This year’s influenza is making itself known in the D.C. area. Doctors at emergency departments say cases are spiking, post-holidays, with the number of diagnoses hitting their highest rate since cold and flu season began in October.
“We’re seeing a lot of flu patients, primarily influenza A,” says Michael Silverman, chair of the emergency department VHC Health, referring to one of the two most common strains of the virus. “It’s very contagious. It makes you feel very bad.”
A new mutation of flu A called H3N2 subclade K is driving the spread. According to the Centers for Disease Control and Prevention, flu A shows genetic differences that make it somewhat resistant to this year’s flu vaccine. But that doesn’t mean you should skip the flu shot. The vaccine still provides crucial protection.
For the week ending Jan. 3, 12% of emergency department visits in Alexandria, Arlington, Fairfax and Loudoun counties were for flu-related symptoms, up from less than 4% only a few weeks ago, according to data from Arlington Public Health. The Fairfax Health District, which includes McLean and the city of Falls Church, also indicates that respiratory illnesses, including flu, are surging this month.
This tracks with nationwide data. The CDC says the number of people seeking emergency care for the flu is very high and increasing.
“After the holidays, we typically see a noticeable spike in flu cases, and this year is no exception. Increased travel, gatherings and time spent indoors make it easier for the virus to spread,” says Meredith Porter, medical director at Inova-GoHealth Urgent Care. “Our Northern Virginia area is experiencing a surge in flu cases, with a high level of respiratory illness activity. We anticipate this trend to continue for several weeks.”
Symptoms to Watch For
Flu symptoms typically include high fever, chills, headaches, muscle aches and weakness, and last for about a week. Most people can treat symptoms at home with over-the-counter medication. Prescription drugs promise relief, too. Tamiflu and Xofluza are prescription medicines that can shorten the severity and duration of flu symptoms when taken within two days of their onset.
“Sometimes I’ll joke with patients and ask them if they feel like they’ve been run over by a truck, and the answer is almost universally yes,” Silverman says. “Generally, you feel better if it’s safe for you to take ibuprofen and acetaminophen and drink lots of fluids—what we would call supportive care. Reduce the fever, stay hydrated, try to take care of the aches and pains.”
When should you see a doctor? It’s time to seek medical care when symptoms include shortness of breath, a persistent high fever (despite medication) and evidence of dehydration, such as decreased urination or dark-colored urine.
People at the highest risk for these complications tend to be at either end of the age spectrum, Silverman says, meaning infants and the elderly. Individuals with underlying conditions such as asthma, COPD, diabetes, coronary disease or cancer also have an elevated risk. “Those are the people that I want to see in the emergency department,” he says.
How to Stem the Spread
“Prevention, timely care and symptom management are key to staying healthy this season,” Porter says.
To avoid getting sick or spreading the virus if you already have it, wear a mask, cover coughs and sneezes, stay home and wash your hands frequently with soap and water for 20 seconds.
But the number one precaution, both doctors advise, is to get the flu vaccine.
“Protecting yourself with the flu vaccination is the most important step to reducing the risk of severe illness, complications and hospitalizations,” Porter says.
Vaccine makers “prepare the vaccine based on what they anticipate will be the different strains,” Silverman says. “This [strain of flu A] is a little bit less vaccine-friendly, but the vaccine still has benefits in giving you some immunity or giving you some ability to reduce symptoms and reduce duration.”
The vaccine also protects against other strains of flu, including influenza B.
It’s not too late to get the jab, he adds: “If you’re going to get the vaccine, now is the time to do it, rather than waiting until later in the flu season.” Flu season typically lasts through February, but can linger as late as May.
RSV and Covid
Flu isn’t the only respiratory illness on the rise in VHC Health’s ED. “We are seeing more RSV,” Silverman says. “RSV can be especially serious for babies and seniors, and prevention can really help. There are RSV vaccines available for elderly patients. Part of maternal care has been providing RSV vaccination, which has been very helpful as well, but we are definitely seeing RSV and some of those patients are requiring hospitalization.”
On a positive note, Covid diagnoses are low. Over the past month, less than 2% of the 5,000 emergency patients at VHC Health have tested positive for Covid, he says.
Because flu season typically peaks in December through February, the number of people getting sick could increase before it tapers off.
“We don’t know that we’re out of the worst of it yet,” Silverman says. “There will be a decline in the number of cases at some point, later in the winter or early spring.”