Swine flu shot battles a novel virus

More than 40,000 doses of H1N1 flu vaccine will be distributed in the Capital Region over the next s
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More than 40,000 doses of H1N1 flu vaccine will be distributed in the Capital Region over the next several weeks as part of the largest mass inoculation of Americans in decades.

The goal is to prevent the H1N1 flu, also known as the swine flu, from overwhelming local medical systems with massive casualties, causing chaos, misery and tragedy.

“If we can get enough vaccine into the public, we can save lives,” said Dr. David S. Pratt, commissioner of public health for Schenectady County.

Local health care professionals are encouraged by early indications that the H1N1 virus is turning out to be less severe than thought.

“It remains the elephant in the kitchen, but what we are seeing is something very mild. It is still serious, but it is looking less serious than the usual seasonal flu,” Pratt said.

Cece Lynch, vice president of nursing at Ellis Medicine, said the hospital has stepped up its surveillance of admissions of people with flu-like symptoms through its emergency departments and into the hospital. She agreed with Pratt that the H1N1 flu appearing in the community has been mild.

“We anticipated with the advent of H1N1 we would see more symptoms, but we haven’t seen it,” she said. “Still, we are as prepared as possible should it come at any time.”

Totally novel flu

H1N1 remains a serous health threat because even though it appears to be mild, “almost everyone is susceptible to this virus,” Pratt said. “Many of us have bits and pieces of immunity to seasonal flu. But H1N1 is totally novel. This unique virus is composed of human, bird and swine genes. It is a salad,” he said.

Unvaccinated people who contract H1N1 flu have no immunities to it. As such, it poses a threat to high-risk groups, such as young children, the elderly, pregnant women and people with immune system deficiencies.

The disease is highly contagious, and on June 11, 2009, the World Health Organization signaled that H1N1 was a pandemic, meaning the disease had spread worldwide. Despite being a pandemic, the WHO said H1N1 is generally a moderate illness.

“People heard the word ‘pandemic’ and they got scared and had questions,” said Mary Constantino, a nurse practitioner in infection control with Nathan Littauer Hospital in Gloversville. “People were confused about regulations, people wanted testing, they want to know where to get a shot.”

In response, Littauer begin a series of community education programs and set up a hot line for people to call for basic information on H1N1. The programs have reached hundreds of people.

“We were getting so many phone calls at our primary care sites about H1N1 and the flu we decided to do this as a collaboration with other departments,” Constantino said.

The state Department of Health, which monitors communicable diseases such as the flu, reported 284 cases of Type A flu as of Thursday. H1N1 is a subset of Type A flu. The department updates its statistics each Thursday.

The DOH said the number of emergency room visits by people with flu-like symptoms, and the number of people hospitalized with flu-like symptoms, is higher than in a similar period a year ago.

H1N1 first appeared in New York in April. According to the DOH, 30 people outside of New York City have died from the flu since April.

Flu season begins

The DOH says the state is now entering the second phase of an H1N1 outbreak — just in time for the start of the seasonal flu season, which begins in October.

After being swamped by medical providers seeking to have patients’ flu samples tested, the state has switched to a new system to track the flu. It now relies on 21 hospitals, or sentinels, as well as reports from emergency rooms to track the disease. The DOH is not releasing the names of the hospitals to the public to avoid a misconception that they have greater expertise in responding to the flu, which could skew the numbers of people choosing the sentinel hospitals.

“We are not testing for H1N1 anymore, just for the flu,” Constantino said. “If someone comes in with symptoms, we do a rapid flu swab, and if comes back with indication they have a virus, it’s the flu,” she said.

Whether a person has H1N1 or seasonal flu, the treatment is always the same: the use of the prescription drug oseltamivir, Constantino said. “The only difference is how we vaccinate,” she said.

There are two separate vaccines, one for seasonal flu, the other for H1N1, and people can receive both. The H1N1 vaccine is arriving in two forms: nasal spray and multi-dose injectables. The nasal spray contains live vaccine and cannot be given to children under 2 or pregnant women. All high-priority groups can receive the injectables, Constantino said.

Lynch said Ellis will distribute around 22,000 doses of H1N1 vaccine to people in Schenectady County. Other counties will receive similar amounts of the vaccine.

Dr. Brian Gordon, D-Niskayuna, chairman of the Schenectady County Legislature’s Health Committee, said it is imperative that all of the appropriate groups get their vaccines as soon as they can.

“The more people who are vaccinated, the better our ability to create a herd immunity. A herd immunity develops when you have enough people immune to the illness that the illness cannot propagate. That was how smallpox was eradicated,” Gordon said.

Pratt said people want to be inoculated.

“Practitioners have a long waiting list for vaccine. That is positive. People recognize it as the right thing to do, and the public is being responsible with this,” he said.

A year ago, there were no reported cases of H1N1. When the virus began spreading last spring, there was no vaccine for it and medical professionals were worried that it could spread like wildfire through the population. They also had concerns that it could mutate into something worse.

Still, the medical community was prepared to deal with it, Pratt said.

Flu disaster plan

The terrorist attack of Sept. 11, 2001, showed the need to prepare for disasters, and the federal and state governments mandated that medical facilities and others develop disaster plans to deal with a wide range of contingencies. Four years ago, Schenectady County developed a disaster plan to handle the outbreak of the avian flu, which remains a serious health risk.

When H1N1 appeared as a serious medical threat, Schenectady County turned to its disaster plan, said Pratt, who became public health commissioner in August.

“What was most impressive was the amount of work the county had done. They were at a high level of preparedness,” he said.

“There have been drills, but it has been a long time since America has done this kind of mass inoculation. The last time was in 1976, and before that it was polio,” Pratt said.

Lynch said Ellis worked with the county on the plan, along with other medical providers in the county.

“Internally we have a group to prepare for these scenarios, but we have been meeting for the last four months with a multidisciplinary group for flu planning. It was initiated by the county,” she said.

Gordon said Schenectady County is a model for other counties in its preparedness for a flu outbreak.

“The bottom line, four years ago when I was elected and became chair of the health committee, my concern was the county should be prepared for the biggest threat out there, avian flu,” he said. “We needed a full pandemic plan in place because of the amount of mortality that would be associated with avian flu. As a result, we became a lead county for pandemic flu preparedness.”

Gordon said the county’s plan “puts us in very good position to handle the current H1N1 pandemic. We are as ready as you can be for an illness like this.”

Categories: Schenectady County

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