July 29, 2009 - Southwest Health District Investigates Influenza A

In response to separate Influenza A outbreaks involving children in two of its 14 counties, Southwest Health District has partially reactivated its Pandemic H1N1 Emergency Operations Center and stepped up surveillance and education efforts in the region.

“We are monitoring what appear to be Influenza Type A clusters in Dougherty and Lee counties,” said Southwest Health District Deputy Director Brenda Greene. “One of the clusters is associated with attendance at a summer program, while the other is associated with a church-related trip. Any time clusters of disease occur, we are concerned. When the clusters involve children our level of concern grows even more.”

Public Health is working closely with the organizations, parents and other healthcare providers to provide guidance and assistance in prevention, control and treatment of the disease, Greene said.

“While these are the first such Influenza A outbreaks we have seen in our District, Pandemic H1N1 (a strain of Influenza A) clusters are becoming common in summer camps and programs elsewhere in Georgia and across the country,” added Southwest Health District Health Director Dr. Jacqueline Grant. “Unfortunately, we expect to see more people, including more children, fall ill, possibly require hospitalization and perhaps even die as the pandemic progresses. Southwest Georgia residents need to be aware of that and prepare, especially when students begin returning to school in the days ahead.”

Public Health disease investigators learned this week that 20 out of 40 students enrolled in a Dougherty County summer program had fallen ill with flu-like symptoms, including two children with confirmed cases of Influenza A, Greene said.

On Monday, the Dougherty County summer program director voluntarily discontinued the program.

At the same time, a cluster of 40 youngsters who had attended a youth-oriented conference was reported in Lee County, Greene said. Ten of the Lee County young people are experiencing flu-like symptoms, with two having confirmed cases of Influenza A.

“Pandemic H1N1 is now so prevalent that we are assuming anytime we see flu-like illness it is the pandemic virus, especially if initial tests confirm the presence of Influenza A,” said Greene, explaining that Pandemic H1N1 is a strain of Influenza A.

“Also, we know that the pandemic has a high attack rate among children, teens and young adults. That makes it even more likely that we are dealing with Pandemic H1N1 when we see clusters in children. Therefore, even though we do not have confirmation that the clusters in Dougherty and Lee are H1N1, we are operating under the assumption that they are,” Greene said.  

Grant emphasized that the Dougherty County summer program’s director made a voluntary decision to discontinue the program.

“At this time, Public Health is following the Centers for Disease Control guidelines, which don’t call for closure of camps, schools or children’s programs with confirmed or suspected cases of H1N1. That’s different from what was recommended early in the outbreak, when we didn’t know how severe the virus was.”

Now, however, data shows most people who catch Pandemic H1N1 experience mild to moderate illness. “So we are going with the same recommendation for Pandemic H1N1 that we make for seasonal flu: Unless so many counselors or so many students are sick that the program can’t operate, there’s no need to cancel the program,” explained Grant.

However, she warned, recommendations could change again – rapidly – should the virus change and become more dangerous. “Influenza is extremely unpredictable. We know the virus mutates. Our concern is that it will begin causing more severe illness or that it will become drug resistant. It is vitally important that the public stays informed and prepared,” Grant said.

Because of the rapid spread of Pandemic H1N1, the World Health Organization, the CDC, and now the State of Georgia no longer count and report cases. The focus now is on severity of illness, Grant said.

 

 

 

“Although work is moving ahead on a vaccine for this new virus, it is not yet available and is unlikely to be available until mid-October. We cannot stop this pandemic, so our best line of defense is to slow its spread and to be prepared to care for cases of mild to moderate flu at home,” she said.

Influenza is thought to spread mainly through the coughs and sneezes of those infected. The main symptoms of Pandemic H1N1 Influenza are fever plus at least either a cough or sore throat. Additional symptoms associated with it include headache, tiredness, runny or stuffy nose, body aches, chills, diarrhea and vomiting.

Additional information on Pandemic H1N1, including homecare for patients with H1N1, is available online at www.southwestgeorgiapublichealth.org and www.cdc.gov/h1n1flu/.

    

August 14, 2009 - Public Health Provides Flu Update and Tips

The influenza-like illnesses affecting students and staff in Southwest Georgia schools are being treated as a pandemic H1N1 flu clusters, even though not all of those who are sick have received positive test results for the infection, Southwest Health District Health Director Dr. Jacqueline Grant says.

“Public Health has been working closely with school systems, many of which are reporting incidents of flu-like illness,” Dr. Grant said. “Pandemic H1N1 is in our District, so we are not surprised to see clusters popping up as schools reopen for the fall.”

Once clusters – groups in which everyone has similar symptoms – are identified, disease investigators need only one positive diagnosis and do not test everyone who has symptoms, she said.

“Positive confirmation that one of the sick people in a group has H1N1 allows us, from an epidemiological standpoint, to treat everyone in the group with similar symptoms as H1N1 cases,” she said. “By treatment, we mean that they are handled (for instance, placed in isolation until the parent arrives to pick them up, etc.) as if they had H1N1.”

Not all persons with flu-like illnesses need medical treatment. The majority of pandemic H1N1 flu cases are mild to moderate, with most patients recovering at home as they would with regular seasonal flu, said Dougherty County Health Department Director Cheryl Henley.

“Pandemic H1N1 flu is more contagious than regular seasonal flu, and it has a high attack rate in children and teens. The symptoms are fever, cough or sore throat, headache and fatigue. Many patients, especially young ones, are also experiencing nausea and vomiting,” Henley said. “We are telling students and staff at schools who come down with flu symptoms to go to a room separate from others until they can go home.”

They should also wear surgical masks if possible so that droplets from coughs and sneezes carrying the virus won’t infect others, she said. People taking care of someone with flu-like illness should also wear protective gear.

“It is extremely important to stay home if you are sick until 24 hours after your fever is gone without using fever-reducing medicine,” Henley said.

Further, people at high risk for flu complications who are in close contact with someone with flu-like symptoms – or if they become ill with symptoms of flu – should speak to their healthcare provider as soon as possible, she said.

“Early treatment with antiviral medicine is very important for people at high risk because it may prevent complications,” said Grant. “People at high risk include those who are pregnant, have asthma or diabetes, have immune systems that don’t work well or have chronic illnesses like kidney disease, heart disease or cancer.”

Because H1N1 flu is known to be circulating in Southwest Georgia, more people are expected to fall ill, especially now that schools are back in session, she said. “At this point, whether you are tested and actually diagnosed with H1N1 flu is less important than what you do if you become sick. Rapid flu tests are not 100 percent accurate for diagnosis of H1N1.”

Grant offered the following recommendations for homecare for people with flu symptoms:

  • Check with their healthcare provider about special care they may need if they have an underlying health condition.
  • Make sure patients get lots of rest.
  • Patients should drink plenty of clear fluids so they won’t get dehydrated.
  • Patients should wear a mask if possible so they won’t pass flu germs to the rest of the household.
  • Do not give aspirin to children with the flu. Use a fever-reducer without it, such as Tylenol®.
  • If symptoms include difficulty breathing, vomiting and the inability to hold down liquids, or if flu-like symptoms get better then return with higher fever and worse cough, emergency medical treatment is needed right away.

“In addition, people can help keep the flu from spreading by washing their hands often with soap and water, using alcohol-based hand sanitizer, covering coughs and sneezes and avoiding touching your eyes, mouth and nose,” Grant said.

Finally, Grant praised Dougherty County’s schools for their response. “The schools have responded appropriately,” she said. “They have an excellent working relationship with local and district public health.”          

For more information about Pandemic H1N1, contact the Dougherty County Health Department or go on-line to www.southwestgeorgiapublichealth.org.