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Summer swine flu levels in state go unreported
Officials felt no urgency to inform public
By HIRAN RATNAYAKE ? The News Journal ? September 25, 2009
Swine flu did not disappear from the state after a May outbreak at the University of Delaware. It has been here all summer.
Fifteen to 25 cases have been confirmed each week since June as doctors continued to send specimens to state laboratories after they were told the testing was no longer needed, state health officials said Thursday.
That means approximately 240 to 400 people in Delaware contracted swine flu between June 1 and Sept. 19, the last day for which state numbers were available.
The state has not been publicly reporting the confirmed cases, said Paul Silverman, associate deputy director for health information and science for the state Division of Public Health.
"We haven't been actively publicizing that, but I don't have a good response as to why," Silverman said.
Rita Landgraf, secretary of the Delaware Department of Health and Social Services, said health officials "didn't feel there was an urgency [to report the cases] at that time."
"If we saw those numbers spike, we'd see more attention coming out from a public relations standpoint like you saw in spring," she said. "We weren't actively asking for samples to test and that's because we knew it had been here and we knew that it had trailed off."
Silverman said doctors who were still sending in samples were just more aggressive in seeking confirmation of symptoms.
Though the public health division was unable to provide the exact number of cases that had been confirmed since late May, the "vast majority ... we got in were positive" for swine flu during the summer, Silverman said.
The confirmed cases do not mean that swine flu is widespread in Delaware, he said.
"We can't turn the tap on and off completely. ... We're still going to test anything that comes to our laboratory," Silverman said. "We will always have low-level physicians who send us the specimens for tests even if it doesn't fit the recommended criteria, and on that basis, we've continued to see positive H1N1 tests."
The Division of Public Health uses several indicators to determine how widespread influenza is in the state during the flu season, which typically runs from October until March.
As part of its monitoring, Delaware is partnering with long-term care facilities, hospitals, day care providers and doctors to find out whether they are seeing people with symptoms related to influenza. As state officials start hearing increasing reports of patients with influenza-like illnesses, they will be more active in informing the public, health officials said.
At that point, health officials will begin actively collecting specimens to determine what strain of influenza is spreading, Silverman said.
"We've cautioned many times that the confirmed cases are not indicative of what's going on in the state as a whole, it just has to do with those patients who were tested," he said. "For that information you have to go to the influenza-like illness data, and the influenza-like illness data that we have [are] not suggesting an increase [in swine flu cases]."
The CDC characterizes the swine flu activity in a handful of states -- including Delaware -- as "sporadic." Sporadic is defined as cases that have been reported by health care workers as influenza-like or those that have been laboratory-confirmed. Reports of outbreaks in places such as schools, nursing homes and other institutional settings have not been received.
Swine flu activity is considered "widespread" in Maryland and Pennsylvania. In New Jersey, the level is "regional" and considered less active.
Dr. Douglas Chervenak of Bayhealth Medical Center in Dover said he's seen only a couple of patients each week with influenza-like symptoms. He did not know the state had confirmed dozens of swine flu cases each week through the summer.
"I think it may have been helpful to know there were confirmed cases in a diagnostic sense," he said. "Just like it would be helpful to me to know that West Nile virus was detected in the state and to know the Lyme disease incidence in the state. It wouldn't make that much of a difference as to how I'd be treating the patient but it would give me the advantage to tell the person who thinks they have swine flu that it's still going around even though it's summer."
Pam Harper has been following reports of swine flu closely through the summer. She owns Children's Secret Garden in Dover, which offers traditional child care and pediatric extended care services for children with medical needs.
"I think it would've been very helpful to have known that because I didn't hear about it at all," she said. "But it wouldn't change what we've been doing. The whole time we've been emphasizing that everyone should be practicing clean hygiene."
Officials felt no urgency to inform public
By HIRAN RATNAYAKE ? The News Journal ? September 25, 2009
Swine flu did not disappear from the state after a May outbreak at the University of Delaware. It has been here all summer.
Fifteen to 25 cases have been confirmed each week since June as doctors continued to send specimens to state laboratories after they were told the testing was no longer needed, state health officials said Thursday.
That means approximately 240 to 400 people in Delaware contracted swine flu between June 1 and Sept. 19, the last day for which state numbers were available.
The state has not been publicly reporting the confirmed cases, said Paul Silverman, associate deputy director for health information and science for the state Division of Public Health.
"We haven't been actively publicizing that, but I don't have a good response as to why," Silverman said.
Rita Landgraf, secretary of the Delaware Department of Health and Social Services, said health officials "didn't feel there was an urgency [to report the cases] at that time."
"If we saw those numbers spike, we'd see more attention coming out from a public relations standpoint like you saw in spring," she said. "We weren't actively asking for samples to test and that's because we knew it had been here and we knew that it had trailed off."
Silverman said doctors who were still sending in samples were just more aggressive in seeking confirmation of symptoms.
Though the public health division was unable to provide the exact number of cases that had been confirmed since late May, the "vast majority ... we got in were positive" for swine flu during the summer, Silverman said.
The confirmed cases do not mean that swine flu is widespread in Delaware, he said.
"We can't turn the tap on and off completely. ... We're still going to test anything that comes to our laboratory," Silverman said. "We will always have low-level physicians who send us the specimens for tests even if it doesn't fit the recommended criteria, and on that basis, we've continued to see positive H1N1 tests."
The Division of Public Health uses several indicators to determine how widespread influenza is in the state during the flu season, which typically runs from October until March.
As part of its monitoring, Delaware is partnering with long-term care facilities, hospitals, day care providers and doctors to find out whether they are seeing people with symptoms related to influenza. As state officials start hearing increasing reports of patients with influenza-like illnesses, they will be more active in informing the public, health officials said.
At that point, health officials will begin actively collecting specimens to determine what strain of influenza is spreading, Silverman said.
"We've cautioned many times that the confirmed cases are not indicative of what's going on in the state as a whole, it just has to do with those patients who were tested," he said. "For that information you have to go to the influenza-like illness data, and the influenza-like illness data that we have [are] not suggesting an increase [in swine flu cases]."
The CDC characterizes the swine flu activity in a handful of states -- including Delaware -- as "sporadic." Sporadic is defined as cases that have been reported by health care workers as influenza-like or those that have been laboratory-confirmed. Reports of outbreaks in places such as schools, nursing homes and other institutional settings have not been received.
Swine flu activity is considered "widespread" in Maryland and Pennsylvania. In New Jersey, the level is "regional" and considered less active.
Dr. Douglas Chervenak of Bayhealth Medical Center in Dover said he's seen only a couple of patients each week with influenza-like symptoms. He did not know the state had confirmed dozens of swine flu cases each week through the summer.
"I think it may have been helpful to know there were confirmed cases in a diagnostic sense," he said. "Just like it would be helpful to me to know that West Nile virus was detected in the state and to know the Lyme disease incidence in the state. It wouldn't make that much of a difference as to how I'd be treating the patient but it would give me the advantage to tell the person who thinks they have swine flu that it's still going around even though it's summer."
Pam Harper has been following reports of swine flu closely through the summer. She owns Children's Secret Garden in Dover, which offers traditional child care and pediatric extended care services for children with medical needs.
"I think it would've been very helpful to have known that because I didn't hear about it at all," she said. "But it wouldn't change what we've been doing. The whole time we've been emphasizing that everyone should be practicing clean hygiene."
