The Influenza A (H1N1) virus, which became pandemic in 2009-2010 with at least 18,138 global deaths, has staged a comeback in the U.S., including Ann Arbor.

IT WAS RECENTLY reported that, “Health officials at University of Michigan Hospital in Ann Arbor say they’re dealing with a severe outbreak of the flu. A minimum of six people were in the intensive care unit on Thursday, as doctors dealt with what was believed to be multiple cases of H1N1, also know as ‘Swine Flu.’”

According to Dr. Lena Napolitano, director of the University of Michigan’s Surgical Critical Care and Intensive Care units, several  patients — mostly young or middle-aged — are not doing well.

Dr. Napolitano told WWJ Newsradio 950: “The patients are on very advanced life support. There are other intensive care units — our medical ICU, our pediatric ICU — who also have other patients. And I don’t have those exact numbers; but suffice it to say, it is a striking increase, and these patients are very, very ill.”

News stories like this raise awareness that we are in the midst of flu season in the United States. The stories can also incite fear, particularly the thought of young children and healthy adults dying from complications resulting from a bout of the flu.

“[Usually] the most common problem from the flu isn’t the virus itself, but the bacteria and pneumonia that the virus sets you up for,” said Bruce Hirsch, M.D., an infectious disease specialist at North Shore Long Island Jewish Hospital in New York. “(But) this season — unlike few others — we’re seeing this H1N1 flu cause viral pneumonia in and of itself and causing an occasionally fatal flu in young adults who would not be otherwise vulnerable.”

When H1N1 was first detected in 2009, it was called “swine flu” because the virus was similar to those found in pigs. Although it also circulates in pigs, you cannot get H1N1 flu by eating properly handled and cooked pork or pork products.

According to the Washtenaw County’s Health Department officials: “Influenza reports continue to increase in Washtenaw County residents.  Influenza A is dominant so far this season, with A/H1N1 subtyped in the majority of cases.  A few influenza B cases have been diagnosed. Respiratory illness rates in schools and child care centers are low.”

On December 24, 2013 the Center for Disease Controls released an alert to health clinicians which reads, in part, “From November through December 2013, CDC has received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with influenza A (H1N1) pdm09 (pH1N1) virus. Multiple pH1N1-associated hospitalizations, including many requiring intensive care unit (ICU) admission, and some fatalities have been reported. The pH1N1 virus that emerged in 2009 caused more illness in children and young adults, compared to older adults, although severe illness was seen in all age groups. While it is not possible to predict which influenza viruses will predominate during the entire 2013-14 influenza season, pH1N1 has been the predominant circulating virus so far. For the 2013-14 season, if pH1N1 virus continues to circulate widely, illness that disproportionately affects young and middle-aged adults may occur.”

There have been a total of 39 flu-related hospitalizations reported to the county’s Health Department by local health care facilities and officials but no deaths reported, as of January 4, 2014; in the month of December 2013, 16 flu-related hospitalizations had been reported, and in December 2012 10 flu-related hospitalizations were reported to county officials.

According to data gathered by the county Health Department, during the 2012-2013 flu season, flu-related hospitalizations reached a peak of 23 the week of January 12, 2013. In total, 198 individuals were hospitalized during the 2012-2013 flu season in Washtenaw County. That’s out of a total population of 347,962 individuals.

During the 2012-2013 flu season, lab confirmed cases of influenza peaked in January when 100 cases were reported. Likewise, confirmed cases of respiratory illness among the county’s schools and day cares peaked in January 2013 and again in March 2013, when 80 cases each month were reported.

During the present 2013-2014 flu season, which began in September, as of December 21, 2013, just under 20 confirmed cases of respiratory illness among schools and day cares had been reported to the Washtenaw County Health Department.

Again according to the CDC, which compiles data—comparable to those collected by the Washtenaw County Health Department—in order to provide a nation-wide picture of the flu season’s impact: “During September 30, 2012–May 18, 2013, laboratories in the United States tested 311,333 specimens for influenza viruses; 73,130 (23 percent) were positive. Of the positive specimens, 51,675 (71 percent) were influenza A viruses, and 21,455 (29 percent) were influenza B viruses. Among the seasonal influenza A viruses, 34,922 were subtyped and 1,497 (4 percent) were pH1N1 viruses.”

So what are your chances of coming down with the flu? CDC officials estimate that each year between 5 and 20 percent of the U.S. population will get the flu. Of that number, again on average, 200,000 people will require hospitalization due to complications such as those described by infectious disease specialist Dr. Hirsh.

As for flu-related deaths in Washtenaw County, during the 2010-2011 flu season, data collected by county health officials show that four people died. During the 2011-2012 flu season one person died. Nation-wide, according to data from the CDC, of the 200,000 people who, on average, are hit with the flu each year, between, 1.5 and 12 percent of them die.

Flu viruses are thought to spread mainly from person to person through droplets made when people with flu cough, sneeze, or talk. Flu viruses also may spread when people touch something with flu virus on it and then touch their mouth, eyes, or nose. Many other viruses spread these ways too.

People infected with flu may be able to infect others beginning one day before symptoms develop and up to 5-7 days after becoming sick. That means you may be able to spread the flu to someone else before you know you are sick as well as while you are sick. Young children, those who are severely ill, and those who have severely weakened immune systems may be able to infect others for longer than 5-7 days.

One crucial way to avoid the flu is to get vaccinated. Dr. Terry Frankovich is Michigan’s Western UP Health Department’s Public Health Medical Director. Frankovich said there is no cause for global alarm related to the H1N1 outbreak because since that flu strain hit the world stage four years ago, scientists have developed a vaccine to contradict its effects on its victims.

“This year, the flu vaccine has coverage for that strain as well,” said Frankovich.

Mr. Frankovich said a vaccine, to become effective, needs two weeks to work its magic inside a person’s body.

“If I get exposed yesterday and I get my flu vaccine today, it doesn’t have time to provide me with protection,” Mr Frankovich said. “So, the vaccine itself will not give anyone the flu, and that’s important for people to know, but it does need some time to provide protection.”

Another important—albeit somewhat disconcerting—bit of information to remember is that vaccines don’t work all the time. While a flu vaccine is not perfect, getting a vaccination is much better than not getting one. CDC officials said that at the current time, seven influenza vaccine manufacturers are projecting that as many as 138-145 million doses of influenza vaccine will be available from currently licensed manufacturers in the U.S. for use during the 2013-14 influenza season.

The CDC website links to a Flu Vaccine Locator (http://flushot.healthmap.org/). The Washtenaw County Health Department website links to the same Flu Vaccine Locator website.

Since not all flu vaccines are the same, and not all flu vaccines are foolproof, this means that people should take some precautions to prevent infection and spread of the virus. The CDC website suggests “Three Actions To Fight The Flu” (http://www.cdc.gov/flu/protect/preventing.htm). These include vaccination, stopping the spread of germs and the use of anti-viral drugs, if prescribed by a physician.

Here is a list of tips CDC officials offer up to help people stem the spread of germs during the flu season (and beyond):

• Try to avoid close contact with sick people.
• If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
• While sick, limit contact with others as much as possible to keep from infecting them.
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
• Avoid touching your eyes, nose and mouth. Germs spread this way.
• Clean and disinfect surfaces and objects that may be contaminated with germs like the flu.
• Routinely clean frequently touched objects and surfaces, including doorknobs, keyboards, and phones, to help remove germs.