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PITTSBURGH (KDKA) — Many states have been seeing widespread flu activity, and now Pennsylvania has joined in. So, you or someone you know may very well come down with it.

Which means, you may have some questions.

The Local Picture

Q: “What are you seeing here in Allegheny County?”

A: “Last week really showed a dramatic uptick in the number of cases. This happened nationally, and this is also echoed here in Allegheny County,” says Dr. Karen Hacker, director of the Allegheny County Health Department.

“Get about 8 to 12 positive flu cases a day that we’ve been seeing in our emergency department,” says Dr. Brent Rau, of the Allegheny General Hospital Emergency Department.

The flu is coming strong and early here: 1,700 laboratory-confirmed cases now compared to 1,200 cases in the same time frame last year.

“We consider this to be a bit of the tip of the iceberg in terms of the number of people likely to have flu or to be exposed to flu,” Dr. Hacker adds.

Hospitalizations

Q: “I worry about if somebody has to go to the hospital.”
“Would probably be just more the elderly that would be hospitalized, but again, I don’t know the severity of it, so it could actually be anybody I would guess?

A: A higher percentage of cases are being hospitalized.

“We are seeing the complication of pneumonia at a higher rate this year than we’ve seen in several years,” says Dr, Marc Itskowitz, an internist at Allegheny General Hospital. “There have been many patients that have been hospitalized in the intensive care unit, some have required mechanical ventilation, many of them are requiring mechanical ventilation for days. we’re using antiviral medication as well.”

“It definitely has taken a toll as far as the patients that have had to be admitted to isolation rooms. we currently have 40. But we aren’t on diversion like some of those things I’ve heard in California,” adds Dr Rau.

Circulating Strains

Q: What strains are circulating, and what do H and N mean?

A: “The predominant strain this year is H3N2,” says Dr. Itskowitz.

The H and N refer to the virus’ surface proteins.

The thing about H3N2, it can be hard to make vaccine against it, and the virus seems to be changing making it harder to test in the lab.

“The years in which H3N2 is predominant, we tend to have more severe illness, especially in older patients. It’s unclear whether it has to do a more vigorous immune response, lack of preexisting immunity, or just more of a mismatch with the existing vaccine,” Dr. Itskowitz explains.

Flu Vaccine Effectiveness

Q: “Haven’t gotten a flu shot yet this year. Wonder if those are really helpful or not.”

A: “We anticipate it’ll be low. It’ll probably be lower than it’s been in several years. We don’t know if it will be as low as in the southern hemisphere. We know the data from Australia showing 10 percent efficacy,” says Dr. Itskowitz, “And just clinically, we are seeing many cases even in patients who have been vaccinated.”

A flu shot is still your best bet for preventing the flu. While it may not be as good as hoped this year, some protection is better than none. For older adults, a repeat vaccine has shown to be helpful in some cases.

Only after the flu season is over will we really know how effective the vaccine was.

Viral Spread

Q: “Is it that contagious? Do we have to take extra precautions at work?”

A: “If you are sick, you should avoid going to work, especially when you’re contagious during those first two to three days,” says Dr. Itskowitz. “Covering your mouth helps, but does not fully eliminate the respiratory droplets. They probably hang in the air for minutes. And then they can attach to a surface. You’re not doing anyone any favors by going to work while you’re sick. It’s very contagious right now.”

Treatment

Q: Is there any medication for the flu?

A: If you are in a high risk group for complications (you’re older, you’re pregnant, or you have a chronic medical condition), and you start to have flu symptoms (fever, cough, or aches), the antiviral medication Tamiflu, if taken in the first 48 hours, can shorten your illness.