted well with B/Victoria viruses with a three amino acid deletion, such as the V1A.3 viruses. These findings suggest that vaccination with the current season’s vaccine might offer protection against circulating B/Victoria viruses.”

Early Season Pediatric Influenza B/Victoria Virus Infections Associated with a Recently Emerged Virus Subclade — Louisiana, 2019

And while we already know that this year’s flu vaccine isn’t a perfect match, it should offer protection.

Flu mortality surveillance data is still below epidemic threshold, although it is unlikely to stay there much longer.
Flu mortality surveillance data is still below epidemic threshold, although it is unlikely to stay there much longer.

Unfortunately, early flu seasons don’t always peak and end early. And they are sometimes among the worst, like the 2012-13 flu season. But that was an H3N2 season, which often are worse than others.

This year we are in new territory, having an early season that has been dominated by a flu strain B. Since it is not something we have seen before (at least not since the since the 1992–93 season), you can expect the unexpected, just like you should always do when it comes to the flu.

And know that there is really only one prediction that will end up holding true, that a yearly flu vaccine is the best way to protect your family from the flu.

More on Flu Deaths

Do Flu Vaccines Cause RSV?

Why do some people think that getting a flu vaccine can cause them to get RSV?

Flu vaccines do not cause RSV.
Flu vaccines do not cause RSV.

The usual suspects…

Do Flu Vaccines Cause RSV?

Like the flu, RSV or respiratory syncytial virus, causes infections during cold and flu season.

Unlike the flu, we don’t yet have an RSV vaccine, but that hasn’t stopped anti-vax folks from trying to link them together.

Of course it is silly think that a flu shot could cause a child to develop RSV.

For one thing, you can just look at who gets RSV, especially severe RSV infections.

“The average seasonal RSV hospitalization rate in this study was 5.2 per 1000 children who were <24 months old, but the rate varied by season as much as fourfold. Nevertheless, 1-month-old infants consistently were most likely to be hospitalized, almost twice as often as the next 2 most at-risk groups: infants <1 month old and infants 2 months old. These youngest infants accounted for an important proportion of all children admitted with RSV infection in the first 2 years of life: 11% were infants <1 month old, 44% were ≤2 months old, and only 36% were >5 months old.”

Hall et al on Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age

While anyone can get RSV, even adults, it is infants who are under 6 months old that typically are at the greatest risk to have severe infections. And of course, these kids are too young to even have a flu vaccine!

The other reason?

It is no surprise that the flu vaccine delays of 2015 didn’t affect RSV season…

RSV season not only starts before flu season, but often before the time when we are even giving flu vaccines!

Anyway, the whole idea that “RSV is an adverse reaction from flu vaccine” comes from the misuse of a study, Increased risk of noninfluenza respiratory virus infections associated with receipt of inactivated influenza vaccine, that doesn’t even mention RSV.

“Being protected against influenza, TIV recipients may lack temporary non-specific immunity that protected against other respiratory viruses.”

Cowling et al on Increased risk of noninfluenza respiratory virus infections associated with receipt of inactivated influenza vaccine

And it is very important to keep in mind that it was a small study about interference caused by non-specific immunity.

Another larger study that did include RSV, “Influenza vaccination is not associated with detection of noninfluenza respiratory viruses in seasonal studies of influenza vaccine effectiveness,” found that “influenza vaccination was not associated with detection of noninfluenza respiratory viruses.”

What to Know About Flu Vaccines Causing RSV

The bottom line is that flu vaccines do not cause RSV and do not increase your risk of getting RSV.

More on Flu Vaccine Side Effects

The 2019-20 Flu Season Update

Breaking News: The 2019-2020 season is well underway, but flu activity has “declined slightly.” (see below)

It is way too early to tell if flu season has peaked...
It is way too early to tell if flu season has peaked…

Flu season started early this year.

The 2019-20 Flu Season Update

That’s not the only surprise though. We are seeing a lot of flu B, which is also unusual for the beginning of flu season.

And we are already seeing quite a few pediatric deaths – 39 so far this season.

The overall cumulative hospitalization rate was 19.9 per 100,000 population which is similar to what has been seen during recent previous influenza seasons at this time of year.
The overall cumulative hospitalization rate was 19.9 per 100,000 population which is similar to what has been seen during recent previous influenza seasons at this time of year.

But none of this should really be a surprise – it’s flu season, which is always unpredictable.

“It’s not too late to get vaccinated. Flu vaccination is always the best way to prevent flu and its potentially serious complications.”

Weekly U.S. Influenza Surveillance Report

Some things to know to about this year’s flu season include that:

  • the most active flu B virus strains belong to a sublade that was not in the flu vaccine, but is similar enough that getting vaccinated should offer protection
  • again, it is never too late to get a flu vaccine. Remember, a yearly flu vaccine is recommended for everyone without a contraindication who is at least six months old, with younger children getting two doses during their first season.
  • anti-viral flu medications (Tamiflu, Relenza, and Xofluza) are available, but are mainly recommended for those who are at high risk for serious flu complications, including young children (under 2 to 5 years of age), pregnant women, seniors, and those with chronic medical conditions, like asthma and diabetes, etc.
  • most people do not need a flu test, as it is possible to have a negative flu test and still have the flu (false positive test) and most people don’t need to be treated with anti-viral flu medications
  • if you get the flu, avoid others and seek medical attention if you develop any serious, emergency warning signs, like trouble breathing, dehydration, or confusion, etc.
  • people with the flu can generally return to school or work once they are fever free for at least 24 hours

And let’s hope we don’t see any other surprises this year…

More on the The 2019-20 Flu Season Update