Follow the flu

October 19, 2004 11:54 PM

The National Flu Surveillance Network maps flu threats at the state and zipcode levels. They also have an animated map of previous seasons. The CDC also has a map of activity included in the weekly updates at their flu site.
posted by euphorb (18 comments total)

I feel like I'm the only one left in America wondering why the rest of the country is suddenly freaking out over the flu.
posted by agregoli at 9:08 AM on October 20, 2004

There is something really cool about that first map. I see that the "Bush flu" (why not call it that) has already started to show up in some states. But the suggestion that it is not too late to get a flu shot is of course a cruel joke.

I imagine I'll have the Bush flu before the season is over. This is the first time in 10 years I haven't gotten a shot. My work used to offer it.

So, uh, thanks George. Nice idea to outsource that job. I don't notice any other countries with a shortage. Maybe the socialists in Canada or France will bail you out. Maybe not.
posted by Slagman at 9:09 AM on October 20, 2004

As for freaking out... well, more people die from the flu every year than are killed by many things that we seem to fear more. And it's entirely preventable.

Or, rather, it was.

Yes, the "Bush flu" -- I like that. Bye bye Grandma.
"The old people's friend" has returned. Nice way to cut down on pension and social security costs, not to mention all those people out there with compromised immune systems from HIV and other nasty stuff.

Now that's a health care plan.
posted by Slagman at 9:12 AM on October 20, 2004

agregoli, I wonder about that too.

I would have preferred it, though, if Bush had been more careful about monitoring conditions at Chiron, in Great Britain; and I do think he should have completely overhauled the way this country obtains flu vaccine. The way all his predecessors did. Because he's our National Daddy.
posted by coelecanth at 9:34 AM on October 20, 2004

I'm not fuly informed on the issue but it looks like some public health officials really dropped the ball.

“When Chiron informed us of the potential problems at the end of August, we made contingency agreements,” said Alison Langley, a spokeswoman for the Medicines and Healthcare Products Regulatory Agency, or MHRA, the British equivalent of the U.S. Food and Drug Administration.

Armed with essentially the same information, however, U.S. officials relied on Chiron's early assurances that only a small portion of the flu vaccine from its Liverpool plant was contaminated.

It was not until Oct. 5, when the British pulled Chiron's license, that they knew that half the U.S. flu vaccine supply had just disappeared, producing the lines and shortages that the country is now enduring.

posted by euphorb at 9:44 AM on October 20, 2004

I feel like I'm the only one left in America wondering why the rest of the country is suddenly freaking out over the flu.

Flu produces six times more fatalities PER YEAR than 9/11 did. Look at how this country flipped out over an anomaly like 9/11, or a handful of anthrax-laced letters. Freaking out is what we do. For many in high-risk categories (seniors, those with chronic illnesses especially immune disease, healthcare workers, infants) flu poses a very real and imminent threat. Whether panic is a productive response, it's at least an understandable one for the millions of people affected.
posted by nakedcodemonkey at 11:01 AM on October 20, 2004

Correction: the annual rate of U.S. flu deaths is 12 times more than from the 9/11 attacks.
posted by nakedcodemonkey at 11:12 AM on October 20, 2004

Project BioShield contracts never materialized
posted by homunculus at 11:33 AM on October 20, 2004

The current flu panic isn't understandable to me at all, no matter how many times people try to quote statistics to me. This is because the people I see freaking out about it are HEALTHY YOUNG ADULTS, to whom an occurance of flu would cause them to lose a few days of work and keep them miserable during that time. They are not going to die from it. Yet these same people are worrying and fretting up a storm, anxious to get a shot, one that might not even prevent them from getting flu, if they were even going to get it in the first place (an unknown possibility). By all means, let the sick and infirm get flu shots, and the smallest kids. But I don't get why the average healthy person like myself would want so desperately to get one.

I find the whole thing preposterous.
posted by agregoli at 12:25 PM on October 20, 2004

I wonder how those of us who are healthy and have had flu shots forever would be protected against the flu. All those shots must offer SOME resistance as the core virus is the same. Perhaps an easier flu?

I'm worried because I've talked to a guy who's had the flu this year and said it was the worst flu of his entire life. He said it totally wiped him out.
posted by geoff. at 2:15 PM on October 20, 2004

Unlike U.S., Europe Sees No Shortfall of Flu Shots
posted by homunculus at 2:54 PM on October 20, 2004

agregoli, I don't personally know anyone who is "freaking out", but I do know people who were planning to get shots who are pretty annoyed by the situation. (For starters, what might have been a simple walk-in thing now entails jumping through state health board hoops, making an appointment (locally up to 4 weeks wait now), and scheduling around it).

True, as you say, healthy adults generally need not fear for their lives. Nevertheless, flu does cause great loss of life, chiefly among the elderly, the very young, and the already ill; and the fear of a pandemic remains. The world hasn't seen a bad one in a while, SARS and Ebola notwithstanding; many experts worry very seriously about the possibility of another avian or porcine virus making its way into the human population, and the mystery of the 1918 "Spanish Flu" epidemic remains, for the most part, unsolved.

The expansion of vaccination to healthy adults was a slow process, but it has become routine for many classes of people, from health-care workers to teachers to parents to restaurant staff. The lack of vaccinations for these healthy adults, meanwhile, is not only going to affect their individual absenteeism, it's likely to allow any flu strains to spread more quickly and more widely than we've become accustomed. In short, this has the potential to be the worst flu season in memory for many people, simply because many more people are going to get sick and in the process expose others. This increases the risk even for vaccinated adults. There's a circle of potential infection around every one of us, and if that circle includes the three risky categories I mentioned -- who doesn't know someone who's very young, very old, or very ill? -- you run the real (if small) risk of being a carrier of death to someone you know. That's heeby-jeeby inspiring. Certainly there will be immediately obvious effects on health services in many communities, with hospital beds filling up more quickly and nursing staffs running short. There may be localized outbreaks involving hundreds or thousands of people. Schools and businesses may close. I think we'll muddle through, of course, but you're obviously not thinking of any secondary or tertiary effects. Well, this is what they are.

One hard-to-articulate worry among all this is that when the flu bug is widespread, doctors are less likely to closely investigation other infectious diseases with similar early symptomology. That means that something like SARS could gain a foothold before it's detected. This hasn't been a problem in the US, but it is a problem in emerging nations with less-mature medical cultures.

What's especially galling isn't the simple fact that the US public health system screwed up in a big way (and there should be a congressional investigation to determine exactly why -- I'm not alone in suspecting a laissez-faire attitude toward regulation). It's that flu management is a shared worldwide responsibility, and the US has led that management effort in many ways. The CDC is still the premier laboratory, and with all of the groundwork for a flu season beginning 18-24 months before, any modern nation ought to be able to handle its vaccination needs.

Even if this doesn't become a disaster, it's a monumental fuckup, on the scale of (and in some ways the flip side of) the Swine flu scare of 1976, when the Ford administration expected an epidemic of a strong flu strain, ramped up vaccinations accordingly, and the incidence ended up being something of a whimper. A lot of people were left with the unhealthy impression that flu warnings are hoo-hah, and skepticism about public health efforts which continues to this day. I'm concerned that this vaccine shortfall may have similar far-reaching effects. (It's already affecting the debates over prescription drug importation and federalized health plans.)

And that leaves us with the last concern, which is that this is the same government and public health system on which we will rely in the event of a bioterrorist attack. So far, it isn't pretty.

So, with that in mind, you'd better get used to washing your hands. A whole lot. It's the "duct tape" of the flu season, this year.
posted by dhartung at 9:35 PM on October 20, 2004

Kudos to dhartung for that brilliant explanation of the dangers an average-to-bad flu season poses.

Not to pile on the freak out, but it is very troubling that we aren't better prepared for a traditional flu. It makes me wonder how well preparations are going for a potential pandemic strain. From the linked article:

It now takes six to eight months to develop a new vaccine against the slightly different flu strains that circulate every winter. A pandemic strain would be genetically very different. Government scientists plan to create "seed viruses" as potential vaccine candidates in hopes of speeding production. And HHS is working with manufacturers to ensure fast access to supplies -- including the chicken eggs that flu vaccine is grown in -- so production could start at a moment's notice.

There aren't that many manufacturers to begin with, and with Chiron out of the picture this year, just how well are those pandemic plans going?

Last year, my brother-in-law, a healthy man in his 30s with two small children, got the "normal" flu. It hospitalized him for two days with severe dehydration and fever. The hospital was overrun with flu patients of all ages; when we visited him, we were treated to the lovely sight of a middle-aged woman with the flu vomiting into a pan in the emergency room because there wasn't anywhere for her to lie down. I already had a healthy respect for what the flu could do, having read this book. After that trip to the hospital, I swore never to go without a flu shot again.

But now I am, because there are people who obviously need it more than I do. But I am less hysterical than pissed: with each year, and each flu, there's hoohah about "needed improvements in the system" and dire predictions about what's going to eventually happen if we don't get it together on this. It really is a serious public health issue, one of so many badly mishandled by our government (under any administration in my memory, I should add).

(A sidenote on pandemics: a number of people who didn't die outright from the 1918 event went into irreversible coma or Parkinson-like unresponsive states. The patients Oliver Sacks treated with L-dopa, chronicled in the book and film Awakenings, were the elderly remnants of that group. Imagine "waking up" from the flu in the 2040s still believing that it's 2004, you are still young, and that The Simpsons are still on -- though hell, it may be. Abres sus ojos, anyone?)
posted by melissa may at 11:03 PM on October 20, 2004

Here's a two page PDF with some facts about flu and why vaccination is important for everyone. I thought this was rather notable:

Flu vaccination has resulted in up to 44 percent fewer physician visits, 45 percent fewer lost work days, and 25 percent less antibiotic use for flu-associated illnesses in adults under the age of 65.

Pretty good reasons for everyone to be able to get a flu shot every year.

you run the real (if small) risk of being a carrier of death to someone you know

This is actually what bothers me. I can't get a flu shot due to having had an awful reaction to it the first time I did so, but my family is all older people (mostly ill as well - some of whom haven't been able to get a shot themselves yet) or families with small children and new babies (also some of which haven't gotten shots yet or aren't on the eligible list anyway). We are expecting to have to deal with some sick folks in our family this season, as we do every season. This year though, with few to none of us having been vaccinated, all of us may very well get it from each other. We aren't freaking out about it, but we are a little concerned about our older folks and babies. And everyone acts like the flu just can't kill healthy younger people, and that's just not the case. Not to mention, getting the shot isn't a guarantee that you won't get the flu.

That means that something like SARS could gain a foothold before it's detected.

This is actually something to be concerned about. You have to deal with SARS and it's ilk in entirely different ways ... by keeping the people isolated from others, and that's not normally done with standard flu when the hospitals start getting full (my hometown hospital always gets overly full during flu season). It might go un-noticed until it's a full fledged outbreak ... which would SERIOUSLY suck, wouldn't it?

I'm with Melissa on this one. I'm not hysterical. I'm pissed, because this shortage situation has been building for a while. It's not like people haven't been saying we needed to be better prepared than we have been, and that was before there was a major shortage.
posted by Orb at 11:19 PM on October 20, 2004

I'm just wondering why in the past few years this is big news - if the flu has been this serious for years upon years upon years, why hasn't it been talked about? I think it's because with a shortage, the media can be hysterical.

There will always be certain diseases. Flu will always be one of them. And yes, there will probably be a worldwide killer strain of flu one of these days. I don't think the vaccination program as it stands will protect one single person from that.
posted by agregoli at 7:23 AM on October 21, 2004

Experts fear escape of 1918 flu from lab
posted by homunculus at 10:48 AM on October 21, 2004

And that leaves us with the last concern, which is that this is the same government and public health system on which we will rely in the event of a bioterrorist attack.

Yeah, that worries me more than the flu. The poor performance of Project BioShield thus far does not inspire confidence.
posted by homunculus at 10:55 AM on October 21, 2004

There will always be certain diseases. Flu will always be one of them. And yes, there will probably be a worldwide killer strain of flu one of these days. I don't think the vaccination program as it stands will protect one single person from that.

Yes, agregoli, which is why we must change how the flu vaccine program and planning works, as most medical and public health professionals would attest. Flu we may always have with us (I hope not), but routine flus that kill thousands, and pandemics that kill millions, can be significantly lessened by intelligent public health policy.

This isn't media hysteria. It's media mismanagement -- fallout from the Swine flu debacle as dhartung notes:

A lot of people were left with the unhealthy impression that flu warnings are hoo-hah, and skepticism about public health efforts which continues to this day.

It's worth repeating his words to answer your question about why, if this is such a big deal, that it's only recently the issue has gotten attention. Swine flu was a humiliating error for public health custodians. It taught the public that injections were both unneeded and dangerous. Health journalists who'd written stories exhorting people to get their Swine flu shot got burned and stopped writing. Now, the pendulum is swinging hard and fast the other way, as the threat the flu presents becomes more and more impossible to ignore.

I understand irritation with all the many types of "[seemingly inconsequential risk] Can Murder You and Your Whole Family, Too!" stories beloved of American media, and I am irritated too, because here we have an actual wolf for once and this kind of media-fostered skepticism kills people who don't get shots. It prevents politicians from adequately funding initiatives to better defend against the flu. It keeps us having the same pointless public conversation every year instead of rolling out the cash and brain power to fix this. As policy goes, it's stupid, it's short-sighted, and it's an indication of the unresponsiveness and poor planning endemic in our public health systems.
posted by melissa may at 12:55 PM on October 21, 2004