By Bara Vaida
People tend to think of influenza as a nuisance winter illness that might keep one in bed for a few days, but it is a serious disease that kills thousands every year. The flu and pneumonia were among the top 10 causes of death in the U.S. in 2017.
The flu is caused by a virus that attacks the lungs and is endemic to humanity. The virus is always circulating and often strikes populations in the late fall or winter seasons. The word “influenza” comes from the Italian word “influence,” meaning an illness that was influenced by the cold. Research has shown that high humidity and warm temperatures hinder the spread of the flu, which is why the disease strikes during colder months of the year.
When flu virus attacks the respiratory system, it can weaken the immune system leaving the body vulnerable to contracting other serious diseases like pneumonia and tuberculosis, and cause death. Older people, pregnant women, children and those with certain chronic health conditions are most at risk for flu complications.
Over the past several years, there have been more studies showing “strong associations” between the development of respiratory infections, especially influenza, and heart attacks and strokes in older adults. The flu virus can cause an inflammatory response in the heart and brain that lingers weeks, increasing the risk of heart attacks and stroke, the studies say.
The U.S. Centers for Disease Control and Prevention estimates that the flu infects about 49 million people in the U.S. annually. The 2018-19 flu season lasted 21 weeks and was one of the longest on record, according to Health and Human Services Secretary Alex Azar. Between 36,400 and 61,200 people in the U.S. died from the flu and between 531,000 and 647,000 were hospitalized, according to the CDC. Flu season begins Oct. 1 and people are urged to get a shot before the beginning of November.
Though it was one of the longest on the record, it was milder in comparison to the previous year, when around 80,000 died from the flu and 900,000 were hospitalized. On average, about 5% to 20% of the population will contract the flu annually, costing $10.4 billion in direct medical spending and $16.3 billion in workdays lost.
Public health officials monitor the flu virus to determine what vaccine pharmaceutical companies should make. The determination is made six months in advance – February for the Northern Hemisphere and September for the Southern Hemisphere – to give drug companies time to make the vaccine and regulators time to ensure their safety. The challenge is that because the virus mutates quickly public health officials can’t always match the vaccine to the strains that will be causing illness that year.
Public health officials urge everyone over the age of 6 months to get an annual flu vaccine. Last flu season, the CDC said 45.3% of American adults got a flu shot, up 8 percentage points in the year before. Among children 6 months to 17 years old, 62.6% got a flu shot, up 4.7 percentage points from the previous season. This means that more than half of adults and more than a third of children aren’t immunized from the flu
Part of the reason why adults say they don’t get a flu shot is that flu vaccine effectiveness fluctuates. For the 2018-19 flu season, the flu vaccine, on average was about 29% effective, said the CDC.
Because the flu vaccine isn’t 100% effective, researchers continue to work on developing a “universal flu” vaccine – that is, one that targets a piece of the virus that doesn’t mutate. In April 2019, the National Institutes of Health announced that its researchers had begun the first phase of clinical trials for a universal vaccine, but scientists are many years from having a product that is available to the general public.
In covering the flu, reporters can monitor the CDC’s FluView to get weekly national and regional updates on flu outbreaks. This U.S. map provides a weekly summary of flu cases and is a good source for finding out what is happening in the local community.
Questions reporters might consider:
- How many people were infected by the flu in the community last year and how many were hospitalized or died? Were there any children that died?
- What was the vaccination rate?
- How well do people in the community understand the flu?
- Are doctors encouraging their patients to get the flu shot?
- How well prepared are local health providers and hospitals for flu season that was as bad as last year’s?
- Are there enough laboratories to test for the flu?
- Do hospitals have enough respirators and other equipment for flu patients?
- Visit one of the influenza labs in your state that report to the CDC, learn who the researchers are and ask how they are monitoring the flu.
- Liz Seegert, AHCJ’s topic leader on aging, compiled other questions for reporters to consider when covering the flu
Recent coverage
What You Need To Know About The 2019-2020 Flu Season – Everyday Health, September 2019
The Year the Flu Came in Two Waves – Medical Express, May 2019
Santa Clara County Records Two Flu Deaths, Including Child – CBS Local News, September 2019
Flu Season is Coming, and It Could be Nasty – USA Today, September 2019
Crikey! Australia Flu Season Was Bad, What Does That Mean for the US? – HealthLine, Sept. 2019
This Year’s Flu Season May Be a Bad One – NBC News, September 2019
Flu Shot Is Critical But Only Half of Americans Plan to Get One: ABC News, September 2019
First In Human Trial Begins on Universal Flu Vaccine, Older Adults Still Encouraged to Vaccinate – Forbes, April 2019
A New Push for A Universal Flu Vaccine – Scientific American, May 2018
Covering U.S. Efforts to Create A Universal Vaccine – AHCJ, March 2018
Universal Influenza Vaccine: A Game Changer in Prevention – Infectious Disease Advisor, January 2018
Why Flu Vaccines So Often Fail – Science magazine examines why flu vaccine varies in effectiveness and why a better flu vaccine is needed (9/20/17)
Flu experts
William Schaffner, M.D., professor of preventive medicine, Vanderbilt University School of Medicine, 615-322-2037, mwilliam.schaffner@vanderbilt.edu
Patricia Whitley-Williams, MD, professor, chair of pediatrics at Rutgers Robert Wood Johnson Medical School, 732-235-7900, whitlepn@rwjms.rutgers.edu (can speak to children and the flu shot)
William Borden, MD, associate professor of medicine, George Washington School of Medicine & Health Sciences, 202-741-2233, (can speak to the connection between heart attacks, strokes and the flu)
Wendy Sue Swanson, M.D., pediatrician and chief of digital innovation at Seattle Children’s Hospital, 206-987-5147
Laura Riley, chair of the department of obstetrics and gynecology at Weill Cornell Medical Center, 646-962-9564
Litjen (L.J.) Tan, chief strategy officer, Immunization Action Coalition, member of the Health and Human Service Department’s National Vaccine Advisory Committee, 651-647-9009, lj.tan@immunize.org
Michael Osterholm, director, Center for Infectious Disease Research & Policy, mto@umn.edu 612-625-4110 (media affairs)
Robert H. Hopkins, Jr., MD, Professor of Medicine and Pediatrics and Director of Division of General Internal Medicine, Department of Internal Medicine, University of Arkansas for Medical Sciences, 501-686-5236
Patricia Stinchfield, R.N., M.S., C.P.N.P., C.I.C., senior director of infectious prevention and control at Children’s Minnesota, 651-220-6444
Kathleen Neuzil, M.D., director of the Center for Vaccine Development at the University of Maryland School of Medicine, 410-706-4946, mkneuzil@som.umaryland.edu
Kanswar Talaat, M.D., assistant scientist, International Health Center for Immunization Research at Johns Hopkins University, 410-502-9627
Marla Dalton, executive director, National Foundation for Infectious Diseases, 301-656-0003 x150, mdalton@nfid.org
Flor Munoz, M.D., associate professor of pediatric infectious diseases, Baylor College of Medicine, florm@bcm.edu
Kristen Nordland, press officer at the CDC’s National Center for Immunization and Respiratory Diseases. She handles all flu questions for the CDC. Office: 404-639-7387, Mobile: 404-956-0336, hok4@cdc.gov
U.S. government sources
CDC Flu Activity and Surveillance
NIH Research on How Influenza Spreads and Developing New Vaccines
Influenza Genome Sequencing Project
National Vaccine Program Office
The business of the flu
Flu Manufacturers and their Products – CDC detail on flu manufacturers
An explainer on the U.S. flu vaccine regulatory process:
A primer on new technologies used to manufacture better flu vaccines
NIH primer on flu vaccine manufacturing er
Big PhRMA Has the Flu, Wired February 2018. Why vaccine makers don’t want to invest in a better vaccine.
The Business of the Flu Vaccine – A CNBC analysis of the size of the flu market and the manufacturers (10/19/15)
Social determinants and the flu
Influence and Vaccine Disparities in the US
Influenza Hits Poor People the Hardest
Role of Risk Perception In Flu Vaccine Behavior Among African-American and White Adults in the U.S. (3/17/17)
Research on the flu’s connection to heart attacks and stroke
Influenza vaccination and 1-year risk of myocardial infarction, stroke, heart failure, pnemonia – Intensive Care Medicine – July 2019
Outcomes of Patients With Acute Myocardial Infarction in Patients With Influenza, American Journal of Medicine, May 2019
Influenza Virus and Atherosclerosis, Jan 2019
Clinical Infectious Disease, June 2018
European Respiratory Journal, volume 52, issue 3, 2018
New England Journal of Medicine, January 2018
Oncotarget, November 2017
Other Research
Tamiflu’s effectiveness – A May 2014 Cochrane review of the effectiveness of antivirals.
Cochrane Review on Flu Vaccines and Effectiveness – February 2018
Genes Linked to Better Immune Response to Flu Vaccine Identified – Science Daily report on how genes might impact flu vaccine. (8/25/17)
Data
Center for Disease Control and Prevention Weekly Influenza Map
FluNearYou – A website and mobile app created through a partnership between HealthMap, the American Public Health Association and the Skoll Global Threats Fund that maps the reporting of flu cases in the U.S. and Canada.
Webcasts
Webcast of the 2019-2020 CDC/NFID press conference on annual flu vaccination campaign: In September 2019, the CDC and the National Foundation for Infectious Diseases hold a joint press briefing to launch an annual flu vaccine campaign. The Secretary of Health and Human Services Alex Azar led the discussion.
Understanding the Flu: In July 2018, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, was the keynote speaker at the National Press Club where he where he explained the origins of the flu, why the season flu vaccine doesn’t work as well as public health officials would like and efforts to create a more effective flu vaccine.
A Primer for the Media on the Flu: A September 2017 webinar explaining how the CDC monitors the flu, picks the annual vaccine and how reporters can use the flu data on its website.
Graphic animation video explaining how the flu virus enters the body, hijacks cells and gives you the flu. It also touches on how a vaccine prevents it.
History
History of Influenza and Development of Seasonal Vaccines
Flu Season: An interview with Jeffrey K Taubenberg: In this Q & A, the molecular biology publication EMBO Reports interviews Taubenberg, the scientist who mapped the gene of the 1918 flu virus, about the current state of flu vaccines.
The Great Influenza – by John Barry – This history of the deadline 1918 influenza pandemic includes a chapter explaining in layman’s terms how the flu virus works.
Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It, by Gina Kolata. Kolata, a New York Times reporter, tells the compelling story about the key scientists who discovered the flu virus and the search for the deadly 1918 strain.
Organizations and experts
Association of State and Territorial Health Officials – The Arlington, Va.,-based association represents state and local public health officials and is a good resource for connecting with community health officials.
Center for Infectious Disease Research & Policy: This University of Minnesota-based research group provides daily and breaking news on infectious diseases, including flu outbreaks.
Families Fighting Flu: A nonprofit group that represents patients who have been injured or killed by the flu.
Immunization Action Coalition – An organization backed by the Centers for Disease Control and Prevention that aims to boost the nation’s immunization rates.
National Foundation For Infectious Diseases – A Bethesda, Md.-based foundation created to educate the public on the causes, treatment and prevention of infectious diseases.
Infectious Diseases Society of America – An Arlington, Va.-based medical association that represents physicians and scientists and other health care professionals who specialize in infectious diseases.
