Local officials cope with growing swine-flu problem

If the flu has gotten you down recently, chances are it's the swine flu.

With the U.S. Centers for Disease Control estimating that H1N1, or swine flu, accounts for 99 percent of all current influenza-like illnesses, the Ohio Health Department has stopped testing for the designation in most cases.

But in Athens County, health officials are now investigating whether the death of a 3-year-old Thursday at O'Bleness Memorial Hospital in Athens may have been caused by H1N1 influenza. Athens County Coroner Harold Thompson said that a postmortem test has showed that the girl was positive for influenza A, of which H1N1 is a subtype.

Thompson confirmed that an autopsy, including an H1N1 test, is being conducted, with results anticipated in six to eight weeks.

On Friday, the World Health Organization reported that nearly 5,000 people have died from swine flu since it emerged this year, though that's reportedly considered a gross under-estimate. Federal officials have estimated that H1N1 has killed 1,000 Americans and hospitalized more than 20,000. On Saturday, President Barack Obama declared the swine flu outbreak as a national emergency.

Treatment for H1N1 influenza is the same as treatment for the seasonal flu according to the CDC, so most patients with clinical illness consistent with uncomplicated influenza who reside in an area where influenza viruses are circulating do not require diagnostic influenza testing for treatment. Symptoms for H1N1 are also the same as seasonal flu, including fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills fatigue, diarrhea and vomiting.

Patients who should be considered for diagnostic testing, the CDC recommends, include hospitalized patients with suspected influenza, patients for whom a diagnosis of influenza will inform decisions regarding clinical care, and patients who died of an acute illness in which influenza was suspected.

Area hospitals have recently announced a limitation on visitors due to widespread H1N1 influenza. O'Bleness in Athens is allowing only one visitor per patient in patient areas and no visitors under the age of 18. One exception is that grandparents and a designated companion may attend a delivery in the birth center. Any visitor with a cough or runny nose will be asked to leave the hospital and will be given a surgical or procedure mask to wear on the way out, O'Bleness said in a release.

At Doctor's Hospital in Nelsonville, visitors under age 18 are not permitted in any part of the hospital, only two persons will be allowed to visit each patient at one time, and visitors who have any flu-like symptoms will not be permitted in the building.

Meanwhile, Ohio University will hold its first 2009 H1N1 vaccination clinic for priority group members of OU, including students, faculty staff and dependents, on Nov. 1 from 9 a.m. to 4 p.m. at Nelson Dining Hall.

The university recently received its first shipment of 500 doses of injectable H1N1 vaccine. Priority groups include pregnant women, household contacts and caregivers for children younger than 6 months of age, health-care workers and medical service personnel, children 6 months through 4 years of age, and individuals with high-risk factors including chronic pulmonary, cardiovascular (excluding hypertension), renal, hepatic, cognitive, neurologic/neuromuscular, hematologic or metabolic disorders.

There is no pre-registration and no charge for the vaccination clinic, and the vaccine will be administered on a first-come, first-served basis. The university has established a Web site to provide more information about H1N1 at www.ohio.edu/h1n1.

According to the CDC, the U.S. government has purchased 250 million doses of H1N1 vaccine, so anyone who wants to get the vaccine will have the opportunity to do so. The CDC said that the vaccine will be made available as quickly as possible as it rolls off the production lines, so initially, the vaccine will be available in limited quantities. The CDC estimated Ohio's first allocation of the H1N1 vaccine at 61,500 doses.

Officials remain uncertain as to when the H1N1 vaccine will be available to the population at-large.

Athens City-County Health Department Administrator Charles Hammer said that the county has seen few tested cases because influenza-like illnesses are so widespread right now.

"The main reason we do the testing for H1N1, originally, was to identify early cases so we could try to isolate them and maybe prevent the spread," Hammer said. "We're way past that right now."

The other reason to test, he said, is in the case of hospitalization or death. Hammer provided numbers for confirmed influenza A hospitalizations, but warned that the numbers provided are deceptively low.

"It's not a good reflection of the number of cases out there because there's a lot of people who have mild cases and they're not seeking any medical treatment, and where medical treatment is sought only a few are sent for confirmatory testing," Hammer said. "And then there are also cases that are laboratory confirmed that aren't communicated back to the health departments."

Nevertheless, the numbers show, for confirmed influenza A hospitalizations, Athens County has one case, Gallia County has six cases, Hocking County has two cases, Jackson County has four cases, Meigs County has two cases and Vinton County has one case as of Oct. 22.

Anecdotally, Hammer said, quick-care facility managers he's talked to have said that normally this time of year they see around 30 cases per day, while this year they are seeing more like 90 cases.

"There's a real spike in activity and we suspect that a lot of those influenza-like illnesses are H1N1," Hammer said.

Figures from the American College Health Association show that 95 percent of reporting institutions had new cases of influenza-like illnesses in the week ending Oct. 16. In Ohio, this averaged to about 15.1 cases per 10,000 served at the institution. That figure, naturally, doesn't include unreported cases of illness.

In a letter to students, faculty and staff earlier this fall, Dean of Student Ryan Lombardi emphasized that there is no cause for panic. The university is stressing that prevention is key to reducing the chances of becoming ill, he said.

These prevention techniques include good hand hygiene by washing your hands and using sanitizer. He also suggested covering your mouth and nose with a tissue when coughing or sneezing. Lacking the tissue, he said to cough or sneeze into your elbow or shoulder, not into your hands.

David Hopka, assistant vice president for safety and risk management, said previously that OU has designated 25 rooms in various residence halls and another 34 in Bromley Hall for students who need to "self-isolate" themselves if they become ill with the flu. Dining services will prepare nutritious meals that other students can take to their friends in self-isolation, Hopka said. The university will be encouraging students to develop their own buddy systems for getting food back and forth to sick students.

In a weekly press update, CDC Director Thomas Frieden said H1N1 has affected disproportionately young adults and children, people ages 5 to 24.