White Coat Underground

Flu update

It’s been a slow flu season this year—until now. In the last week I’ve seen people dragging themselves into the office looking like absolute hell—fevers, cough, severe muscle aches—in other words, they’ve got the flu.

The latest CDC data shows a marked increase in flu activity.


A large percentage of isolates are influenza A, type H1N1, which is currently resistant to one of our antiviral medications oseltamivir (Tamiflu). Of 110 influenza isolates collected so far in Michigan this season, 74 are A(H1N1). The strain is still susceptible to zanamivir (Relenza), rimantadine, and amantadine. Flu A (H1N1) isn’t any nastier than any other strain of flu, but knowing the resistance pattern is important when planning treatment.

So, ladies and gents in the medical field, it’s time to strap in and get ready. It’s only going to get nastier from here. And it’s not to late to vaccinate.


  1. #1 D. C. Sessions
    February 19, 2009

    And it’s not to late to vaccinate.

    It is for those of us who already have 🙂

    However, you didn’t mention whether the strains showing up are ones the current vaccine covers.

  2. #2 beelzebub
    February 19, 2009

    We’re about through here in the Netherlands. (I guess about 1 more week before we hit baseline levels again) Quite a nasty ride though, more severe than past 2 years.
    Vaccine matched quite well here, but H3N2 was the dominant strain, with a bit of influenza B starting to show up since last week.

  3. #3 Kat Thomas
    February 19, 2009

    Great to see Flu view represented on a blog!

  4. #4 epiABC
    February 19, 2009

    Great to see FluView on ScienceBlogs

  5. #5 leigh
    February 19, 2009

    i’m with everyone else- how well did the vaccine scientists guess this year? i so don’t have time to get sick right now.

    [sure, i could look this up. but i’m actually supposed to be grading exams right now 🙂 ]

  6. #6 Ahcuah
    February 19, 2009

    My daughter, on the campus of the Ohio State University, came down with it on Tuesday.

    The Tamiflu does seem to be working for her, though.

  7. #7 Paul
    February 20, 2009

    I have a question for anyone that knows more than I regarding flu vaccines (so I’m guessing most of the people that read this blog, feel free to chip in 🙂 ).

    I’ve never caught the flu. I’ve lived in close quarters with those who have, several times. Assuming no shortage of flu vaccines, is it better to vaccinate to reduce incidence of being a carrier and infecting others (assuming my current luck holds up)? I’m not too familiar with the flu, other than that there are many different strains.

  8. #8 Chuck
    February 20, 2009


    Given your current condition with your back, I hope you don’t get the flu this year. I can’t imagine the pain and suffering of the flu plus the pain and suffering from back pain together. You know my story, so I won’t chime in anymore on this topic.

    Have a good weekend.

  9. #9 The Perky Skeptic
    February 20, 2009

    Thank goodness for flu shots.

    Er… is this strain the one we got vaccinated for?

  10. #10 PalMD
    February 20, 2009

    From the CDC:

    CDC has antigenically characterized 309 influenza viruses [194 influenza A (H1), 37 influenza A (H3) and 78 influenza B viruses] collected by U.S. laboratories since October 1, 2008.

    All 194 influenza A (H1) viruses are related to the influenza A (H1N1) component of the 2008-09 influenza vaccine (A/Brisbane/59/2007). All 37 influenza A (H3N2) viruses are related to the A (H3N2) vaccine component (A/Brisbane/10/2007).

    Influenza B viruses currently circulating can be divided into two distinct lineages represented by the B/Yamagata/16/88 and B/Victoria/02/87 viruses. Twenty-three influenza B viruses tested belong to the B/Yamagata lineage and are related to the vaccine strain (B/Florida/04/2006). The remaining 55 viruses belong to the B/Victoria lineage and are not related to the vaccine strain.

  11. #11 PalMD
    February 20, 2009

    BTW,that’s a good thing.

  12. #12 Chuck
    February 20, 2009

    Last year about 33% of the population was vaccinated. Given all the pretty colors so far, what is the guess for this year’s coverage especially since the CDC recommended that all children should be vaccinated?

  13. #13 PalMD
    February 20, 2009

    As quoted above, so far most isolates match the vaccine quite well.

  14. #14 Chuck
    February 20, 2009

    Not the answer I was looking for so I will re-phrase the question.

    Do you think that a larger percent of the population has received the influenza vaccine given the new guidelines issued by the CDC and advertising campaigns early in the season?

  15. #15 The Perky Skeptic
    February 21, 2009

    WOW! This year’s vaccine is kicking viral ass and taking, er, RNA sequences. Thanks for the CDC info!

  16. #16 Chuck
    February 21, 2009

    Last year’s vaccine was not a “good match”, to be generous. Comparing this year’s and last year’s geographic map for week 5 shows that this year is the same or slightly worse in the eastern states and slightly better in the “ fly over” states. Given both the CDC recommendations and a better match than last year, I cannot explain why most states are in the same categorizations for both years.

  17. #17 PalMD
    February 21, 2009

    That’s because you always ask the wrong questions due to your willful ignorance

  18. #18 Chuck
    February 22, 2009

    On the contrary, you simply choose to incorrectly answer a question you cannot objectively spin to your own satisfaction. If there was indeed a larger population vaccinated with a better matching vaccine, the states should not be the same color, so please objectively explain why most of them are.

  19. #19 PalMD
    February 23, 2009

    Chuck, i do recall that you have very little knowledge of statistics, but let me school you just a little:

    You can’t make any judgments about the overall severity of the flu season without, you know, the season actually having run its course. A simple person would look at last weeks map and compare it to the same period last year, but that kind of one to one comparison of composite data is not correct.

  20. #20 Chuck
    February 23, 2009

    And no one can have an opinion about a quarterback’s, coaches’, or referee’s decision until after the Super bowl is over, right? Right now the information presented makes this year’s season about the same as last year’s. What good is a doctor’s opinion if he cannot actually form one with the information that is currently available to him?

  21. #21 PalMD
    February 23, 2009

    Don’t be a moron (if that’s possible). It’s just not the correct question. The only answers that are available so far are that the strains in this years isolates (to date) match well. What the overall season will show us is up for grabs. We cannot compare two calendar months or weeks or days between years since we don’t know if the dates are going to be “comparable”, that is, let’s say that the season peaked during week 24 last year (i have no idea if that’s true, it’s just an example)…if we were to compare last year’s week 24 with this years, we don’t know what that means. If, after the season is over, we compare the peak from each season, that may tell us something.

    But since in the past you’ve shown no desire/ability to understand, well, anything, that’s all for now.

  22. #22 Chuck
    February 23, 2009

    You cannot form an educated opinion for this season is all you needed to say, which is quite contradictory to most of the other posts on this blog.

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