By: Macy Meyer, Ashley Collins, Kathy Peña, Spencer Koelewyn

 

Influenza is a highly contagious infection that is characterized by high fever, body aching, and congestion of the airways. Influenza makes its most popular appearance during the winter months which starts as early as October and as late as May. There are multiple factors that lead to the acquisition of the highly contagious influenza infection. Influenza impacts thousands of people across America every year. Omaha is no different and contributes to this total annually. Most people do not have the knowledge about influenza and all the things that contribute to it. This study will explore how age and environment impacts influenza and the hospitalization and vaccination rate associated with the disease. Influenza has various effects on people of different ages. People’s environments of where they go to school, where they work and where they live all have an effect on influenza. Vaccinations rates and habits of the people getting the vaccine can determine how people’s health is every year. All of these are factors which may lead to the hospitalization, and possibly the eventual death, of an individual.

Methodology

Using the Douglas County Health Department, the Nebraska Department of Health and Human Services, the Center of Disease Control, and local newspaper articles we will evaluate the presence and impact that influenza has on Omaha.  We collected articles and information over an eight week time period. This gave us enough time to research, code our data and write up a complete sociological paper. We coded the data by coming up with different themes and collecting data from the websites that we founded. Then we put the data into a chart so we could compare our research and see what themes had the most informations so we could construct our paper.

Age

Influenza affects all age groups differently. It is easy to overlook the influenza virus, but some people have even died from this illness. According to the Omaha World Herald, a 43-year old police officer passed away because of the influenza virus. Also, Live Well Nebraska posted a story on February 25, 2017 about a young boy being the first to die in the state from influenza this season. The influenza virus can affect any age group therefore we should be better aware of the virus.

Ages 0-4

Influenza can start affecting children from even a young age. It is known that children with weaker immune systems can be contagious for over a week. About 20% of children aged 0 to 4 years of age were affected by influenza in a weekly surveillance by the Douglas County Health department during the week of May 8, 2013. However, only one case of influenza was reported for this age group by the Nebraska Department of Health and Human Services (DHHS) in a surveillance report for 2017 to 2018.

Ages 5-24

People within the ages of 5 and 24 are some of the most affected by influenza. In the 2009 to 2010 study by the Nebraska Department of Health and Human Services, it was discovered that the age group most susceptible to the influenza virus was children ages 5 through 24. According to the Douglas County Health Weekly Surveillance, for the week of May 8th, 2013, about 39% of influenza cases were reported with in this age group. Even in current study it is evident that this group is still one of the most impacted by the virus. For a study by the Nebraska Department of Health and Human Services for this year onto 2018, 5 cases of influenza were reported for this age group.

ILI by age
Chart showing the ages accounting for influenza-like illnesses in 2009-2010

Ages 25-59

Adults are also at risk for catching the influenza virus. In the weekly survey done by Douglas County Health in May of 2013, about 35% of the influenza cases. According to a study for this season, 5 cases of influenza have been reported. Adults tend to be contagious for a day prior to being sick and 5 days after the develop symptoms (Nebraska Department of Health and Human Services).
Ages 60 and older

Finally, elderly are also highly susceptible to the influenza virus. According to Live Well Nebraska, elderly people are who is hit the hardest by this strain. In a story by the Lincoln Star Journal on January 6th, 2012, an elderly woman from Omaha died of this influenza virus. It was confirmed that this was the first case of flu-related death for the season. Also, the Nebraska Department of Health and Human Services reported 8 cases of influenza for people 65 years of age and older. Within this age group, it is also common for a higher risk of complications related to the flu (Glissman). The average age of the deceased for this virus was around the age of 59.

Environment

Influenza is one of the most popular illnesses, here in the United States. Where and how people get the influenza is based off a lot of different things. People’s environments such as where they work, go school or where they live all have an effect on the influenza. Germs spread easily in every environment but it depends on the type of place where the germs start to make people sick. Schools and daycares are more likely to be contaminated with germs that cause illnesses such as influenza because of the large number of children. People’s work environments have an effect on illness and it can be worse depending on the job. Also, Elderly people that live in care facilities have a better chance of getting influenza. We have noticed that during the winter months influenza is the most common, which starts as early September and goes to as late as May. We need to make public health a priority. Illnesses are getting out of hand because people are getting careless. (Peters)

Schools

Children that are school aged have a higher chance of getting influenza because of the number of students in one small area. The spread of germs is easier in schools because children do not get the proper etiquette on how to reduce the spread of bacteria. 1 out of every 4 students do not cover their mouth when they cough and sneeze. (DHHS) With that being said we can only imagine the number of germs that are being spread in schools and how many of those germs contain a form of influenza. The outbreaks of influenza all depend on the year but there is a high number of school closings because of influenza. In the year of 2009-2010 according to Nebraska Department of Human Health Services there was 26 related school closures due to influenza outbreak. Just recently in the school year 2017, there was an 11% absenteeism. With that being said we clearly see that influenza is an issue in schools. One school in particular Chandler View Elementary closed down for a week due to a confirmed case of H1N1 influenza. After this case, the OPS spokeswoman Luanne Nelson Is changing their guidelines to close down schools. They now advise that schools stay open even if there is a case of influenza. Then make sure that they detect students at an early time so they can get them to stay home and not infect anyone else. (Abourezk)

Work place/Middle aged

Ages 19-63 is the least common group to get influenza but this does not mean that it is completely unmanageable to catch influenza. This is because between this age adults have the strongest immune system and are able to fight off infection.

Long-Term Care Facilities

Another common place for influenza outbreaks is in care facilities. With lots of elderly people around it is very common and easy for them to get influenza. As we grow older our immune system gets weaker so it is easier for older people 64 and older to get influenza because their body can no longer fight off bacteria. Germs spread just as easily in care facilities because the large number of people living in one area. These people are not allowed to leave so they aren’t picking up the germs from outside places but living so close together bacteria spreads fast.  All care facilities require employees and residents to receive the influenza vaccination. To help the spread of getting influenza. If two or more residents test positive for influenza it is officially called an outbreak and the facility has to take extraordinary measures to keep it from spreading to other residents. According to Douglas County Health 2013-2014 influenza summary, there was only one case of influenza in care facilities compared to 6 in the 2012-2013 year.

Vaccinations

History

Influenza was discovered by researchers in 1933. Vaccinations for influenza have been around since 1938 to help the people around the world to be protected by influenza which was invented by Jonas Salk and Thomas Francis. The influenza vaccination was originally invented to protect our military forces against the flu in World War Two. Influenza viruses have been known to grow and multiply, they grow and separate from most of the egg and it’s antigens however it does not separate completely. Therefore people with egg allergies may show an allergic reaction to the influenza vaccination.

Background of the vaccination

To prevent from people from getting sick with influenza and people very rarely dying from it annually, people all across the world get the vaccination annually. Each year the vaccination is slightly mutated to fit the needs of the newest type of influenza according to Douglas County Health. In the annual year of 2009/10 in Douglas County, sixty three percent of the influenza tests came back positive (Nebraska Department of Health and Human Services). Most cases were of influenza type A however with those fifty year olds or older are more likely to get influenza type B (Douglas County Health Weekly Surveillance). To help prevent getting influenza, one should get the vaccination at least once a year. However for those that are six months to eight years in age are recommended to get the vaccination twice a year.

Side effects

With almost every medication and vaccination, there comes side effects for some people. Five percent to ten percent of people who get the vaccination suffer from mild side effects. Those side effects include headache, sore throat, low-grade fever, muscle cramps, nasal congestion and sometimes even dizziness and nausea. Less than one third of the people that get vaccinated experience muscle soreness where the shot was administered. From surveys taken, the vaccination has been proven to be between eighty and ninety percent effective. However it takes twenty one days for the vaccine to kick in and start protecting against the influenza virus.   

 

Where and how to get the vaccination

There is plenty of places to get the influenza vaccination every year in Omaha. It can be as simple as going to the closest CVS or Walgreens and getting the shot. Another option is getting it at your doctor’s office as you have your annual checkup. You can also get vaccinated as some business companies and schools have times and days where they offer free or discounted vaccination shots.

 

Hospitalization

Influenza is an illness that can strike at any time, and truly can strike anyone who has not been vaccinated against the disease. Influenza often carries miserable side effects associated with the common cold. While normally these side effects will eventually be fought off and an individual can return to normal activities, people sometimes need to be hospitalized due to the severity of the side effects or because of the complications that can occur due to influenza. These issues call for a lot of care, and sometimes the death of an individual can occur due to influenza. Influenza could lead to the hospitalization of any infected individual, and if not treated, it could lead to death.

Although influenza typically causes the hospitalization of the very young and very old, it sometimes can affect regularly healthy people. This was the case of 43 year-old Greg Hamill, a 12 year veteran of the Omaha Police Department. Hamill passed away in 2014 from complications of the H1N1 strain of influenza (O’Brien). This was a strain that predominantly struck the United States as well as Nebraska in the 2009-2010 season. It was responsible for 63% of flu cases, it lead to the closure of 26 schools in Nebraska, and claimed an additional 13 lives (Nebraska Division of Public Health). This pandemic not only hit Omaha hard, but it also hit the rest of the nation hard. During 2009, influenza, and particularly H1N1, led to an alarming 53,000 deaths, making it the eighth leading killer in 2009 (Nguyen).

Screen Shot 2017-12-07 at 5.43.08 PM
This chart shows the amount of influenza tests in correlation with the number of positive influenza tests of the 2009-2010 Influenza season.

Diseases such as influenza can often expose underlying health issues, which could have possibly been the case with Mr. Hamill. This was a similar issue with a Blair teacher who also passed away from complications of influenza. While Jeff Nannen was slightly older than Hamill, he was still only 55 when he suffered a heart attack that would take his life (O’Brien).

Influenza can be an intense disease that can lead to a necessity of hospitalization. Often times, the elderly are getting hit the hardest due to weaker immune systems. Young people will get sick but are often able to fight it off, but it is then passed to the elderly who either have a more difficult time fighting it, or complications may arise due to the influenza illness. The illness can be so severe that it was responsible for 7% of Douglas County hospitalizations during the week of January 10, 2015 (Glissmann).

The toll influenza has on the elderly can often be seen throughout long-term care facilities, as well as the age groups that are most often hospitalized. In the case of the 2009-2010 season, of all hospitalizations due to influenza-like illnesses, 31% were of people 65 years and older (Nebraska Division of Public Health). The effects that influenza has on the elderly can be seen in the death of an 80 year-old from Omaha. The flu has a larger impact on the elderly due to their weakened immune systems and the constant threat of underlying health issues that may be brought to the surface (Flu Death Reported in Nebraska). While the elderly are often the main group falling victim to influenza-like illnesses, this trend was different during the H1N1 outbreak in 2009-2010. Out of all groups, those aged 65 and older were the least affected during the 2009-2010 outbreak, which is an interesting outlier given the typical statistics (Karageorgopoulos).

Depending on the severity of influenza in any given year, hospitalization and mortality rates can vary dramatically. There will be years with few deaths in Douglas County related to influenza, as seen in 2013 and the 2015-2016 seasons where only one person died. There will also be years similar to the 2016-2017 season with 34 deaths related to influenza-like illnesses. These numbers often vary due to the different strengths each strain may have.

Influenza can be a tremendously strong disease that can land any individual in a hospital. Influenza and complications from the illness can also be extremely easy to avoid by taking precautionary measures such as hand washing and receiving the vaccine. By taking precautionary measures, an individual can avoid getting sick and avoid ending up in the hospital, or even worse, dying.

Conclusion

Nearly 55 million days every single year are lost due to the influenza infection. It is an illness that primarily affects the extremely young and the extremely old, but anyone can contract the deadly disease. Due to the highly contagious nature of the illness, environment plays a crucial role in succumbing to the influenza illness. Vaccination is a proper way to evade the illness and is created annually to help individuals remain healthy throughout the winter. Those who are not vaccinated run the risk of being hospitalized and possibly dying. Anyone has the possibility of being hospitalized depending on the severity of the symptoms, but certain people tend to be more susceptible to these severe symptoms that may require the hospitalization of an individual depending on age, environment, and whether or not they were vaccinated. As Educator Harvey V. Fineberg once said, “The flu is very unpredictable when it begins and in how it takes off.”

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