The number of older people hospitalized with the flu has risen sharply, prompting federal officials to take unusual steps to make more flu medicines available and to urge wider use of them as soon as symptoms appear.
The U.S. is about halfway through this flu season, and "it's shaping up to be a worse-than-average season" and a bad one for the elderly, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.
It's not too late to get a flu shot, and "if you have symptoms, please stay home from work, keep your children home from school" and don't spread the virus, he said.
New figures from the CDC show widespread flu activity in all states but Tennessee and Hawaii. Some parts of the country are seeing an increase in flu activity "while overall activity is beginning to go down," Frieden said. Flu activity is high in 30 states and New York City, up from 24 the previous week.
Nine more children or teens have died of the flu, bringing the nation's total this flu season to 29. That's close to the 34 pediatric deaths reported during all of the last flu season, although that one was unusually light. In a typical season, about 100 children die of the flu and officials said there is no way to know whether deaths this season will be higher or lower than usual.
The government doesn't keep a running tally of adult deaths from the flu, but estimates that it kills about 24,000 people most years.
So far, half of confirmed flu cases are in people 65 and older. Lab-confirmed flu hospitalizations totaled 19 for every 100,000 in the population, but 82 per 100,000 among those 65 and older, "which is really quite a high rate," Frieden said.
"We expect to see both the number and the rates of both hospitalizations and deaths rise further in the next week or so as the flu epidemic progresses,"' so prompt treatment is key to preventing deaths, he said.
About 90 percent of flu deaths are in the elderly; the very young and people with other health problems such as diabetes are also at higher risk.
If you're worried about how sick you are and are in one of these risk groups, see a doctor, Frieden urged. One third to one half of people are not getting prompt treatment with antiviral medicines, he said.
Two drugs -- Tamiflu and Relenza -- can cut the severity and risk of death from the flu but must be started within 48 hours of first symptoms to do much good. Tamiflu is available in a liquid form for use in children under 1, and pharmacists can reformulate capsules into a liquid if supplies are short in an area, said Dr. Margaret Hamburg, head of the Food and Drug Administration.
To help avoid a shortage, the FDA is letting Tamiflu's maker, Genentech, distribute 2 million additional doses of capsules that have an older version of package insert.
"It is fully approved, it is not outdated," just lacks information for pharmacists on how to mix it into a liquid if needed for young children, she said.
This year's flu season started about a month earlier than normal and the dominant flu strain is one that tends to make people sicker. Vaccinations are recommended for anyone 6 months or older. There's still plenty of vaccine -- an update shows that 145 million doses have been produced, "twice the supply that was available only several years ago," Hamburg said.
About 129 million doses have been distributed already, and a million doses are given each day, Frieden said. The vaccine is not perfect but "it's by far the best tool we have to prevent influenza," he said.
Carlos Maisonet, 73, got a flu shot this week at New York's Brooklyn Hospital Center at the urging of his wife, who was vaccinated in August.
"This is his first time getting the flu shot," said his wife, Zulma Ramos.
Last week, the CDC said the flu again surpassed an "epidemic" threshold, based on monitoring of deaths from flu and a frequent complication, pneumonia. The flu epidemic happens every year and officials say this year's vaccine is a good match for strains that are going around.