Preparing for the pandemic

Doctors’ offices around Butte County are dealing with a sudden spike in kids sick with flu-like symptoms and questions from parents about the new swine-flu vaccine, keeping pediatricians such as Dr. Craig Corp busy.

“Our phones have been ringing off the hook all day because of this,” Corp said on Monday (Oct. 12). “We’ve been giving out vaccinations all day.”

His office, Chico-based North Valley Pediatric Associates, received about 500 of the 2,300 swine flu—or H1N1—vaccinations distributed to health-care providers throughout the county, and started administering the new inoculation on Friday (Oct. 9).

Corp has been reassuring concerned parents that the vaccine is completely safe and is made by the same company that produces the seasonal flu vaccine. The virus is similar to the seasonal influenza—H1N1 is simply a different strain of flu.

Corp relayed his message as county health officials were trying to predict how hard swine flu would strike the region. For now, though, it’s pretty much a waiting game.

Since April, there have been 71 confirmed cases of swine flu in Butte County, and 15 of them have resulted in hospitalization. However, Butte County Public Health’s medical director, Director Dr. Mark Lundberg, said it’s nearly impossible to track the number of infected individuals, since the county has limited its testing to those who have been hospitalized or become severely ill from the virus.

“It doesn’t tell the story at all,” he said. “That just tells the story of the sampling we’re doing out there.”

The seasonal flu hasn’t yet hit the region, so Lundberg said a “good fraction” of those suffering from flu symptoms likely are infected with swine flu. The good news is that the virus typically affects people the way seasonal flu does—a few days of aches, pains and fever. The bad news is that those who are at risk of being hospitalized by seasonal flu are also more likely to become extremely sick from H1N1.

“Although most of us will do fine with the [swine] flu, it’s unpredictable,” Lundberg said. “There will be some people who will be fine, and some who will be hurt by this.”

The first doses of the H1N1 vaccine arrived in Butte County on Oct. 8. Lundberg said private doctors’ offices authorized by the state and the Public Health Department were first on the priority list, and were sent the vaccine directly from the distributor.

Medical officials have linked H1N1 to 76 pediatric deaths nationwide since April, according to the Centers for Disease Control and Prevention. Sixteen of those were confirmed in the past week. No deaths from Butte County have been reported.

Prevention, Lundberg emphasized, is the best insurance to staying healthy.

That’s also the message federal health officials are sending to schools across the country, through campaigns such as “www.flu.gov” and “www.findaflushot.com.”

Lundberg said the virus, which can live on surfaces for periods ranging from one hour to a day, is most often spread through hand contact with surfaces. The virus’ properties, combined with the close proximity children have with one another in school environments, pose a particular complication to schools. In response, Chico Unified School District has been working closely with local health officials to prevent the virus from spreading throughout the district.

Dave Scott, CUSD’s director of educational services, said some district schools will be the sites of H1N1 vaccine clinics during after-school hours once the county receives the vaccine. When it arrives, likely before the end of this month, children (the most at-risk group) and health-care workers will get to the front of the line.

District administrators are keeping close tabs on info from the Public Health Department and the CDC to monitor the level of H1N1 activity in the state and throughout Butte County. Additionally, they are focusing on prevention and promoting good hygiene, instituting such measures as stationing bottles of hand sanitizer in high-traffic areas around schools.

Meanwhile, CUSD’s nurses, whose jobs remain intact despite recent budget cuts, are paying close attention to student health. “Thankfully, we’ve been able to maintain all our school nurses,” Scott said.

The district has an emergency preparedness plan in case there is an outbreak at one of its 23 campuses. The “Safe Schools Plans” devised by the district are compiled with the help of the county’s and city’s fire and police agencies, as well as other local resources that may help in the event of a particular crisis.

“We have emergency preparedness plans for a whole variety of different situations, ranging from—God forbid—an airplane going down near a school site to chemical spills,” Scott said. “Now, we’ve included the pandemic flu.”

Parents have been kept up to date through newsletters and links on the district’s Web site. The district’s most current pandemic-flu plan focuses on prevention rather than the potential of school closures. Scott said the preparation contrasts sharply with last year, when health officials encouraged the district to shut down campuses with infected students. He said H1N1 diagnoses will now be handled on a case-by-case basis, and any temporary closures will be determined by the health department.

At the same time, since the swine flu has been around for multiple months, private clinics are starting to test for the virus. The results will help the county monitor local activity.

For now, the federal government, state health officials and the local school district are encouraging, but not mandating, parents to get their kids vaccinated for both the seasonal and H1N1 flu strains—if not for health reasons, for convenience. “The flu will set you back, it will interrupt your life,” Lundberg said. “Whether it[‘s plans for vacation, finals are coming up, the holidays or a skiing vacation. [Getting vaccinated] is just the best insurance.”

As of yet, the H1N1 vaccine is available only in the form of nasal spray, which isn’t safe for children younger than 2 and others with compromised immune systems, including those with asthma, heart disease or diabetes. Since the amount of available vaccine is limited, Corp said doctors have been advised to give the vaccine only to children ages 2 to 9 and individuals who live with someone who is infected with H1N1.

In a couple of weeks, he expects the health department to broaden the recommendation to include young people up to age 22. Other high-risk individuals, including pregnant women, who have been hit harder by the virus than other populations, will have to wait for the vaccine to be released in the form of a shot. That may take another month.

Meanwhile, physicians will keep busy with their first allotment. As of Wednesday morning (Oct. 14), the physicians at North Valley Pediatric Associates had administered 55 doses.

Corp recommends the vaccine for his healthy patients, and noted that if all children were vaccinated for seasonal and pandemic flu at the beginning of flu season each year “we could wipe out pandemic flu all together.” For parents whose children have already come down with the virus, there’s still no need for panic.

“Healthy kids are going to do great,” he said. “They’ll fight it off on their own—they’ll just be sick and miserable for a few days.”