Flu Cases Flood Emergency Rooms


.c The Associated Press

GLENDALE, Ariz. (AP) - (December 29, 1999)  Linda Lindquist thought things might slow down at Thunderbird Samaritan Medical Center after the Christmas weekend.

But the flood of sniffly, feverish patients that started flowing into her emergency room last week has just kept coming and coming.

The hospital turned to extra staff and volunteers to help comfort patients. And for several days in a row, it's diverted ambulances until it could get the waiting room under control.

``It's at disastrous levels with the number of people we're seeing,'' Lindquist said. ``Not just in terms of us, everybody is seeing it. We're overwhelmed.''

Hospitals throughout the Phoenix area are being overrun by patients complaining of coughs, fevers and sore throats.

Meanwhile, emergency rooms in Southern California and Wisconsin also report being flooded with flu patients.

Indeed, the flu season nationwide has picked up noticeably in the last couple of weeks, said Dr. Carolyn Buxton Bridges of the Centers for Disease Control and Prevention.

It's too early to say for sure, but the flu season looks like it may peak in January this year - a month earlier than 1998, she said.

Nineteen states reported widespread or regional flu activity during the week of Dec. 12-18, according to the most recent CDC data. Roughly 3 percent of doctor visits in the states were related to flu-like symptoms, the agency said.

The rate was 6 percent in the Southwest and Pacific states.

With many doctors' offices closed for the holiday weekend, patients turned to hospitals for treatment in a ``tidal wave,'' said Dr. Joseph Kezele, a physician at Thunderbird.

In some Phoenix-area emergency rooms, flu patients had to wait 12 to 18 hours to see a doctor. Others couldn't get hospital beds, even when their physician called.

Walter Adams, 76, was trying to get admitted to Thunderbird for the second day in a row on Tuesday.

He and his 74-year-old wife both went to their doctor's office on Monday with fevers and coughing. Adams' wife was admitted to the hospital Monday night, but no bed was available for him.

On Tuesday, he waited for admission in a triage bed.

``When I get a cough, it just tears me up,'' he said, clutching its metal rails.

Last week, Southern California hospitals, including those in Los Angeles, Orange and San Diego counties, were rerouting patients while they dealt with packed rooms.

Reporting statewide outbreaks in December were Montana, Utah and Washington.

Those reporting concentrated outbreaks were Arizona, Colorado, Hawaii, Illinois, Minnesota, Missouri, Nebraska, New Jersey, New Mexico, New York, Ohio, Pennsylvania, South Dakota, Tennessee, Virginia, and Wisconsin.

AP-NY-12-29-99 0214EST



Brooke C. Wheeler

People often toss around the word "flu" when maybe they're just talking about a bad cold. But does it really matter what we call it? Yes -- it's important to know the difference because influenza is a greater threat to your health. While a cold will go away on its own, the flu can cause secondary infections such as pneumonia, which might be overlooked and create bigger health problems for you. Those complications are responsible for the hospitalization of 100,000 people and death of 20,000 people in the U.S. every year.

What we know as the common cold is caused by many different viruses, which makes it nearly impossible to create a vaccine -- so you just have to suffer through it. But scientists have identified three specific types of viruses that cause influenza, so an annual vaccination and/or antiviral drugs can prevent or lessen the effects of the flu for many people.

But how can you tell if you have the flu, or just a bad cold? One way to look at it is that the flu is a hot and dry illness (high fever, mostly dry cough, no pronounced nasal congestion) while colds are cooler and wetter (mild fever, if any, with runny nose, nasal and chest congestion). Also, cold symptoms gradually build over several days -- for example, you may have a scratchy throat one day, stuffy nose the next, mild fever the day after, etc. Flu symptoms come on fast -- victims often feel they've been "hit" or "knocked down" by the flu, over the course of a few hours going from feeling fine to being flat on their back in bed with a high fever.

Note that the flu doesn't usually cause nausea, vomiting, or diarrhea -- what people sometimes call the "stomach flu" is most likely either food poisoning or a gastrointestinal malady caused by bacteria or a non-influenza virus.

Your Symptom Checklist

A Cold:

Gradual onset of symptoms

Possible mild fever

Possible mild headache

Mild to moderate body aches

Mild fatigue

Nasal congestion and sneezing

Sore throat

Symptoms can last 2-4 days

Lingering congestion can last 5-7 days

Complications include sinus infection and earache

The Flu:

Sudden onset of symptoms

High fever (102-104 degrees) that lasts 3-4 days

Loss of appetite

Muscle aches


Severe headache

Severe muscle and body aches

Severe fatigue, weakness, exhaustion

Possible sore throat

Severe dry cough

Symptoms can last 4-7 days

Lingering fatigue and weakness can last 2-3 weeks

Complications include bronchitis and pneumonia (potentially life-threatening)

Now What?

Once you've started experiencing symptoms, stay in bed, minimize your contact with others, and get as much rest as possible. A few days off of work are not only needed for recovery, but to prevent you from infecting others -- you can be contagious 3-7 days after you start feeling sick.

Take ibuprofen or aspirin for body aches and fever. But DON'T give aspirin to children or teenagers with a fever, due to its risk of contributing to a rare but sometimes fatal illness called Reye Syndrome that develops during recovery from viral infections.

Don't force yourself to eat, but drink as many liquids as you can -- a high fever will dehydrate your body. Also try taking zinc, vitamin C, and echinacea to bolster your immune system, which takes a beating from the flu and make you more vulnerable to secondary infections, especially during your recovery period.

Gastroenteritis vs. Flu

by Ronen Arai, MD

Q.Are gastroenteritis and influenza the same illness?


A. Gastroenteritis is an infection of the digestive tract, usually caused by a bacteria or virus. Symptoms of gastroenteritis include nausea, vomiting, diarrhea and crampy abdominal pain. The disorder usually lasts no longer than several days and often occurs in clusters of people, reflecting its infectious nature. Patients typically are urged to drink plenty of fluids and take anti-vomiting and/or anti-diarrheal medications during a bout of gastroenteritis.

Influenza, commonly known as the flu, is an infectious disease caused by a virus spread by respiratory or direct-contact routes. Symptoms include fever, muscle/joint aches and upper-respiratory problems such as coughing, congestion, runny nose and watery eyes. In addition, patients often suffer gastrointestinal complaints such as nausea, abdominal cramps and diarrhea. Thus, flu is often mistaken for gastroenteritis. Another source of confusion is the common use of the term "stomach flu" to refer to gastroenteritis; this actually has nothing to do with influenza.

There are vaccines to protect against various strains of the influenza virus. If diagnosed early, flu can also be treated with an antiviral medication (amantadine), which may reduce the length of the illness. This may be particularly helpful in elderly patients who tend to be more severely affected by the flu than younger people. There is no specific therapy for the germs that cause gastroenteritis, but much work is being done on a vaccine that would protect against them.


Choose one: two weeks of being miserable with the flu, or two seconds of being poked with a needle. Sounds like a no-brainer, but flu shots are still widely disregarded by many people who are underinformed about their effectiveness.

Around 100,000 people are hospitalized and 20,000 die every year in the U.S. because of complications resulting from flu viruses, according to the Centers for Disease Control. Much of that can be prevented with a simple annual vaccination.

The CDC says even though flu vaccine effectiveness varies from person to person, for healthy adults it can be 70 to 90 percent effective in preventing flu. For people with certain chronic medical conditions or for the elderly, flu shots can lessen the severity of the flu, chance of complications (such as bronchitis and pneumonia), hospitalization and death by 50 to 80 percent.

In the U.S., flu season starts in November and lasts until April, peaking from late December until early March. The best time to get a flu shot is from October to mid-November, and it takes one to two weeks for the flu antibodies to kick in and protect you. Now's the time to start planning for your shot!

What Is the Flu?

Influenza, or "the flu," is a viral infection of your respiratory tract. It's much more severe and long-lasting than a cold -- often taking people one to two weeks to recover, creating many days of lost work and sometimes creating potentially deadly complications such as pneumonia.

Flu viruses are divided into types A, B, and C. Types A and B are what cause yearly epidemics responsible for hospitalization and death. Type C infections are milder, sometimes have no symptoms, and don't cause epidemics. Flu shots contain three representative flu strains for A and B types, based on evaluations by the CDC about which strains are currently circulating worldwide.

So how do you know whether you have the flu or just a bad cold? According to the CDC, it could be the flu if you have:

A high fever (100-103 degrees for adults, higher for kids)

Muscle aches


Sore throat

Runny or stuffy nose


Extreme fatigue

Prolonged exhaustion

But what's "stomach flu"? Actually, although nausea, vomiting, and diarrhea occasionally happen during the flu (more likely in kids), they're not typical symptoms. What's popularly called "stomach flu" is more often just food poisoning or a gastrointestinal bug.

Who Should Get a Flu Shot?

Flu shots are a convenient boon for healthy adults who want to reduce their chances of getting the flu, but they're an absolute necessity for people at risk for flu-related complications, and for those who live or work with at-risk people. This includes:

Pregnant women who'll be in their second or third trimester during flu season

Anyone with a chronic pulmonary or cardiovascular disorder, such as asthma or heart disease

Anyone with chronic metabolic diseases such as diabetes, kidney dysfunction, immune system disorders, and severe forms of anemia

Children and teenagers (6 months to 18 years old) receiving long-term aspirin therapy

Adults 65 years or older

Anyone living in or working for a facility that houses people with chronic medical conditions, such as a nursing home or recovery clinic

Health-care providers, including home care staff, for anyone at risk

Household members (including kids) of anyone at risk

Also, if you didn't get a flu shot during the last fall or winter, consider getting vaccinated at least two weeks before a trip if you'll be:

Traveling to the tropics at any time of year

Traveling with a large tourist group at any time of year

Traveling to the Southern Hemisphere from April to September

Where Can I Get Vaccinated?

Many cities offer free flu shots during peak vaccination time (September to November) -- check with your local hospital, university or health clinic. If your workplace offers free shots, sign up. If you can't find a place to get a free flu shot, Medicare will cover your flu shot if you're enrolled in Medicare Part B. If you're in an HMO, you're probably required to get your flu shot through them.

Remember, even if you get a flu shot, you're not fully immune. During flu season, wash your hands regularly (especially before rubbing your eyes or preparing food), and nurture your immune system by monitoring your stress levels, getting enough sleep, and using immune-boosting supplements such as vitamin C, zinc, and echinacea.

A Few Flu Facts

You may be contagious one day before symptoms appear and three to seven days after you start feeling sick. Kids can be contagious for even longer than seven days.

If a doctor diagnoses you with the flu fewer than 48 hours since the start of your symptoms, antiviral drugs known as rimantadine or amantadine can help ease your symptoms.

Flu shots need about two weeks to take effect, and last about four months.

Flu vaccines are available in the U.S. beginning in September each year, but they can be scarce after December.

People who have severe allergic reactions to eggs should NOT get a flu shot, since the vaccine is made from flu viruses grown in eggs. If this is you, ask your doctor about rimantadine and amantadine.

You need a new flu shot every year -- vaccines are updated yearly because the viruses mutate constantly.

Side effects are minimal: less than 30 percent of patients will have soreness at the injection spot, and about 5 to 10 percent -- most commonly in kids who've never been exposed to flu viruses -- have mild side effects (headache or low-grade fever) for about 24 hours.

Influenza statistics and data are from the Centers for Disease Control.