Dr. Karen Tait said Lake County had a second reported case of H1N1, the pandemic strain of Novel Influenza A – previously known as “swine influenza” – in the last few weeks, and she's expecting the local number of cases to increase over the coming week.
The first local case, reported late in June, was an outpatient, but since then the state and the federal Centers for Disease Control have changed reporting guidelines for the virus, limiting the formal count to hospitalized cases and deaths, Tait said.
Outside of those officially reported cases, Tait said there have been several other local outpatient cases that Public Health found out about, but which health care providers no longer are required to report to the agency.
She said the CDC changed the reporting requirements for a few reasons, one of them being that they're attempting to focus on the more serious cases, which provides more meaningful data and helps them prioritize the groups they'll vaccinate.
The California Department of Health on Monday reported that there have been 1,057 hospitalizations and 104 fatalities for H1N1 in the state. Nationwide, there have been 7,511 hospitalizations and 477 deaths, according to the CDC.
In its severity, the H1N1 virus has resembled the seasonal flu, said Tait. However, its severe cases have tended to target children and young adults, whereas she said seasonal influenza tends to be more problematic for older adults and very young children.
H1N1 also has been problematic for pregnant women. Tait said a disproportionate numbers of cases have been found among pregnant women; approximately one-third of California women of child-bearing age hospitalized for H1N1 have been pregnant.
One of the local cases Tait heard of involved a pregnant woman diagnosed with H1N1. “Fortunately she never required admission to the hospital, so we lucked out there,” Tait said.
Both forms of influenza can cause severe illness in people of any age with chronic medical conditions, she said.
Another possible risk factor Tait mentioned is obesity. “That hasn't really been definitely listed as a risk factor but there's some significant obesity in patients who have been hospitalized or died throughout the states, and so they're looking at that as a possible risk factor.”
Tait said she's expecting more cases of H1N1 to show up this fall, at about the same time as the normal seasonal flu begins to make its rounds.
Tait said it will be important than ever this year to avoid getting the flu and to get immunized for both flu strains as soon as vaccines become available.
She said there will be two separate influenza vaccines – one for the usual seasonal influenza strains and one for H1N1.
The seasonal flu vaccine is expected to arrive earlier this year, with inoculations or a nasal spray application to become available later this month or in September, Tait said.
She said the seasonal flu vaccine is especially important for adults 50 and older; children aged 6 months up to their 19th birthday; pregnant women; nursing home residents; health care workers; individuals with a chronic health condition; people who live with or care for an adult over 50, a children under 5 or anyone with a chronic health condition.
The H1N1 vaccine currently is in development and is anticipated to be ready by October, said Tait. Supplies of the vaccine are expected to be limited.
Tait said Public Health will follow federal guidelines from the Centers for Disease Control in recommending who should be vaccinated earliest, with the focus likely to be on children, pregnant women, health care workers (including emergency medical responders), children and adults under
age 65 with certain chronic medical problems, and parents/caretakers of people at high risk of complications or children under 6 months of age.
When supplies of the vaccine are more readily available, it will be recommended for everyone over 6 months of age, said Tait. Vaccination against H1N1 likely will require two doses approximately one month apart for all age groups.
While Public Health gears up to do some vaccinating, Tait said the agency will be working with several local pharmacies, which also will be offering vaccinations. She said they've had the legal ability to do so for some time. That will help get the vaccines out to more people.
“We are so small ourselves that we are really going to depend on the medical community to help us with this,” Tait said.
Health officials continue to urge simply precautions, including regular hand washing and covering coughs and sneezes, to help prevent spread of either type of influenza. As well, people who are sick with influenza symptoms should stay home from work or school, generally for one week after
the onset of illness or until fever-free for 24 hours, whichever is longer. Healthy people experiencing mild illness can be treated at home.
Tait said those who have chronic medical conditions, are under age five, are pregnant or are experiencing shortness of breath or other severe symptoms should consult a health provider early when
ill with influenza-like illness. Symptoms include fever of 100 degrees or higher, sore throat and/or cough.
For more information contact Lake County Public Health, 707-263-1090, or visit the California Department of Public Health online at www.cdph.ca.gov/HealthInfo/discond/Pages/Influenza(Flu).aspx or www.cdph.ca.gov/HealthInfo/discond/Pages/SwineInfluenza.aspx .
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