Officials remain on guard against confluence of seasonal, H1N1 influenzas

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“We’re hoping for the best – and preparing for the worst.”

So stated Minnesota Department of Health Commissioner Dr. Sanne Magnan as she addressed members of the state and local media Tuesday regarding the advent of the fall flu season.

Magnan warned that the coincidental occurrence of both seasonal and novel H1N1 influenza could have potentially devastating consequences as the fall season gets under way. She went on to stress that the public needs to be engaged in the situation in order to help manage it but urged against overreaction.

“We want our citizens to be motivated but not frantic,” Magnan spelled out, “informed but not overwhelmed, prepared but not panicked.”

In outlining the primary differences between seasonal flu and the H1N1 virus, Minnesota State Epidemiologist Dr. Ruth Lynfield explained that the vast majority of those who have contracted the H1N1 virus to date have been under the age of 21, while seasonal flu tends to be more of a threat to the population over the age of 65.

As of Aug. 25, 2009, Lynfield said the state of Minnesota has recorded 263 cases of the H1N1 influenza, 18 of which were pregnant women. The median age of those hospitalized with the illness was 11 years old, and 75 percent were under the age of 25. The average length of hospital stay was three days, and 15 percent of the cases ended up in the Intensive Care Unit. Eighty percent of the documented cases occurred in the seven-county Twin Cities metro area.

Cases of the H1N1 influenza in Minnesota last spring peaked during the second and third weeks of June, with 90 occurring during that time period.

Lynfield added that one of the characteristics of a pandemic such as the novel H1N1 virus is that more than one wave of the influenza is likely, making this fall’s flu season all that much more of concern since the seasonal influenza tends to crop up during the fall and winter months as well.

“We may very well expect to see an increase in illness due to the incidence of seasonal and H1N1 influenzas at the same time,” she stated. “If this happens, it could create a big burden on the health care system.”

Lynfield went on to state that one of the primary lines of attack against influenza should be vaccinations. She said the vaccine for seasonal influenza is already starting to arrive and added there should be plentiful supplies for all who wish to be vaccinated. The H1N1 vaccine, however, is still under development and won’t be available until late September at the very earliest, but more likely in mid- to late October.

Even then, Lynfield pointed out, the vaccine will likely arrive in batches, so clinics will have to prioritize how it is distributed, beginning with health care workers, followed by pregnant women and children from ages 6 months to 4 years, people caring for children in that age group, young people up to the age of 24, and then people ages 25-64 with high risk factors such as diabetes, asthma or other chronic health problems.

For optimum protection, those vaccinated against the H1N1 virus should receive two doses.

Kristen Ehresmann, director of infectious disease epidemiology, prevention and control for the Minnesota Department of Health, emphasized that since people can contract both seasonal and H1N1 influenza, sometimes back-to-back, it is wise to be vaccinated against both if possible.

Community prevention measures are also advised in the face of a possible influenza outbreak. Sick people are urged to stay home until 24 hours after their temperature returns to normal. Parents should monitor their children daily for signs of illness and keep them home if they are exhibiting symptoms, and schools are advised to do the same.

In the case of a significant increase in the severity of a possible H1N1 influenza outbreak during the upcoming season, Lynfield said the household members of someone having the disease may be advised to stay at home as well, and community members may be urged to maintain “social distances” by doing business over the telephone or Internet in place of meetings and appointments whenever possible. If the incidence of the H1N1 virus should climb significantly in a particular area, child care, public gatherings and school classes may have to be temporarily suspended in order to control the outbreak.

According to Kevin Leuer of the Minnesota Division of Homeland Security and Emergency Management, extreme-case scenarios as they pertain to a pandemic such as the novel H1N1 virus could create significant reductions in the work force, possibly as high as 30-40 percent. With that in mind, his office and the Department of Public Safety have been working to come up with a plan to make sure the critical infrastructure of communities continues working.

“We want to make sure our jails, dispatch, fire and police will be adequately staffed,” he said, “as well as our utilities and communications systems.”

“One of the characteristics of a pandemic is that it’s ever-changing,” concluded Ehresmann. “We need to be nimble and adjust as the outbreak continues to unfold.”

Tags: h1n1 flu, news, health