During the recent Ebola scare, Americans became transfixed with the infectious disease that ultimately killed two individuals on American soil. To the frustration of many medical providers and public health officials, it has been extremely difficult to gain the same kind of attention and traction for another virus that has proven to be much more contagious and deadly in the United States … the flu.

Now in the height of the annual influenza epidemic, the Centers for Disease Control and Prevention estimate on any given year, 5-20 percent of the U.S. population winds up getting the flu. In the best year between 1976 and 2006, flu was responsible for about 3,000 deaths … in the worst year, there were almost 50,000 flu-associated deaths. Additionally, more than 200,000 people are hospitalized each year from seasonal flu-related complications.

Typically, the death toll exceeds 35,000 annually … and, unlike Ebola, influenza is contagious before symptom onset in a significant number of people. Also unlike Ebola, there is a vaccine readily available to the public to prevent the deadly virus or lessen its severity. Yet, millions of American will once again skip getting vaccinated.

Chris Taylor, director of Community Health for the Metropolitan Public Health Department, said Nashville is well stocked with the full range of flu protection from the regular shot to the high-dose vaccine to the nasal mist at the three public health centers — Lentz, East, and Woodbine. While an appointment isn’t required, he said individuals should sign in by 3:30 p.m. for the walk-in service.

Although there is a $25 fee for the flu shot, Taylor noted many insurance companies, including TennCare, cover the immunization. For the uninsured, he said a sliding scale is available that reduces cost depending on income and ability to pay. For many, the fee slides all the way down to zero, especially when factoring in programs such as the federal Vaccines for Children.

At the time Taylor spoke to Nashville Medical News in December, the city and state were still in the ‘green zone,’ meaning there was minimal flu activity. However, Taylor noted, “My expectation is that we’re looking exactly like the pattern last year, which means heavy flu activity in late December, early January. That’s when I expect our flu season to really peak.”

Typically seasonal flu remains through the cold weather months and begins to lessen in March or April as temperatures rise. “You really want to get your flu shot before the meat of the flu season, but it’s never too late,” Taylor stressed. He added that even though it takes a couple of weeks to get the full immune response, most people are afforded some benefit from the vaccine well before that.

Although plenty of vaccine is available, it remains to be seen how many will take advantage of this year’s protection. Complicating matters was a Dec. 3, 2014 health advisory to clinicians noting that one of the four strains included in the 2014/15 vaccine had mutated. In the advisory, the CDC stated:

“Influenza viral characterization data indicates that 48 percent of the influenza A (H3N2) viruses collected and analyzed in the United States from October 1 through November 22, 2014 were antigenically "like" the 2014-2015 influenza A (H3N2) vaccine component, but that 52 percent were antigenically different (drifted) from the H3N2 vaccine virus. In past seasons during which predominant circulating influenza viruses have been antigenically drifted, decreased vaccine effectiveness has been observed. However, vaccination has been found to provide some protection against drifted viruses. Though reduced, this cross-protection might reduce the likelihood of severe outcomes such as hospitalization and death. In addition, vaccination will offer protection against circulating influenza strains that have not undergone significant antigenic drift from the vaccine viruses (such as influenza A (H1N1) and B viruses).”

Taylor said that even though the H3N2 strain didn’t match as well as it would have without the antigenic shifting, the hope is that the vaccine still offers partial protection for that strain. Furthermore, he continued, the vaccine has thus far shown to be effective against the other three strains in this year’s dose – H1N1 and two B strains.

The purpose of the CDC health alert, Taylor added, was to remind clinicians to discuss supportive care and antiviral medication options with patients, especially those in high-risk groups, should the vaccine not offer optimal protection. By reporting symptoms soon after onset, the use of neuraminidase inhibitor antiviral medications could help lessen the duration or severity of the flu.

Taylor’s hope is that Middle Tennessee providers will help explain the news stories circulating around the CDC advisory and remind patients that the vaccine is still the best way to protect against flu.

“Tell them it’s still important to get a flu shot,” he said. Taylor added it’s also a good time to share other preventive messages including the need to wash hands frequently, cover coughs, stay away from people who are sick … and perhaps most importantly, stay home and take care of yourself if you get sick.

A Look at the New Lentz Public Health Center

Last summer the Metropolitan Public Health Department moved into a state-of-the-art facility with the opening of the new Lentz Public Health Center located at 2500 Charlotte Ave. in midtown.

Named after John J. Lentz, MD, who served as health director in Nashville and Davidson County from 1920-1964, the three-story building features 106,000 square feet of space and houses more than 300 Metro Public Health Department employees. Developed in agreement with HCA as part of a public-private partnership, the hospital company developed the new facility on its property for Metro. In turn, Metro gave HCA ownership of the former Lentz property on 23rd Avenue North.

In the much larger new facility, the number of exam rooms in the preventive health clinic nearly doubled. The new dental clinic, which provides services for children up to age 21 and some limited adult emergency care, features an open bay design and x-ray suite for more efficient patient flow. Other onsite services include immunizations, birth and death certificates, Women Infants and Children (WIC) nutrition services, family planning, food protection services, a tuberculosis clinic and a sexually transmitted disease clinic.

The light-filled building was designed to pursue LEED Silver Certification and has multiple features that support sustainability and promote healthy lifestyles. There is an indoor walking track, soaring staircase to encourage climbing, and an outdoor quarter-mile walking track for both employees and the community. The WIC demonstration kitchen on the first level will be used to showcase healthy family recipes. Two public art installations, funded by Metro’s One Percent for Art Fund, add to the facility’s beauty. The center also offers improved access with sidewalks, a bus stop and a B-cycle kiosk, making it easy to arrive by foot, motor or pedal power.

Gresham Smith and Partners served as the architecture, interior design and engineering lead on the project with Supportive Design, LLC providing additional planning and procurement services. Bell/ICF was general contactor on the project, which broke ground in June 2012.