With the return of pumpkin spice lattes and cooler temperatures comes another annual rite of passage: flu season.
It's hard to predict just how hard the influenza will strike Michiganders this year, said Angela Minicuci, a spokeswoman for the Michigan Department of Health and Human Services, because "every flu season is different so we can’t really predict how severe or mild a season may be."
Seasonal flu activity most commonly begins to rear its ugly head as early as October and can continue to make us sniffly and feverish as late as May, according to the Centers for Disease Control and Prevention. The number of cases tend to peak nationally from December to February.
And yet, sometimes, flu season gets an earlier start.
Kent County had an outbreak in mid-August among 120 people who attended the National Rural Letter Carriers' Association Conference in Grand Rapids. Several of the people linked to the conference tested positive for an influenza A (H1N1) strain of the virus.
"The best thing that we can do to prepare for this flu season is begin to vaccinate as many people as possible," Minicuci said. "Flu vaccine is recommended for all people 6 months of age and older."
But have you ever wondered what's in the serum that gets poked into your arm each fall?
Because flu viruses are constantly changing, scientists at more than 100 influenza centers around the world work on surveillance, sending their data and samples to the World Health Organization. Those scientists collaborate with other public health experts to determine which strains are most likely to spread during the upcoming season. Vaccines are then developed to target those strains.
Did you catch "Michigan" in the first strain listed? It's an H1N1 virus that Minicuci said was first isolated in a lab in Michigan and submitted to the CDC.
University of Michigan scientists in the Influenza Vaccine Evaluation Group lab play a key role in helping public health experts determine which vaccines are most effective and isolate strains of the virus that might be useful in combating the spread of the virus.
"The strain was identified and tested at the University of Michigan in Ann Arbor with Dr. Arnold Monto’s research team," Minicuci said. "This is how each strain is named, as to where they are identified."
The Free Press caught up with Emily Martin, an assistant professor of epidemiology at the University of Michigan School of Public Health. She works in the lab that first identified the strain. We asked her some questions about what people should know as we head into flu season this year:
QUESTION: Is it a badge of honor to have a Michigan strain included in this year's vaccine or is it more like a dubious distinction?
ANSWER: In the flu world, it’s an honor to have collected a strain that becomes part of the vaccine. In fact, the original live vaccine that became FluMist in 2003 — that was developed here at the University of Michigan and the strain of virus that became that vaccine was titled A/Ann Arbor. So for a long time it was called the A/Ann Arbor vaccine and people were very proud of that. It’s been updated since then.
Q: How did the sample that became known as A/Michigan/45/2015 (H1N1)pdm09 get into this year's flu vaccine?
A: We are one of … six programs around the country that do active surveillance throughout the year to find out how good the flu vaccine is.
So those numbers that come out in the middle of the flu season that estimate how well it’s working, we contribute to that number out of the University of Michigan. It’s a huge program, and it’s really exciting to work on.
We partner with a number of local hospitals. When patients come in and they’ve got respiratory symptoms, we find out whether or not they have the flu, and we find out whether or not they got vaccinated and what flu vaccine specifically they received. Then, we work with the CDC to pool our data with people all around the country to see how well the flu vaccine is working.
It’s about 3,500 total people that we work with every year.
Q: How effective is the flu vaccine overall?
A: We track it from year to year. In years when we have mostly H1N1 viruses, effectiveness is higher. It’ll be in the 60- or the 70-percent range. In years when we’ve got H3N2 — unfortunately, the last three years — we can see estimates in the 20 percent to 30 percent effectiveness range. We believe the vaccine is still avoiding illness even at that level. It’s still averting influenza illnesses, just not as many as we would like.
The final estimate for vaccine effectiveness in the 2017-18 flu season was 25 percent against the H3n2 strain; 65 percent against H1N1, and 49 percent against influenza B.
Q: If effectiveness rates of the vaccine vary so much, why should I bother getting the shot?
A: With all the research we’ve done about trying to make a better vaccine, it’s still better to get it than not get it. The people who get vaccinated as a whole — even though it’s not as good as we want it to be — they are still getting flu less often than the people who don’t get the vaccine.