JOPLIN, Mo. — For Wayne Johnson, a real estate agent with Pro 100 in Joplin, time is money. So when the flu hit, he felt it in his bottom line.

“It was the old-fashioned flu,” Johnson said. “It was aches and pains. It knocked me down for five to six days.”

And Johnson had a flu shot.

“All I can figure is that it was a different strain (from the ones targeted by the vaccine),” he said. “There really wasn’t anything I could do short of just rest and take ibuprofen for the aches. I mean I was down.”

Chances are you might be suffering with flulike symptoms now or you know someone who is. That’s because there has been a significant surge in what local health experts are describing as “true influenza” cases. These are cases that are confirmed by laboratory tests.

Those tests are showing that both the A version and B version of the virus are circulating in the Joplin area. The B version appears to be the dominant strain. So far, no cases of H1N1, also known as swine fu, have been detected locally.

Flu outbreaks early in the influenza season, which continues through April, are not unusual, but this one is striking. According to the Missouri Department of Health and Senior Services, the state had 9,842 reported flu cases during the last week of 2012. During the same week in 2011, there were 378 cases.

And it’s just not in Missouri. More flu cases are being reported nationwide, according to the Centers for Disease Control and Prevention. That increase has taken place in the past four weeks or so. The CDC had reported that Missouri’s flulike activity was regional. It now reports that Missouri and 29 other states have high levels of influenza-like activity.

Emergency room doctors at Freeman Hospital West and Mercy Hospital Joplin have experienced an uptick in patients with flulike symptoms since the beginning of the year. The urgent-care clinics operated by those hospitals and the Community Clinic of Joplin also have been busy. Even local Walgreens stores, a provider of flu vaccine, is seeking more vaccine.

So far, Missouri has had no influenza-associated pediatric deaths, according to the state health department. The CDC has confirmed 18 pediatric deaths nationwide related to the flu this season.

In Joplin’s schools, nurses reported an increase in flulike cases in mid-December, according to Kelli Price, spokeswoman for the school district. She said daily attendance is down slightly. She said anecdotal evidence suggests that an increase in absenteeism is possible, but that it is difficult to confirm any trend because classes just recently resumed after the holidays.

Though the situation is serious, the proportion of deaths attributed to pneumonia and influenza based on the “122 Cities Mortality Reporting System” has been slightly below the epidemic threshold, the CDC said. The current levels of influenza-like illness are nearing what have been peak levels during moderately severe seasons in the past. Typically, the flu season peaks in February.

“We are seeing the typical symptoms,” said Karen Watts, infection control officer at Freeman Hospital West. “It’s congestion, headache, fatigue, fever, loss of appetite and just feeling all around cruddy.”

This year’s vaccine, she said, appears to be a good match for the strains that are circulating, especially the type A virus.

“It’s important to remember that there are hundreds of viruses that can cause illness,” she said. “We are seeing more type B than the CDC is reporting. It’s seeing more type A.”

Most patients at Freeman are being treated and sent home. Few have been hospitalized. That’s holding true as well at Mercy Hospital Joplin, said Dr. Sean Smith, an emergency room doctor.

“Most can be treated with outpatient therapy and sent home, but we have had a couple of patients admitted,” he said. “It can take seven to 14 days to recover.

“We have seen over the last month or so a lot of flulike illnesses. They were like the true flu with symptoms that include fever, chills and body aches. But it has only been in the last two weeks that patients have been testing positive for A and B.”

Smith said it is possible that a virus has been circulating that mimics the symptoms of the flu.

There also is the possibility that the vaccine does not provide protection for a particular strain. The vaccine includes protection for B/Wisconsin/01/2010-Like. The CDC has confirmed this strain in Missouri, and nationwide it accounts for about 69 percent of the influenza B viruses. The remaining 31 percent of the tested influenza B viruses belonged to the B/Victoria lineage, which is not reflected in the vaccine.

Still, it’s never too late to get a flu shot — if you can find one.

“That’s the No. 1 recommendation for prevention,” Watts said. “Another thing that helps is to wash your hands frequently, and stay away from people who are sick.”

The vaccine is available locally, but supplies are limited.

Louis Niewald, manager of the Walgreens at 20th Street and Range Line Road, said, “With the CDC reporting an earlier than normal start to the flu season and suggesting there could be widespread flu activity, it’s really important to get your flu shot — as it takes two weeks to build up full immunity.

“We’ve seen strong demand for flu shots this week since the CDC report came out, and many of our stores have seen a noticeable increase in flu shots administered the past couple of days. We’ve had a run on it, and we are looking for product now.”



100 doses

BARBIE BILTON, director of the Community Clinic of Joplin, 702 S. Joplin Ave., said: “We still have flu shots, and it’s not too late to get one. We’ve got about 100 shots, and they’re free to anybody who needs one.”