As warned early last month, Nebraska is seeing an early surge in influenza this year.

Dr. Tom Safranek, Nebraska’s state epidemiologist, said the season appears to be running about four weeks ahead of schedule. The last time it took off this early was in 2003-04.

By Friday, the state's flu activity was officially listed by federal officials as “widespread.” Nebraska also had the dubious distinction of being one of 12 states with 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. The rest of the states on the list are all south of Nebraska.

“I would say we’re in the middle of it right now,” Safranek said. “Our numbers are pretty sizable and probably going to go up.”

He and other health officials urged people who haven’t already gotten the flu shot to do so without delay, particularly those who are most vulnerable — the very young, the very old, pregnant women and those with compromised immune systems.

That last category includes people taking medications that hinder their immune response, said Dr. Scott McPherson, medical director of Clarkson Family Medicine at the Old Market Health Center.

It takes about two weeks after getting the shot to develop full immunity.

Locally, the Douglas County Health Department on Monday reported a continued increase in flu activity, with 1,066 lab-confirmed cases recorded by Saturday. Two outbreaks in long-term care facilities had been reported. The Three Rivers Public Health Department, which covers Dodge, Saunders and Washington Counties, also noted increasing flu activity, with one outbreak at a long-term care facility.

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Dr. Scott McPherson discusses this year’s flu numbers at the Old Market Health Center, 1319 Leavenworth Street. You can see where he’s going with this.

In addition, the Omaha area ranks among the top 10 markets for flu activity on the Walgreens Flu Index, which is compiled based on the drugstore chain’s weekly retail prescription data for antiviral drugs, the medications used to treat influenza.

“We’re high this year for this time of year,” said Debbie Hartle, a pharmacist at the Walgreens at 90th and Blondo Streets.

In addition to seeing people come in for prescription flu medications and over-the-counter drugs to manage symptoms, Walgreens is also giving flu shots, which are in good supply.

In response to the local surge, Nebraska Medicine this week began offering walk-in flu clinics, where people experiencing flu symptoms can get treatment without an appointment. That’s well ahead of the setup of last year’s clinics, which opened in early February. This year’s walk-in clinics will be available at the Eagle Run Health Center near 129th Street and West Maple Road and Clarkson Family Medicine at 1319 Leavenworth St.

McPherson said the clinics are intended to make it easier for patients to get in quickly and to free up resources in emergency rooms to deal with critical illnesses and injuries.

Dr. Rudolf Kotula, an infectious disease physician with Methodist Physicians Clinic, said the early flu surge doesn’t necessarily mean that the season will be worse overall. Australia’s flu season, which runs ahead of the U.S.’s, began this year in April, two months earlier than usual, but then plateaued.

Safranek notified health care providers in early November that the flu could make an early appearance after seeing a steady trickle of positive tests in September and October.

The strain of flu virus that’s dominating so far in Nebraska is a type of influenza A called H1N1, which first turned up in 2009. The good news, Safranek said, is that it’s usually a little less severe than some others. But health officials are seeing a sizable number of children sickened, he said. Not only are they getting hit pretty hard, but they could pass the virus and create a second wave.

But in some other parts of the country, an influenza B strain that typically shows up later in the season has dominated the flu lists.

Influenza isn’t the only source of misery in the area. Dr. Robert Penn, medical director for epidemiology at Methodist Hospital, said eight to 10 other viruses that cause respiratory symptoms are also circulating.

That list includes respiratory syncytial virus, which normally causes mild, coldlike symptoms but can be serious in infants and older adults. Douglas County health officials said in their weekly report that the number of positive RSV tests remains high.

Still, there are steps people can take to protect themselves and those around them, starting with the influenza vaccine. While it’s not always perfect, health officials said, the vaccine is the best protection we have. Even if it doesn’t prevent flu entirely, it can lessen symptoms and duration and keep recipients out of the hospital — or worse.

Dr. Mark Rupp, an infectious disease specialist with Nebraska Medicine, said testing of this year’s vaccine is promising so far.

“Our early information is that the vaccine is well matched to this year’s strains, so hopefully it has the maximum chance to be effective in preventing flu,” he said.

Dr. Renuga Vivekanandan, an infectious disease doctor with CHI Health, said people who’ve been exposed to the flu — say, by a spouse or child who tests positive — can ask a health care provider for antiviral drugs, such as Tamiflu.

Same goes for those who’ve just developed symptoms. The medication is most effective if started within the first 72 hours.

The doctors said people can also protect themselves by avoiding sick people and staying in when they’re sick; washing hands frequently; disinfecting surfaces if possible in areas frequented by those who are sick; avoiding touching their eyes, nose or mouth; and practicing good health habits such as getting plenty of sleep, being physically active, managing stress, drinking plenty of fluids and eating nutritious food.

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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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