Swine flu on the rise in Niagara County

by Elaine Roman
Niagara Wheatfield Tribune, July 1, 2009

To date, New York state Department of Health laboratories have confirmed 18 cases of Novel H1N1 Influenza A in Niagara County.

The number of laboratory-confirmed cases represents only a small fraction of actual cases in the area.

The majority of H1N1 infections diagnosed in Niagara County occurred in school-aged children. One pre-school-age child recovered at home after discharge from a local hospital.

In the United States, the Centers for Disease Control and Prevention reports that the largest number of H1N1 cases, overall, occurred in people 5 to 24 years of age. No children and few adults under age 60 have demonstrated any immunity to the H1N1 virus.

Signs and symptoms of H1N1 swine flu infection are similar to seasonal flu, with fever greater than 100 degrees, headache, sore throat, body aches, and may also include nausea, vomiting and diarrhea. Antiviral medications can prevent infection or ease symptoms, but are not effective if given later than two days after the onset of influenza-like-illness symptoms.

Because H1N1 is now widespread in New York, the CDC and NYSDOH released new recommendations for testing, treatment and reporting on June 16. The new guidelines discourage testing and treatment of mild cases of ILI, except in individuals with underlying medical conditions, or in residential settings, such as group homes or nursing homes. The definition of “mild ILI” is: fever equal or greater than 100 degrees, and cough or sore throat.

Individuals with mild ILI should contact physicians by phone for an evaluation, and should not report to physician offices unless instructed by their doctors. People with mild ILI or who have been exposed to ILI should not report to hospital emergency departments for testing. The vast majority of people will recover without any treatment, and testing will not influence treatment decisions. By following these guidelines, people can help to prevent the spread of H1N1 from mildly ill people to vulnerable high-risk patients in doctors’ offices and hospital emergency departments.

The Novel H1N1 flu virus is spread from human to human in the same manner as seasonal flu. The virus is different from the still-circulating seasonal flu virus, which can cause mild to severe respiratory disease.

Overall, H1N1 illnesses in the U.S. have been relatively mild. Most H1N1-infected individuals, who died from complications, had pre-existing medical conditions. The same groups that are at increased risk for complications from seasonal flu are at increased risk for H1N1-related flu complications. Individuals in the following categories or with the following conditions are at high risk of H1N1 complications:

•Under 5 years of age

•Pregnancy

•Chronic illness, such as asthma, diabetes, cancer

•Immune system disorders either from medications (like chemotherapy) or from diseases  (such as HIV)

 •Under 19 years of age on long-term aspirin therapy for diseases such as rheumatoid arthritis or Kawasaki disease

 •Blood diseases such as sickle cell disease

 •Neurological diseases that affect swallowing or breathing

 •Residents in nursing homes and other chronic care facilities

 Individuals in the above categories should not attend mass gatherings or functions where others could be ill with ILI. This is the season for graduation parties, holiday gatherings, summer sports, summer camp and summer school. People with signs and symptoms of ILI should not attend these functions.

The CDC defines the H1N1 infectious period as one day before the onset of flu symptoms until seven days after. Therefore, adults and children with flu-like illness should stay home and away from others for no less than 24 hours after a fever ends, and up to seven days after ILI begins, if returning to an environment with high-risk individuals.

 H1N1 infections are expected to continue throughout the summer. The Niagara County Department of Health will continue its efforts to address the current H1N1 situation, and prepare for the upcoming fall flu season. Production of a new H1N1 vaccine will begin in July, and may be available as early as October. 

In the meantime, people can take the following steps to reduce the risk of H1N1, as well as any other respiratory infection:

•Cover coughs and sneezes with a sleeve or disposable tissue. 

•Dispose of tissues in a wastebasket and immediately cleanse the hands.

•Wash hands often and vigorously with soap and water for 15 to 20 seconds, especially after coughing, sneezing or blowing the nose, before and after eating, after using the bathroom, and always before touching or caring for infants, elderly or chronically ill. Use waterless alcohol-based hand sanitizer when hand-washing facilities are unavailable.

•Keep hands away from eyes, nose and mouth.  Many respiratory infections are picked up by touching the eyes with fingers contaminated by viruses.

•In households, keep family toothbrushes separate and consider individually designated tubes of toothpaste to avoid cross-contamination from one family member to another.

•Stay home if sick with flu-like symptoms; keep ill children home from school or day care.

•Avoid unnecessary contact with individuals who show signs of respiratory illness.

•Sports team members should not share drinking containers. 

 The New York state Department of Health has established a Novel H1N1 Hotline that can provide additional information to concerned individuals. Call 1-800- 808-1987.  

Additional H1N1 information can be found at the following Web sites: www.health.state.ny.us/diseases/communicable/influenza/pandemic/index.htm, http://www.cdc.gov/h1n1flu/ or www.niagaracounty.com.

Elaine Roman is director of public health planning and information/emergency preparedness, Niagara County Department of Health.