Saint John's Health Center (Photo by Daniel Archuleta)

The avalanche of flu patients that began filling local emergency rooms this holiday season has yet to relent. A mismatched flu vaccine compared with a particularly aggressive strain of influenza A has led to a pile-up of patients in Santa Monica urgent care centers and hospitals. The flu season typically peaks in February.

“There is no comparison to previous years,” said Dr. Wally Ghurabi, medical director, Nethercutt Emergency Center at UCLA Medical Center in Santa Monica. “You come at 10, 11 o’clock in the morning in the ER and the place is wild. We have chairs and stretchers in the hallways and three – sometimes four – doctors working continuously.”

Ghurabi says the onslaught began two days after Christmas, when he saw more than 200 patients in 24 hours. The symptoms of the flu are not worse, per say, but the effectiveness of this year’s vaccine is only about 30 percent, meaning more people are getting it.

Providence hospitals, including St. John’s Health Center in Santa Monica, have seen a 70 percent increase in emergency room visits this flu season. The flu is particularly dangerous to the young and elderly and patients with weakened immune systems from illness or treatment.

If you are not in an at-risk group, doctors recommend you stay home, rest and drink plenty of water as soon as you feel yourself coming down with symptoms. Going to work or social gatherings while recovering from the flu risks spreading the illness to coworkers, friends and family. More doctors are turning to virtual visits to keep the spread of the flu down in medical centers.

“This year, with overcrowded ER waiting rooms, you risk exposure to the flu coming into the ER – where you might be told you just have a severe cold,” said Dr. Russ Kino, a caregiver at Saint John’s. “The best thing to do is old-fashioned resting at home in bed, boosting fluid intake and using over the counter medicines.”

The flu vaccine is developed based on previous years’ popular strains and its effectiveness fluctuates from year to year. It is a challenge for scientists to stay ahead of the constantly mutating virus – at best, the seasonal vaccine is 60 percent effective. A few years ago, protection dropped to 19 percent because of a mismatch. This year has been a difficult year.

“Please get the vaccine,” Dr. Ghurabi said. “It’s about 32 percent effective. But that’s one in three. So if you can protect yourself with 32 percent of not getting the flu, I’d take it.”

Labs around the country are hunting for a supershot that could eliminate the annual fall vaccination. A universal flu vaccine is now a top priority for the National Institute of Health’s infectious disease department. To develop a better shot, researchers are dissecting the cloak that disguises influenza as it sneaks past the immune system and finding some rare targets that stay the same from strain to strain, year to year.

“We have to do better and by better, we mean a universal flu vaccine. A vaccine that is going to protect you against essentially all, or most, strains of flu,” said Dr. Anthony Fauci of the NIH.

“We’ve made some serious inroads into understanding how we can better protect ourselves. Now we have to put that into fruition,” said well-known flu biologist Ian Wilson of The Scripps Research Institute in La Jolla.

The new vaccine quest starts with two proteins, hemagglutinin and neuraminidase, that coat flu’s surface. The “H” allows flu to latch onto respiratory cells and infect them. Afterward, the “N” helps the virus spread.

They form the names of influenza A viruses, the most dangerous flu family. With 18 hemagglutinin varieties and 11 types of neuraminidase – most carried by birds – there are lots of potential combinations. The strain causing so much misery this winter, H3N2, is a descendent of the 1968 pandemic strain.

Scientists now think people respond differently to vaccination based on their flu history. “Perhaps we recognize best the first flu we ever see,” said NIH immunologist Adrian McDermott.

The idea is that your immune system is imprinted with that first strain and may not respond as well to a vaccine against another.

“The vision of the field is that ultimately if you get the really good universal flu vaccine, it’s going to work best when you give it to a child,” Fauci said.

Until then, doctors say the best defense is getting the yearly vaccine and then cutting your risk of exposure to those who are sick. This year, Dr. Ghurabi says those worried about becoming infected because of a compromised immune system may want to wear a mask when they leave the house.

Kate Cagle

Senior reporter for the Santa Monica Daily Press