County urges caution but calm on H1N1 swine flu

David Gulliver - posted 4 pm Friday, Aug. 21

County health and school officials repeated their message of calm but cautious preparation for new cases of the H1N1 virus, or swine flu, as children return to classes.

“The flu is really widespread in our community,” said Dr. Bill Heymann, medical director for the Sarasota County Health Department, in a press conference Thursday. "We expect we will see flu in our schools,” he added.

But he stressed that “it is too early to determine the impact” of the virus, and that people should prepare and respond the same way they do for traditional flu season.

“The severity is very similar to that of seasonal flu,” he said. The symptoms include fever of 100 degrees or more, cough and sore throat. The H1N1 flu also is more likely to cause nausea or diarrhea than seasonal flu. It can be severe but fatal cases are extremely rare, about as common as with seasonal flu, experts say.

(see the Sarasota Health News primer on H1N1 flu here.)

Heymann and schools Superintendent Lori White described efforts to track and minimize the virus’s spread.

Maintenance crews will increase cleaning and concentrate on places where germs are passed, like doorknobs, hand rails and light switches. Schools staff have been instructed on how to spot signs of sick children, who will be sent to the school nurse or health room, and then home. They can return to school after they go 24 hours with no fever without the use of fever-reducing medicines.

Officials said parents to make plans in case one parent needs to stay home with a sick child. Schools will report illnesses and absences to the Health Department, which will look for trends. The Health Department no longer tracks confirmed cases, because virtually all flu cases now are H1N1 cases and because it takes days to get lab results, but White said the schools’ tracking information could be made available.

They also were quick to defuse any sense of panic. White said there was no “magic number” of illnesses where officials would close schools. Officials have contingency plans to maintain school activities but reduce the sort of student contact that could spread germs, she said.

“We know that the sudden closing of a school has a ripple effect in a community,” White said. “We will do that thoughtfully and carefully and only if we feel it is absolutely necessary.”

On Friday, health officials disputed a report in the Sarasota Herald-Tribune that claimed Heymann said 30 percent of students in any given school or class could be ill at the same time, conjuring the image of decimated classrooms.

In a statement from the county Health Department, a spokeswoman noted that Heymann estimated 30 percent of students might eventually contract the virus, but continued on to say “not at the same time.”

With seasonal flu, up to 20 percent of the population normally contracts the virus. But people under 25 are believed to be more susceptible to novel H1N1, because it is a new form of flu and young people are unlikely to have the partial immunity that people over 50 seem to have.

H1N1 vaccines are still in clinical trials, but are expected to be available in October. (Seasonal flu vaccines will be separate, and available sooner.) Heymann and White said that children would not be immunized without parents’ consent.

Many states have announced plans to use schools as immunization sites. Florida has yet to do so, though it is likely to follow suit. In an Aug. 13 letter, Gov. Charlie Crist told schools superintendents they should “take an active role in determining those locations.”

This week, health officials in Boston, Mass., said they would target minority neighborhoods with their vaccination campaigns. Statistics from Boston’s H1N1 cases to date show a disproportionate number of cases in black and Latino people.

They attribute it to socioeconomics: Most children in the Boston school system are minorities, and children are more susceptible to the virus, both for a lack of immunity and for their greater exposure. And their parents are less likely to be able to leave work to keep a sick child home, officials said.

Sarasota has no such plans for a targeted campaign. So far, Heymann said, there has been no local trend of a higher-than-expected share of cases in minorities, and the county is following vaccination guidelines from the federal Centers for Disease Control and the Florida Department of Health.