The flu, how it could be worse...

[mooreea8]

According to the CDC, the influenza activity continues to increase from week to week this 2017-2018 season. The number of influenza cases is extremely widespread and seen across all the states in America. As a matter of fact, the number of states experiencing widespread influenza activity increased this past week to 47 states.

Each year there are different strains of influenza dispersing in the population. The current strains this season include H3N2, H1N1 and B viruses. It has been noted that H3N2 is the most prevailing strain and is linked to more hospitalizations according to the CDC. Due to the high involvement of H3N2 in this year's flu season, health officials are seeing more health complications and higher flu-related deaths. The H3N2 is noted to hit people harder than other strains of the flu. The flu vaccine is modified or revised every year in hopes of targeting the most common strain. However, this is not a guarantee and the CDC estimates that this year the vaccine is approximately 30 percent effective against the H3 strains.

Research shows that the current H3N2 component of the vaccine is a poor match for the circulating strain and has a low effectiveness rate. This week it was noted that the hospitalization rate for influenza is higher than the previous years. Recent data collected by the CDC shows that the flu-related hospitalizations increased to about 60 people out of every 100,000. It was also noted that people seeking medical attention for influenza-like symptoms is 7.7 percent. This is the highest reported percentage since the flu pandemic in 2009.

However, there is something even more dangerous to our health than influenza and that is pneumonia. Pneumonia is a serious infection of the lungs that leads to inflammation. Pneumonia can be caused by bacteria, a virus or even a fungus. Influenza can absolutely turn into pneumonia without people even realizing it. In the United States, approximately one-third of all pneumonia cases were caused by respiratory viruses, and the most common contributor was influenza. The flu and pneumonia were actually the eighth leading cause of death in 2014 in the United States. The percentage of deaths contributed to influenza and pneumonia has drastically increased this season to 9.7 percent.

Everyone is at risk for getting pneumonia since it is airborne and highly contagious. However certain populations are more at risk including the elderly (especially with multiple comorbidities), pediatrics, people who are immunocompromised, people in intensive care units, people who recently had a cold, people with respiratory illnesses such COPD, smokers, and people who recently had surgery.

What's important to remember is if you have influenza and begin developing new symptoms such as a new fever, shortness of breath, tightness in the chest, congestion leading to chest pain, rapid heart rate, coughing up green/yellow or bloody mucus and rapid breathing, seek medical attention. Do not wait! The flu creates the perfect breeding ground for pneumonia. As soon as the pneumonia-causing organism enters the lung tissues, the air sacs known as alveoli, fill up with fluid and mucus. The organism then causes the lungs to swell blocking the flow of oxygen. This combination is what makes it difficult to breathe. The fluid and mucus buildup in the lungs along with the sedentary recovery period associated with being sick allows for the growth of the organism. The key is not to stay at home with the development of these symptoms.

Untreated pneumonia can develop into sepsis. Sepsis is a serious complication of an infection caused by the body's reaction to that infection. It can be life-threatening. Sepsis is when the body's defense mechanisms work overtime to fight an infection. When sepsis occurs the body releases a large number of chemicals in the bloodstream to the fight the infection resulting in an inflammatory response. The inflammation can then lead to a cascade of changes causing damage to organ systems and clotting disorders, ultimately resulting in organ failure. Severe sepsis restricts the blood flow to vital organs such as the brain, heart, and kidneys.

Sepsis is treatable but early detection and aggressive treatment are vital. Antibiotics and fluids play a huge role in treating sepsis depending on the infectious organism. If the organism is bacterial then antibiotics are required. If the organism is fungal then antifungal medications are used. If the organism is viral then rest and fluids are required. It's important to stop the infection to keep the vital organs functioning. Fluids and vasopressors are often used to help improve low blood pressures associated with sepsis.

There is a vaccine available to help prevent pneumonia and hand washing is also important to help reduce the occurrence of pneumonia. Covering your mouth when you cough or sneeze can go a long way in decreasing the exposure of gems. It's important to wipe down surfaces that come in contact with infectious organisms because the flu contagion can live up to 24 hours on them. Prevention is key but if you or someone you know starts to develop symptoms of pneumonia seek medical attention.

Are you guys seeing any complications from influenza in your work setting? If so, what are they and how have they affected the overall health of your patients? Also, are you finding that many of your staff members are contracting the flu?

[FranEMTnurse, CNA, LPN, EMT-I]

I have had pneumonia 8 different times. It all began when I was 2 years old. I have also had double pneumonia, and have had pneumonia with septicemia. I was diagnosed with Chronic asthmatic Bronchitis in 2002, and have had respiratory failure twice. Thankfully, we have excellent Physicians in the area where I live.