Calif. ER, Ambulances Overwhelmed by Flu Outbreak

The Modesto Bee

Jan. 08—One of the worst flu seasons in years is sending droves of patients to medical clinics and emergency rooms and filling hospital beds in the region.

The seasonal flu struck the Northern San Joaquin Valley earlier than usual with a virulent strain, causing fever, headache, body aches, congestion and serious complications in some patients.

"It is pretty bad," said Dr. Navneet Gil, a contagious disease specialist at Doctors Medical Center in Modesto. "We are seeing a lot more cases and people are more sick than you typically see."

In contrast to previous years, more of the patients admitted to the Florida Avenue hospital are otherwise healthy adults who came down with severe symptoms.

"It is probably the strain of the virus," Gil said. "The vaccine was not very effective. It is just a more virulent strain."

On Monday, more than two-thirds of the emergency department beds at Doctors were filled with sick patients waiting to be admitted, forcing ambulance crews to wait in the halls with newly delivered patients.

Ambulance crews in Modesto were on "round-robin" status, in which patients are delivered to hospitals on a rotation regardless of their insurance. Some pharmacies had run out of Tamiflu, a prescription medicine to treat flu in children two weeks or older.

The flu virus has slammed most areas of the state from Southern California to the Bay Area and Central Valley. As of Friday, the California Department of Public Health had recorded 27 flu-related deaths statewide, though a single county in Southern California had reported almost twice that many deaths. The state only keeps track of influenza deaths among patients younger than 65.

Stanislaus County officials confirmed a single death from the flu last month.

The predominate virus identified in test samples is an Influenza A strain called H3N2 that is often connected with more severe flu seasons and especially threatens older adults and very young children.

People are saying the illness is miserable; and, in come cases, the wretched symptoms last a couple of weeks.

Stephanie Frye, in a post on a Modesto Bee article, wrote that she caught the flu and pneumonia after getting vaccinated for both. "I'm not sure I have been more miserable in my life."

Of the 490 visits to Memorial Medical Center's emergency department Friday and Saturday, the hospital said 147 checked in with flu symptoms. Some were admitted to the hospital, but many others were not seriously ill. They were given a quick examination, tested and sent home.

"There are a sizable number of patients that require admission," said Dr. Salahuddin Bibi, infection control medical director at Memorial.

He said most of those placed in hospital beds have underlying conditions, such as diabetes or chronic illness, that make them vulnerable to serious complications including pneumonia.

Bibi said Friday that six people stricken with influenza were in Memorial's intensive care unit.

Bibi said that three out of four people testing positive for influenza at Memorial have an Influenza A virus; the rest are infected with Influenza B. The hospital did not know how many patients were sick from the H3N2 virus. Tests to identify the specific strain are sent to a state or federal lab.

Patients in the hospital are given supportive care to help them fight off the illness and may be given antiviral medication.

It's possible the flu season is more severe because vaccinations this year were not a good match for the H3N2 virus. Health experts are hoping the vaccine's effectiveness is 30 percent or better, but that won't be known for a month.

"The effectiveness of the vaccine varies from year to year and we only know in hindsight if it is effective or not," Bibi said. Those getting an annual flu shot have more protection against influenza viruses, even if the matching is not perfect.

"You will retain some antibodies from previous vaccinations. You get some measure of protection passing from year to year," Bibi said.

"When you are dealing with public health, you want herd immunity," he added. "If 70 percent of the population is immune to the virus, it will not reach epidemic proportions."

Bibi said a flu shot remains an option for avoiding infection in the local outbreaks, which may be a threat until late March or April. The immunity develops two weeks after the vaccination.

Other precautions are frequent hand-washing and avoiding contact with people who are sick.