Health

Unforgiving flu takes worst toll on the poor

Research finds virus doesn't strike demographics equally

Eden Murray, 6, who died of the flu last month, is hugged by her father, Brandon Murray. Two days after her death, he suffered a life-threatening stroke. Research is beginning to find that people like the Murrays who live in low-income communities are not only more likely to contract influenza and end up in the hospital, but also are more likely to see symptoms resulting in intensive care admissions and even death. (Photo courtesy of the Murray family)
Eden Murray, 6, who died of the flu last month, is hugged by her father, Brandon Murray. Two days after her death, he suffered a life-threatening stroke. Research is beginning to find that people like the Murrays who live in low-income communities are not only more likely to contract influenza and end up in the hospital, but also are more likely to see symptoms resulting in intensive care admissions and even death. (Photo courtesy of the Murray family)
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IN IOWA

So far this flu season, 185 people in Iowa have died of the virus as of Feb. 24, the state Department of Public Health reported Friday.

While health experts say the peak of the flu season has passed, deaths from it in Iowa have continued to rise. The number of flu deaths reported in the state rose from 157 as of Feb. 17 to 185 as of Feb. 24.

None of the flu deaths reported by the public health department have been of children.

WHEELING, W.Va. — When their daughter was diagnosed with severe autism, Heather and Brandon Murray realized they’d have to protect her in ways they hadn’t with their other two children. They never left her alone. They raised the locks in their house beyond her reach so she couldn’t get out alone and wander. They stuck a sign onto the back of their car: “In an emergency situation, please be aware child may ... have no awareness of danger.”

But it was the parents who were unaware of the danger posed this winter as the worst flu season in a decade hospitalized at least 21,000 people and killed thousands. By the time it passes, it probably will have hit poor families like the Murrays the hardest.

Public health officials say this flu season is likely to continue until mid-April. But a new report Friday warns that a second wave with a different strain could be coming. While the overall proportion of influenza A viruses is declining, the report said, the proportion of influenza B viruses is increasing.

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Even when Eden stayed in bed all day one Saturday in January, the Murrays weren’t too concerned. Maybe she was just tired from school.

The next day Eden, 6, hadn’t improved, so Brandon took her to an urgent care center. The doctor prescribed antibiotics, and Brandon, 42, who made $10 an hour working for a disability service provider, took her home, noting the doctor had said she was “supposed to be OK.”

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The family went to sleep. Brandon woke at 6 a.m. and checked on Eden, who because of her condition slept in a crib in their room. In the darkness, however, he could see she wasn’t breathing, and he screamed in panic.

Thinking an ambulance would take too long, he carried her downstairs. He drove to Wheeling Hospital.

Hours later, after the doctors had come and gone, he pulled out his phone. “O god,” he wrote on Facebook. “I need a friend so bad.”

“I can’t believe this is happening,” Heather, 41, wrote on her own Facebook page.

Their daughter was gone, but the worrying was just beginning.

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Although the Centers for Disease Control and Prevention does not collect data on flu hospitalizations and deaths by income, recent research has begun to show influenza does not attack all demographics equally.

People who live in low-income communities are not only more likely to contract influenza and end up in the hospital, but are also more likely to see symptoms resulting in intensive care admissions and even death.

One study, published in 2016 in the CDC’s Morbidity and Mortality Weekly Report, found that a neighborhood’s poverty rate was deeply associated with the effects of the flu — across all regions, races and ages. Another study, this one rooted in Tennessee, found that poverty was related to the influenza hospitalization rate. A third study in November confirmed the findings.

“The ‘why’ is much more difficult,” said Kimberly Yousey-Hindes, author of the study in the CDC journal and a lecturer in epidemiology at the Yale School of Public Health. There are hypotheses: The poor often have a lower baseline of health and usually live in more crowded homes and neighborhoods. Research also has shown they are less likely to get flu shots, which, for children on Medicaid, are funded through a government program called Vaccines for Children.

For adults in some states, he shot is covered by Medicaid. But the decision to skip the flu vaccine, experts say, appears to be as much about the difficult realities of poverty as it is about access to vaccines.

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“We hear from a lot of families that, ‘I wish I could have come sooner, but I was afraid I would lose my job,’” said Marcee White, a doctor with Children’s National Health System.

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It an be a long illness of can move with an unforgiving quickness.

It haunts Rebecca Hendricks three years after Scarlet’s death.

Their family had just spent eight months in a motel, living on food stamps and insured by Medicaid. Hendricks didn’t think about flu vaccinations because she had so much going on, because she wanted to succeed at her job, because why would she ever worry about the flu?

Scarlet, 5, was sent home from kindergarten on a Wednesday. Friday, she went into the hospital. Three hours later, she was dead.

“I didn’t take my daughter to the doctor’s,” Hendricks said, unable to forgive herself.

The guilt, the powerlessness — it led her to start a grass-roots group called the End-Fluenza Project and to seek out mothers like herself, one of whom she found living on the other side of the country, in a poor town, in a poor state.

“From one flu mom to another,” Hendricks wrote to Heather Murray that day. “I, too, lost my babygirl to flu.”

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Two days after Eden died, when Brandon had been inconsolable with grief, he had a stroke.

Now his wife looked at him in the hospital bed, still recovering after surgery to remove the right side of his skull to ease swelling in his brain.

She wanted to believe he could recover soon, but knew she would probably be visiting hospitals and rehab centers for the foreseeable future — another worry in a life quickly becoming defined by them.

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The entire family already had the flu that year, shortly before Eden got sick, and maybe it wasn’t done with them yet. So Murray rarely allowed the kids out of the house, fearful a return to school could allow another flu strain into the house. She had all but stopped having visitors over. And when she left the hospital, she always made sure to lather her hands in antibiotic foam.

She barely slept. Her two other kids came down with some sort of illness, and she didn’t know whether she should take them to the hospital or wait to see if they would feel better.

At the house, the blinds were drawn. A blanket was draped across the front-door window. “I’m just so paranoid now about everything,” Murray said, trying to pull herself together. But today was not the day for it.

She canceled her only appointment and remained inside, closed off from everything, waiting for the flu season to pass.

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