Story Published on Tuesday, August 4, 2009
By Teresa Hicks


The U.S. Centers for Disease Control and Prevention estimates that more than a million Americans have been infected with novel H1N1 influenza, commonly known as swine flu. That number is expected to increase over the next few weeks. ?We believe that once school gets in session early in the fall, we?re going to see the numbers really start to spike,? said Dr. Tim Jones, state epidemiologist for the Tennessee Department of Health. ?It will probably be more people than in a normal year because we don?t have immunity to this new strain.?

Only a few thousand cases of H1N1 flu have actually been documented in the U.S. to date, and health officials recently announced that they have stopped tracking individual cases. One reason for the decision is that only a small percentage of people infected with H1N1 are sick enough to see a doctor, so a precise count is difficult to get. Instead, the health department is tracking pneumonia and influenza deaths and taking key samples from sentinel physicians scattered around the state.

Once the regular flu season commences this fall, health officials expect to see multiple spikes of different kinds of flu continuing for a longer period because both the H1N1 flu and seasonal flu will be circulating at the same time.

The severity of an H1N1 flu infection is about the same as regular seasonal flu, Jones said, although the number of H1N1 infections is expected to outstrip seasonal flu this year.

Two separate vaccines will be available this fall. One will be the familiar seasonal flu shot, available around the beginning of September, and the other will be for H1N1 flu, available in mid to late October. In order to get full immunity from the new vaccine, patients will need to have two shots three weeks apart, Jones said.

?The unfortunate part of that is that people are going to have to come in for a total of three shots, and it?s hard enough to get yourself in for one,? he said. ?But we?re really going to push people to do that.?

The main problem with the this year?s vaccine production schedule is that it?s entirely possible that the flu season will already be in full swing by the time the vaccine is available.

?That?s not a reason for people to be terrified, but we just have to expect it,? Jones said. ?We also don?t want that to be a reason that people say it?s too late (to get the shot). Even if the flu season is already underway, it?s not going to be too late.?

For the school systems, health officials urge caution and careful judgment this season.

?In general, the recommendation is not too close school because of the flu,? Jones said.

A better solution is to try to keep sick and well people separated by making sure sick kids (and adults) stay home.

?We?re telling the schools that if a kid comes to school and they?re hacking and coughing, send them home,? Jones said.

Both city and county school officials said they have not made any policy changes in light of the presence of H1N1. Infection control efforts revolve, as they always have, around hygiene education and isolating sick individuals.

?We do lots of education about hand washing in several different grades,? said Shannon Bishop, coordinator of the Washington County Department of Education Coordinated School Health Program.

?Washington County has a nurse in every school. And that is to our advantage, because we can kind of keep an eye on things a lot better. We have the manpower to say, ?This is flu-like symptoms; you have to go home,? versus a secretary or someone like that making that decision.?

Local city and county schools are also equipped with alcohol-based hand sanitizer dispensers, thanks to a partnership with Mountain States Health Alliance.

?They?re kept fully stocked at all times,? said Debra Bentley, supervisor of instruction and communications for Johnson City schools. ?The teachers encourage (students) to use those or to wash their hands when they go to the restroom (and also) when they go into the cafeteria or at any time when they think that they have come in contact with something on their hands that they need to sanitize them.?

Parents are encouraged to keep children home if they have a fever or are vomiting.

Both city and county schools will work closely with the health department this year to monitor cases of flu-like symptoms and decide how best to contain infection.

?We hope it doesn?t get to the point as it did in some school districts last year where you have to close a school or even a school district. We certainly would not want to see it get to that point,? said Bentley.


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