Lifestyle

Snowy winter also an unusually sickly one

By Lee Bowman
Scripps Howard
Published: February 22, 2008

The winter of 2007-08 isn't going out with a whimper, but rather with a racking cough.

Government disease trackers say the flu season shows signs of being one of the worst in several years, with 44 states reporting widespread illness, and a startling number of people getting felled by the flu even though they got a flu shot last fall.

That's because the three-strain vaccine formula is a good match for only about 40 percent of the flu viruses that have been making the rounds this season.

But the flu is just part of the misery menu in a winter that seems to have had more than a normal share of bugs. In many parts of the country, doctor's offices and clinics have seen a surge of upper-respiratory, lower-respiratory and intestinal illnesses that started even before the holidays.

Respiratory syncytial virus, highly contagious and common in young children, has been widespread this season, although cases are starting to decline. The virus has also been blamed for some illness and deaths among the elderly.

Strep infections, often tenacious and demanding more than one round of antibiotics, have been rampant in schools and workplaces, along with other viral and bacterial agents that can bring on bronchitis and pneumonia.

No one can really be sure how severe all the illnesses are, but things may seem worse because of several factors.

For one, the previous three flu seasons were fairly mild, with vaccines a good match for the viruses going around. And with over-the-counter cough and cold remedies for children pulled from shelves and frowned on by doctors, more parents may be seeking professional treatment for their children than in years past.

The federal Centers for Disease Control and Prevention keeps tabs on the flu with a regular survey of a few hundred doctor's offices and labs that identify flu strains for a fraction of patients, along with reports of flu illness and deaths from state and local health departments.

That's how officials know what the predominant bugs are — and how they're not a good fit for at least two of the three viruses used in the vaccine mix for this year. The CDC also keeps close track of child deaths from the flu — there have been 10 so far this year — and four of them were also infected with staph bacteria.

Making the season worse for a miserable minority of flu patients is that about 5 percent of the flu viruses tested turned out to be resistant to antiviral drugs like Tamiflu, up from fewer than 1 percent of samples last year.

All of this has the officials responsible for designing flu vaccine for next year both in the United States and at the World Health Organization scrambling to anticipate what the most widespread viruses will be starting next October. Most years, at least one or two strains carry over from the previous year.

Already, the World Health Organization has recommended a complete revamp of the formula for next year, and the Food and Drug Administration is likely to follow suit soon.

At the same time, a team of British researchers on Monday gave another reason for why respiratory crud may be lingering. They report in the Journal of Experimental Medicine that recovery from a flu infection left mice unusually susceptible to infection with pneumonia-causing bacteria.

The reason: Immune receptors for the bacteria are shut down in the lungs for as long as six months, apparently to protect from too much inflammation as other immune cells go after the flu.

If the same thing happens in people — and more research is needed to confirm that it does — it explains why so many people get both the flu and bacterial infections and many flu victims die from pneumonia.

Coincidentally, another report based on mouse research by Canadian scientists in the journal Nature outlined a method that shuts off two genes that act to slow production of the protein interferon, a cell's first line of defense against viruses.

The researchers said the same knockout system would not work in people, but that some pharmaceutical switch could eventually be designed to have the same effect and boost our ability to kill any strain of flu that attacks us immediately, without having to anticipate what's going around months before.