Flu Season Floods Southland Hospitals With Patients

A mighty wave of flu and respiratory disease is sweeping through Southern California, filling hospital emergency rooms and doctors’ offices @with hacking, wheezy, sneezy victims, many of them very young or old.

Hospitals from Ventura to San Bernardino counties are treating and admitting patients in record numbers, leading doctors to warn of an epidemic influenza season. Although the season began unusually early, the greatest number of flu sufferers has swarmed to emergency departments within the last two weeks.

The recent upsurge in disease has caused Los Angeles County health officials to wonder whether the region has been hit with two predominant strains: a familiar subtype like last year’s and a recent, unexpected arrival from Australia for which this year’s flu shots provide no protection.

If so, Southern California is the new subtype’s first U.S. target, and the rest of the country may be in for a very wheezy, sneezy winter too. Already there are rumblings of possible contagion in Northern California and other Western states.

“I can think of two times in the past 22 years when we have even had a [flu] season near this one,” said Dr. Shirley Fannin, director of disease control for Los Angeles County.

Doctors and hospitals on the front lines are struggling to cope.

“We have been absolutely inundated,” said Joan Cole, nursing supervisor at North Hollywood Medical Center. “I can’t remember when it has been this bad, and I’ve been here 20 years.”

At Providence Holy Cross Medical Center in Mission Hills, officials said emergency room patients who need admission must wait eight or nine hours for a bed.

“We leave them in a place where a nurse can look after them,” said hospital supervisor Richie Steinborn. “Still, it’s a long time to wait.”

“It’s been a very rough season,” said Dr. Brian Johnston, director of the emergency department at White Memorial Medical Center in Boyle Heights. “In my hospital, we’re setting records. It’s very hard to get beds. In fact, when you get a suzge like this, we don’t have enough beds. We have not had enough beds in the hospital for six weeks.”

Fannin said it will be three weeks or so before the county learns from the federal Centers for Disease Control and Prevention whether a new subtype of flu is the culprit.

First Wuhan, Now a Second Outbreak

The first flu outbreak this year occurred in October in the San Fernando and San Gabriel valleys, weeks earlier than anticipated. At that time, health officials traced the cases to Influenza A-Wuhan, the same subtype as last year’s predominant strain. But the second wave of illness this month may be due to a substantially different subtype, Influenza A-Sydney, which sickened members of three cruise ships last summer during Australia’s flu season, Fannin said.

The subtype is no more virulent than Wuhan, but this fall’s flu shots would not protect against Sydney, nor would protection carry over from contracting Wuhan last year, Fannin said.

“When you have a whole population susceptible--9 million people--a lot of people have to be sick before you run out of victims,” she said. “When there is variation [in the strains], you can expect it to last longer in the population.”

That means that the flu season, which normally runs from about December to February, may last from October to March this year.

The disease--which is spread through coughing, sneezing or contact with an infected person--is enhanced by the holiday season, when millions of people interact in malls and airports and at family gatherings.

Doctors generally give the same advice to flu sufferers--stay home, get plenty of rest, drink lots of fluids and take over-the-counter medications--such as acetaminophen or ibuprofen for fever and aches.

So far, Los Angeles County health officials have not been able to determine whether there have been any flu-related deaths, Fannin said. Death from influenza is usually a result of complications such as pneumonia. But Fannin cautioned the public not to panic about recent reports of a “chicken flu” that has killed several people in Asia.

“For people who have been listening to the news about the avian flu in Hong Kong, don’t worry about that,” she said. “We don’t have that problem.”

Even if health experts are able to attribute this Southern California flu surge to a new strain, there isn’t much they can do about stopping it this year. Most efforts must go into preventing a resurgence next year--and dealing with this year’s misery.

In Ventura County, officials went so far as to ask hospitals to invoke “disaster plans,” speeding up discharges of patients to make room for others. All county hospitals reported midweek that they were at or near capacity. They were looking for possible help from hospitals in other counties--including Los Angeles--but finding little or no space available.

“We’re just expediting our discharges,” said Rita O’Connor, a spokeswoman for both St. John’s Regional Medical Center in Oxnard and St. John’s Pleasant Valley Hospital in Camarillo.

The flu isn’t the only problem. Besides influenza, which includes high fever, body aches, gastrointestinal problems and coughing, many patients with upper respiratory infections, colds, broken bones, heart maladies and indigestion--the usual holiday spoilers--have sought medical care. That only has added to the crowding and long waits in emergency rooms.

It has created some “unusually crazy days in the clinic,” said Dr. Bruce Rogen, an internal medicine specialist at Kaiser Permanente’s West Los Angeles facility.

Rogen said the hospital was seeing “25% more patents then we usually do compared to a week or two [before]. The emergency room is busy with older patients, because they are the ones affected more.”

Other doctors said the overloaded emergency rooms may, however, be less related to health than to changes in the way health care is delivered. Dr. Alan Heilpern, an emergency room physician and president of the Los Angeles County Medical Assn., said many patients, either because they are not insured or because they face hurdles in getting care, put off seeking medical attention until they are very sick.

Still, many physicians advised using emergency services judiciously.

If Otherwise Healthy, Advice Is to Stay Home

Patients are advised to first call their family doctors to see if their ailments can be remedied without going to the hospital, where many nurses and doctors have been called in from vacations to help with the winter rush.

“If you are young and otherwise healthy, don’t come in,” Rogen said. “We’ve had a lot of people coming in not really in need of seeing a doctor.”

He also said that adults age 65 or older, or those with chronic illnesses such as heart problems, should receive vaccinations each year during fall immunization drives. Some of this year’s cases have been traced to a strain that shots might have prevented, Fannin said.

“I ask the people I’ve been seeing, like the elderly that have come in with influenza, if they received their flu shot, and they give me a sheepish look and say, ‘I was too busy.’ ”

Doctors said that the flu is always unpleasant, even for relatively healthy people, but in most cases it just has to be endured.

“Sitting in an ER for six to eight hours isn’t going to help you,” Fannin said. “We can’t do much for you other than sympathize, tell you to drink plenty of fluids, eat lightly . . . go to bed and don’t cough on anybody.”

But sometimes the flu or a cold can lead to serious complications, especially in young children, the elderly and those with compromised immune systems. Physicians say cases of meningitis and respiratory syncytial virus, which strikes infants and younger children, often follow flu season.

“It’s kind of a tag-along which comes in January,” Fannin said.

Bacterial meningitis, with early symptoms of a headache, a stiff neck or a rash, is uncommon. But at least one fatal case has surfaced this season. A 13-year-old Riverside County boy died Dec. 26 of an infection that progressed rapidly and killed him within 24 hours.

It is unclear whether the boy, Brandon John Lloyd, had the flu before developing the apparent case of meningitis, but he had been seen by a doctor the day before for flu- or cold-like symptoms. He was treated aggressively with antibiotics, said Dr. Gary Feldman, the Riverside County public health officer.

“It’s the meningitis we fear the most, and it is the most contagious,” he said. “It can move so rapidly that a child can go from well to morbid within 24 hours.”

Feldman estimated that 5% to 10% of the general population carries the germs that lead to bacterial meningitis “and it’s a little bit of a puzzle how to explain why the germ, which is so widespread, affects so few people. . . . Every day, you should say a prayer to your immune system.”

Bacterial meningitis is transmitted through sneezing and coughing, and outbreaks are generally among people living in close quarters, including dormitories and barracks.

Times staff writers David Haldane, David Colker, Tom Gorman and Lisa Fernandez contributed to this story.