It Feels Bad Enough to Be Flu, but It Isn’t : Health: Despite big numbers missing work or school, experts haven’t detected a single case of influenza locally. So what is it? Well, ‘a combination of things.’

Coughs, fevers and other flu-like symptoms are keeping a lot of people out of school and work this winter, but most aren’t actually sick with influenza.

Flu viruses, say the experts who track them annually, have arrived late and, so far, in small numbers to Southern California, compared to last winter when they attacked nationwide in epidemic proportions.

“We are seeing a very light influenza year,” said Kay Rekrut, supervisor of a Kaiser Permanente virology laboratory in Hollywood that has a contract with the federal Centers for Disease Control to look for influenza viruses in throat cultures gathered nationwide.

Dr. Hildy Meyers, medical director of communicable disease control and epidemiology for the Orange County Health Care Agency, said not one case of influenza has been confirmed in the county through laboratory testing. She added that she was awaiting more information about a case of suspected influenza recently reported by a local physician.

“Last year in December we started to get reports from schools about very high absentee rates and then some reports of positive cultures,” Meyers recalled, underscoring how slowly the flu season has begun this year.

The Centers for Disease Control in Atlanta contends it has enough information to indicate that the influenza going around this year is the “Type B” strain which is considered far less dangerous than the “Type A” strain that predominated last year and caused a number of deaths among elderly victims.

Rekrut said that since Christmas, 25 cases of influenza B have been confirmed among the 2 million subscribers to Kaiser Permanente’s medical delivery system in Southern California. “Usually those with influenza B are not sick enough even to go to the doctor,” she added.

This winter only two influenza cases have been confirmed in Southern California, one of which was identified a week ago in Pasadena and the other six weeks ago in Santa Clarita, Rekrut said. She cautioned, however, that the winter is not over and the “Type A” strain influenza still could pose a menace.

So what is making so many people ill?

“There are a combination of things going around,” Rekrut said. Some, she acknowledged, may indeed be suffering from influenza. Many doctors, she noted, do not go to the expense and trouble of confirming a flu diagnosis by swabbing the throats of their patients and shipping the cultures to laboratories.

But it is most likely, Rekrut said, that viruses other than influenza are to blame for the majority of flu-like illnesses that children and adults are suffering from this year.

She said some doctors are writing “flu” on throat swabs that upon laboratory analysis have turned out to be “enterovirus”--a very contagious virus that causes respiratory problems similar to those of influenza.

This current outbreak of enterovirus, Rekrut said, is unusual because it generally occurs in the summer. She said the virus is contracted orally and is most prevalent among young children who put shared toys in their mouths.

Moreover, she said, there is an epidemic of rotavirus, which causes diarrhea and other stomach problems, lasts about a week and is most serious in children and infants, although it also affects adults.

Whatever the cause, people of all ages are definitely getting sick. Sally McAuley, a registered nurse in the Garden Grove Unified School District, said that when elementary and junior high children returned from Christmas vacation Jan. 4, they began complaining of nausea, vomiting and diarrhea.

“It is going right through families,” she said, and can last three or four days. “We have had teachers out sick too.”

Karen Kuhn, attendance officer at Laguna Beach High School, said on Thursday that 132 of 705 students enrolled at the school were absent, about two-thirds of whom were ill.

Marsha Osborn, the health clerk at the school, said: “There are a lot of sore throats and body aches and coughs often going into bronchitis. I think this year the strain (of virus) is strong and they don’t get over it unless they get lots of rest and take antibiotics to prevent secondary infections such as earaches and sinus infections.”

Nor has absenteeism skipped the workplace. Herb Rosenswag, Orange County’s director of medical services, said there are a lot of people with colds and coughs among the county’s health program administrators.

“I wouldn’t say it is influenza, but we have noticed a lot of employees have been ill and are taking some time off,” he said.

Kaiser Permanente spokesperson Mona Ziada said Kaiser’s six outpatient clinics in Orange County have seen a surge in patient requests for appointments in the past two weeks. “Sixty percent of those have colds or a gastrointestinal virus,” she said.

Delores Wilson, a nurse and manager of the UCI Medical Center outpatient clinic in Orange, said in the last six weeks there has been a marked increase in bronchitis and other upper respiratory infections among patients, the nursing staff and doctors in residency. She said low-grade fevers associated with the illnesses vanish in a couple days, but upper respiratory congestion and coughs can persist up to three weeks.

Wilson said some patients who received influenza vaccines in October or November are angry that they have contracted illnesses anyway. That’s especially true of older people, some of whose illnesses have progressed to pneumonia.

Wilson said: “We try to explain to them that it is not influenza they are having. But they think the shot protects them against any upper respiratory viruses.”

The County Health Care Agency is unable to say how much of a problem non-influenza viruses may be causing.

“Colds and a lot of common viral infections are not reportable to us, so we don’t have any statistics,” Meyers said.

Influenza is tracked, epidemiologists say, because it can quickly spread to epidemic proportions. Also, the influenza virus tends to mutate frequently and so must be monitored closely to help the medical community formulate effective vaccines. By contrast, there is no vaccine for the other viruses, against which people gradually build resistance.

But each year, Rekrut said, more physicians are referring specimens to laboratories to determine just what kind of viruses are causing the flu-like symptoms in their patients. She said that is because an expanding arsenal of virus-specific drugs is being developed that will allow physicians to do more to speed their patients’ recovery than simply send them home to bed.