The first confirmed flu cases of the season in New Mexico suggest the virus has reared its head in an ugly way, with four people falling ill at a health care facility in Bernalillo County and one 90-year-old woman dead of causes suspected to be related to the flu.
While both national and international indicators hint that the illness could be severe this year, officials at the New Mexico Department of Health say it's too early to predict how bad the flu season might be.
Warnings of a particularly nasty flu season started in the Southern Hemisphere, where U.S. officials often turn for early indicators of the severity of winter sickness.
In Australia, the outlook was grim.
According to the Australian government's Department of Health, the country saw the highest flu levels since 2009, when the swine flu pandemic swept the globe. There have been more than double the number of flu cases reported this year in Australia compared to last year, and early estimates show the vaccine might have only been 10 percent effective against the most common strain, A (H3N2), and 33 percent effective against all influenza viruses.
Since the first flu cases started revealing themselves a few months ago in the U.S., "several influenza activity indicators were higher than is typically seen for this time of year," the U.S. Centers for Disease Control and Prevention reported last week. According to The Washington Post, more than 6,000 people across the nation had tested positive for the flu as of last week - more than twice as many as were reported at the same time last year.
What comes next is still unclear.
"Speculation is so difficult throughout the whole season, particularly as it's really getting started," said Dr. Joan Baumbach, the deputy state epidemiologist for New Mexico. Predominant strains could change throughout a flu season, and the duration and severity of each season can vary dramatically from year to year, Baumbach said. Overall, she said, "predicting is really tricky."
At the moment, Baumbach said, the flu season in New Mexico is off to a fairly typical start.
Through mid-November, fewer than 2 percent of people reported flu-like illnesses at different surveillance sites across the state, according to Department of Health data. The agency's charts show that is comparable to - or slightly lower than - the same period in most recent years.
The H3N2 strain of influenza that tormented Australia is, at the moment, the most prevalent flu strain both in the state and across the U.S. That strain has caused increased hospitalizations and deaths in years past, according to the Centers for Disease Control, and Baumbach emphasized that it's always a good idea to be cautious.
Tens of thousands of people die from the flu each year in the U.S., the CDC reports, and getting vaccinated saves lives, even if the effectiveness of the vaccine varies from year to year, Baumbach said.
"In the context so far, very early, of having a predominant H3N2 set of viruses, people should definitely pay attention and think seriously about getting vaccinated," she said, "not only to protect themselves, but to protect vulnerable populations ... and prevent the worst outcomes."
The young, the old, pregnant women and Native American people can be particularly vulnerable to influenza, according to the CDC, as well as people in long-term care facilities.
So far, Christus St. Vincent Regional Medical Center has counted almost 60 flu patients since August, according to spokesman Arturo Delgado, the vast majority of them in November and December.
Monica Leyba, chief nurse executive at Christus St. Vincent, recommended that anyone with a fever above 101 degrees or with difficulty breathing seek out their doctor or an emergency facility. Minor coughs, sore throat, body aches and runny noses don't require hospitalization, but should prompt people to consider whether they should stay home from work or school, she said.
Leyba said anyone who is feeling ill should not come to the hospital to visit a loved one being treated there and risk infecting the patient or others.
All health care professionals in the facility without flu shots are required to wear masks while they work on patients, she said, and nurses sanitize their hands religiously. Leyba recommends that everyone do this - just as a precaution.
Caution is particularly necessary when it comes to Gino Rinaldi's line of work. Rinaldi runs the Senior Services Division for the city of Santa Fe. He estimates that the agency serves roughly 5,000 seniors - some of the people in the community who are most vulnerable to the flu - whether at facilities around town or through home visits and meal deliveries.
Senior Services helps facilitate flu shots and medical visits for clients at senior centers, Rinaldi said, and will offer to drive senior citizens to the pharmacy or doctor if they don't have transportation.
In a way, he thinks the "informal gatekeeping" that seniors develop with their friends and neighbors is just as important to keep them safe and healthy.
Seniors who see one another regularly at the centers will notice if someone is missing, Rinaldi said, and will call a missing senior or their family members for a welfare check.
"That's an easy way to check on people, and it means a lot," Rinaldi said. "If there is a problem, you might be the one responsible for it being a small problem - not a big one."
Contact Sami Edge at (505) 986-3055 or firstname.lastname@example.org. This story first published in the Santa Fe New Mexican, a sibling publication of The Taos News.