More than 14,000 flu cases reported in Arizona

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The flu has hit the country harder than in previous years, resulting in over 14,000 cases reported in Arizona compared to the 1,000 cases seen during last year’s flu season.

Dr. Eric Katz from the Maricopa Integrated Health System says the flu vaccine targets two or three dominant strains, and this year it missed one of its targets. Viruses change every year, and it’s a guessing game for doctors to figure out which viruses are the strongest and they build the vaccine around their findings.

More than 70 percent of people with the vaccine build a resistance to the virus, Katz says. He says he has seen more people in the hospital who didn’t have the vaccine than those who did. Even if it’s not doing all of its job, says Katz, the vaccine can lessen the effects of the flu.

Once the flu sets in, all one can do is treat the symptoms, Katz says. Katz suggests getting plenty of rest because not only does that give your body time to heal, but you won’t be spreading the flu as well. It’s also important to consume plenty of fluids. While if your symptoms seem extreme, Katz says, most cases can be treated with over the counter medication.

It has been a rough flu season in Arizona. Take a look here at the latest numbers. More than 14,000 cases have been reported around the state as of last week. That is 13,000 more than this time last year. Doctors’ offices and emergency rooms are filling up with sick patient and one of the physicians in the mist of this is Dr. Eric Katz, he's chairman of emergency medicine at Maricopa integrated health system. Welcome to Arizona "Horizon." Good to have you here. Why so what’s going on, why so many cases this year as opposed to last year?

DR. ERIC KATZ: This year is one of those weird times when the vaccine missed some of the target viruses and as a result there has been a wave of patients who were exposed to the virus. The virus has hit more heavily among both vaccinated and unvaccinated people, but particularly among the unvaccinated.

TED SIMONS: As far as the difference between this year’s flu and last year’s flu. Year after year, do they change a lot or a little?

They actually change quite a bit. Each year in the intestines of geese and chickens in the Far East. These viruses are mutating and recombining and so every year dozens there are dozens of strains that are trying to come out and become a dominant strain. The vaccine companies go out to other countries and sample people and animals and try to figure out which strain to vaccinate against. And each year it involves guess work because there is so many. Most years the vaccine is pretty good at picking those out. This year of the three strains, one of them missed.

TED SIMONS: Let's talk about some of the strains. We have a panel showing the ethicacy of each strain so to speak. Why are there so many differences, there are three different strains. One of them is unknown for goodness sakes. It sounds like influenza A is the biggy. Why isn't the vaccine focused on influenza A?

DR. ERIC KATZ: The vaccine actually is, so each vaccine that you get usually immunizes you against three or four different types of flu. That’s usually two influenza A and one influenza B, but because it recombines so often it is difficult to pick out the specific strain of influenza A and B.

TED SIMONS: Does it recombine while it’s here? Is it changing now?

In general, no. You tend to get a dominated strain coming through which is why you see a disparity between 91% influenza A and 8% influenza B. There is usually one dominate strain but there can be multiple strains coming through at once. That is why it is difficult to immunize against.

TED SIMONS: I was gonna ask, I mean I’ve heard reporters in Australia. They were hit hard by the flu as well and it seems like the vaccine wasn't doing a lot. Here in the United States the vaccine is doing a little better. Why the discrepancy?

It’s a really good question. The three strains that were most commonly vaccinated against here, two of the vaccines worked very well. Over 70% of people who got the vaccine developed resistance to that virus. The problem is one of the influenza A viruses specifically the H3 missed and 2 variety kind of missed and only 10% of people who got vaccinated developed a resistance to it. Australia got hit with the h3 and two. That seems to be what we’re seeing most of here in the U.S.

TED SIMONS: That is the damaging one?

DR. ERIC KATZ: Yes. It is important to realize even though we are seeing more influenza we don't know who is exposed to one of the other strains and didn't get sick from it. Similarly because there are multiple strains someone who got the influenza early, especially if they are unvaccinated, is prone to getting another strain down the road and because the virus hit earlier this year there is fear there will still be virus around to secondary infect or re infect someone. I said that poorly. They will be infected with one strain and later infected with the other strain.

TED SIMONS: It could be a longer flu season?

DR. ERIC KATZ: It could be, we haven’t seen that yet. It is important to note it hit so early this year. It caught a lot of people before a lot had their vaccines. We don't know if it will end early. It seems to be tapering off but that’s not a guarantee by any stretch.

TED SIMONS: You get that boomerang effect and all of a sudden it could stretch a little bit longer. You get the flu. Let's talk about the traditional ideas. We will start with rest. They always say rest when you get the flu. Most folks who have the flu can't help but rest. They can't get out of bed. What does this mean? Rest when you get the flu. Don't try to be an overachiever? Stay out of the office?

DR. ERIC KATZ: When we say rest, it is a vague term. One of the advantages of saying rest is you take the person and reduce the amount of activity they are doing and generally kind of what our grandmothers would have told us to do is probably a good idea. Which is if it hurts, don't do it. If your muscles are sore, you don't want to lay in bed you want to get up and keep the blood flowing but short of that is don't push it. Don't try to get to the gym or go jogging. The other advantage of resting is it takes you out of circulation so you are not infecting everybody around you. Because this does go in waves. It is spread person to person rapidly and it is hard to prevent that.

TED SIMONS: Another old tried and true method of getting over the flu is drinking fluids. Why is it important to drink fluids with the flu?

DR. ERIC KATZ: With the flu and many viruses the importance of influence is because you have a sore threat and may not want to eat, because you may just not feel well and not want to eat. It is easy to become dehydrated. When we are dehydrated there are all sorts of other changes that happen. We get acid buildup, electrolyte imbalances. We can also get dizzy and light headed just because we can’t support our blood pressure. So keeping some fluids running through is a really great way to keep all that from happening. We can live a long, long time without calories. We can’t live a long time without fluids. We usually say push fluids not so you won’t eat but to make sure you getting hydrated while sick.

TED SIMONS: Let's talk medication. Is over the counter stuff to treat the symptoms because the flu works its course and there is not much you can do about it?

DR. ERIC KATZ: My disappointment with the flu is that when I see folks in the emergency department that have the flu most of what I can offer them can get at my local pharmacy. I kind of want to help them and my message to them is I know you are sick and here is what I can do to make you feel better and next year the vaccine might keep this from happening to you and that’s a message we try to deliver.

TED SIMONS: In the emergency room, most of the people you see unvaccinated?

DR. ERIC KATZ: The vast majority, yes.

TED SIMONS: Over the counter medicine, do what you can if it makes you feel better fine. What about Tamiflu, what’s the deal with Tamiflu?

DR. ERIC KATZ: Tamiflu has some interested history behind the medication itself. It isn't for everybody. Some people who get it swear by it some people say it doesn't do any good. I think the medical literature is pretty up in the air about how useful it is. There is certain populations it is recommended for. Folks over age 65, kids under 5 years old, Native Americans, people who are obese, people who are imunno suppressed or people with chronic heart or lung disease.

TED SIMONS: That’s interesting. So there is something to it you just don’t know what it is.

DR. ERIC KATZ: Any medication that has an effect probably also has side effects and with Tamiflu the question is how big the effect is and how big are the side effects and what the risk benefit is for the individual patient.

TED SIMONS: Ibuprofen, Tylenol, decongestions, those fall under the over the counter things if they make you feel better good for you but it is not going to attack the flu?

DR. ERIC KATZ: It is not a cure but helps the symptoms but once you have the symptoms and the flu has set in really treating the symptoms is the best you can and they do a pretty decent job at it.

TED SIMONS: I always wondered why in the world does the flu always starts in Asia. What’s going on over there why isn't it starting in Arkansas and moving around the world from there, but it is because of the migrating birds?

DR. ERIC KATZ: The birds are the reservoir for it and why the Far East and not Arkansas I cannot tell you. There are hundreds of strains there. Because the geese are flying around and things are recombining and constantly excuse the language. Pooping out the virus all over the place you have a bunch of different reservoirs to crop up from and from there it spreads and tends to spread west to east. The interesting thing comparing us to last year. Last year it hit the west coast kind of hard it skipped us here in Arizona. It actually hit the east and the south east and then never really got back to us at all. So, we had a 1,000 cases at this point last year. We have 14,000 this year. Part of that is yeah, the virus missed one of the three strains. I am sorry the vaccine missed one of the three strains. Got the other two. But also then we are comparing it with a season that never made it to Arizona which is really unusual.

TED SIMONS: It could have been someone on a plane flight. There is no reason it skipped one year and doesn't skip the next. You just don't know?

DR. ERIC KATZ: Correct. There is no such random movements. Bird movements. People movements. I’m not sure how you’d predict it.

TED SIMONS: Good information and good to have you here.

Dr. Eric Katz: Maricopa Integrated Health System

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