Flu kills second Iowan as winter illnesses spread

Two wintertime bugs — the flu and norovirus — are ramping up in Iowa, with the flu causing its second death of the season, the state's top public-health expert said Tuesday.

Both types of virus have begun to cause outbreaks around the state. “We’re starting to see it, and it’s only going to get worse,” Patricia Quinlisk, medical director for the Iowa Department of Public Health, said Tuesday.

The department said the season's second flu victim was an elderly central Iowa man with underlying health conditions, which could have made him more susceptible to complications. The state recorded its first flu death of the season Dec. 19, when officials said an elderly woman from central Iowa had died from the disease.

Although the state hasn’t seen a huge spike in flu cases yet, Quinlisk said she’s particularly concerned because all four main strains of the flu virus are circulating. “I can’t remember in my career when we had all four strains active in Iowa and all causing problems,” she said.

Flu and norovirus are often mistaken for each other. Flu viruses tend to cause coughing, sneezing, body aches and fevers. Noroviruses tend to cause vomiting and diarrhea.

“I can’t tell you how many people I’ve heard say, ‘I got the flu shot this year, but I’m vomiting — so it didn’t work.’ Well, those are two different diseases,” Quinlisk said.

For most healthy people, norovirus is miserable but not deadly. Influenza can be a more serious risk.

The good news is that all four flu strains are covered by this year’s version of the flu vaccine, Quinlisk said. The department reports slightly more Iowans have been vaccinated this winter than last. Unlike in some past years, plenty of shots are still available. Quinlisk recommends people ask for the “quadrivalent” version of the shots, which protects against four strains. But if need be, she said, they can take the “trivalent” version, which shields against the three most common strains.

The shots don’t provide perfect protection, but experts say they make flu infections less likely, and they can lessen symptoms in people who do become infected. Unvaccinated people risk becoming repeatedly ill with the flu during a single winter, because each flu strain could cause a new round of sickness. Doctors also say flu shots can't cause the flu, because they're made from dead viruses.

Norovirus can spread year-round, but it tends to be most common in winter. That’s partly because many holiday gatherings include the sharing of food, which is the top way to spread the illness, Quinlisk said.

Quinlisk said norovirus can be particularly infectious, including via surfaces that infected people have touched. When an outbreak is reported in a school, the staff has to take stringent cleaning measures, and students who have had diarrhea are told to stay home. Also, she warned, alcohol-based hand cleaning gels don’t work against noroviruses. “If you have norovirus, you’ve got to wash your hands with soap and water.”

Most people can recover safely at home from either type of virus. Quinlisk said people with chronic health problems, such as diabetes, asthma or heart disease, should call their doctors if they catch seasonal illnesses. Others should consider calling for help if they have high fevers, trouble breathing or severe lethargy. They also should seek help if they become dehydrated, which often is demonstrated by dark urine.

In general, elderly people and babies are the most susceptible to complications.

One of the main dangers from either disease is that they can lower the body’s defenses against other bugs, including bacteria. In flu patients, doctors warn to be on the lookout for a sudden fever that begins after a person seems to have started improving. Such a secondary fever can indicate a bacterial infection, which should be addressed immediately.