Threat of H1N1 flu has officials on high alert

MANALAPAN — David Richardson, Manalapan's health officer, enlightened concerned members of the community with the latest information about the H1N1 influenzaAvirus, also known as swine flu, at two meetings conducted in the auditorium of the Manalapan Englishtown Middle School on Sept. 24 and Oct. 7.

Richardson's presentation encompassed the difference between seasonal, novel and pandemic influenza, the status of H1N1 flu vaccination plans, the steps everyone can take to prevent the spread of respiratory illness and where to locate reliable information about the flu.

Ryan Green, a member of the Manalapan Englishtown Regional School District Board of Education and chair of the school district's H1N1 task force, introduced Richardson.

Green said district administrators and the board are taking the H1N1 issue very seriously. He said a task force was sanctioned in June and a comprehensive plan was developed over the course of the summer.

During a slide show presentation, Richardson discussed the seasonal flu people face annually from October through April as well as the new H1N1 influenza A virus that surfaced in the spring of 2009. He said although many people take for granted that they may have to deal with the symptoms of flu such as fever, aches, a sore throat and a cough, and most people do recover within a week or two, more than 36,000 people on average die every year from complications of the seasonal flu and approximately 200,000 people are hospitalized each year.

People can spread the seasonal flu up to 24 hours before they even feel sick. The incubation period is one to three days. The flu weakens the immune systems, allowing other illnesses such as pneumonia to sneak in. Elderly individuals, people with weak immune systems and young children are most vulnerable. Health experts recommend that children and the elderly get a seasonal flu shot every year.

Richardson explained that the flu viruses live in birds and pigs naturally and usually communicate within a species such as bird to bird (Avian flu) or swine to swine, but the virus allows for mutations, or changes and shifts. As flu viruses mutate and share genetic material over time, they may begin to infect other species, including humans.

In the case of H1N1, a virus that affected the swine population developed just enough traction to infect humans with the ability to spread from human to human and create a novel virus (one that has never appeared in an area). It started in Mexico and Texas and quickly spread throughout the United States. H1N1 spread quickly because the human population had no resistance to it, having never been exposed to it before, and without the ability to fight it off the illness easily spread.

This summer the H1N1 virus was declared a pandemic disease by the World Health Organization because it spread globally, as opposed to an epidemic, which spreads throughout a smaller region. During an influenza pandemic there will be many widespread waves of epidemics all over the world at the same time, lasting about six to eight weeks in a given community.

T

here were three pandemics documented

during the 1900s. The most severe, the Spanish flu (also classified as H1N1), occurred in 1918. It killed tens of millions of people worldwide. The first wave of the Spanish Flu came in the spring of that year and was relatively mild. When it came back stronger in the late summer/early fall it caused more severe illness.

The other pandemics in the 1900s were the Asian flu in 1957 and the Hong Kong flu in 1968.

Richardson said the current H1N1 virus did not disappear over the summer and is expected to show up again. As it stands right now, it is relatively mild and those afflicted with H1N1 are not expected to feel any worse than they would from the seasonal flu. However, if the virus has changed it could become more serious than it was in the spring and can lead to severe medical complications in those at high risk. That is why the high risk groups are the people who will be focused on first when a vaccination initially becomes available in limited amounts in mid-October.

According to the Centers for Disease Control and Prevention (CDC), those in the highest risk group (those who had the most serious disease in the past) are pregnant women, caretakers of infants younger than 6 months old (because infants between birth and 6 months old cannot get the vaccination so those around them should be immunized to build a protective shell around them), children ages 6 months to 24 years, high risk adults ages 25 through 64 with underlying medical conditions, and healthcare workers or emergency medical personnel who have direct contact with sick patients.

Richardson noted that healthy adults over age 65 are not listed among the high risk group for the H1N1 virus, according to criteria set forth by the federal government based on studies of past illness patterns. Those individuals will eventually be immunized, but not in the first round.

Unlike 1918, health professionals now have more knowledge and the tools to fight the H1N1 virus when it re-emerges. The preventive tools are in the form of common sense hygienic precautions and vaccinations to prevent the illness. Prescription antiviral medications can decrease flu symptoms if taken when first diagnosed.

The flu is spread primarily through respiratory droplets that are expelled during bouts of coughing or sneezing. Touching those droplets, whether on a person or an object, then touching a mouth, nose or eyes without washing the hands spreads the virus.

The CDC recommends frequent hand washing or using hand sanitizers to prevent the spread of flu. Also avoid touching the eyes, nose and mouth and cover the nose and mouth with a tissue when coughing or sneezing. If a tissue is not available, cough or sneeze into a sleeve, not the hands. Those who are ill should stay at home.

The H1N1 vaccinations will be administered in private doctor's offices and at public clinics through a coordinated, regionalized effort throughout Monmouth County. Initial availability will probably be limited so those most at risk will be given the vaccination first. Vaccinations will be administered on a voluntary basis. No one will be forced to take the vaccination, but authorities do recommend that everybody get the vaccine as it becomes more readily available.

In addition, there are plans for clinics to be set up in Manalapan's schools for the sole purpose of immunizing those students who have received parental permission to receive the H1N1 vaccine.

Richardson said, "The more people we can get vaccinated now and protect that group of the population from illness, the less chance the illness will have to get a hold in our community and become a real problem. One of the best defenses we'll have to avoid having to close the schools is to make sure the kids don't get sick and if we can vaccinate as many kids as we possibly can, we should have a better chance of being able to successfully complete the school year."

Although the vaccination is new, Richardson assured the audience that the H1N1 vaccine is subject to the same criteria that is employed for the seasonal flu shots that are given each year. He explained that the H1N1 vaccine is being tested on human subjects of all ages who volunteer to have the shot. Their antibody response is measured through a blood test to see how well they develop immunity and to see if there are any side effects. That is how health officials make determinations for recommended doses for different age groups.

"It's going to be a good flu vaccine when it's here in our hands," Richardson said. "I expect that it will become a component of our flu vaccine for some time to come"

Recommended strategies for prevention of the spread of the flu include keeping people apart, which can help slow the start of the flu; isolation and treatment of sick people; voluntary home quarantine of healthy people who may have been exposed to the flu; and social distancing.

Social distancing means decreasing contact between healthy and infected people and keeping them physically apart. Staying home when sick and limiting time spent in crowds can help keep the illness under control.

It is important that those with a fever not go out until they are fever-free without medication for 24 hours.

Richardson noted that the decision to close schools is ultimately up to the school board based on input and guidance from the Manalapan Health Department. He said the last thing officials want to do is close the schools. They believe that keeping schools open is more beneficial to the community in some situations because the children are being monitored by teachers and the school nurse.

Manalapan-Englishtown Superintendent of Schools John J. Marciante Jr. said, "The best place for a healthy child is in the schools and the best place for a sick child is at home. We need to do everything we can do to keep the schools open. If the educational process is compromised, that's when (officials) would have to consider closing the schools."

The New Jersey Board of Education is looking into the possibility of accepting virtual leaning alternatives should a school have to close, the superintendent said.

Georgianna Petillo, assistant director of pupil services and nursing supervisor for the school district, said that prior to the start of the school year district teachers and nurses were trained in proper methods to help control the spread of the H1N1 flu throughout the schools. The importance of hand washing is stressed in the schools and reinforced by teachers and signs placed throughout the schools. Hand sanitizer dispensers are in all classrooms and children are encouraged to use them frequently.

Additionally, school staff members were trained to recognize the signs and symptoms of the flu and teachers have been instructed that if a student exhibits flu symptoms he must be sent to the nurse's office to reduce the spread of the virus. Teachers also have access to wipes to sanitize areas exposed to germs. Areas frequently touched by many people, such as door handles, are being cleaned by custodians on a daily basis.

Parents are asked to keep in touch with school nurses when their child is ill to report the child's symptoms as well as what the doctor has said, if applicable.

Parents are urged to isolate sick children if possible. The CDC has found that children who are diagnosed with the flu will most likely be sick for between three and five days, but children must stay home until they are totally fever free for 24 hours without the use of medication.

The CDC advises everyone to wash their hands whenever they look dirty, in addition to before preparing/eating food, before and after caring for someone who is sick, and before and after treating a wound. Also wash after blowing the nose, coughing or sneezing, using the toilet, changing diapers or assisting anyone who had gone to the bathroom, handling garbage, touching an animal or its waste, and touching any surface/ object frequently touched by others.

"The bottom line is you can't wash your hands too much," Richardson said.

A healthcare provider should be contacted if children are breathing fast or having trouble breathing, have bluish or gray skin color, are not drinking enough fluids, exhibit severe or persistent vomiting, are not waking up or not interacting, are so irritable that the child does not want to be held or if they exhibit flu-like symptoms that improve but then return with fever and a worse cough.

If adults are having difficulty breathing or experiencing shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting or if flu-like symptoms improve but then return with fever and a worse cough, they should contact a doctor.

For more information, visit www.pandemicflu. gov, www.njflupandemic.gov or www.mtnj.org, or call the Manalapan Health Department at 732-446-8345.