If this year's sneezing, nose blowing and aching around Minnesota seems louder, grosser and more painful, it's because we are in one of the worst flu seasons in years.
More people have already been hospitalized this winter than in most years this past decade — and we still have several weeks to go.
"It does seem to be particularly nasty this year," said Karen Martin, influenza monitoring coordinator for the Minnesota Department of Health.
"Every influenza season is severe in that we always have hospitalizations and in some cases death, but we've had peak activity for several weeks in a row now, and that's a bit unusual."
The flu is widespread in almost every state across the country right now, according to the U.S. Centers for Disease Control and Prevention, but the Twin Cities metro area topped a list ranking cities across the country by the severity of their outbreaks. Minneapolis-St. Paul had a 9.5 out of 10, according to the Doctor's Report Illness Tracker, which draws data from physician diagnoses on insurance reports to make the rankings.
"It's the prevalence ... and we gauge that based on the history for each ZIP code and metro area," as well as by the percentage sickened, said Dan Shaw, president of the association that operates doctorreports.com.
Numbers raise concerns
Nearly 3,500 Minnesotans have been hospitalized with influenza as of Jan. 27. For the entire season last year, there were 3,750 hospitalizations.
The elderly in particular have been at risk from this year's influenza A, which is dominated by an H3 strain. That type of virus is typically more severe.
H3 seasons often have more hospitalizations and deaths, partly because the flu shot is less effective. Last year, H3 vaccinations were only 30 to 40 percent effective, whereas vaccines for other strains of flu were typically between 40 and 60 percent effective, Martin said.
The last time the H3 strain dominated was the winter of 2014-15, the season with the most hospitalizations of the past decade, so far.
About 70 percent of people hospitalized by influenza this year were 65 or older, with the median age being 73. When a different strain dominates, the younger population often suffers more. Yet this year, children and schools have been hit harder than usual as well.
One pediatric influenza-related death has been reported so far this season in Minnesota.
Schools take precautions
Minnesota schools report an outbreak when the number of students absent with an influenza-like illness reaches a certain threshold. in mid-January, 123 schools reported an outbreak in just one week, the highest number in several years.
And children have been out sick for as many as five days — much longer than normal, said Mary Yackley, supervisor of student health and wellness for St. Paul Public Schools.
"Normally, when children get viral illnesses they may only miss a day or two," Yackley said.
When a student reports to a school nurse with flu-like symptoms, they are quickly isolated from other students to prevent the further spread of the illness, Yackley said.
She didn't have illness data on teachers and other school staff, but said she's heard the flu has hit their ranks as well, particularly since winter break.
Prolonged spike after holidays
Numbers spiked for this season's hospitalizations right around the holidays, and they haven't gone down much since, according to Martin.
"Typically, we'll have very high activity for maybe a couple of weeks. At this point, we've been seeing quite high activity for longer, more like five to six weeks," Martin said.
Even if the H3 strain settles, there's still a chance a different strain could strike — and often it does. The spring frequently has a separate peak of flu activity, Martin said.
That is why Minnesota health and school officials are encouraging people to stay home with illnesses and to get the flu shot if they haven't yet.
"It's a vaccine-preventable disease, and we are also trying to protect those that can't be vaccinated," such as the very young or those with other illnesses, said Michele Belde, lead nurse at the Ramsey County Public Health Center in St. Paul.
"It's not too late, please get vaccinated."