Call it flu or flulike: There's lots of it in Ohio

1/14/2004
BY LUKE SHOCKMAN
BLADE STAFF WRITER

For several months, Ohioans have been warned the flu is going around.

Well, not exactly.

It turns out a lot of flu is going around.

Because of a mixup at the Ohio Department of Health, the number of flu and suspected flu cases in Ohio has been counted incorrectly for more than a month.

So, instead of reporting about 6,000 cases of influenza and influenza-like illness, the state should have been reporting 23,311 cases.

Now, before you use this new knowledge to call in sick, renew your hunt for flu shots, or otherwise panic, here are a few things to keep in mind:

•  The error doesn't mean much from a public health perspective. The state and federal authorities estimate weekly about how much flu is going around. In this recent situation, whether it was 6,000 cases or 23,000 cases, Ohio still would have been classified as a state having “widespread” flu activity. And all that means is that there's a lot of flu going around.

If the numbers had been counted correctly, the state may have been classified as widespread a week earlier. Other than that, nothing would have changed, said Jay Carey, Ohio Department of Health spokesman.

In fact, Ohio was just downgraded to having “regional” flu activity. That means the flu is still out there; it's just, well, more regional than widespread.

•  Even 23,000 cases is a vast undercount. The federal Centers for Disease Control and Prevention estimates that 10 to 20 percent of the U.S. population catches the flu each year. Figure there are about 11 million people in Ohio, so probably one million Ohioans catch the flu annually, said Tony Payton, manager of the state's immunization program.

•  Influenza-like is different from influenza. Ohio reports to the media and the public influenza and influenza-like cases. However, it performs few definitive tests for influenza because after it detects quite a few, it's safe to assume a lot of suspected cases are confirmed, according to state officials.

Of the 23,000 cases, only about 100 are confirmed cases; the rest are suspected cases. Still, many of those suspected cases could be the common cold or other viral illnesses.

It's for this reason that Michigan authorities don't normally report “flu-like” illness, said T.J. Bucholz, spokesman for the Michigan Department of Community Health.

Michigan now reports “more than 100” confirmed cases of the flu. Wonder how many flu-like cases they had last year? 524,330, a huge difference if it had been counting the way Ohio does.

Finally, it appears the flu is starting to taper off in many parts of the country. In addition to Ohio, Michigan also was downgraded to regional flu activity.

Dr. Donna Woodson, a Maumee family physician who takes part in the “sentinel site” network that helps report flu cases to the Ohio Department of Health, said it doesn't surprise her the numbers were higher than reported.

She said knowing there were 23,000 cases rather than 6,000 wouldn't have changed how she treats patients. She said it's no secret to any physician there's a lot of flu going around.

No kidding. Mr. Carey said that last flu season Ohio reported about 1,000 cases of flu and flu-like illness compared to the just-corrected 23,311 case total.

But he cautioned that the public shouldn't assume that the flu has been 23 times more prevalent. Instead, he said much of the increase could be attributed to widespread media attention that prompted more people to seek medical attention. That resulted in more cases being reported.

All those caveats aside, Ohio Department of Health officials admit their errors are “distressing and regrettable.” Though it uses other data, such as the number of school closings and how full hospitals are, to determine whether to classify the state as having widespread flu activity, the error is frustrating.

That's because accurate numbers help inform the public. If the public hears there are thousands of cases of the flu, as it did this season, they may be more likely to seek treatment or get flu shots, which could prevent some deaths or illness.