Swine flu is back -- and it's starting to kill Californians again.
As Contra Costa County health officials on Tuesday announced the second recent Bay Area death this month from the virulent H1N1 flu strain, local counties reported an uptick in the number of people showing up in emergency rooms with flu-like symptoms.
Officials said the peak of the flu season is just beginning and the numbers are relatively small compared to other parts of the country, but they reminded the public that there is still time to get vaccinated.
"Some people think if they don't get it in the fall, it's too late,'' said Erika Jenssen, chief of communicable disease programs at the Department of Public Health in Contra Costa County, where 17 flu patients younger than 65 have recently been admitted to intensive care units. "The peak flu season in California comes January through March."
While different types of the flu virus have surfaced across the country, a vast majority are suffering from the 2009 strain of H1N1, health officials say. This time, however, there is no shortage of vaccine to battle the strain.
The East Bay victim, a 48-year-old woman, died last week, said Kate Fowlie, a spokeswoman with Contra Costa Health Services. The agency was made aware of her death Monday night, she said.
A 41-year old Santa Clara County woman died of complications related to the H1N1 strain last week. And over the weekend, Sacramento County reported a second and third victim from the strain. The victims were a woman in her 30s and a man in his 50s.
The U.S. Centers for Disease Control recently reported that the flu is in full swing nationally. The latest CDC figures from the final week of 2013 show widespread flu activity in 25 states, including the Pacific Northwest and Nevada, and most of the country's biggest states, including Texas, New York and Illinois.
In the 2009-10 flu season, 284,000 people -- including 657 Californians -- died from swine flu worldwide.
In Orange County, H1N1 killed a 28-year-old San Juan Capistrano woman last week. And three people in Stanislaus County died from swine flu in the last month, said Dr. John Walker, a county health officer.
Classic flu symptoms include body aches, fever, headache, sore throat, nasal congestion, runny nose and powerful bouts of sneezing.
People like 17-year-old Sophia Duran, of San Jose, aren't taking chances. She didn't get a flu shot last year, but decided to get one Tuesday during a checkup at a Santa Clara County clinic.
"It's important so I don't spread anything if I get the virus," said the Del Mar High School senior.
At the Walgreens drug store in downtown San Jose, a pharmacist said that three people already had stopped by Tuesday by mid-afternoon to get a shot. While most of the people who came in for flu shots during the fall were elderly, now younger adults are showing up, the pharmacist said.
In general, medical professionals split patients into two groups: low-risk patients with typical symptoms and those with severe symptoms who also have additional medical risk factors such as pregnancy, heart or lung disease, diabetes and asthma. Patients younger than 5 and those 65 and older are also considered high risk.
The first patient group, typically given Advil and Motrin, are sent home for bed rest and told to drink lots of fluids and avoid contact with others. The latter group gets more attention and might even be hospitalized.
"Patients with higher risk factors are told to have a follow-up visit with their own physicians," said Xavier Varela, a physician's assistant who works the ever-busy emergency room at Valley Medical Center. "But they are also the ones we tend to give anti-viral medicine -- Tamiflu -- which is in short supply nationwide."
Health professionals, noting that vaccines are plentiful and easy to secure from hospitals, clinics and pharmacies, say there are no good excuses for someone not getting their shot.
Still, people figure out a variety of ways to avoid it.
"In my family, the flu shot makes us ill," said Maria Perez, 31, of San Jose.
She said her sister, a nurse in Southern California, was told she either had to get the shot or wear a surgical mask during her work day. After two days of wearing the mask, Perez's sister decided to get a flu shot "and then she got sick for a week," Perez said.
In downtown San Jose, construction worker Frank Martinez said he hasn't gotten the flu shot yet either. "I just don't do it," the 39-year-old said. "I never have because I don't get sick."
Contra Costa County's Jenssen said that many people operate with plenty of flawed information about the flu.
"I've had many people tell me, 'I don't get vaccinated, but when I feel sick, I stay home from work so I don't spread my germs,' " said the health official. "However, for someone with the flu who is not vaccinated, they can spread the germs a full day before they feel any symptoms. By the time they stay home, they might have already passed the flu around to friends, family and colleagues."
Staff writer Katie Nelson contributed to this report.
1. Know the signs: Can include fever, cough, sore throat, runny or stuffy nose, body aches, headaches, chills and fatigue. Sometimes there can be vomiting and diarrhea.
2. Always get your annual flu vaccine. It protects against three of the most common strains: H1N1 and Influenza A and B. It's strongly suggested for young children, the elderly, pregnant women and those who are pregnant, or have asthma, diabetes, heart or lung disease.
3. Take all possible preventive actions: Wash hands frequently. Avoid contact with sick people. If you have flu symptoms, stay home for at least 24 hours after your fever is gone. Keep sick kids home from school. Cover your nose and mouth with a tissue when you cough or sneeze -- and throw the tissues away. Avoid spreading germs by not touching your eyes, nose or mouth. Drink plenty of fluids and get bed rest.
4. Faithfully take prescribed antiviral drugs: Within two days of getting sick is best, but taking them later is better than not taking them at all. They can make the flu milder and shorten the time you are sick.
Source: U.S. Centers for Disease Control