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The 2019-2020 flu season started early — the earliest beginning in more than 15 years — and has local hospitals placing restrictions on visitors.

But is it worse than recent flu seasons? Maybe. Marion County emergency room visits for flu-like illness in late December reached the highest point in the past decade, local health officials reported.

Here’s what we know:

Is the flu especially strong this season?

Dr. Christopher Doehring, vice president of medical affairs for Franciscan Health, said it has been an interesting early flu season.

While he said this year’s flu virus isn’t causing unusual symptoms, Doehring said he saw a slightly unusual predominance of influenza B in early November with kids. That spike has continued with adults in the last two or three weeks.

“It’s primarily driven by young people, kids and adolescents,” Doehring said, “but we are now in the last couple of weeks seeing a significant uptick in older patients getting sick and having to be hospitalized.”

Doehring said having so much early activity in young people could be dangerous because of intergenerational gatherings that often occur around the holidays. He said we could see a spike in cases of people 65 or older a week or two after the holidays.

Hospitalizations due to flu-like illnesses were low initially but have started to increase in the last week or so, Doehring said. Despite the increase, hospitalization totals have not reached levels usually seen during the peak of flu season.

“We certainly haven’t seen the deaths yet associated with the flu like we do in some years, but some of that may still be to come as the older population gets affected.”

The Indiana State Department of Health does not have data on the severity of illness, communications project manager Greta Sanderson said.

How many people have had the flu in Indiana this season?

While precise numbers of people experiencing flu-related illness aren’t available, the Marion County Health Department and Indiana State Department of Health track the percent of patients who visit health professionals with flu-like illnesses.

From Dec. 22 to Dec. 28, 6.16% of Marion County emergency department visits had symptoms of a flu-like illness, the highest percentage since at least the 2010-2011 season.

Statewide, 3.39% of patients in Indiana emergency departments and urgent cares complained of flu-like illnesses in late December, the most for that time period since reporting standards changed in the 2015-2016 flu season.

Nationwide, the Centers for Disease Control and Prevention estimates there have been at least 4.6 million flu illnesses and 2,100 deaths from the flu this season, which started in about October.

How many people have died from the flu in Indiana?

There had been seven influenza-associated deaths in Indiana as of Dec. 21, according to the most recent data available from the Indiana State Department of Health.

Five of those deaths were people 65 years old or older.

Three flu-related deaths were reported in Indiana at the same time in the 2018-2019 season, nine in the 2017-2018 season.

Is the flu better or worse in Indiana compared to other states?

Indiana’s flu activity is high, but CDC maps show it’s even worse in more than a dozen states, including neighboring Illinois and Kentucky. Kentucky has the highest classification, joining many Southern states, including Tennessee, Alabama, Mississippi and Georgia.

On the other hand, the CDC categorized flu activity in Ohio as minimal.

Is the flu shot effective this year?

Effectiveness estimates for this season are not yet available because it’s early in the season.

The effectiveness of a flu shot is depends on how the vaccine lines up with the year’s strand of the virus and the health and age of the person being vaccinated, the CDC says.

At this point in the season, Indiana is predominantly experiencing the influenza A/H1N1 strain, followed by influenza B Victoria, said Sanderson with the Indiana State Department of Health. The CDC says current vaccines tend to work better against these two viruses, with lower protection against the influenza A/H3N2 virus.

Overall, recent studies cited by the CDC show the flu vaccine reduces risk of illness by 40% to 60% during seasons when the viruses are well-matched to the vaccine.