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The waiting game

By Staff | Oct 30, 2009

Anticipate a long and complicated flu season.

Lisa Thorp, a registered nurse at Johnson Clinic, said she heard this comment during a recent state health department teleconference and she thinks the public should take notice.

This is surely the case this season where information not only about seasonal flu, but also the 2009 H1N1 is more abundant than ever. Both Johnson Clinic and the county health nurse have been given very limited amounts of H1N1 vaccine and are out of seasonal flu vaccine.

Hundreds of confirmed cases of seasonal flu have been reported this fall. The numbers are still climbing for people with infections of H1N1. Just last week, the state department of health announced the first death of a resident associated with H1N1.

The Johnson Clinic had received an extremely limited amount of H1N1 vaccine and administered that to 10 people earlier this month. They have given an estimated 1,000 vaccinations for the seasonal flu so far. They have not received any more vaccines for either H1N1 or seasonal flu and don’t know when they will.

“The health department is recommending some priority groups for the H1N1 vaccine. Children age six months to four years old, for instance, were the first group and we made sure the few vaccines we did get went to that group,” Thorp explained. “Now the next group that has been identified as a priority is household contacts and caregivers of children under six months of age.”

Pierce County Public Health Nurse Deb Schiff said they have a very limited supply H1N1 vaccines available for children ages 6-35 months of age. She anticipates those doses will all be given to the public within a short period of time. She’s not sure when she will receive more.

As more vaccine becomes available, Schiff plans to hold either walk-in clinics or take appointments depending on how much of the vaccine she receives. People are encouraged to call her at 776-6783 or stop in her office at the courthouse for more information.

As for seasonal flu vaccines, there are none available at this time. Schiff anticipates another shipment in late November, but that could change as demand increases.

Deciding whether to seek medical care

Thorp said that the clinic has seen a slight increase in children with flu symptoms over the past couple of weeks. Some people might be uncertain about when to seek medical assistance and when to just stay at home in bed and “wait it out.”

The North Dakota State Health Department lists symptoms that would be warning signs for people to seek medical care. They include: in children – fast breathing or trouble breathing, bluish skin color, not drinking enough fluids, not waking up or not interacting, being so irritable that the child does not want to be held, flu-like symptoms improve but then return with fever and worse cough, fever with rash; in adults – difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting.

Most people with H1N1 have had mild illness and have not needed medical care or anti-viral drugs and the same is true for seasonal flu. However, some people who are at high risk of serious flu complications should talk to a healthcare provider about whether or not they should be examined should they develop symptoms.

“We tend to tell parents that they know their kids best and if at any point they are thinking, ‘this is not my kid’ then it’s time to bring them in,” Thorp said. “We’ve been seeing a lot of sick kids, but most people will recover well at home. Rest and fluids go a long way.”

Healthcare officials do not want to discourage people from seeing a medical provider if they feel they need to, but extra precautions are being made to try to protect employees and other patients. The Johnson Clinic asks people who come to the clinic with flu symptoms to notify the clinic personnel so a mask can be given in order to help stop the spread of the infection.

Testing continues

A major source for confusion this flu season is people with symptoms wondering whether they have the seasonal flu versus H1N1.

To add to the confusion, seasonal flu symptoms and H1N1 symptoms are usually the same and can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. One difference is that children infected with H1N1 flu are more likely to have diarrhea and vomiting than those with seasonal flu.

Thorp said that the Johnson Clinic is still testing patients to confirm H1N1 and have seen three or four positives recently.

A nasal swab is conducted and is sent on to the state laboratory in Bismarck to confirm the presence of H1N1. Thorp noted that once a community reaches a certain number of positive tests, the lab determines the virus has become widespread in that area and no longer accepts tests from that community.

Vaccination still a good choice

Thorp cautions against skipping the vaccine this season. Some people might figure if they’ve made it through the first wave of widespread infection that is circulating they might be safe, but that may not be the case as the flu has a tendency to carry through a long season from October to as late as March.

“Despite not having the vaccine available right now, we don’t want people to just decide to skip it,” Thorp said. “It’s still wise to get the vaccine when it becomes available to get protection from the next wave.”