Influenza keeps low profile in valley -- so far

banderson@fresnobee.comNovember 20, 2012 


MARCI STENBERG/ Katherine Belen, Rite Aide Pharmacist, getting flu vaccine ready for the next customer, Monday, Sept, 26, 201 afternoon.

MARCI STENBERG — Merced Sun-Star

— It's beginning to look a lot like Christmas and Thanksgiving could be flu-free holidays in the central San Joaquin Valley.

Richard Rios, program manager with the Merced County Department of Public Health, said local and national trends on influenza activity have been low.

But it's important to recognize, he said, that mid-November is still relatively early for influenza and flu virus transmission in Merced County.

"The months where flu is more prevalent would be starting in December through early spring," he said. "We hope, as always, that the strains of flu that circulate this year are strains that are matched up well with the flu vaccine. This is the best time to remind folks to get it. We know that getting the vaccine is the best way to prevent catching the flu and potentially getting sick from the flu."

Even though the influenza virus has yet to arrive, keep the tissues handy. The common cold and other respiratory germs are here, and doctors expect coughing and sneezing at many holiday dinner tables. Respiratory syncytial virus, better known as RSV, is the most common respiratory virus that infects infants and children and it's spreading in the community.

Children's Hospital Central California had 10 RSV cases in October and 12 this month, said Gregg Pullen, a microbiologist and manager of infection prevention and control at the hospital.

The virus, which is spread through coughing and sneezing, can cause bronchiolitis, an inflammation of the small airways in the lungs of babies that can make breathing difficult. "In the last five days, we admitted three babies with bronchiolitis," Pullen said.

Adults can get RSV, but usually it's less problematic than in infants and children, said Dr. Dee Lacy, an infectious disease specialist at Kaiser Permanente Medical Center. Symptoms in adults often are mild, but sometimes they can be flu-like, including fever and muscle aches. What distinguishes RSV from the flu? "Lots of mucus," Lacy said.

Medical providers worry that adults can spread RSV to infants. "If there are tiny people in your life, especially premature infants or children less than 6 months of age, and you have a respiratory infection, stay away," Lacy said.

If this RSV season follows what doctors see as its usual pattern, it will be a bad year. The virus tends to wane one year and comes back the next with a vengeance. Last year was mild.

Kaiser expects cases to increase in coming weeks. In the past six years, RSV has reached a peak "right at the turn of the year and it's really rip-roaring by Christmastime," Lacy said.

At Children's Hospital, another virus, parainfluenza, or the croup virus, has shown up this year. Not to be confused with influenza, the virus causes a bark-like cough. Children's had 14 cases in September, 18 in October and 10 this month, Pullen said. Croup can be confused with whooping cough or pertussis; it takes an examination or test to tell them apart, Pullen said. This year, the hospital has had seven cases of whooping cough, he said. During a whooping cough epidemic in 2009-10, the hospital admitted two children a day. Statewide, thousands were sickened and 10 babies died, including a Fresno County infant.

The virus that's missing in the valley this year is influenza. Children's has not identified a single case since May. As of last week at Kaiser, which tracks the flu, only 1 percent of specimens tested positive for the influenza B strain and less than 1 percent for influenza A.

Even so, doctors recommend getting a flu shot. The federal Centers for Disease Control and Prevention recommends that everyone older than 6 months be vaccinated.

Family HealthCare Network clinics in Tulare and Kings counties haven't been flooded with flu patients, but Dr. Steven Palmer, the medical director, is ready: "I always kind of hold my breath, because we can end up having a late season and all bets are off."

Tips to avoid getting sick:

Wash your hands.

Wash telephones, computer keyboards and other shared instruments.

Use tissue and cover your mouth when coughing or sneezing, then wash your hands.

Get a flu shot. (Pharmacies, doctors and county health departments all give them.)

When ill, stay home to protect others.

After a fever abates (without fever-lowering medicines), wait 24 hours before returning to work or school.

Sun-Star staff writer Yesenia Amaro contributed to this report.

Fresno Bee reporter Barbara Anderson can be reached at (559) 441-6310 or @beehealthwriter on Twitter.

Get a shot

For more information about flu shots, call (209) 381-1180 for English or (209) 381-1181 for Spanish.

Information about the flu in Merced County can be found at and clicking on the "Information for the 2012-13 Flu Season" link in the "Help Center" section.

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