Protect Your Family from Serious Infectious Diseases

Extreme Flu Season and Measles Outbreak Underscore Importance of Prevention and Vaccination

According to the California Department of Public Health’s Influenza Surveillance Program, influenza (flu) infections in the state have been at high levels since December, and the flu season is not over yet.

“The peak of flu season usually hits the San Francisco Bay Area around the end of February, but in December we had four times the number of flu screenings at Washington Hospital than we had in the same month the previous year,” says Dr. Dianne Martin, an infectious disease specialist and co-chair of the Infection Prevention and Control Committee at Washington Hospital.

“Last year, during the month of January 2014, we tested 213 patients for flu, and 31 patients – 14 percent – tested positive,” she adds. “This year, from January 1 to 15, we tested 159 patients, and had 42 patients – 26 percent – who tested positive. That was in just the first half of the month. I have never seen so many cases of flu this early in the year. Our admissions of flu patients at Washington Hospital have been way up, including 10 admissions in one weekend.”

The flu is a contagious respiratory illness that is spread mainly by droplets made when people with the flu cough, sneeze or talk. The flu can cause serious secondary complications such as pneumonia or complications of chronic medical problems. The Centers for Disease Control and Prevention (CDC) recommends a yearly flu vaccine as the most important step in protecting against flu viruses.

“This year’s flu vaccine hasn’t worked as well as we had hoped, because some of the viruses spreading this season are different from those in the vaccine,” Dr. Martin notes. “Vaccination can still provide some protection against the flu, and since flu season can continue as late as May, it’s not too late to get the vaccine. Other steps you can take to avoid catching the flu include washing your hands often with soap and water and avoiding close contact with sick people.”

The CDC recommends flu vaccinations for everyone over the age of 6 months. Because children younger than 6 months are too young to be vaccinated, the people who care for them should be vaccinated instead. The flu shot given during pregnancy has been shown to protect both the mother and her baby (up to 6 months old) from flu. Vaccinations also are important for health care workers and other people who live with or care for high-risk people.

Some people who have had Guillain-Barré syndrome (a severe paralyzing illness, also called GBS) should not get the flu vaccine. If you have ever had GBS, talk to your doctor about whether you should receive a flu vaccine.

The CDC notes that some of the people considered to be at high risk of developing serious complications from the flu include:

• Children under age 5 – and especially those under 2 years old
• People over age 65
• Pregnant women
• Native Americans
• People who are morbidly obese (body mass index of 40 or greater)
• People with chronic health conditions such as diabetes, lung disease, asthma, heart disease, liver disorders and kidney disorders
• People younger than age 19 who are receiving long-term aspirin therapy

“People who have a weakened immune system because of diseases such as cancer and HIV are also at high risk for complications of the flu,” Dr. Martin cautions. “Cancer patients who are undergoing chemotherapy treatment should consult with their oncologist to find a window of time that is appropriate for receiving a flu vaccine.”

Symptoms of the flu may include fever, cough, sore throat, runny or stuffy nose, body aches, headaches, chills and fatigue.

“If you do get sick with the flu, you should stay home and seek medical treatment as soon as possible,” Dr. Martin says. “Don’t go shopping or to work and spread it to other people, and don’t send a sick child to school. You can treat the symptoms of the flu with over-the-counter medications. Prescription antiviral drugs also can reduce the severity of the illness and shorten the duration, but it’s important to use these drugs within the first 72 hour after the onset of symptoms.”

Resurgence of Measles is Cause for Concern

In addition to experiencing an unusually high rate of flu infections, California is currently “ground zero” for a rapidly expanding number of cases of measles. The outbreak started when at least 40 people who visited or worked at Disneyland theme park in Orange County in mid-December 2014 contracted measles. As of February 4, the California Department of Public Health had confirmed 99 cases of measles statewide, including six cases in Alameda County, two in Marin County, three in San Mateo County and two in Santa Clara County. The measles outbreak also has now spread to at least half a dozen other states.

“This outbreak of measles in California is a concern, since measles is a serious disease that can cause severe complications such as pneumonia and encephalitis,” Dr. Martin explains. “Like the flu, measles is a highly contagious viral disease. The early symptoms of measles can mimic those of the flu – fever, cough, runny nose, sore throat and red eyes. The rash typically associated with measles doesn’t appear for a few days. Infected people are usually contagious from about four days before their rash starts to four days afterwards.”

According to the CDC, before the introduction of a live measles vaccine in 1963, the average yearly number of measles cases in the U.S. was 549,000, and nearly 500 deaths per year were attributed to measles. Once the measles vaccine was introduced, there was a huge drop in measles cases. In 2000, endemic measles was declared "eliminated" from the United States.

The measles vaccine is usually combined with mumps and rubella (MMR) or with mumps, rubella and varicella (MMRV). Children routinely get their first dose of the MMR vaccine at 12 months old. The second dose of MMR is usually administered before the child begins kindergarten but may be given one month or more after the first dose.

The CDC notes that two doses of the MMR vaccine are more than 99 percent effective in preventing measles. Most of those people who have contracted measles in the current outbreak are unvaccinated. During the last school year, 3.3 percent of California kindergartners – about 18,200 – were allowed to skip vaccinations, according to the CDC. Some were exempted from vaccination requirements because of medical reasons, such as a weakened immune system resulting from chemotherapy or other causes, but the majority of exemptions were due to religious or philosophical reasons. The number of measles cases in California over the past month is higher than the median number of cases for the entire country for each year between 2001 and 2011, according to CDC figures.

“Another cause for concern in the Bay Area is that we have a large immigrant population, including some people who may have no record of immunization against measles,” Dr. Martin says. “There is a blood test that can determine if you are immune to measles as a result of either vaccination or previously having the disease. You should consult your physician about whether you should get the measles vaccine. Most pediatric clinics would have a supply of measles vaccine. It might be more difficult to obtain measles vaccines at some adult clinics, but many local clinics and pharmacies offer measles vaccines.”

The Washington Urgent Care Clinic located at 2500 Mowry Avenue in Fremont currently has flu vaccines available. Call 510.791.2273 for more information. The Washington Township Medical Foundation Primary Care clinics currently carry the flu and measles vaccine. Go to www.mywtmf.com or call 510.248.1000 for more information. For general information about flu and measles vaccines and prevention, visit www.cdc.gov.