ATLANTA – The number of states hit hard by the flu has nearly doubled to 24 in the past week, the government said Thursday as it rushed to ship 100,000 doses of the vaccine to combat shortages and head off what could become one of the worst flu seasons in years.
The outbreak has taken an enormous toll nationwide: At least 20 children have died. Schools have shut down. Emergency rooms have been filled with sick children. And doctors' offices have been forced to turn away droves of people seeking flu shots.
Some experts predict this year's death toll easily could surpass the annual average of 36,000 flu deaths. Health officials are unsure why the outbreak has hit so early, why it has caused so many problems in the West, and why it seems to be so lethal in children.
"If it were me, I'd be on the phone to your doctor, calling around to see if you could find some" vaccine, said Dr. Randall Todd, Nevada's epidemiologist.
The Centers for Disease Control and Prevention (search) said the flu has hit all 50 states at least sporadically, and the season has not yet peaked nationally. Nearly the entire western half of the country — California being the major exception — is now considered to have widespread flu. Last week, 13 states had widespread outbreaks.
Health and Human Services Secretary Tommy Thompson said the government had arranged for 100,000 doses of adult vaccine to be shipped from Aventis Pasteur (search) immediately and distributed based on each state's population. In addition, 150,000 doses of children's vaccine are expected to be shipped to the states by January, Thompson said.
The nation's two producers of flu shots reported last week that they had shipped their entire supply of about 80 million doses. However, Aventis had set aside 250,000 doses at the CDC's request last week when it became clear that shortages might develop.
Dr. Julie Gerberding (search), director of the CDC, said the center is recommending that doctors give high-risk groups top priority for flu shots. That means the elderly, children under 2, those with chronic medical conditions, and women in the second and third trimester of pregnancy.
"The flu season is far from over, we are going to have to prioritize," Gerberding said.
Around the country, several schools closed because so many students are out with the flu.
In Colchester, Conn., the public Bacon Academy closed Thursday after more than 300 students — more than one-third of the student body — called out sick with flu-like symptoms. Madison Junior High in Mansfield, Ohio, also closed for the rest of the week after 250 of 900 students were out sick Wednesday, principal Timothy Rupert said.
"We've never closed down for flu," said Rupert, who has worked at the school about 60 miles north of Columbus for 23 years.
One of the hardest hit communities was Malad, Idaho, a town of about 2,000 people near the Utah state line that virtually shut down in the past week because so many people were ill. Church services and Christmas programs were canceled, as was the wrestling match and drill team show. Even Santa had to postpone his visit with the children.
Students in Malad returned to class on Thursday, but 15 percent of the 860 students were still out sick.
"It's the worst I've seen in many years," said School Superintendent Lynn Schow. "We think we're OK here, and it hit us hard."
In Illinois, more than 500 people, many toting their children, lined up in the bitter cold Thursday to receive the last of the DuPage County Health Department's flu vaccine supply. In Las Vegas, residents had to wait hours to get flu shots.
"We are out of the vaccine at this point," said Jennifer Sizemore, spokeswoman for the Clark County Health District. "We are working hard to get some more because there's still a demand out there."
States are not required to track the number of flu cases, so the exact total is not clear. Many cases are written off as ailments such as pneumonia or colds and never classified as the flu, but doctors say they are seeing a clear increase this year.
Despite the severity of the early outbreak, health experts are not ready to predict just how bad the flu season will be. The season still may peak as early as December, rather than February, which is the norm.
On Thursday, the CDC added Arizona, Indiana, Iowa, Mississippi, Missouri, Montana, North Carolina, Oklahoma, Oregon, Rhode Island and Virginia to the list of states with widespread flu activity.
Last week, only Alaska, Arkansas, Colorado, Idaho, Nebraska, Nevada, New Mexico, Pennsylvania, Tennessee, Texas, Utah, Washington and Wyoming were listed as having widespread activity by the CDC.
As for why the West is having the most cases, Dr. Kimberley Shoaf, assistant director for the UCLA Center for Public Health and Disasters, said one reason might be that the flu strain changed as it moved West.
"I think it mutated just as it got here, and we have this different strain," she said.
The CDC said it is unable to know how many children typically die of the flu each year, making it unclear whether this is in fact a particularly lethal outbreak for youngsters.
But anecdotally, this flu season seems to be worse for children, and the CDC said it plans to watch flu complications among them closely. Flu and its complications are the sixth-leading cause of death nationally among children age 4 and younger, according to the CDC.