‘Robust’ flu season may be in store due to new variant

• By Lucy Albright/LNP | LancasterOnline

A local doctor predicts a “robust” influenza season in Lancaster County with earlier peaks and more cases, during a year when a new variant may render flu shots less effective.

This variant, a version of the H3N2 influenza A virus known as subclade K, emerged too late to be accounted for in the development of the current flu shot.

Medical experts currently do not believe that this year’s vaccine protects against the K strain, said Dr. Eugene Curley, medical director for infection control and prevention at WellSpan Health and an infectious disease physician for WellSpan York Hospital. But he noted that there are multiple strains of influenza going around, not just subclade K.

“It’s still recommended that you get vaccinated to protect you against as many strains as possible,” Curley said.

But Dr. Shawn Phillips, family medicine physician at Penn State Health Medical Group – Mount Joy, wasn’t so quick to dismiss the benefit of the vaccine against subclade K.

“We know from past years that when we see new variants like this that weren’t included with the vaccine, we do know that the vaccine still offers protection,” Phillips said.

Though it’s hard to say definitively when it comes to this variant, in situations like this, vaccines still offer protection against severe disease — though the vaccine probably won’t be as effective at preventing infection, Phillips said.

It’s too soon to determine how well this year’s flu vaccine will work, Pittsburgh-based infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security Dr. Amesh Adalja told TribLive for a Nov. 25 article.

“There is concern about a vaccine mismatch in the H3N2 component of the vaccine,” Adalja told TribLive. “The vaccine covers three different strains. There does not appear to be a mismatch with the other two, so it is unclear what the overall effectiveness will be until we see which strain dominates in the United States.”

What’s ahead?

Lancaster County has had 281 recorded influenza cases as of Nov. 29, since counting began in late September. That’s up 104 cases from the previous week’s tally, according to the Pennsylvania Department of Health data.

With low influenza numbers in Pennsylvania and nationwide, Curley said this flu season is currently a typical one, but it’s too early to tell — the season’s severity likely won’t be apparent “until we get into December and January,” he said.

As the New York Times reported, Australia just had its worst recorded flu season — significant because flu seasons in the United States can resemble those in the Southern Hemisphere. The flu has hit hard for Japan and Britain in the Northern Hemisphere as well, with Tokyo issuing its first flu warning since 2009 and Britain seeing an early start to its season with triple the cases it had during the same time last year, according to the Times.

“Based on what I’m already seeing here, let alone what we’re already seeing in other places, I do think we’re gearing up for earlier peaks … and more spread based on the fact that we may not have as much benefit to provide some immunity within … our population,” Phillips said.

But Phillips said he hopes that Lancaster County can avoid a record flu year like Australia’s, and that public health measures and warnings to the public can help us adapt.

In Lancaster County, the flu season may be starting slightly earlier than usual — though it’s hard to know whether this is the start of an upward trend or not, according to Phillips. Flu activity in the county is still considered low right now, he said.

“We’re maybe seeing a few more cases than we would expect to see at this time of year, both in Lancaster County and throughout the state,” Phillips said.

Seeing more cases now is concerning, because as holiday gatherings continue in December, there’s a higher risk that a bigger jump in cases could occur earlier as a result, he said.

Phillips said he expects a “robust” flu season ahead in Lancaster County, particularly due to the presence of a variant that’s probably not as easily preventable through vaccination as variants in past years. And an uptick in flu cases could happen earlier during this year than in previous years, Phillips said.

In terms of the number of cases, this year could be significantly worse, Phillips said. But he hopes it will not be worse in terms of flu severity — though that is a possibility to prepare for due to the new variant, he said. And on a population level, more cases of flu would mean a higher number of people could end up with severe illness.

“I would encourage people not to get hung up on the fact that there’s a new variant, but instead just know we’re gonna see influenza this year, and influenza can make people really sick, so you take precautions to protect yourself,” Phillips said.

Phillips recommends vaccination, frequent handwashing, isolating while sick and calling a doctor early so that flu treatment, if needed, can be started quickly.

Curley is also a proponent of vaccination, and recommends getting tested when sick, noting that antiviral treatments are available to prevent severe disease from both influenza and COVID-19.