County, schools brace for swine and seasonal flus

ADDISON COUNTY — Every year in the United States, anywhere from five to 20 percent of the population gets the flu, and more than 200,000 individuals are hospitalized from complications from seasonal flu.
But the buzz this year isn’t about the seasonal flu. It’s about the flu caused by the H1N1 virus, which was first detected in individuals in the United States in April. In June the World Health Organization signaled that a pandemic of the novel H1N1 flu was under way.
Now, local schools, health care providers and state health officials are keeping close tabs on the spread of the virus heading into the fall and winter flu season.
That’s meant monitoring cases of the flu in the southern hemisphere, which experienced its flu season this summer, and carefully watching the virus in the United States.
“Because there’s not really widespread immunity on any level, there’s a potential that it will make more people sick than the seasonal flu does,” said Patsy Kelso, the Vermont state epidemiologist.
Commonly referred to as “swine flu,” the novel H1N1 flu is a respiratory infection caused by a type-A virus that regularly causes outbreaks of influenza in pigs.
As of Sept. 1, the Vermont Department of Health has confirmed five cases of H1N1 in Addison County. Sixty-eight cases had been confirmed statewide. So far, no deaths have taken place in the state as a result of the virus, and three hospitalizations have occurred.
According to a report released in August by a presidential advisory panel, the flu virus could cause 30,000 to 90,000 deaths in the U.S., primarily among children and young adults. (About 36,000 Americans die from seasonal flu-related causes annually.)
So far, no vaccine is available for H1N1, though one is being developed. Kelso said the state anticipates receiving the first shipment of the new vaccine in mid-October.
The first doses of that vaccine will be available to individuals in five priority categories that the Centers for Disease Control and Prevention (CDC) has identified. Those categories include pregnant women, individuals who live with or care for infants less than six months old, health care and emergency medical service personnel, children and young adults between six months and 24 years old, and individuals between 25 and 64 years of age with medical conditions like asthma, heart disease, diabetes or immune suppression disorders that put them at higher risk for flu-related complications.
Unlike the typical seasonal flu, Kelso explained, the H1N1 virus seems to disproportionately affect children and young adults, which is why vaccinating older individuals is not a CDC priority at this time.
The thought, she said, is that senior citizens have lived through many flu seasons, and have in some cases built up antibodies that could protect them from the H1N1 strain.
“Younger people, having been exposed to far fewer viruses over their lifetime, really don’t have protection at all,” Kelso said.
At this point, the state anticipates having enough doses of the H1N1 vaccine — which requires two shots — to vaccinate everyone who is interested. The five priority groups will simply be the first to receive the vaccine. Once that demand has been met, individuals who do not fall into any of those categories, including those over the age of 65, will be eligible for the vaccine.
Each state will receive a certain number of vaccines in their first shipment based on population. Kelso said the Vermont Department of Health is working with health care providers, long-term care facilities, colleges and other institutions to determine interest in the vaccine.
The state is also considering setting up voluntary vaccination clinics in schools.
Once the first shipment of vaccines goes out in October, the state anticipates receiving weekly additions to its stockpile.
At Porter Medical Center, spokesman Ron Hallman said the hospital is confident it will receive enough doses of the vaccine to inoculate employees and provide the immunization to patients who elect to receive it.
“Beyond that role, which is fairly limited, we’ll be here to take care of sick people if they’re needing hospital care,” Hallman said.
Hallman also said the hospital will practice “good preventative measures” to isolate any patients who do require in-patient care at the hospital for H1N1.
“It’s going to be something that we’re going to have to figure out as it presents itself,” Hallman said. “You really can’t anticipate at this point the magnitude of any kind of public health issues.”
Given that the H1N1 virus disproportionately affects children and young adults, local schools and Middlebury College are gearing up to plan for the possible spread of the disease.
As students headed back to school in many parts of the county, school nurses from around the region sat down with state officials, members of their supervisory union, and doctors and nurses to map out a plan.
The CDC, Kelso said, is stressing that schools should remain open, limiting students’ exposure to the flu in the schools while not disrupting the learning process.
“We’re trying to balance the risks and benefits of keeping schools open (if the virus spreads),” Kelso said.
Anne Cohn, the nurse at the Ferrisburgh Central School for more than 10 years, said her school district is sending out a letter to parents and staff updating them on the virus. That letter urges parents to remind their children about basic hygiene practices, and to keep students home from school if they fall ill.
Because no one knows how severe the H1N1 pandemic could be, Cohn said, nurses are trying to strike a balance between educating the public and preventing the spread of any panic.
“It could be a little blip or it could be more severe,” Cohn said. “It’s an unknown. We’re all just saying, let’s communicate.”
Meanwhile, at Middlebury College, college officials are monitoring reports from the World Health Organization and the CDC. The school is keeping students updated on the virus through its Web site, and is requiring all students to register evacuation plans with the school outlining their plans should the school be forced to close.
While that’s not a likely course of action, the college has said it would shut its doors temporarily if H1N1 mutates into a lethal illness for college students.
Though speculation about H1N1 has dominated talk of this year’s flu season, local health care providers are also bracing for the seasonal flu.
At the Marble Works Pharmacy in Middlebury, pharmacist Tom McDonald said he is waiting for a supply of seasonal flu vaccine, which the pharmacy receives and distributes every year. That vaccine should be arriving in early September, and McDonald said the pharmacy has booked a large supply.
At the state level, Kelso encouraged individuals to speak with their health care providers about getting the seasonal flu vaccine. While this vaccine is not expected to provide protection against H1N1, Kelso said that, in general, most people who want to reduce their chances of getting the flu can get vaccinated.
Of course, in addition to obtaining vaccinations, Kelso and the CDC recommend individuals follow basic hygiene practices. Those include covering one’s mouth and nose with a tissue when one sneezes; avoiding touching one’s eyes, mouth or nose; and staying home from work or school when ill to limit contact with other individuals.

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