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Learn how you can avoid the flu

In Lake Oswego, number of flu sufferers not much higher from previous years, but different groups are being affected


by: LEGACY MERIDIAN - Each year, the flu differs in severity and target demographic. Although children ages 4 and younger and adults 65 and older are generally considered the most vulnerable populations, this years pH1N1 virus, a strain of Influenza A, is disproportionately impacting young and middle-aged adults, according to the U.S. Centers for Disease Control.Oregon authorities are urging people to get the flu vaccine as hospitalizations increase. A 5-year-old died from the disease after falling ill Christmas Day, and a 52-year-old Salem woman died Jan. 7 from complications from the flu.

According to the Oregon Health Authority, there were 81 flu-related hospitalizations during the week of Christmas, with many of the cases involving the H1N1 strain. So far in Portland, at least seven people have died from the flu this season, according to KOIN 6 News.

The flu is tracked locally in two main ways. First, hospitals within the Portland area report when patients are admitted and have a laboratory-confirmed case.

Second, a network of 25 clinics around the state reports the percentage of patients with flu-like symptoms. If that number is below 1 percent, it’s usually considered just colds and other viruses. When it’s more than 1 percent, flu season has started. That number recently hit 4 percent. This flu season is expected to last another six to eight weeks.

Flu season began Nov. 26, 2013, according to Legacy Meridian Park Medical Center in Tualatin.

That’s when the first of 329 people visited the hospital with concerns they were suffering from this year’s brand of the H1N1 virus.

Fifty-eight of them were, although the majority of flu cases don’t merit a visit to the doctor.

As flu-related visits continued to rise, Legacy implemented visitor restrictions on Jan. 9, allowing no more than two visitors per patient and limiting visitors age 18 and younger to immediate family members. The Providence medical system is now also limiting visitors at its maternity wards to family members age 18 and up, and allowing just two visitors at a time.

But so far in Lake Oswego, health-care clinics and major employers haven’t seen a surge in flu cases over previous years. However, the types of patients seeking treatment for flu symptoms have shifted.

Dr. Kara Kassay, of Kassay Family Medicine in Lake Oswego, said she has treated 10 flu cases over the past two months — not an unusually high number at this early point in the flu season.

But what is perhaps more troubling are the kinds of people coming down it: healthy young people who have never previously had the flu. This year, it seems they are just the type of people the H1N1 strain now running rampant is liable to strike.

“With H1N1, younger people always have more vulnerability,” Kassay said. “Older folks are more immune.”

People can quickly go from being very healthy to being unable to get out of bed, racked by coughing, burning from fevers of up to 104 degrees and facing the possibility of getting pneumonia.

And yet all 10 of her patients treated as of this week had failed to get flu shots.

“It’s surprising, but it is so common for people to be nonchalant about getting a flu shot,” Kassay said. “Young people have a complete lack of immunity to this flu.”

The Lake Oswego School District had its fair share of absences last week, but there were no more than usual.

In fact, there were fewer than usual: 115 students absent because of illness, 43 of whom had flu-like symptoms, said Nancy Duin, director of communications for the school district.

Riverdale Elementary had the biggest proportion of sick students with flu-like symptoms: nine out 13 absentees. Riverdale was followed by Westridge Elementary and Lake Oswego High School, which each had eight absent students with flu-like symptoms. At Lakeridge High School, 13 students were absent because of illness, three of them with flu-like symptoms.

There was “no spike in the number of staff out sick,” said Duin. “Our need for substitutes is currently below average.”

The city government hasn’t seen a marked increase in employee absences either, although employees who do call in sick might be out “a tad longer” than in previous years, said Lake Oswego Human Resources Director Megan Phelan.

Employees don’t report a specific type of illness when they use sick leave, she said, and so it’s hard to tell whether the flu or maybe the common cold is to blame for any slight uptick in the amount of time workers are missing.

Even so, it appears the city government has largely escaped the epidemic being reported elsewhere.

Phelan said that might be thanks to flu shots offered to employees in October. In addition, she noted that custodians have been asked to show extra care in cleaning public facilities, such as disinfecting handrails and doorknobs on a nightly basis, until the flu season is over.

Sean Harper, a physician with Legacy Medical Group-Tualatin, explained that healthy people struck down by the flu simply need to ride it out. But infants and young children, some elderly sufferers and other groups are more at risk, including those with lung disease, asthma, heart disease and other chronic illnesses.Harper

If you are not in one of those high-risk groups, do not suffer a persistently high fever, do not have trouble breathing and do not appear to be suffering from an aggressive form of the illness, Harper said, unfortunately, you’ve just got to let the illness run its course.

But there are two definite signs you should seek immediate attention: if you have trouble breathing or have a persistently high fever.

It’s a popular misconception that the flu must always be accompanied by a stomach illness and symptoms like vomiting or diarrhea, Harper said.

“It’s actually a respiratory illness, and it affects sinuses, the nose,” he said, adding that body aches, fevers, chills, a sore throat, cough and headaches are some of the usual suspects that can point to the flu.

Each year, the flu differs in severity and target demographic. Although children age 4 and younger and adults 65 and older are generally considered the most vulnerable populations, this year’s pH1N1 virus, a strain of Influenza A, is disproportionately affecting young and middle-aged adults, according to the U.S. Centers for Disease Control.

“It’s hitting people in the area pretty hard,” Harper said.

Particularly severe cases of the flu can be treated in a clinic setting, according to Harper, but widespread use of antiviral medications is risky, as viruses can become resistant and increasingly difficult to treat.

“We try to minimize the amount of overtreatment,” Harper said. “We don’t have a whole lot of medications (for the flu), and we want the ones we do have to work.”

Prevention is key. Two-thirds of the patients admitted to Legacy Meridian Park for flu treatment had not received their seasonal flu vaccines.

“You can get a flu shot and still get sick from the flu, but if you’re not immunized, you tend to have harsher symptoms,” Harper said. “It’s like if you wear a seatbelt, you’re less likely to get injured in a car accident.”

The CDC recommends everyone 6 months of age and older get a flu vaccine, with rare exceptions.

The Oregon Perinatal Collaborative is also urging every pregnant woman to get a flu shot. Health complications resulting from influenza infection, such as pneumonia, can be serious and even deadly.

“Pregnant women and their newborn infants are at increased risk for serious complications from the flu, particularly from the strain that is currently out there,” said Dr. Mark Tomlinson, a member of the perinatal collaborative and regional medical director for obstetrics within the Oregon region for Providence Health and Services.

Newborns whose mothers receive the flu shot during pregnancy can be protected for up to six months until they begin receiving their own flu vaccinations.

Even those who claim robust health and little to no history of getting sick should get the flu shot, Harper said, in the interest of herd immunity.

“If we immunize everyone in the herd, then the weak people in the herd have greater protection,” he said. “The chance of that newborn getting sick is less, because there’s less of a chance of the flu coming into that house.”

The flu vaccine changes each year, but typically guards against three strains of the flu determined most likely to hit that year. Because the vaccine addresses only a fraction of flu strains circulating, it is possible to still get sick, or to get sick more than once in a season.

“If patients have influenza, I tell them, ‘As soon as you start feeling better, let’s bring you in and get that shot,’” Harper said.

— Jillian Daley, Kara Hansen and Cliff Newell contributed to this story.

Get vaccinated

Legacy Emanuel Medical Center, in partnership with Immunize Oregon and the Multnomah County Immunization Program, will offer free flu shots while supplies last to people age 6 months and older from 11 a.m. to 3 p.m. Monday, Martin Luther King Jr. Day, at 2801 N. Gantenbein, Portland.



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