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The 2018 Flu Scare: A False Alarm

By Dr. Arthur Lavin

​The news is out:  the flu epidemic of 2018 is big, and it’s scary.  Children have died of the flu, and what people once thought was a sort of bad cold is not that at all, it is “the flu,” and this year one better beware.

This is the sort of headline that flashes across our public channels of communication every winter, but is it true this time?

We are very pleased to tell you that the answer is very simple:

No.

The Facts of the 2017-2018 Influenza Virus Epidemic

The key facts of this season are that more people are getting sick from the influenza virus than in recent years past, but fortunately not nearly as many are getting critically ill, that is dying.  The influenza virus infections that children are getting remain, in the vast, vast, vast, majority of cases simply variations on the common cold.

Let’s take a look at the scariest possibility, that someone, especially a child, could die from the influenza virus infection.

​To get a handle on this concept, keep in mind we live in a country of over 320 million people, and of those, about 100 million are our children.

In recent influenza epidemics, about 125 children die of infection from the influenza virus across the whole nation of about 100 million children, every year.  It can be as few as 90, or as many as 148.   So far, the CDC has reported a total of 30 deaths in childhood, meaning we may reach 90 or even 100, but no more than usual.   And the usual makes clear that only about 1 in a million children who get an influenza virus infection, will die from it.

To make sense of this number, keep in mind that out that total of 320 million Americans, about 300 die of being struck by lightning every year, it does happen.   But at a 1 in a million chance of it happening, it remains extremely safe to go outside still.

Putting it all together, it is indeed the case that 999,999 out of 1,000,0000 cases of influenza, our children will not die.  It simply is not a very dangerous illness way over 99% of the times.  Just like going outside is safe in well over 99% of the time.

We are seeing more colds and flus caused by the influenza virus this season.  Typically about 3-5% of all colds and flus are actually from the influenza virus at the peak of an influenza epidemic.  We don’t know if we are at our peak yet, but so far that percentage is higher than most years, it has reached nearly 7%.   That is higher, but again, if you take a step back and look at the numbers, there is no cause for alarm.  There is more influenza virus out and about than in most years, but for our children, way more than half of all their colds and flus, still, this year, not caused by the influenza virus.

How can the flu not be caused by the influenza virus?

Regular readers of Real Answers will already know the answer to this.

It turns out the words “cold” and “flu” are not precise terms, they really are slang words.  The way they are used, if someone has a viral infection, if the family and/or friends think it is mild we call it “a cold,” and if it looks or seems real bad, we call it “the flu.”  Notice we never say, she has “the cold” or he has “a flu”.  It’s always “a cold,” or “the flu.”  Why?  Because what we are really saying when we use the word flu is that our person we care for is really, really sick, not just any cold, but this time it’s THE flu.

But that language has nothing to do with the species of virus causing the illness.

All viral illnesses, of course, are caused by germs called viruses.  In the winter, there are literally millions and millions of viruses floating in the air, and they come in all sorts of species.  There are the rhinoviruses, which actually cause the great majority of all colds and flus, and the coronaviruses, and the respiratory syncytical viruses (RSV), and the parainfluenza viruses, and of course, the influenza viruses.

Each of these species cause mild colds and severe colds, or flus.  They all tend to cause respiratory problems: runny noses, sore throats, coughs, with accompanying fever, headache, loss of appetite, altered sleep, in a word, misery.

You can’t tell by the severity which species it is, because they all cause mild to severe illness.

So, if you have a bad viral infection, and call it “the flu,” it could be from the influenza virus, but there is an over 90% chance it is some other virus, even though it’s “the flu.”

None of this has to do with another unrelated flu, the stomach flu, by the way.

When to worry

Now, even thought it is very, very unusual, some people, including kids, but by far and away mostly the frail elderly, can get dangerously ill from any virus, including the influenza virus.

How to know when to worry?

Here are the three key signs:

  1. Struggling to breathe.  Not congestion which is having trouble breathing through your nose.  But struggling to get air from your mouth to your chest.  This is unusual to see, but if it happens, we need to hear about it right away.
  2. Severe pain.  Everyone with “a cold” or “the flu” has misery, it’s awful thing to be sick, and the sore throats really hurt, and headaches and stomach aches are bad too.  But those are expected discomforts.  If the pain gets severe well beyond the usual cold or flu experience, we need to hear about that right away too.
  3. Altered consciousness.  Of course, if your child seems to have trouble getting to full awake when they should, let us know right away.

 

BOTTOM LINES

  1. Not only the influenza virus, but a number of other species of winter cold viruses hit our nation, every winter.  And so every winter we are amazed by how much illness they cause, how miserable the colds and flus are, how long they last, and often they seem to come one after the other.   But sadly this is a normal and universal experience of winter every year.
  2. The 2017-2018 influenza epidemic is raging right now.  More people have their colds and flus caused by influenza virus than in years past, but the difference is not dramatic- now close to 7% of cases are from the influenza virus, instead of the usual 3-5%.
  3.   The scary news reports, really the terrifying reports of children dying of the influenza virus are real, but so far the CDC has reported only 30 such deaths out of a nation of about 100 million children.  And in past years that number has reached as high as 148.   Even at the peak number of 148, the risk of a child dying from the influenza virus is about 1 in a million, very, very, very unlikely.    We are all getting colds and flus, and about 7% of them are from the influenza virus, but for nearly everyone, these unpleasant experiences are just that, unpleasant, but not dangerous, certainly not deadly.
  4. Any viral infection can turn bad, though, so know to look for signs that the cold or flu has left the usual and become dangerous, including:  trouble breathing into the chest, severe pain, altered consciousness.

We are very pleased to share the big news that this winter is fundamentally like all winters, cold, dark, filled with colds and flus, including the winter appearance of the influenza virus.  And, most importantly, it is not really more dangerous now than before, kids with a cold or the flu should do very, very well.

Of course, if you are concerned, feel free to contact us if you are in the practice.

To your health,
Dr. Arthur Lavin

 

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