The Bitterroot Valley has experienced an uptick in the number of influenza cases being reported by Ravalli County Public Health officials since the holiday season ended.
Angie Allen, the county public health nurse, said that they had 43 lab-confirmed cases of flu so far this season, primarily influenza type A, and that’s fairly typical.
“We’re not seeing anything that’s alarmingly high,” Allen said. “It usually picks up after the holiday season, when people are getting together in enclosed areas.”
Alida Merritt, a nurse who leads the Quality Department at Marcus Daly Memorial Hospital, said that the flu season typically runs from October to April, but the peak months are December through February.
“So we’re hot and heavy in the middle of the influenza season,” Merritt said. “They’ve found through research that in the winter months there are congregations of people and that provides an excellent mode of transmission.''
Montana’s Department of Health and Human Services defines influenza as “a respiratory illness with symptoms that may include fever, cough, sore throat, body aches, headache, chills, and fatigue.” About 1,440 new cases, 239 hospitalizations, and 12 deaths due to influenza have been reported in Montana during this flu season. In the first week of 2018 alone, 425 new cases were reported from 38 counties.
During the 2016-2017 flu season, DPHHS said it recorded 829 hospitalizations and 56 deaths related to influenza.
While most of the deaths this year were for people aged 65 and older, an obituary in the Jan. 12 Missoulian reported that Joseph Hackenbruck, 38, died Dec. 20, 2017, from complications of the flu.
Hamilton School District Superintendent Tom Korst reported that Hamilton Middle School was needing "lots of subs" due to the flu, but other area schools in Darby, Victor, Stevensville and Corvallis said they hadn't any reported cases. Dana Huseby, the Florence school nurse, said they were seeing average illnesses for this time of year.
Nationally, the Centers for Disease Control and Prevention said that during the week ending Dec. 30, 46 states reported widespread flu activity. That was an increase from 36 states the previous week.
The CDC notes that the particularly virulent substrain H3N2 is dominating the severe cases, and while some cases are being reported in Montana, that’s not something they often test for, Allen said.
“We have had some of those detected, but not all tests are sub-typed out,” Allen said.
Merritt notes that influenza is spread by droplets, which can spread the virus even before any symptoms begin, and a person can be infectious for up to two weeks afterward.
“So if I cough or sneeze, if it lands on your mucus membranes or it showers on the surfaces, where it can live for several hours … and it gets on your hands and you rub your T-zone, which is your eyes, nose and mouth, it has a portal of entry,” Merrit said. “You can see why hand hygiene is a critical element to stop the spread of influenza.”
She urges people to wash their hands thoroughly with regular soap and water, paying particular attention to the backs of hands and the thumbs.
“Physically, through scrubbing and using soap and friction, you remove germs from your hands, and that’s the goal,” Merritt said. “Alcohol-based hand rubs … also kill the germs.''
MDMH has had a few people admitted with severe influenza cases and related complications since December, which is earlier than last year, when the first hospitalizations occurred in March, Merritt said.
Influenza typically affects those older than 65 and younger than 5, but also can be harmful to people of any age who have another chronic illness.
“If you’re 50 years old with diabetes, or 35 years old with asthma, you have an increased risk for complications,” Merrit said.
Both Allen and Merritt say that the best way to avoid influenza is to get a vaccination shot. Allen’s office still has some vaccines available.
Stacey Anderson of the DPHHS Communicable Disease Epidemiology section agrees.
“The influenza vaccine protects against multiple strains of flu,” Anderson said in a press release. “Even if the vaccine may not prevent every case of influenza, the evidence shows that getting a flu shot still can prevent severe illness and hospitalization. The vaccine also provides protection against other strains that circulate during the season.”
If a person does come down with the flu, they should see their personal doctor immediately for Tamiflu, which is used to treat symptoms caused by the influenza virus, Merritt said. The next step is to go home and stay there.
“Stay home to minimize your contact with other vulnerable people, because you could be the mode of transmission,” she said. “Take measures for comfort: medicine to reduce the fever and lots of fluid because dehydration is common. You may be out for a few days or a couple weeks, or even several weeks if you develop complications.”
While hospitals sometimes restrict visitors during influenza outbreaks, MDMH hasn’t needed to do that this year. Merritt said they have offered vaccinations to all MDMH employees, and also have respiratory hygiene kiosks strategically placed throughout the hospital with face masks and hand sanitizers for visitors and staff alike. All rooms also have hand-sanitizing stations inside and outside the entrance door.
“We ask people if they have to come into the hospital and have a respiratory illness to stop at the kiosks,” Merritt said. “That reduces your potential to spread the illness.”