Sorry, You Might Get the Flu Twice This Year — Here’s Why
By Julia Ries
- Two flu strains are overlapping each other this flu season.
- This means you can get sick twice from different flu strains.
- While the flu vaccine isn't a perfect match, it's the best defense against the flu.
To say this flu season has been abnormal is an understatement.
For one, the flu season got its earliest start in 16 years.
Up to 18 million people have gotten the flu this year, according to the Centers for Disease Control and Prevention's (CDC) latest estimates. Up to 210,000 people have been hospitalized and thousands have died, including 39 children.
We're also seeing B strains of the flu dominate, something that hasn't happened in the United States in nearly 30 years.
And, unfortunately, the vaccine missed the mark with B/Victoria, the most common strain we're seeing this year. The CDC believes the shot only covers about 58 percent of B-linked cases.
Now, halfway through flu season, A strains are picking up, increasing the odds we'll have a "double-barreled flu season," in which two strains strike back to back — a pattern health experts say is extremely rare.
Between the early start, rise in B strains, and recent spike in A-strain illnesses, this flu season officially has infectious disease experts stumped.
"This season has turned a lot of [what we know about flu] on its head," said Dr. William Schaffner, an infectious disease specialist with Vanderbilt University Medical Center and the medical director at the National Foundation for Infectious Diseases. "There's a lot we know, and even more we don't know about flu."
Double-Barreled Flu Season
A double-barreled flu season occurs when two flu outbreaks overlap one another, a pattern which is very unusual, according to flu experts.
Last year, for example, we saw A/H1N1 infections peak early, followed by another wave of A/H3N2 infections.
Though the predominant strains are different this year, we're seeing the same pattern play out: Activity took off with B/Victoria and now that second wave of A/H1N1 is coming for us, according to Schaffner.
"Around the country, my colleagues and I are seeing H1N1 come up strong, and it's now about 50-50 [with B/Victoria]," Schaffner told Healthline.
The most worrisome part of a double-barreled flu season is that you can get sick twice.
Just because you caught a B-strain flu doesn't mean that you're immune from the A strains.
"There will be the rare person who gets two flu infections in the same season — one with B and one with H1N1," Schaffner said.
Though there will be some protection within each strain — in that contracting an A strain will protect you against other A strains, and B strains will protect against other B's — there's not much cross protection.
A double-barreled season also means we're more likely to see a prolonged influenza season.
What to Know About B and A Strains
The fact that B strains are predominating this year isn't just confusing, it's concerning as well.
B strains haven't hit this hard for nearly 30 years, since during the 1992–1993 season, the CDC told Healthline.
This means that many people — especially kids — have never been exposed to the strain, and consequently, don't have residual immunity against it.
"When there's a rarity, it actually sets you up for another bigger push to get it, because at that point, we really don't have anybody with any strong immunity going around, so we're all potential vessels for getting exposed and transmitting it," Moore said.
This is one of the reasons kids are being hit harder this year. They've never been exposed to this type of the flu — it's their first go around.
"These kids are just brand new to getting flu B," Moore said.
And because we haven't seen much of the B/Victoria strain in the past few years, this year's vaccine missed the mark.
"We thought initially the match was perfect, but it's not. It's off a little bit, and that means in many populations the vaccine is not going to function optimally," Schaffner explained.
Fortunately, the vaccine covers H1N1 well. According to Schaffner, the match to H1N1 is right on.
And because A strains circulate every year, most people have built up at least some "immune memory" to it — despite the fact these strains change and mutate each year.
"Our past experience with influenza viruses does give us some residual protection that lasts," Schaffner said.
There’s Still Time to Get Vaccinated
"It's not too late," Moore said about the vaccine, noting that we still don't know for sure what's going to happen next.
If flu A continues to get worse, as predicted, the flu shot will protect you through the rest of the season.
And even though the vaccine isn't a perfect match to B strains, it can still help lessen the severity of the flu.
"If you've been vaccinated, and even if there is a mismatch, you are likely to have a less severe infection when you get it," Schaffner said.
Remember: By getting immunized, you're not only protecting yourself, but others as well who may be more at risk for developing severe complications — like the elderly, pregnant women, children under 2, and immunosuppressed people.
"When we protect ourselves, we are really protecting those around us," Moore said.
The Bottom Line
Health experts say this has been an extremely unusual flu season. It started very early with a strain that we typically don't see much of. Now, another strain is building momentum and creating a path for what's known as a double-barreled flu season, in which two types of flu strike back to back. With a second wave coming, flu experts say it's not too late to get vaccinated before things pick up again.
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Human actions have taken a steep toll on whales and dolphins. Some studies estimate that small whale abundance, which includes dolphins, has fallen 87% since 1980 and thousands of whales die from rope entanglement annually. But humans also cause less obvious harm. Researchers have found changes in the stress levels, reproductive health and respiratory health of these animals, but this valuable data is extremely hard to collect.
Researchers work with trained dolphins to learn more about their sensory abilities, seen here testing a dolphin's hearing. Jason Bruck / CC BY-ND
A Lot to Learn From Hormones<p>When sampling the blow, we are looking for hormones in mucus as these can be used to gauge psychological and physiological health. We are specifically interested in <a href="https://dx.doi.org/10.1371%2Fjournal.pone.0114062" target="_blank">hormones like cortisol</a> and <a href="https://doi.org/10.1016/j.ygcen.2018.04.003" target="_blank">progesterone</a>, which indicate stress levels and reproductive ability respectively, but can also help determine overall health.</p><p>Additionally, blow samples can detect <a href="https://dx.doi.org/10.1128%2FmSystems.00119-17" target="_blank">respiratory pathogens</a> in the lungs or nasal passages - blowholes evolved from noses after all.</p><p>This health analysis is especially important in areas with oil spills as the chemicals can cause hormonal problems that harm <a href="https://www.carmmha.org/investigating-how-oil-spills-affect-dolphins-and-whales/" target="_blank">development, metabolism and reproduction</a> in dolphins.</p><p>Hormone samples can provide scientists with valuable data, but collecting them from intelligent and unpredictable animals is challenging.</p>
Cetacean Collaborators<p>To build a drone that can stealthily collect spray from moving dolphins, we needed more data on their eyesight and hearing, and this is data that couldn't be collected in the wild nor simulated in a lab.</p><p>We worked with dolphins at facilities like Dolphin Quest in Bermuda, which provides guests opportunities to learn about dolphins while allowing <a href="https://dolphinquest.com/about-us/our-story/" target="_blank">scientists access to animals for noninvasive research</a>. Here the dolphins can swim away if they choose not to work with us, so we had to design the study like a game; the way a kindergarten teacher entertains a class. If the dolphins aren't interested, we don't get to do the science.</p><p>Over the course of hundreds of sessions, we sought to answer two questions: What can dolphins hear and what can they see around their heads?</p><p>To test dolphin hearing, we set up microphones and cameras to record dolphin behavior as we played drone noise in the air. We analyzed the responses to each noise – such as how many dolphins looked at the speaker – and used these as a proxy for their ability to hear the sounds.</p>
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="5f31daf07a652b8d64a093b993ee4e96"><iframe lazy-loadable="true" src="https://www.youtube.com/embed/UjmQeH3vXHI?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Robodolphin doesn't look like a real dolphin, but it doesn't need to in order to train our drone pilots. C.J. Barton / Oklahoma State University / CC BY-ND<p>To build robodolphin, we worked with dolphins trained to "chuff" or sneeze on command to measure spray characteristics. We used high-speed photography to see the dolphins' breath as it moved through the air. Then we conducted high resolution CT scans of a dolphin head and 3D-printed a replica of a nasal passage.</p><p>Now, we have a complete robodolphin and are tweaking its sprays to be nearly identical to the real thing. This will allow us to determine how close we need to get to collect the samples, and therefore, how quiet our drone needs to be.</p>
The replica dolphin blowhole was designed from a scan of a real blowhole passage, and the spray it produces closely matches the real thing. Alvin Ngo, Mitch Ford and CJ Barton / Oklahoma State University / CC BY-ND
A Bit of Practice, Then Into the Wild<p>In the next few months, we will test flights over robodolphin with existing drones to determine the timing and strategy for collection. From there, we will fabricate a low-noise drone that can fly fast enough and with sufficient maneuverability to capture samples from wild dolphins. Like a video game, we will use the visual field data to develop approach trajectories to stay in the visual blindspots.</p><p>We plan to test our drones on a truck-mounted robodolphin moving down a runway, then using a boat to simulate realistic conditions. The next steps will involve ocean testing with dolphins trained for open ocean swimming. These tests will determine if our devices can catch and hold the hormones as the drone flies back to a researcher's boat.</p><p>Finally, we will deploy the system to collect data on wild dolphins. Our first goal is to test resident dolphins – animals that live on the coasts and deal directly with boat and oil industry noise – which will allow us to learn more about stress resulting from human impacts.</p><p>Those samples are a way off, but if all goes well we will have a specially built drone capable of flying long distances and capturing samples undetected in a few years. The samples collected will allow researchers to do better science with impact on the animals they study.</p>
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Environmental and Health Hazard<p>Experts say e-waste, which is now the world's fastest-growing domestic waste stream, poses serious environmental and health risks.</p><p>Simply throwing away electronic items without ensuring they get properly recycled leads to the loss of key materials such as iron, copper and gold, which can otherwise be recovered and used as primary raw materials to make new equipment, thereby reducing greenhouse gas emissions from extraction and refinement of raw materials.</p><p>Refrigerants found in electronic equipment such as fridge and air conditioners also contribute to global warming. A total of 98 Mt of CO2-equivalents, or about 0.3% of global energy-related emissions, were released into the atmosphere in 2019 from discarded refrigerators and ACs that were not recycled properly, the report said.</p><p>E-waste contains several toxic additives or hazardous substances, such as mercury and brominated flame retardants (BFR), and simply burning it or throwing it away could lead to serious health issues. Several studies have linked unregulated recycling of e-waste to adverse birth outcomes like stillbirth and premature birth, damages to the human brain or nervous system and in some cases hearing loss and heart troubles.</p><p>"Informal and improper e-waste recycling is a major emerging hazard silently affecting our health and that of future generations. One in four children are dying from avoidable environmental exposures," said Maria Neira, director of the Environment, Climate Change and Health Department at the World Health Organization. "One in four children could be saved, if we take action to protect their health and ensure a safe environment."</p>
Europe Leads the Way<p>While most of the e-waste was generated in Asia (24.9 Mt) in 2019, Europe led the charts on a per person basis with 16.2 kg per capita, the report said.</p><p>But the continent also recorded the <a href="https://www.dw.com/en/the-eu-declares-war-on-e-waste/a-51108790" target="_blank">highest documented formal e-waste collection and recycling</a> rate at 42.5%, still below its target of 65%. Europe was well ahead of the others on this front. Asia ranked second with 11.7%.</p><p>The authors said while more that 70% of the world's population was covered by some form of e-waste policy or laws, not much was being done toward implementation and enforcement of the regulations to encourage the take-up of a collection and recycling infrastructure due to lack of investment and political motivation.</p><p>"You have to think about new economic systems," said Kühr.</p><p>One approach could be that consumers no longer buy the products, but only the service they offer. The device would remain the property of the maker, who would then have an interest in offering his customers the best service and the necessary equipment. The maker would also be interested in designing his products in such a way that they are easier to repair and easier to recycle, Kühr said.</p>
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