Two of the three members of a Maryland family who died of flu complications last month also had been infected with the drug-resistant bacteria commonly known as MRSA, according to a report released today (April 26).

All three family members who died were infected with the influenza A virus, and two were also infected with methicillin-resistant Staphylococcus aureus (MRSA), the report from researchers at the Centers for Disease Control and Prevention said. 

The cases serve "as a reminder that influenza can cause very severe illness and can result in death," the CDC researchers wrote.

News reports have identified the family members as Lou Ruth Blake, 81, and her children Lowell Blake, 58, and Vanessa Blake, 56, of Calvert County, Md. Three additional family members were infected with the flu and two needed to be hospitalized, but neither was infected with MRSA and both recovered, the report said.

People infected with both the flu and MRSA have a higher mortality rate than people infected with only the flu, according to the report.

Signs that a person is infected with both include a rapid worsening of symptoms, and signs of pneumonia.

Two of the three family members who died had been vaccinated against flu, according to the report. Although the influenza vaccine does not prevent all cases of flu, it remains the best method for preventing complications from influenza, the CDC said. The agency recommends that all people over 6 months of age be vaccinated against the flu. Hand washing and covering coughs and sneezes can also prevent the flu from spreading, according to the CDC.

People with severe respiratory illness should be treated with antiviral medications, the report said. In addition, when there's a high suspicion that a bacterial infection exists, treatment with antibiotics should be considered.

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Rich Pedroncelli / AP

Ramon Maldonado-Cardenas grimaced as he got a flu shot from pharmacy student Khoa Truong in Sacramento, Calif., last fall. He was protected early from this year's flu season.

It’s been a remarkably mild flu season so far this year, with far fewer reports of the fever, coughing, aches and pains that usually make winter so miserable.

Of the laboratory samples sent to the Centers for Disease Control and Prevention through the second week of January, only about 3.7 percent have come back positive for flu, compared with about 26 percent of those tested at the same time last year, records show.  

Visits for flu symptoms are only about half the national baseline, and when CDC plots the spread of flu on a national map, it shows only minimal or low flu-like illness nationwide.

So far, Colorado is the only state to report even regional flu activity, and local activity has been reported in eight states. Everywhere else has reported only sporadic flu activity -- or none at all.

But even the mildest flu season doesn’t mean people should be complacent about getting vaccinated against the bug, experts say.

Those who haven’t gotten their shots yet probably still should, said Dr. Neil Fishman, an associate professor of medicine and infectious disease and associate chief medical officer of the University of Pennsylvania Health System.

“I think we have yet to see the peak,” he added.  “Influenza can be a serious disease resulting in anywhere from 36,000 to 43,000 deaths each year. So I would still get vaccinated.’

Flu seasons are quite variable and can start as early as October and run as late as May, according to the CDC. They often don’t peak until February.

But statistics show that most people who are going to get vaccinated do so by the holidays, with only about 20 percent of all flu shots doled out between December and May. About 36 percent of people in the U.S. older than six months had received flu shots by early November, according to the CDC. That was slightly more than the same time last year.

There are two theories as to why this season seems so mild, Fishman said. One  --  which would predict little increase -- is that we’re benefiting from an increased rate of vaccinations in children.  In fact, about 37 percent of kids had been vaccinated by November, up from about 31 percent the previous year.

The other theory is that the season just hasn’t really kicked off yet. If that’s true, some folks who thought they could get by without a flu shot this year might wish they’d gotten the jab after all.

While there was a time that the CDC suggested flu shots only for people at especially high risk, the agency currently recommends the vaccine for anyone over 6 months of age.

That change in recommendations hasn’t percolated down to average Americans, though. Many still think the annual flu shot is just for the very old and those with respiratory conditions.

One clear sign of that complacency comes from a study of the response to the swine flu in 2009. Even when the nation was obsessing over that version of the flu, just 1 in 5 adults aged 36 to 39 actually got vaccinated in 2009, according to a new University of Michigan report that looked at the flu-related behaviors and attitudes of Generation X.

Many reported being concerned about the bug, but that didn’t translate into high rates of immunization against a flu that was especially dangerous among children and young adults.  The author of the study suspects the low rate of immunization is related to how we’ve come to view the flu.

“I think historically young people think the flu affects older people,” said Jon Miller, director of the longitudinal study of American Youth at the University of Michigan’s Institute for Social Research. “Most people in Generation X have never experienced a major epidemic of any kind.”

Fishman hopes to see a change in people’s attitude towards flu vaccinations.

“This is still the largest cause of vaccine-preventable death in this country,” Fishman said.

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By Rachael Rettner
MyHealthNewsDaily

Here's a reason to get your flu shot that you probably haven't considered: infection with swine flu may trigger baldness.

A new report from Japan suggests a link between alopecia areata, a condition in which patches of hair fall out, and swine flu. The researchers report that seven patients experienced hair loss one to four months after developing the illness.

The exact cause of alopecia areata is unknown, but it is thought to occur when the immune system attacks a person's hair follicles, causing the hair on their head to fall out. Rarely, patients may lose all the hair on their head, or on other parts of their body. While the condition may have a hereditary component, a "trigger" from the environment, such as a traumatic event or illness, may also be needed to set off the disease.

Previous studies have linked viral illnesses, including infections with the Epstein-Barr virus, and onset of alopecia areata. The new findings suggest flu infection may be another trigger of this form of baldness, said study researcher Dr. Taisuke Ito, an assistant professor of dermatology at Hamamatsu University School of Medicine in Japan.

Between 2009 and 2010, the researchers examined seven patients with hair loss following swine flu infection s that caused high fever. Four of the cases were recurrences of the condition, and three were first-time occurrences. On average, hair loss occurred 1.5 months after swine flu infection in those who experienced recurrences, and 2.7 months after swine flu infection in those who experienced first-time hair loss.

All of the patients were under 30 years old, and four were under 10. Three of the cases involved females.

In one case, a 4-year-old girl first experienced alopecia areata in 2006, but recovered completely. Then in 2010, she contracted swine flu and had hair loss two months later.

"I consider it very plausible," that a flu infection could trigger hair loss, said Nanette Silverberg, director of pediatric and adolescent dermatology at St. Luke's-Roosevelt Hospital Center in New York City, who was not involved in the study. "I definitely have seen individuals develop autoimmune conditions," after infection with common viruses, Silverberg said. (An autoimmune condition is one in which the immune system attacks the body's own tissues, rather than foreign germs.)

The fact that more than half of the cases were recurrences of alopecia areata further suggests that certain people are genetically predisposed to develop the condition, Ito said.

Individuals who have had alopecia areata in the past should consider getting their flu vaccination, Silverberg said.

The study was published online Dec. 5 in the Journal of Dermatology.

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Phil Coale / AP file

Shopping cart handles are even grosser than you think.

We've all been warned about the germiest areas of the shopping mall -- the bathroom sinks, escalator handrails and dirty food court tables.

But what about those hacking, sniffling people standing next to us in the checkout line?

"I've had people cough all over me or cough into their hand and then hand me money," says Lisa Phillips, 49, of Eugene, Ore., who's worked in retail for six years. "It's like they want to share. ... I feel like saying, 'Have you heard of online shopping?'"

Dr. Paul Kassab, who practices internal medicine at Virginia Mason Medical Center in Seattle, says going out shopping with a bad cold or flu can definitely put others at risk.

"I wouldn't call them walking germ factories but you could do some serious germ spreading without knowing it," he says. "If someone has a cough or is sneezing or blowing their nose, then basically the germ -- whatever it is -- will be on their hands. If you're handing people your credit card, looking at stuff on the shelves and putting it back, using a shopping cart -- anything you handle will have germs on it."

Shopping carts, in particular, have been shown to harbor all kinds of germs -- and not just cold and flu bugs. A study in March found that 50 percent of them carried E. coli and 72 percent carried markers for fecal bacteria.

Colds and the flu are what most people pick up this time of year, though. And Phillips, who's sold everything from toys to books to women's lingerie, says she's experienced plenty of germ warfare during the holiday retail season.

"People will have little kids with them and they'll have a nice croupy cough and green stuff coming out of every orifice and then they'll let their kids gnaw on all kinds of toys and clothes," she says. "And then they'll hand it to you and say, 'I don't want this' after their kid has totally germed it out. It's disgusting. You have to put on gloves and throw it away."

Kassab says sickos who still feel the need to shop should make sure they wash their hands with soap and water or use hand sanitizer as much as possible.

"Obviously, if you're coughing, cough into your sleeve," he says. "But it's really more the touch. If you're out shopping and you have a cold, using Purell would tremendously reduce the chance of giving it to others."

Is it possible to pass along a cold or flu bug to someone in a gaily-wrapped holiday package?

"That's a tough one to answer," says Kassab. "Probably not if the gift has been wrapped for more than a day or two. Most bugs need a host or they'll die."

Last minute sickly shoppers may want to take advantage of a store's gift wrapping service, though.

Got a cold or the flu and feeling feverish? You may not want to be so quick to reach for a pill to get rid of it, a new study suggests.

Scientists have found more evidence that allowing your fever to burn out may actually help certain types of immune cells to work more efficiently. They say that a type of lymphocyte called CD8+Cytotoxic T-cell is capable of destroying virus-infected and tumor cells and low-grade fevers enhance them.

Researchers from the Department of Immunology at the Roswell Park Cancer Institute in Buffalo, N. Y. injected two groups of mice with an antigen and watched the T-cells activate. They raised the body temperature two degrees centigrade in half the mice, and the other half maintained a normal body temperature.

The warmed mice showed a greater number of the CD8 T-cells that were capable of destroying infected cells. Their findings were in the November 2011 issue of the Journal of Leukocyte Biology.

Scientists have long known that a fever is the body’s protective response to fight off bacteria and viruses. If you can stand the discomfort until your fever reaches 102, Dr. Amesh A. Adalja says it’s fine to let the fever go away on its own – but not always.

“Once the body temperature reaches certain levels, it becomes dangerous because it can be toxic to brain cells, and can also precipitate seizures as well as increase your heart rate and basal metabolic rate, causing people to more likely become dehydrated,” says Adalja, clinical assistant professor in the Department of Critical Care Medicine at the University of Pittsburgh Medical Center.

It's probably best not to take the chance with a feverish child, or with an adult if the fever spikes higher than 102 degrees. A high fever in some children can result in seizures, he says. Adalja also warns it’s also not worth the risk to your own health if you have heart disease, have suffered a stroke or endure other medical complications.

“This is not a blanket recommendation,” he says. “Secondary consequences to the fever can cause other conditions in the patient to occur or worsen. If someone has a persistent fever of 104, it’s a sign of infection, and it’s not just some viral thing you are  going to get over.”

 Ouch! Does this year's flu shot hurt more?

Flu shot not as effective as thought (but get one anyway)

Nikki Carlson / AP

Registered Nurse Patricia Rigney, right, gives Jessie James-Howley of Harlem, Mont., a flu shot.

If this year’s flu shot seemed like a bigger pain in the arm than last year’s, it might not be all in your head.

This year’s vaccine targets the same flu strains as last year’s. (That’s happened only eight times in the last 42 years.) So, thanks to some leftover antibodies from the 2010 vaccine, you might have a little more of an immune response around this year’s injection site, which could cause some tenderness, redness, and swelling, says infectious disease specialist William Schaffner, chair of preventive medicine at the Vanderbilt University School of Medicine in Nashville.

Don’t go thinking you can skip this year’s flu shot since it’s a repeat of last year’s, though. Immunity does wane over the course of the year, so the Centers for Disease Control and Prevention urges everyone ages 6 months of age and older to get vaccinated. True, a study out Wednesday found that the flu vaccine is less effective than previously thought, but it’s the best protection we’ve got.

If you haven’t gotten your flu shot yet, there are a few steps you could take to reduce the pain (and remember, reports that this year’s shot hurts more are not scientific, only anecdotal). You could try the new, smaller needle that injects the vaccine under the skin instead of into a muscle. Reportedly, people don’t feel a thing when it’s used. But the tiny needle’s pricier, and not all insurance plans will cover it.

Or you could take family practice doctor April Calderon’s advice. Before you go in for your flu shot, pop 400 milligrams of a non-steroidal anti-inflammatory drug, or NSAID, like ibuprofen (do not take it if you’re allergic or have other reasons to avoid NSAIDs).

 “It will help offset some of the symptoms,” says Calderon, who practices at Scott and White’s Round Rock West Clinic in Texas.

Another thing: Try to keep your arm relaxed (I know, easier said than done). If you tense up your arm muscles, the shot might hurt more, Calderon says.

After you get your flu shot, she says, rub the injection area or move your arm around to help spread out the immune response. If necessary, an ice pack will help reduce the aching.

Of course, if you really have a thing about needles, you could inhale your flu vaccine in the form of the nasal spray called FluMist. But it’s approved only for people 2 to 49 years old, so if you’re not in that age range, you’re out of luck.

Flu vaccines don’t work as well as previously thought, although they’re still the best protection available against seasonal influenza, researchers report Tuesday.

Overall, flu shots in adults 18 to 65 are 59 percent effective, the scientists estimate. Evidence for protection in people 65 and older was lacking, they write in a paper published online by The Lancet.

They reached their conclusions by pooling the results—an approach called a meta-analysis--of 31 studies of flu vaccine. The effectiveness varied from year to year in the studies analyzed. In several flu seasons, there was no evidence of effectiveness.

The new finding contrasts with the conclusion of meta-analyses by the respected Cochrane Collaboration, which last year found that flu shots were 73 percent effective in adults.

“The studies we present are the very best studies that we have for the last 70 years,” says Michael Osterholm, lead author of the new report and director of the Center for Infectious Disease Research & Policy at the University of Minnesota.

A major difference between Osterholm’s meta-analysis and the Cochrane reviews is the type of studies they included. Osterholm’s used only studies that confirmed the presence of influenza virus in sick people with either sophisticated polymerase chain reaction technology, or PCR, or laboratory cultures. PCR can take a single piece of DNA and generate thousands to millions of copies.

The Cochrane reviews, on the other hand, included studies that determined whether sick people had the flu by checking to see whether they had elevated levels of flu antibodies in their blood, not whether influenza virus was present.

The problem, Osterholm says, is that the antibodies don't become noticeably elevated in three out of four people who contract influenza after getting a  flu shot.  So, he says, the studies in the Cochrane review probably missed diagnosing influenza in many people who became sick after getting flu shots.

While flu shots contain inactivated, or killed, influenza virus, the nasal-spray flu vaccine, sold as FluMist, contains live, albeit weakened, virus. Osterholm’s meta-analysis found that FluMist consistently was most effective in children 6 months to 7 years old. One study suggested it was also effective in people over 65, but FluMist is approved in the United States only for those age 2 through 49.

In related news, the Food and Drug Administration is cautioning against using jet injectors, such as PharmaJet, with flu vaccine. The only vaccine currently approved for use with a jet injector is the measles, mumps and rubella, or MMR, vaccine.

 “Jet injectors represent a different method of delivery that has the potential to change the characteristics of an approved vaccine,” according to the FDA.

Kroger, Publix and Walgreens have administered flu vaccine with jet injectors, agency spokeswoman Shelly Burgess says. But, says Centers for Disease Control and Prevention spokesman Tom Skinner, neither the CDC nor the FDA think it’s necessary for people immunized with a jet injector to be re-vaccinated.

Earlier this week, news about a malaria vaccine that is 50 percent effective “drew cheers from the biomedical and policy communities,” notes Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania. It would be ironic if people decided not to get a flu shot because, though 59 percent effective, it’s not as effective as previously thought, Caplan says.

“We certainly need more effective vaccines, and governments should start putting serious resources into developing them,” Caplan says.

Osterholm agrees. He says vaccine manufacturers have told him they’re reluctant to invest in a new-and-improved flu vaccine because the one on the market now is cheap, safe and recommended for people of all ages. “We shouldn’t get rid of it,” Osterholm says, “but it’s not nearly the vaccine that we need for the future.”

Despite the lack of studies that included people over 65 in Osterholm’s meta-analysis, “the vaccine works reasonably well” in that age group, says Andrew Pavia, chair of the Infectious Disease Society of America Pandemic Influenza Task Force.

“The good news about this paper,” says Pavia, chief of the division of pediatric infectious diseases at the University of Utah, “is it hopefully will stimulate interest in new vaccines.”