I spent Sunday morning in the ER of my local community hospital in Hays County, Texas.  While my husband lay on the gurney having an IV line inserted, I distracted his attention by conversing with the nurse. I can’t recall what prompted it, but the nurse, Elizabeth, offered her experience with this year’s influenza season.

“I’ve been an ER nurse for 10 years. When it comes to the flu, this year was a lot different. We’ve only seen a handful of cases.”

Like many U.S. hospitals, it’s used by the community for primary care.

I asked Elizabeth if she had any ideas to explain why they’re not seeing patients with influenza.

“A lot more kids do the Dracula cough,” she said. “You know, coughing into their elbow. The schools really emphasize it with the kids, and it’s getting to be the norm.”

Elizabeth and I quickly rattled off a few more possibilities:

• Did more people get a flu shot this year compared to previous years?
• Did it have something to do with this year’s four-strain vaccine?
• Are those strains less virulent?
• Is it just an anomaly in our locality?

The flu season will continue for several months. Elizabeth and her fellow ER nurses may eventually see more cases as the season continues into next year. By June 2014, the CDC’s National Respiratory and Enteric Virus Surveillance System will answer some of our questions. They’ll likely report on the virulence of the strains and percentage population vaccinated. We’ll have to wait for other researchers to examine the impact of the Dracula Cough.