Doctors, Educators On East End Battle Nasty Flu Outbreak And Urge Vaccinations

Deborah Maile, Director Of Infection Prevention at Stony Brook Southampton Hospital. RACHEL VALDESPINO

Stony Brook Southampton Hospital, as well as pediatric offices and local schools, all reported this week that they have seen an early outbreak of flu cases this season.
And as peak flu season continues, medical professionals say the best advice in preventing getting sick is still to get vaccinated — even if the vaccine does not offer full protection this year.

“The basic message is to get vaccinated,” said Dr. Fredric Weinbaum of Stony Brook Southampton Hospital. “There are two things that we know the vaccine does. One, it does reduce the risk of getting influenza. And, two, if you get influenza, it’s less severe.

“One thing that has absolutely been proven is that the death rate from influenza is reduced by being vaccinated,” Dr. Weinbaum continued. “The vaccine is not perfect, and not necessarily going to give 100 percent protection — even on a good year, it’s 50 to 60 percent protection — but it’s certainly better than not being vaccinated, because you are much less likely to die, and if you get it, it’ll more than likely be less severe.”

There are two types of influenza, Type A and Type B, each with two strains. There are also multiple types of vaccinations. The trivalent vaccination contains both types of Flu A and one strain of Flu B. The quadrivalent vaccine contains all four strains, and the high-dose quadrivalent — often recommended for those age 65 and older — contains both strains of Flu A and one strain of Flu B.

Typically, Type A is seen in patients early in the season, followed by Type B. But this year, that trend seems to have reversed.

“It’s been fairly similar to what we were seeing last year. Initially, there was some increase, but I believe the rate of increase is slowing down,” explained Dr. Weinbaum. “There are a couple of new things that we’re seeing this season. One is, in general, the numbers of Flu B cases are higher than last year. Most years, you see mostly Flu A early, then Flu B late. This year, for whatever reason, there’s a higher prevalence of Flu B.”

Dr. Weinbaum said that he has seen mostly Flu B, strain Victoria. The other strain of Flu B is called Yamagata, which is not included in the trivalent vaccine.

Stony Brook Southampton uses the quadrivalent vaccine, and officials say that reports received from the state laboratory reveal that the flu that has been isolated so far is sensitive to the anti-flu agent that is available — meaning that the vaccinations used to prevent the flu have been effective.

Since September 1, Dr. Weinbaum said the hospital has seen more than 160 cases of the flu. He noted that the hospital has admitted more than 20 patients, mostly adults ages 35 to 90, and a majority of those admitted had Flu A.

Officials say that even if you have had the flu this season, it does not exempt you from getting a second case — so getting vaccinated is still recommended.

Deborah Maile, the director of infection prevention at Stony Brook Southampton Hospital, agreed that this year Flu B got a very early start. Doctors at the hospital started seeing Flu B patients two to three months earlier than normal.

“According to the Department of Health, a lot more people are getting sick,” she said. “We are always encouraging the flu vaccine — even if you get it, it should be a shorter course of infection. This year is on the level of H1N1 — it’s hitting people fast and hard, and the numbers are pretty high.”

Deborah Maile, Director Of Infection Prevention at Stony Brook Southampton Hospital.

Each year, a new vaccine is created based upon last year’s virus. The influenza virus has the tendency to shift, and it has to shift only a small amount to make it no longer identical to what the vaccine protects against.

“We do a survey every week so the state can keep track, and the state is seeing a surge in cases everywhere,” Ms. Maile said.

According to the most recent reports given by the State Department of Health, by the week that ended on January 18, the influenza activity level had been categorized as geographically widespread for the eighth week in a row.

The Department of Health reported that there were 13,483 laboratory-confirmed influenza cases, an increase of 22 percent from the week prior. The number of patients hospitalized with the flu was 1,756, a 5 percent decrease from the week before. Although there were no flu-associated pediatric deaths reported on January 18, there have been three cases reported this season.

Local schools have been experiencing the effects of peak flu season firsthand.
John M. Marshall Elementary School Principal Beth Doyle said the East Hampton school had 24 confirmed cases of students and six staff members with the flu. She noted that the school has over 500 students, so the numbers seem to be consistent with years past.

“I think our custodial staff is good at ramping up the sanitizing this time of year,” she said. “They are cleaning the doors multiple times a day, as well as the desks and other shared spaces, to minimize the spread of it.”

Ms. Doyle noted that the school had a day when a CVS pharmacist came in to administer the vaccine to administrators — but even some of those who received the shot that day still got the flu.

Hampton Bays Schools Superintendent Lars Clemensen said that kids are definitely getting sick, but he wouldn’t call it an epidemic. “We have a great nursing staff, our teachers have been promoting hand washing, and we’re going through flu season with our eyes open,” he said.

Westhampton Beach Elementary School Principal Lisa Slover said she’s happy to report zero cases of the flu this month. She said in December there were more cases of the flu than usual, but the number dropped off.

In Montauk, Superintendent of Schools J. Perna said the district has been experiencing an increase from last week, but not from last year, in regard to confirmed flu cases. Karen Theiss, the school nurse, said that there have been 12 confirmed cases of influenza among the staff.

“We’ve been taking the extra necessary steps this time of year, like wiping down all the doorknobs and handrails,” she said.

Local pediatric offices have been swamped with patients. Dr. Gail Schonfeld of East End Pediatrics of East Hampton said that this is the height of the season. “It’s been very unusual that Flu B has been seen so early on,” she agreed. “It usually follows Flu A, but this year it is preceding it. That’s why it is not really being covered by the vaccine.”
Dr. Schonfeld said that Flu B tends to cause more muscle aches than Flu A, and children tend to do worse with it than most adults.

“I think as far as mortality,” Dr. Schonfeld said, “it is on par with an average year. We’ve been seeing both Flu A and B cases. Last weekend, I saw 10 in one day.”

Dr. Nadia Persheff of Hampton Pediatrics in Southampton has been seeing similar cases. She said she has been practicing for 23 years and hasn’t seen Flu B start as early as it has this season. “It’s been insane,” she said. “We can’t even keep up our supply of flu tests, and my staff walks around with masks.”

Dr. Persheff encourages washing surfaces and hands frequently, as it’s most often school-age children who cause outbreaks in the community. She has seen about 20 patients per day who report flu-like symptoms. She noted that some years she doesn’t see 20 in the entire season.

“The scary thing is that everyone seems to have the flu or strep,” she said. “Last year, we saw the flu early in October. But this time, it was strain B, which hasn’t been covered well by the vaccine.”