Surge in flu cases packs local hospitals

Hospitals throughout Santa Clara County are grappling with an unusually lethal flu season that has led to hospitalizations rivaling those of the 2009 “swine flu” pandemic.

There have been 97 flu-related deaths in California among people under the age of 65 since the start of the flu season in October, 20 of whom lived in the Bay Area, according to a report last week from the California Department of Public Health. That’s up from 23 deaths around the same time last year.

The report also notes that hospitalizations and outpatient visits for “influenza-like” illnesses are higher this year, putting a strain on local hospitals struggling to handle the influx of ill patients. El Camino Hospital’s inpatient admissions — both at the Mountain View and Los Gatos campuses — are up 30 percent compared to last year, maxing out the hospital’s bed capacity through the beginning of January, according to Daniel Shin, medical director of quality and patient safety at El Camino.

The number of inpatient admissions put this year’s flu season on par with 2009, during the height of the swine flu pandemic, Shin said. During the busiest days in January, El Camino’s emergency department had to divert ambulances to other hospitals due to a lack of available beds.

Hospitals are required to report flu-related deaths, but only for patients under 65. Deaths for those 65 and over are not reported.

The vaccine for this year’s flu season is not particularly effective, with an efficacy rate estimated at about 30 percent, according to the U.S. Centers for Disease Control and Prevention (CDC). Although manufacturing a vaccine is always something of a guessing game — planning for genetic mutations and forecasting which strain will be the most prevalent — it’s particularly difficult for the H3N2 strain of the influenza A virus, which makes up a large majority of this season’s flu cases.

“Between the time when the composition of the flu vaccine is recommended and the flu vaccine is delivered, H3N2 viruses are more likely than (other flu) viruses to have changed in ways that could impact how well the flu vaccine works,” according to the CDC website.

Shin said the H3N2 strain has been around since about 1968, and it just happens to be the prevalent version of the flu virus this year. The people who are getting extremely ill and dying from the flu were likely vulnerable because they had no built-up immunity, either through lack of vaccinations or having never been exposed to it in the past, he said.

“In order for a patient to be prepared or kind of immune, you would either have had to be exposed to H3N2 before or vaccinated multiple times,” Shin said.

In response to the widespread flu outbreaks, El Camino Hospital announced temporary visitor restrictions that went into effect on Jan. 8, and will continue to the end of the flu season. All children under age 16 are barred from visiting, and community members are asked not to visit the hospital if they have flu-like symptoms, including a cough, fever, runny nose, sore throat or body aches. Younger visitors are not only more likely to get sick and suffer health complications like respiratory infections, they are also more likely to spread the flu.

The hospital is also taking precautions by placing all flu patients in isolation, Shin said, which means housing them in separate rooms with “droplet precautions,” including masks and gloves for anyone entering. All patients entering the emergency room are also asked to wear masks to avoid inadvertently spreading the flu.

Although the flu season began months ago, Shin encouraged people to get the vaccine if they haven’t yet, noting that it can reduce the severity of the flu even if it doesn’t prevent it outright.

“Even if the effectiveness in preventing the flu is low, say 30 percent, you will get a less severe illness if you get vaccinated,” he said.

The influenza season reached the status of “widespread,” meaning there are confirmed cases of the flu in at least half of the regions in the state, with a majority in the Bay Area and the southern-most region of the state bordering Mexico, said Sara Cody, Santa Clara County’s health officer and public health director, at a Health and Hospital Committee meeting in December.

She said the public health recommendation is to get vaccinated.

“Even if the vaccine effectiveness is low, it’s still better than no vaccine,” she said. “It can still prevent severe illness, hospitalization and death, and we still strongly recommend it.”

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