Updates on Three Key Infectious Epidemics This Winter (2015-2016)

Updates on Three Key Infectious Epidemics 

This Winter (2015-2016):

• Influenza
• Stomach Flu
• Hand-Foot-Mouth Like Illness

As we approach February, we thought it would be of interest to hear how the winter flus and illnesses are shaping up for this year.

Every December we brace for the onslaught of influenza virus infections, the germ for which we offer flu vaccine, but this year was a surprise in two big ways.

INFLUENZA VIRUS

The first very big surprise has to do with the 2015-2016 influenza virus epidemic.  Keep in mind that every typical year, the influenza virus suddenly appears across North America sometime in December, peaks around New Years, and fades away in the next 2-3 months.

Not this time.  This year, so far, is officially a big dud.   We are experiencing some of the lowest incidences of illness from the influenza virus.  No one knows why.  It may have to do with more people getting the influenza vaccine, but we await more information before knowing if that is the case.

Take a look at the map and graphs at the CDC influenza tracking site:

http://www.cdc.gov/flu/weekly/index.htm#ILIMap

The US map turns red as the virus becomes epidemic, green means hardly any has appeared.  In January, nearly every year, the US looks very red, I have never seen it this green in this graphic.  Truly a very low influenza year, very nice!

STOMACH FLU

The stomach flu is an illness usually unrelated to influenza, which causes more respiratory troubles.  It's typical season, during the era of rotavirus infections, was in February.  But rotavirus infections have nearly disappeared given mass immunization against it in the US.  But now comes noravirus, the famous virus of the big cruise ships, taking the place fully of rotavirus, and causing the same symptoms:  fever, vomiting for a few days, and diarrhea for a week or two.

We have been impressed at the number of cases of stomach flu starting late in November of 2015 and cooking along at a good clip still in January 2016.

No surprises here.  The good news is that if your child can sip some fluids during the 1-2 days of heavy vomiting, we don't see much dehydration or any other complications from this year's infection in the gut.

THE HAND-FOOT-MOUTH LOOK ALIKE

A few weeks ago, we saw a number of children in the office all with the same unusual rash:  blotchy red bumps on the face around the mouth along with small pimple-like dots on the body, sometimes including the palms and soles.  On the body, the rash appeared in a variety of forms on the same child:  blotchy red bumps that could be 1-2 inches across, red bumps with a tiny white head to them, red bumps that look more like mosquito bites do.  The mouth is often fine, but sometimes large cold-sore like lesions are seen on the back of the throat.  None of these children have tested positive for strep.

The occurrence of rash on the mouth, foot, and hand, is reminiscent of hand-foot- mouth disease (HFMD), but HFMD usually has more uniform rash, and rarely has that blotchy large red bump appearance on the face.  Further, HFMD is caused by a species of virus called enterovirus which typically appears in June and goes away by September.

This infection may be an odd winter appearance of an atypical enterovirus, but is more likely simply a different virus, and not true hand-foot-mouth disease.

The course and care are similar though:  no drugs clear the rash, but comforting helps and should be offered.

BOTTOM LINES:

1.  GOOD NEWS:  Almost no influenza infections this winter, so far.

2.  NO NEWS:  Stomach flu is rampant but that's expected.

3.  BAD NEWS:  An odd hand-foot-mouth like illness is here, completely unexpected.

4.  For all three infections, the approach is the same for all viruses, know that antibiotics do not kill or heal viruses, comfort and care is the best treatment, fever is a normal event, but call if signs of serious illness occur:  severe pain, trouble breathing, not urinating or looking limp or weak, stiff neck.

To your health,
Dr. Lavin

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