Spread of local H1N1 cases keeps slowing

David Gulliver - posted 5:20 p.m. Friday, Oct. 23

Federal and local health officials on Friday provided more good news about the H1N1 swine flu virus: Its spread is slowing, it still can be treated effectively with flu medications, and shows no signs of genetic changes that would help it defeat a vaccine, which is finally becoming more widely available.

The percentage of flu-like cases in Sarasota County’s hospital emergency rooms fell for the fourth straight week, and fifth of the last six weeks, according to a county Health Department report.

This week, about 5.5 percent of ER visits were because of flu-like symptoms. That’s still far above the 3 percent mark common at the peak of seasonal flu, but down from the 9 percent mark shortly after schools reopened.

The number of reported flu cases in county schools fell to an average of eight a day, less than the peak of the regular flu season, the report said. That's less than half the peak of five weeks ago. And the number of outbreaks in schools -- clusters of related cases -- also is down, county epidemiologist Scott Pritchard said.

But another measure, the percentage of flu-like of cases at two local but unnamed medical practices, spiked back up this week. That measure has see-sawed wildly, but Pritchard said the overall trend suggests the first wave of flu is not over yet and people still need to take the recommended measures: Cover a cough, wash hands often and avoid work or school if flu symptoms appear.

“It’s very important that we do not become complacent as vaccine becomes available,” he said.

That vaccine is steadily arriving in Sarasota County, though far below the levels officials initially expected. About 8,700 doses have been received and distributed to local OB/GYNs, pediatricians and hospital workers for distribution to the most vulnerable groups of children, health care workers and pregnant women.

Another 4,500 doses are expected next week, said Chuck Henry, who heads the county’s flu response. The county tracks all local vaccine requests through Florida’s computerized ordering system and then allocates them to providers serving the vulnerable groups. “We expect to receive more than 200,000 doses in Sarasota County,” he said, but that will take several more weeks.

Locally, major pharmacies have said they expect to have the vaccine on hand before the end of the month, but Henry said he was unaware of any orders by the drug store chains to date.

County officials hope to have vaccination clinics in early November at elementary schools and Health Department facilities. (Children would need to be accompanied by a parent. Private school and home-schooled children would be eligible.) But they believe they need 12,000 doses in hand first, and are waiting and watching the incoming supply before setting the date.

In a briefing at the Centers for Disease Control and Prevention in Atlanta (which Sarasota Health News monitored by telephone), agency director Dr. Thomas Frieden said he understood people were angry over delays in distributing the vaccine.

“It’s frustrating to all of us,” he said. Health officials faced what he called a difficult “ethical choice”: Release the vaccine in small batches as it became available, to selected vulnerable groups, or stockpile the vaccine in warehouses until there was enough for everyone. They chose to help people as soon as possible.

CDC had expected 40 million doses to be available by the end of October, then adjusted that to 30 million this week. On Friday, Frieden said 16 million doses were now available to the states. He acknowledged that with 1,000 flu deaths and 20,000 flu hospitalizations nationally, that was little consolation. "The vaccine is arriving too late for many," he said.

National polls have shown some fear and confusion about the vaccine, with less than half those polled saying they will get the vaccine. But Frieden was encouraged by the agency’s tracking of seasonal flu vaccine. More than 60 million people already have been vaccinated, which he said was the most successful year on record.

The H1N1 virus has shown no signs of genetic changes, which could make the vaccine less effective, he said. And the virus remains "overwhelmingly susceptible to Tamiflu," he said, meaning the recommended treatment still is highly effective.