First BV case spikes flu worry

Monday, September 21, 2009

Would you like the bad news, or the not-so-bad-news, first?

The first suspected case of H1N1 (swine flu) has been identified in a Storm Lake area middle school student, and it could spread rapidly. That's the bad. The better news is that the case is proving to be mild, like most of the H1N1 cases seen in the midwest. That's a good sign, local health officials say, that a local outbreak this season could be no more threatening than the usual seasonal flu miseries.

Buena Vista County Public Health spokesperson Pam Bogue says policy is not to identify the school the child attended, but notes that officials of the school were made aware of the case and the strategies for limiting spead of the virus.

The case was identified by a local physician, but test results will not be confirmed until next week.

Rumors of a local H1N1 case began to spread immediately, and Bogue said the public health department has started to field questions and e-mail from worried people in the area.

"I would hate to see the community in a panic," she said, "when there is a good possibility this may not be worse than a regular seasonal flu.We hope to be able to allay some of people's concerns.

"This child is mildly, not severly, ill, and that is pretty common for what we are seeing in H1N1 in the state."

With all the publicity over the H1N1 flu, it is not surprising that people are reacting strongly, but there is also a lot of misinfomation floating around, she says.

Some of the facts people should be aware of:

* WHAT IS IT? - H1N1 (also known as Novel Influenza A) is a new strain of virus that the health care community has not seen before. It's spread may be rapid, because people do not have any immunity built up against the strain.

* WHO IS GETTING IT? - This type of flu seems to impact younger people at an especially high rate - from birth to around age 24. After that, percenges of cases drop off rapidly as age increases, and only about 1 percent of cases are being seen in the elderly. Bogue says this may be because younger people can easily pass germs in classroom or dormitory settings, or because older people may have some related immunity from an outbreak of a swine flu variation in 1972.

* HOW DO YOU GET IT? - Only from other people, never from pigs or pork. It can be passed through germs in the air from an ill person coughing or sneezing, or picked up from surfaces touched by a sick person, then touching your own eye, nose or mouth areas.

* HOW DO I KNOW IF I HAVE IT? - Symptoms are quite similar to other common forms of the flu - fever, cough, sore throat, runny or stuffy nose, body aches, headaches, chills. Some may experiences vomiting or diarrhea.

* WHAT TO DO? - There is as yet no vaccine to prevent the flu. It is expected in mid-October, but at first may be available only to higher risk groups. Treatment is usually as simple as over-the-counter medication like Tylenol, rest, liquids, and waiting three days to a week to get better. In the event of high fever, difficulty breathing, chest pain, severe vomiting, bluish or grayish skin tone, confusion, dizziness or dehydration, see a doctor. If a child becomes suddenly very irritable or is hard to wake up, a parent should also consult a doctor.

* PREVENTION - Good hygiene is still the best defense. Wash hands often with soap and water for at least 20 seconds (you can teach kids that this is the time needed to sing the Happy Birthday song). Alcohol-based hand sanatizer is no replacement, but can help between washings if you can't get to soap and water. Cough or sneeze into a Kleenex and throw it away immediately, or if you must, use your sleeve or crook of your elbow to cover - don't sneeze into your hands.

"If things continue as we are anticipating, we are going to see a lot of people who get a mild illness. Public health and physicians are monitoring the situation - we want to make sure the virus doesn't resort or mutate into something more serious," Bogue said.

The State is launching a campaign to enourage people to do the "Three C's" - Clean, Cover and Confine - that is, wash often, cover sneezes, and stay home when you are sick.

"Don't go shopping, don't go to work for a couple of hours to see how you feel, don't go to school. You need to stay home for at least 24 hours past the time your fever is gone (without the impact of medication).

"This kind of flu is so easy to catch, and with no immunity, it could easily become very widespread. When you think of the number of people that someone in a school bulding or a business may come into contact with in a single day, you get an idea of how rapidly this can get around," Bogue says.

With the H1N1 strain, people may wake up not feeling well, but they probably won't feel terribly sick. This may lead them to try to get through a day at work or school instead of confining themselves, making the spread even faster.

A couple of weeks ago, health officials nationwide were saying that about 60 percent of the flu cases being seen at this early point in the season were H1N1 - now it's about 90 percent, Bouge says.

"We could see a good percentage of especially our people up to the mid-20s age getting this. We really want to stress that people need to protect themslelves, but not to panic about what right now seems to be a very mild illness and may continue to be."

For example, local doctors and health facilities could be overrun if everyone who gets the flu rushes to the doctor. In fact, the University of Iowa labs have already announced that they will not be doing testing to diagnose the illness, just to track it. Health providers will be limited to the number of patients that can be tested, because H1N1 is expected to be too common to keep up with before the season is over.

The World Health Organization is also encouraging people not to use anti-viral medications. The illness could be so vast that supplies are drained, and the anti-virals should be saved for those at higher risk - diabetics, ashtma sufferers, people with compromised immune systems. "Anti-virals aren't a miracle drug anyway. They don't take the flu away, just maybe shorten the symptoms by one day. A normally healthy person can handle it for one more day," Bogue said.

Parents are encouraged not to treat with aspirin, either, in children up to 18, as it is associated with the development of reye's syndrome. When in doubt, consult your physician and use the mediciations he or she advises, Bogue said.

Buena Vista County Public Health has been meeting with other health care providers for a month, encouraging schools and large employers to have a plan. "For schools, it is very important that children wash, and that younger kids be taught how to do it properly. For bsuinesses, the reality is that they may have to deal with large numbers of their workers home sick."

Unfortunately, there is no vaccine to offer yet. It should arrive in mid-October, but public health officials have already been told they will get only a fraction of their doses at a time as it becomes available.

Shots will be offered on a priority system, first to pregnant women, then to health and emergency professionals who will work with flu victims. Next on the list is people in a household with children under age 6 months (children under six months cannot be given flu shots.) Finally, vaccines will be provided to people six months to 24 years in age, and then people 24-64 with medical risk conditions in which a case of flu could be serious.

Only when all those needs are met is vaccine expected to be available to the general ublic, and that will probably be deep into the flu season.

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