Michael Jhung, MD, MPH, MS, is a Medical Officer for the Surveillance and Outbreak Response Team in the Influenza Division of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention. In his current position, Dr. Jhung applies his expertise to responding to influenza outbreaks, providing scientific training of fellows and staff, and contributing key findings to CDC’s pandemic preparedness plans. In our interview, we talk with Jhung about this year’s flu season and what the public needs to do to stay healthy.
What’s happening with the flu season in the United States this year?
The influenza season this year – the 2012 to 2013 season – has had quite an early start. We’re seeing elevated influenza activity about a month earlier than we usually see it. Whether or not the entire season turns out to be worse than previous seasons, we won’t know until the end of the season. But I think we know enough right now to say that this influenza season is likely to be worse than last year’s, and may turn out to be quite a severe season, once all is said and done.
Some people don’t take the flu seriously. Why should people be concerned about the flu particularly because this year is projected to be a severe flu season?
I think there are many ways to answer the question of why some people don’t take flu seriously. I could remind folks that every year for the past 30 years, influenza has contributed to 3,000 to 49,000 deaths – that’s every year – due to influenza. I could remind people that influenza puts several hundred thousand people into the hospital every year in the United States. And I think it’s also important to tell people that even if you don’t end up in the hospital with influenza, it’s really a miserable experience to be pretty much incapacitated for the few days to week of influenza symptoms. Influenza is a respiratory illness, but it is often more serious –at least, it feels more serious – than a common cold. And people who have had flu in the past I think would agree: It’s just not a fun thing to have.
What is the best way to avoid the flu?
Without question, the best way to prevent getting the flu every year is to get an influenza vaccination every year. That’s THE best way to prevent getting the flu and also it’s a very good way to reduce symptoms, reduce the severity of illness if you happen to get the flu. In addition to vaccination, we would recommend that people avoid other people who are sick – other people who are coughing or sneezing. We would also recommend, for people who do unfortunately get the flu, that they stay home from work and keep their kids home from school so they don’t spread illness to other people.
What if people haven’t gotten their flu shot – is it too late?
It is NOT too late to get an influenza vaccine. We strongly recommend that people get their vaccination as soon as possible, as soon as vaccine is available. But as we’ve talked about, there is a lot of flu activity out there right now, and here is every reason to go out and get vaccinated if you haven’t been vaccinated already. Now I want to let people know that this late into the season, we have been hearing some reports of what we call “spot shortages” of vaccine. That means that not every provider in every part of the country still has vaccine supply. But we know that there’s vaccine out there, when know that there is vaccine available for people who want to be vaccinated. It just may be that people will have to go to more than one provider to get their vaccine right now.
How can people find the flu vaccine at this point in the season?
Finding the flu vaccine can be as simple as going to your primary care physician and asking for a vaccination there. If he or she isn’t able to provide that vaccine because they’ve run out, try a local pharmacy. You may have to call around to a couple pharmacies, depending on where you live, to find vaccine at this time of year. There is a very interesting tracking system that is online that people can use, and the website is flushot.healthmap.org. And what you can do at this website is put in your zip code and up pops all the places near where you live that still have vaccine, that you can go to and get vaccine. So I would suggest that people use a combination of this website and calling their primary care doctors and their local pharmacies to find vaccine.
What do you say to people who are afraid of the flu shot because they think it will make them sick?
This is a very complicated question to answer. I’d like to start by saying that the flu shot WILL NOT – CANNOT – give you influenza. Now let me clarify a little bit about what can happen after the flu shot. People can get sick after being vaccinated. It’s possible that they think they have the flu, but they’re actually infected with a cold virus or some other virus that’s similar to the flu – but it’s not the flu. So there are some people who get the flu shot and get sick and think the flu shot didn’t help. But in fact, the flu shot only protects against the flu, and there are many respiratory viruses out there circulating. Another reason why people may get sick even though they got the flu shot is that it takes about two weeks for full protection to kick in after the shot. So if you get a shot today and you’re exposed to the flu tomorrow, there may not be enough time for the vaccine’s full protection to kick in, and you could still get sick with the flu. Finally, there are some groups of people who don’t respond as well as others to the flu vaccine. So they can still get sick even though they’ve been vaccinated. And these are typically people who have reduced immune systems, and people who are over the age of 65, very young children, and some people with underlying medical conditions can sometimes not respond as well to the flu shot. So it’s true that people can still get sick, and they can still get the flu after being vaccinated, but it is not true that the flu vaccine will cause influenza.
Why are some flu seasons worse than others? For example, you said that this flu season looks like it might be worse or more serious than last year’s flu season.
Yes. Influenza seasons, from year to year, are very unpredictable. And very it’s hard to tell how serious a season will be until the season’s over. But there are some reasons why we suspect there are more severe seasons than others. One of those has to do with vaccination: If a lot of people are vaccinated, a lot of people will be protected, and the community will be better protected against influenza, and there might not be as severe a season as if fewer people were vaccinated. One other reason has to do with the influenza virus itself – what is circulating out there in the country. And we know right now that during the 2012-2013 flu season, the most common influenza virus – at this moment, in the middle of the season – that’s circulating is an H3N2 influenza. Now, the bad news is that the H3N2 virus had been associated with some pretty severe seasons in the past. We know that this particular kind of flu does tend to put more people in the hospital, it does tend to cause more severe illness. The good news is that this very same H3N2 that is circulating in the country is very similar to what’s in the influenza vaccine. So if you get the vaccine, you should be well protected against it.
Can you tell me a little bit more about tracking flu infections? Why is it important to track flu rates every year?
There are lots of ways that CDC tracks influenza. We keep an eye on the different viruses that are circulating. And that’s important to understand how well we expect the vaccine to work, and how much severe illness we would expect to see during each season. We keep track of the number of people, the percentage of people who go to the doctor for influenza-like illness, and that helps let us know a little bit about the burden of illness, how many people in the whole country are being hit with flu during any given season. We also ask states to tell us what their interpretation of the influenza season is. So every week we ask every state to give us an opinion of how bad flu is in their state, and that helps us determine just how widespread flu activity is within each state. Finally, we also track severe illness by tracking the number of people who are hospitalized with flu in the United States. And we pay special attention to influenza deaths in children, because influenza can have devastating consequences in young children, and we track influenza deaths in children using our pediatric mortality reporting system.
How does that help? Why is tracking flu infections important?
It’s important to know how much disease we’re seeing every year. It’s important to comment on how severe the season is. It’s also important to track the viruses that are out there so we’ll know what the vaccine is doing and how well the vaccine is working. And it’s also very important to look for new influenza viruses. The vaccine contains protection against 3 influenza viruses right now, but there are many influenza viruses circulating in the country every year, so we’re always on the lookout for new viruses that we may want to include in future vaccines. And we’re also on the lookout for any influenza viruses that might be resistant to the medicines that we can use to treat them.
If you already have the flu, is it helpful to take medications to treat it?
We encourage vaccination as the best way to prevent influenza infection. But we realize that some people will still get sick with influenza every year. And for those people, it’s important that they talk to their doctors about the possibility of being treated with influenza anti-viral medications, especially for people who are at increased risk for severe illness: these are young children, the elderly, and people with underlying medical conditions. If they get signs and symptoms of influenza and they can see their doctors quickly and get treated with influenza anti-viral medicines, then their illness should be much less severe and they should be protected from complications of influenza, even if they get infected.
Listen to the full podcast of our interview with Jhung on the American Public Health Association’s Get Ready campaign website.