For the second week in a row, Douglas County reported a record number of new cases of influenza last week, continuing a season that has hit Nebraska early and hard.

The state’s most populous county, Douglas, recorded 898 cases during the week ending Saturday. That topped the 813 cases confirmed the preceding week, which was a record for any individual week.

About 3,300 cases of flu have been confirmed by testing in the county so far this season, nearly halfway to the 6,000-plus cases confirmed in all of 2017-18, the most recent nasty flu season.

Numbers also continue to climb nationally, according to the federal Centers for Disease Control and Prevention. Nebraska and Iowa, which have seen a slower rise, were among 39 states with widespread flu activity, the highest category the agency reports.

Nebraska also was among 25 states reporting high levels of influenza-like illness. Not all patients get tested for the flu, so that measure is often used as a gauge of how much flu is out there.

Dr. Anne O’Keefe, senior epidemiologist with the Douglas County Health Department, said the actual number of county residents who’ve been sickened by flu almost certainly is higher than the numbers indicate.

The county also confirmed its second flu death of the season in an adult over age 65. Reporting of adult flu deaths isn’t mandatory. Outbreaks have been reported in seven long-term care facilities in the county.

How the season will play out, however, is far from certain. In previous seasons with early peaks, cases have slowed later on, O’Keefe said. But an early peak also could lead to another wave or two, possibly as people mix again over the New Year’s holiday and as children return to school next week.

The strain of flu virus that’s dominated so far in Nebraska is a type of influenza A called H1N1, which first turned up in 2009. But an influenza B strain that has been prevalent in other parts of the country has begun to surge. That strain typically shows up later in the season.

Both types hit younger people harder, which has been the case this season.

O’Keefe urged residents who haven’t gone under the needle to get a flu shot. High case counts can continue through March, which leaves a possible three months to go.

Even if the shot doesn’t prevent the flu entirely, O’Keefe said, it can lessen the severity of the illness and keep people out of the hospital — or worse. Most of the vaccine currently available protects against four strains, including those now circulating.

Getting the shot, she said, also helps protect those around us — the very young, the very old and those with compromised immune systems. It takes about two weeks to provide full protection.

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Julie Anderson is a medical reporter for The World-Herald. She covers health care and health care trends and developments, including hospitals, research and treatments. Follow her on Twitter @JulieAnderson41. Phone: 402-444-1066.

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