Although the flu appears to be leveling off in the East, South and Midwest, numbers are still rising in the Southwest and Northwest, the Centers for Disease Control and Prevention reported.
The flu is widespread now in Washington state, said Donn Moyer of the Washington State Department of Health in Olympia.
"We're continuing to see increases in emergency room visits for flu-like illness," Moyer said. "We have now got 17 lab-confirmed, flu-related deaths, up from 12 last week." That's high compared with last year, when only 18 people died during the entire flu season, but low compared with the 2010-2011 flu season when 36 died, he said.
Washington's usual flu peak usually comes in January or February but it could be as late as March this year. "We're in the early range of normal," Moyer said.
Oregon, too, is continuing to see increases in flu activity "consistent with other states in the Southwest and western U.S.," said Richard Leman, a medical epidemiologist with the Oregon Public Health Division in Portland. The good news is that Oregon isn't experiencing "the same levels of severe illness that some states on the East Coast and in the southern U.S. have had this year," he said.
In New Mexico, flu hit early and hard around the holidays and does seem to be fading a bit now, said Chad Smelser, a medical epidemiologist with the state Department of Health in Santa Fe. The worry there is that when the season starts so early "there's an opportunity for it to last longer," he said.
That can mean more people infected overall and a greater chance of bad outcomes, including hospitalizations, complications and deaths, he said. So far the state has five official flu deaths and is looking in to a few others that might be flu related.
Nationally, 37 children have died from flu this season, according to CDC's weekly FluView. As of Friday, flu was prevalent in 49 states - Maine was the exception - and high in 26 states and New York City. The level of flu activity - high, moderate, low or minimal - is an indication of what percentage of outpatient visits in a state are for a flulike illness, compared with months when there is no flu.
During the week of Jan. 13-19, 9.8% of deaths reported in CDC's 122 Cities Mortality Reporting System were due to pneumonia and influenza. That's above the epidemic threshold of 7.3%. The rate of deaths linked to pneumonia and flu the week before was 8.3%. Most deaths occurred among those 65 and older.
This year's flu season got off to an early start, ramping up in late December, almost a month earlier than usual, according to CDC Director Thomas Frieden. The flu strains circulating in the United States this season also appear to be causing more severe illness, especially compared to last year's mild season. One indicator doctors look at is the number of children who die each year from the flu, the only national death statistics that the CDC keeps for influenza. This year, flu has already killed 37 children, whereas last year the entire season's toll was 34.
As often happens, the flu hits different parts of the country at different times. In the East, South and Midwest the flu appears to be slowly waning.
Still, flu cases are "going strong," said Jim Heffernan, chief of primary care at Boston's Beth Israel Deaconess Medical Center. While he's not seeing overflowing emergency rooms as he was at the beginning of the month, the hospital is still getting "several hundred calls a day" for people who are suffering from the flu.
"It does seem to have peaked here, but there are still a lot of sick people out there," he said, "far more than last year, probably more than we've seen since H1N1," referring to the pandemic flu strain that struck the world in 2009. In that outbreak, an estimated 24% of people worldwide got the flu, according to a paper published last week in the journal Influenza and Other Respiratory Viruses.
In Oregon, Leman emphasized that it's still not too late to get vaccinated. While shortages of flu vaccine are still popping up around the country as the flu hits localized areas, there is still vaccine available, CDC said. As of Jan. 18, a total of 133.5 million doses of influenza vaccine had been distributed to vaccine providers in the United States for this season.
About half of pharmacies that ran out of flu vaccine were able to get more, according to a survey done Jan. 14-16 by the National Influenza Vaccine Summit, a public health group that works on flu vaccine issues.