Flu and Other Respiratory Virus Activity Ramp Up Early Across Alabama and the U.S.

Taniesa L. Sullivan | The Weekly Ledger News | Alabama Department of Public Health

The 2022 flu season is off to an early and vicious start, especially in the South, according to tracking by the Centers for Disease Control and Prevention.

Pediatric leaders across the state of Alabama are warning families about unusually high and severe influenza activity throughout the state, especially in children.

“This is the highest flu activity that we have seen this early in the season since the 2009 Influenza A/H1N1 pandemic” reported Wes Stubblefield, MD, MPH, FAAP, pediatrician and District Medical Officer with the Alabama Department of Public Health.

Outpatient pediatric offices, already short-staffed coming out of the pandemic and facing daily medication shortages, are bearing the brunt of this outbreak. “Outpatient visits for influenza increased over 10-fold between September and October and have shown no signs of slowing in the first five days of November,” said Nola Ernest, MD, PhD, FAAP, outpatient pediatrician in Enterprise, AL and president of the Alabama Chapter of the American Academy of Pediatrics. “The highest number of outpatient visits for influenza-like illness are in young people, ages 5-24.”

At USA Health Children’s and Women’s Hospital in Mobile, positive influenza cases have risen from 51 in September to 745 in October and 138 in just the first three days of November. This swift spread of the flu is also resulting in a rapid increase in hospitalizations among children. At USA Health, there are more children hospitalized for influenza than for Respiratory Syncytial Virus infection, or RSV.

Children’s of Alabama in Birmingham has seen a similar increase. “In the last few weeks, Children’s of Alabama has seen a surge of admissions with children who are critically ill from influenza and associated complications,” said Michele Kong, MD, Professor of Pediatrics and director of the Pediatric Critical Care Research Program at Children’s. “These have included those patients who have required ventilation and some so severe that ECMO (heart-lung-bypass) support was needed. We urge families to take the flu virus seriously and to ensure that their children and adolescents are protected.”

While typically self-limited, influenza can result in severe complications in persons of any age but is especially severe in young children. Hospitalization can result from dehydration and difficulty breathing, but also from myocarditis (inflammation of the heart muscle), respiratory failure, and encephalitis (inflammation of the brain).

An average of 150 children across the United States die of influenza each year. However, in 2009, the last time early influenza activity was this severe, pediatric deaths reached 282.

So far, there have been an estimated 1,300 flu deaths in the United States, including at least three children.

However, pediatricians warn that this data is often delayed by several weeks and may be an underestimate of how many influenza-related deaths are occurring.

Activity has spiked over the past month. Less than three weeks ago, no states were in the “very high” categories. The winter flu season usually ramps up in December or January.

Unlike many respiratory viruses including RSV, there are very specific actions that families can take to protect children against influenza, chiefly vaccination.

Benjamin Estrada, MD, FAAP, pediatric infectious disease specialist at USA Health, urged Alabama families to take steps immediately to prevent influenza infection: “We encourage parents to take the necessary preventative measures to protect their children, themselves, and others through strategies that we know are effective, including influenza vaccination for everyone older than six months, hand-washing, and mask-wearing in crowded environments or when someone is sick at home.”

To find out more about how to get a flu vaccine for your family, contact your pediatrician, family physician, your pharmacist, or county health department.