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BUGGED! Carlton County sees influx of flu

Nat Willgohs (right) demonstrates how to do the swab test for the influenza virus on fellow White Drug pharmacist Carl Kolpin. The local pharmacy joins the growing trend toward offering health care testing in a retail setting. Wendy Johnson/

We all recognize the symptoms — the scratchy throat,  killer headache and nagging body aches, followed by devastating chills, fever and that sick-all-over feeling. The flu virus rears its ugly head around this time every year, and this winter is no exception in Carlton County. In fact, it could be even a little worse than usual.

“We had a ton of students out the first few weeks of December,” reported Kristi Borglund of Cromwell-Wright School. “It’s hit us really hard this year. On one single day we had 60 students out, and for a school our size, that’s a big deal.”

According to the Minnesota Department of Health Weekly Influenza and Respiratory Illness Activity Report, during the week ending Jan. 3, 2015, surveillance indicators showed widespread geographic spread of influenza throughout the state. Since the start of the influenza season, four pediatric (less than 18 years of age) influenza-related deaths have been identified in the state.

Cheryl Fisher, nursing coordinator at Raiter Clinic in Cloquet, said the clinic has seen a steady stream of patients complaining of flu-like symptoms ever since mid-December.

“We’re seeing all ages, from the very young to the very old,” said Fisher, adding that if a patient is diagnosed with Type A or B influenza after a throat swab is administered, most are being given Tamiflu to help ease their symptoms and lessen the severity of the illness.

“Some who are at high risk are given Tamiflu without even being swabbed if they come in suffering from flu-like symptoms,” Fisher added.

She said since Dec. 1, some 190 patients have been tested for influenza at the clinic and at least 51 have tested positive for the influenza virus thus far.

Carolyn Olson, director of emergency services at Community Memorial Hospital in Cloquet, said the emergency room has been extra busy as well.

“From about two weeks prior to Christmas we’ve been bombarded like everyone else,” she said. “We’ve seen tons of positive cases.”

Olson reported that from mid-December to Jan. 1, of the patients passing through the CMH Emergency Room, 82 received a positive influenza diagnosis, and there have likely been some 25-30 more since then. She said approximately 20 of those people dealing with flu-like illnesses have been admitted and isolated. Fortunately, however, there have been no flu-related deaths at the hospital.

The other good news is that the adjoining Sunnyside Health Care Center is “100 percent flu-free!” according to Shelly Demers, director of staff education and infection prevention.

Olson said thus far the staff at both facilities — a high percentage of whom received the flu vaccination both last year and this — have remained basically healthy.

“The staff has really been able to avoid [the flu] through hand-washing, masks, and everything else that needs to be done to avoid getting infected,” she said.

Deb Wolf, employee health infection prevention coordinator at Mercy Hospital in Moose Lake, said the influenza virus has been pretty much “spot grazing,” with a few cases reported every week, though most came during the month of December.

“We have only seen a minimal amount of it at the hospital,” said Wolf, “but there has been a lot of out-patient flu in the lab records. A few of our employees have had it, too. It’s definitely here.”

The adjoining Augustana Mercy Health Care Center has had it a bit rougher, however. R.N. Leslie Bakhtiari, administrative coordinator and infection control specialist, said the nursing home recently had an outbreak of influenza-type illnesses, with 18 cases confirmed within the last couple of weeks among the Health Care Center’s 72 beds. Bakhtiari said all residents at the Center were quarantined for a time. Tamiflu was administered, visitors were restricted and residents exhibiting flu-like symptoms were put on droplet precautions. Fortunately, reported Bakhtiari, there are no new confirmed cases at present, although those who are symptomatic are still being confined to their rooms.

Esko School Nurse Leanne Butler said that reports of the flu among Esko students have been up and down.

“We have had some high absence days,” she confirmed, “but so far we haven’t gotten to the criteria that would require us to report it to Public Health. Monday was a bit on the high side in both the high school and the elementary school, so we were a little concerned, but on Tuesday attendance went back up.”

In the meantime, retail health clinics and services are starting to crop up all over the country, and White Drug Pharmacy in Cloquet has joined the ranks.

According to Chief Pharmacist Nat Willgohs, the local pharmacy participated in a study through the University of Nebraska last winter to “take a step into the future” to see if dispensing basic health services in a retail setting would be feasible. At that time, White Drug Pharmacy, located in Super One Foods in Evergreen Plaza, was able to offer strep throat and flu testing free of charge to customers as part of the study. He said customer response was limited, but the company decided to move forward with the program this winter on its own.

The pharmacy now offers strep throat and flu testing for a flat fee of $75, which at this time Willgohs said is not billable to insurances, though customers might be able to get reimbursed later from their individual insurance companies.

“If the results of a flu or strep test is positive,” he explained, “we are able to dispense the appropriate medicine based on the diagnosis.”

The services are currently available only to adults over the age of 18, though Willgohs hopes that if demand is great enough, that may change in the future.

At present, Willgohs is the only pharmacist on duty trained to administer the tests, so customers would be well-advised to call ahead to make certain he will be on duty when they come in.

“If it takes off, we will have everyone in the store trained,” added Willgohs.

The local pharmacy is one of 10 in the White Drug chain of stores to be offering the flu and strep testing, adding that as far as he knows they are the only one in the immediate area.

Customers should plan on 15-20 minutes for the testing, which is done through the use of throat or nasal swabs to gain a culture. And while Willgohs admitted that such retail health services likely won’t replace family clinics and health care centers, they fill a much-needed gap for people who want a speedier, convenient or more cost-effective way to get tested than a trip to the emergency room or urgent care.

According to reporter Mark Zdechlik of Minnesota Public Radio, “For many consumers, the convenient option [of retail health services] comes at the right time, given dramatic increases in out-of-pocket health care costs….While convenience was the impetus for retail clinics, their relatively low cost is fueling their growth. Consumers, even people with health insurance, are paying more out of pocket for care. According to the Commonwealth Fund, a non-partisan health research organization, the average deductible for individual coverage in Minnesota has soared to about $1,400.”

Access to retail care likely will continue to rapidly expand. The industry projects there will be 3,000 retail clinics by the end of next year, an increase of nearly 60 percent from today.

"There's an epidemic of obesity and diabetes in our country and we have to make it easier for people to take care of those illnesses," she said. "So what we are doing is connecting our electronic medical records with our health system affiliates, then we can co-manage chronic disease and hopefully improve the quality of care for chronic disease."