Fort Mill Times

Think flu season’s been rough in York County? Brace yourself: it hasn’t peaked yet.

Flu season hasn’t peaked yet in York County, according to Piedmont Medical Center infectious disease specialist Dr. Arash Poursina.

“Traditionally, in this part of the country, we peak sometime around February or the end of January,” he said. “I expect it to actually increase over the next few weeks.”

The hospital is full of flu patients with significant complications, many suffering from flu-related pneumonia, sepsis and respiratory failures, Poursina said.

“It’s been crazy this year,” he said.

“We started seeing flu cases back in November. Usually, the flu comes very late here because of our relatively mild winters. Last year, we saw the maximum activity in February and March, but this year it started very early.”

Poursina said he thinks that’s one of the reasons for this year’s heavy flu season, along with the ineffectiveness of this season’s vaccine. Four strains of the influenza virus are included in the vaccine, and although the vaccine is providing good protection for three of them, it’s not covering this season’s most predominate strain – H3N2.

Data from Australia’s flu season foreshadowed this predicament, according to Poursina. Located in the southern hemisphere, Australia weathers the winter while the U.S. basks in summer – so its flu season provides a preview of what’s to come.

“(Australia) had the very same strain down there and they used the same vaccine,” Poursina said. “They had a very bad flu season and they had only 10 percent effectivity of the vaccine, so we expected it to be a little worse than usual here.”

By the time the Australian data was published in November, flu season had already begun in the U.S. Poursina said it takes months to collect and analyze the data, then several more months to develop a vaccine.

“It was too little, too late,” he said.

Case doubled

According to the latest results published by S.C. Department of Health and Environmental Control, flu activity significantly increased Jan. 7-13, the fifth consecutive week of widespread activity in the state.

A total of 9,864 cases were reported, more than doubling the number of cases reported the previous week. Flu-associated hospitalizations rose by 215 with a total of 483 hospitalizations; and nine deaths were reported, five more than the previous week.

“The current influenza season activity appears to be similar to activity observed in the 2014-15 season,” DHEC reported. “In the current flu season, there have been 1,292 influenza-associated hospitalizations and 24 influenza-associated deaths reported.”

DHEC described last year’s flu season as “moderate.” Widespread activity lasted for 13 consecutive weeks and took 94 lives, but the disease caused less damage than it did during the 2014-’15 season.

Poursina said the majority of the patients who have died so far from the flu, in North Carolina and South Carolina, have been patients over the age of 60 – and most have had preexisting conditions.

It’s not only flu season, it’s also cold virus season. So how does someone know if they have the flu?

Poursina said flu is a much more dramatic disease and its symptoms – which come on fast and strong – are difficult to miss.

“Influenza causes a systemic disease. It can be a lower respiratory tract infection, in which case a person will have a cough and shortness of breath, but they may not even have a runny nose,” he said. “Influenza causes fevers, muscle pain, joint pain, headaches and sore throat, so there are a lot of other systems that are involved with influenza. The common cold generally causes runny nose and a little bit of a headache, but you don’t experience a systemic disease with it.”

Poursina’s top recommendation is getting vaccinated. Even though the vaccine is not very effective this year, people who are vaccinated experience a much milder disease with less chance of complications.

Advice: Stay home

“If you feel sick, if you have the flu, if you have body aches and a temperature greater than 100 degrees, if you have a sore throat, cough, shortness of breath and those kinds of things, please stay home,” he said. “Do not go to work or school. This disease is spread very rapidly, so avoid public locations.”

And his last recommendation is for doctors.

Poursina said many patients who end up with significant complications or even die from the flu sought medical care, but were turned away after receiving negative test results.

“(Doctors) don’t go deep enough with the swab to the back of the nose and the throat, the swab has to touch the nasal pharynx or the back of the throat,” he said. “Often, the person who’s doing the test doesn’t do it correctly.”

Sometimes the disease manifests as a lower respiratory tract infection – it’s in the lungs and not in the nose. So swabbing the nose produces negative results, Poursina said, and then the patient ends up with pneumonia.

“The national recommendations from all authorities, as well as the CDC, is that if somebody comes to you with influenza-like illness, start them on treatment,” he said. “We have three drugs available on the market that are 100 percent effective on influenza and they’re very well tolerated with minimal side effects. There’s no reason to deny a person treatment if their test is negative.”

Stephanie Jadrnicek: