Commonground
Senior Moderator
Monday, October 26, 2009
By DAVID BROOKS, Staff writer
dbrooks@nashuatelegraph.com
The H1N1 flu never really left New Hampshire, but in recent weeks it has started to crop up again ? ?widespread? is the way state health officials categorize its presence as of early October ? and schools are starting to feel it.
?We have seen a spike in the number of students here at Hudson Memorial School who exhibit what the medical community refers to as Influenza-like illness,? Principal Susan Nadeau wrote in a note sent last week to parents of pupils in that elementary school.
A similar messages was sent Friday to parents in the Nashua School System, noting ?We are now seeing an increase in absenteeism in our elementary schools and anticipate an increase in absenteeism in all our schools in the next three to four weeks as the flu season progresses.?
All schools are urging parents to keep children home if they appear sick, and not to let them return until they have been without a fever for at least 24 hours since taking the last dose of Tylenol or other medicine. That delay is added because medication can mask the presence of a fever, thus hiding how infectious a child may be.
?People may think, Oh well, the Tylenol?s taken care of the fever, we can send them back to school?? said Paula Edwards, the nurse at Pennichuck Middle School and head nurse of the Nashua School System.
School systems do not expect children to stay home for five days after the flu passes; that requirement was sometimes present in the spring, when swine flu first surfaced and there was more uncertainty about the disease. The state does not recommend that schools close if H1N1 shows up.
Flu usually becomes more prominent when cold weather arrives, because people spend more time indoors and spread disease among themselves, and because viruses survive longer in cooler temperatures.
Seasonal flu usually arrives here in late fall and peaks in mid-winter. One of the things different about H1N1 is that it arrived in late winter and never entirely left, even over the summer.
The Centers for Disease Control said Friday that H1N1 is now widespread in 46 states, a level comparable to what is usually the peak of flu season. The big question for health officials is whether it will continue to spread at a similar rate or whether H1N1 has just shifted the usual peak time a couple of months early.
The Hudson Memorial School note included awkward phrase ?influenza-like illness,? which basically means having a fever, cough and sore throat all at once, as a reflection of a reality that can be frustrating for parents: The so-called swine flu is almost never confirmed, but only assumed from symptoms.
Even if a sick person asks their physician for a test that to put a label on the reason they?re feeling awful, it probably won?t happen.
Because of the time and cost needed to determine which virus was found in nasal swabs taken from sick patients, the state?s protocol says that H1N1 tests are performed only for three groups of people who have ?influenza-like illness?:
1. People who are so sick they need to be hospitalized. This is designed so public-health officials can determine how seriously H1N1 is affecting people, as compared to seasonal flu.
2. Health care workers who may have had direct patient contact during their infectious period
3. Those in an ?outbreak investigation? OK?d by the state Department of Health and Human Services, such as a cluster of sick kids at a school.
On the other hand, says Scott Cote, vice president for facilities and emergency preparedness for Southern New Hampshire Medical Center, if you feel crummy and have a fever, a test probably isn?t needed.
?Right now, if you have (flu-like) illness, it?s likely to be H1N1,? he said.
For example, during the week leading up to Oct. 10, the state Health Department tested 78 samples sent from doctors and hospitals as part of its surveillance program.
Only three were confirmed as flu, and all of those were what is officially called H1N1 2009 influenza A.
Ashley Conley, epidemiologist for the Nashua Division of Public Health and Community Services, said she noticed a ?blip? of school absences due to flu-like illness last week, which has led the city to step up its surveillance.
Happily, however, she said, ?We haven?t seen any severe illness.? In other words the number of sick kids is increasing, but not the number of dangerously sick kids.
In parts of the country, H1N1 has shown a disturbing tendency to be more dangerous than seasonal flu for children with certain existing health conditions, such as bad asthma, diabetes or heart and lung conditions.
That?s why the limited supplies of H1N1 vaccine currently availably are being limited to children under 5 who have such chronic conditions ? the children must be at least 6 months old.
Health care workers and pregnant women are the other two population groups who can get the vaccine until production can be increased to make it more generally available.
Another difference between H1N1 and season flu is that H1N1 does not seem to be affecting the city?s elderly, a population that gets usually hit hard by influenza, Conley said.
http://www.nashuatelegraph.com/apps/pbcs.dll/article?AID=/20091026/NEWS01/910269997/-1/XML15
By DAVID BROOKS, Staff writer
dbrooks@nashuatelegraph.com
The H1N1 flu never really left New Hampshire, but in recent weeks it has started to crop up again ? ?widespread? is the way state health officials categorize its presence as of early October ? and schools are starting to feel it.
?We have seen a spike in the number of students here at Hudson Memorial School who exhibit what the medical community refers to as Influenza-like illness,? Principal Susan Nadeau wrote in a note sent last week to parents of pupils in that elementary school.
A similar messages was sent Friday to parents in the Nashua School System, noting ?We are now seeing an increase in absenteeism in our elementary schools and anticipate an increase in absenteeism in all our schools in the next three to four weeks as the flu season progresses.?
All schools are urging parents to keep children home if they appear sick, and not to let them return until they have been without a fever for at least 24 hours since taking the last dose of Tylenol or other medicine. That delay is added because medication can mask the presence of a fever, thus hiding how infectious a child may be.
?People may think, Oh well, the Tylenol?s taken care of the fever, we can send them back to school?? said Paula Edwards, the nurse at Pennichuck Middle School and head nurse of the Nashua School System.
School systems do not expect children to stay home for five days after the flu passes; that requirement was sometimes present in the spring, when swine flu first surfaced and there was more uncertainty about the disease. The state does not recommend that schools close if H1N1 shows up.
Flu usually becomes more prominent when cold weather arrives, because people spend more time indoors and spread disease among themselves, and because viruses survive longer in cooler temperatures.
Seasonal flu usually arrives here in late fall and peaks in mid-winter. One of the things different about H1N1 is that it arrived in late winter and never entirely left, even over the summer.
The Centers for Disease Control said Friday that H1N1 is now widespread in 46 states, a level comparable to what is usually the peak of flu season. The big question for health officials is whether it will continue to spread at a similar rate or whether H1N1 has just shifted the usual peak time a couple of months early.
The Hudson Memorial School note included awkward phrase ?influenza-like illness,? which basically means having a fever, cough and sore throat all at once, as a reflection of a reality that can be frustrating for parents: The so-called swine flu is almost never confirmed, but only assumed from symptoms.
Even if a sick person asks their physician for a test that to put a label on the reason they?re feeling awful, it probably won?t happen.
Because of the time and cost needed to determine which virus was found in nasal swabs taken from sick patients, the state?s protocol says that H1N1 tests are performed only for three groups of people who have ?influenza-like illness?:
1. People who are so sick they need to be hospitalized. This is designed so public-health officials can determine how seriously H1N1 is affecting people, as compared to seasonal flu.
2. Health care workers who may have had direct patient contact during their infectious period
3. Those in an ?outbreak investigation? OK?d by the state Department of Health and Human Services, such as a cluster of sick kids at a school.
On the other hand, says Scott Cote, vice president for facilities and emergency preparedness for Southern New Hampshire Medical Center, if you feel crummy and have a fever, a test probably isn?t needed.
?Right now, if you have (flu-like) illness, it?s likely to be H1N1,? he said.
For example, during the week leading up to Oct. 10, the state Health Department tested 78 samples sent from doctors and hospitals as part of its surveillance program.
Only three were confirmed as flu, and all of those were what is officially called H1N1 2009 influenza A.
Ashley Conley, epidemiologist for the Nashua Division of Public Health and Community Services, said she noticed a ?blip? of school absences due to flu-like illness last week, which has led the city to step up its surveillance.
Happily, however, she said, ?We haven?t seen any severe illness.? In other words the number of sick kids is increasing, but not the number of dangerously sick kids.
In parts of the country, H1N1 has shown a disturbing tendency to be more dangerous than seasonal flu for children with certain existing health conditions, such as bad asthma, diabetes or heart and lung conditions.
That?s why the limited supplies of H1N1 vaccine currently availably are being limited to children under 5 who have such chronic conditions ? the children must be at least 6 months old.
Health care workers and pregnant women are the other two population groups who can get the vaccine until production can be increased to make it more generally available.
Another difference between H1N1 and season flu is that H1N1 does not seem to be affecting the city?s elderly, a population that gets usually hit hard by influenza, Conley said.
http://www.nashuatelegraph.com/apps/pbcs.dll/article?AID=/20091026/NEWS01/910269997/-1/XML15
