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Fighting the flu: Doctors say seasonal bug joined by others this year

FARGO -- The number of flu cases is on the rise in the state and across much of the country, but local health officials say the influenza virus isn't the only seasonal illness that's sweeping through the population here.

Joan Cook, infection prevention and control director for Sanford Health's northern region, said the health system's hospitals and clinics here ran close to 500 flu tests last week -- up 33 percent from the week before.

Still, only about one-quarter of those tests came back positive for influenza. The remaining patients likely were dealing with norovirus that can cause vomiting and diarrhea, RSV that can cause potentially dangerous respiratory illness in children under 2, other respiratory viruses with symptoms that can mimic the flu or even strains of the common cold.

"It's not all influenza, but there is definitely a lot of respiratory illness circulating in the community right now," Cook said.

In addition to a flu season that struck earlier than normal -- an uptick of the illness has been noted for weeks already -- she said the predominant circulating strain of the virus is a kind that can cause more severe illness and complications.

"This year would be the second worst flu season I've seen out of my 10 years here, in terms of the number of positive influenza swabs I've seen in the clinic," said Dr. Kamille Sherman, a family practitioner with?Sanford's Dickinson clinic, adding that the H1N1 outbreak a few years ago was the worst year for flu in her experience.

Sherry Adams, executive director for Southwestern District Health Unit, said she thought there were more than 100 confirmed cases of influenza in the region.

Sherman could not say why this season would be worst for the flu, but she said the flu is even striking people who have received their yearly flu shot.

"That tells us that the vaccine is not 100 percent accurate based on patient history," she said.

But Cook and other health officials said the flu vaccine that's been available for months is a good fit for this year's strain, and for those who haven't yet gone in for a shot, it's not too late to get the best defense against a seasonal illness that has already hospitalized hundreds in North Dakota and Minnesota and contributed to several deaths.

North Dakota Department of Health officials issued a news release Wednesday urging residents to protect themselves and reduce the spread of the flu, reporting that the number of confirmed cases in the state jumped 72 percent in a week.

Influenza surveillance coordinator Lindsey VanderBusch said 1,077 flu cases had been reported across the state -- up from 625 last week -- and several assisted living facilities and nursing homes have reported outbreaks.

She said those numbers represent just a fraction of the actual number of cases because many people don't see a doctor and aren't tested for the virus.

Minnesota, too, has seen a surge in flu cases, with the Department of Health reporting Wednesday that more than 900 people have been hospitalized this season. Five residents have died from flu complications this winter, including an otherwise healthy St. Louis Park 14-year-old girl who passed away Tuesday after being admitted to a hospital on Christmas Eve.

Preventing the spread

The busy flu season has prompted more than just health officials to take steps to prevent the spread of the virus.

Marketing Manager Jordan McCormick said the Family Wellness fitness center in south Fargo has hand sanitizer and sanitizing wipes "everywhere," and staff members are encouraging clients to wipe down equipment and frequently wash their hands to prevent picking up the illness.

Those hygiene tools are available year-round, he said. But after weeks of circulating illnesses including the flu that have sickened members and employees alike, he said people seem to be using the cleaning products even more.

"I think everyone is obviously a little more sensitive to it now that it is everywhere," McCormick said.

Kristina Hansen, emergency preparedness coordinator for Clay County Public Health, said schools and colleges in Moorhead are responding to the illness outbreaks by beefing up their cleaning routines, focusing on sanitizing doorknobs, elevator buttons and other things people touch frequently that could spread disease.

It's a good time for everyone to "amp up" their personal hygiene habits by frequently washing their hands with warm soap and water, using hand sanitizer and avoiding touching their faces to try to stay healthy, Hansen said.

"When we're all healthy and we don't see really severe flu cases, the general public gets more relaxed about it," she said. "Then it does take these types of situations to really heighten it and get people to go, 'Oh yeah, I better wash my hands for those 15 seconds.' "

Fargo Public Schools spokeswoman AnnMarie Campbell said the district hasn't seen an increase in absent students or teachers yet, and for now, workers continue to follow the usual cleaning policies and encourage everyone to focus on hygiene and covering their noses and mouths while coughing to cut back on the spread of illness this winter.

"So far, so good that way, and hopefully we don't have a big outbreak," Campbell said. "But right now, we're not seeing any high levels."

Cook said Sanford is enforcing its "respiratory etiquette" program in clinics and waiting rooms, asking anyone with respiratory illness symptoms to put on a mask while they wait to see a doctor, and making sure facial tissues and hand sanitizing products are widely available.

The health system hasn't yet had to restrict visitation to patients' hospital rooms, something that more than a dozen Minnesota hospitals have done to protect patients and staff from the flu.

Cook said visitors are asked to stay home if they have any symptoms to keep everyone safe.

"What could be a minor cold to you could be much more significant to somebody who's ill," she said.

Emergency medicine physician Jason Schenck said Essentia Health also is asking friends and family to not visit patients if they're ill, and patients with respiratory symptoms are required to wear masks to cut the chances of spreading illness to other patients.

He said it's hard to know exactly how many Essentia patients have been struck with the flu in recent weeks. So many people have come in with influenza-like illness that the health system has begun to ration its flu test, reserving the lab test for only the most severe cases where patients need to know exactly what's going on.

"We're just diagnosing more based on symptoms at this point than anything else," he said. "I think it's more of a nationwide shortage of the test at this point and not just our shortage."

Health Officer John Baird with Fargo Cass Public Health said the spike in flu and flu-like illnesses isn't only happening locally. More than 40 states are now reporting widespread flu activity, according to the Centers for Disease Control and Prevention.

There is one simple thing residents can do to best protect themselves from the flu -- get a vaccination, which is still widely available at public health centers, clinics and pharmacies by appointment.

Baird said we shouldn't expect an end to the flu season anytime soon. The CDC reports high influenza-like illness activity has occurred across the country for the past four weeks. Because the peak flu season has lasted for an average of 12 weeks over the past decade, the country could be in store for another month or two of rampant illness, he said.

"There's still plenty of time to get a shot," he said.

Cook said no vaccine offers 100 percent protection. Even if the flu shot doesn't prevent illness in a person, it often helps reduce the severity of the flu that they get, she said.

Still, with all of the other viruses making their way through the population now -- some with symptoms similar to the classic flu woes of high fever, body aches, fatigue and possible runny nose, sore throat or cough -- Cook said people shouldn't assume a faulty flu vaccine is to blame if they get sick this season.

"There are other viruses circulating around," she said. "If what you have isn't influenza, which is what we're seeing in a fair amount of the cases, it's not going to help you."

Dickinson Press reporter Betsy Simon contributed to this report.