Early in the Season, Flu Widespread in 10 States

Flu season has kicked into high gear this year, with widespread reports of influenza in 10 states, according to the Centers for Disease Control and Prevention.

Flu activity is highest in the South and parts of the West, with the highest concentrations in  Alabama, Alaska, California, Louisiana, Massachusetts, Nevada, New Mexico, South Carolina, Tennessee and Texas, according to CDC’s from the week ending November 23, the most recent data available.

The last time widespread influenza activity was this high at this point in the flu season was 2009, when more than 20 states reported widespread flu activity, according to CDC data.

In Louisiana, Children's Hospital New Orleans has treated more than 1,400 cases of flu this year, compared to just nine cases this time last year, according to CNN.

States across the country have also reported numerous flu-related deaths this year, including 13 people who died in California and six in Arkansas since the start of flu season.

“National levels of influenza-like illness have been increasing for nearly a month, however, the amount of illness still varies by region,” Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the CDC, told a congressional committee this week. “CDC is actively monitoring the viruses that are circulating, but it is too early to tell which viruses will predominate, or how severe the season will be.”

At Wednesday’s hearing before the House Energy and Commerce Committee’s Oversight and Investigations Subcommittee, federal health officials extolled the virtues of getting flu vaccinations and provided updates on efforts to increase vaccine effectiveness and enhance data-sharing capabilities with states.

Only 63% of children and 45% of adults received flu vaccines last year, according to the CDC. People often hesitate to get flu shots because they mistakenly believe the vaccine will not be effective, Messonnier told the committee.

“If you ask people why they don’t get the flu vaccine, as opposed to other vaccines, it is because they don’t believe the flu vaccine works,” Messonnier said. “We have to do a better job at educating people that even if you can still get the flu with the flu vaccine, flu is milder and it can prevent hospitalizations and deaths.”

Messonnier said the CDC is also working to collect and share better data on the spread of the flu and vaccination rates so that it can be more useful to state and local governments. She said the current systems are antiquated and fragmented, making it difficult to share the type of real-time data that could be most beneficial.

“What we all want is real-time actionable data,” she said.

The CDC posts weekly updates online detailing the spread of influenza during every flu season.

“What you would like to be able to do is use that same picture to click on your state and also understand vaccination coverage in every corner of your state and the capacity of the hospital systems and whether the hospital system is overwhelmed,” she told the committee. “That is what we are working on is trying to integrate all of that data to give your state health officials the big data they need.”

To improve the effectiveness of flu vaccines, federal health agencies are also working to improve the speed and agility of the vaccine manufacturing process.

“The fact that it is unpredictable means we need to be prepared,” said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases at the National Institutes of Health. “And the best way to be prepared from season to season is to develop a vaccine most closely matched to what you would predict the dominant circulating strain would be.”

The most common method of manufacturing flu vaccines, which requires growing the virus in eggs, can take up to 24 weeks. The lengthy process means vaccines are in development long before the start of the flu season and, as a result, the strain of flu going around may not always be the strain of flu that the vaccine protects against. Health officials decided in March which strains would be included in the 160 million vaccines manufactured this year, said Peter Marks, the director of the Center for Biologics Evaluation and Research at the U.S. Food and Drug Administration.

The short timeframe in which health officials have between selecting strains and manufacturing and distributing manufactured vaccines “leave little room for error or for changes in vaccine composition after the initial strain selection process,” Marks said.

Advances in manufacturing are in the works that could reduce the amount of time it takes to produce flu vaccines, Marks said. This could also provide health officials with more opportunities to adjust the composition of the vaccine as flu season approaches, enabling the manufacture of vaccines that could include protection against new strains of the flu.