Monday, August 24, 2009
WALLA WALLA — At the exact point in the year when flu viruses should be as gone as summer company, Walla Walla is seeing a "fair uptick of influenza-like illness" in the area’s emergency departments and medical clinics, noted Harvey Crowder, administrator for Walla Walla County Public Health Department.
With little testing being done, the illnesses can’t be technically labeled influenza — swine or otherwise, he said, "but if it looks like a duck, walks like a duck ..."
Most of the testing (done when a person is hospitalized with severe symptoms) is revealing victims of influenza Type A, most of which is pandemic influenza, Crowder said. "In practicality, it’s treated the same as pandemic or annual epidemic."
Sort of a bad-news, bad-news situation at this time of year, he noted. A vaccine for swine, or pandemic, flu is in the development and testing stage and the regular doses of vaccine for seasonal flu have not yet been released by manufacturers.
"We are not immune. We are not armored," Crowder pointed out. "Once the virus begins to spread, if we are not careful with hand washing, covering your cough, staying home ... we will see fairly widespread disease fairly quickly."
That feared spreading could begin in earnest this� week as school districts in the Valley open their doors.
The swine, or H1N1, flu has shown to be an illness of younger people and pregnant women, Crowder said. "When kids congregate in schools, we should see a fair uptick, and that dramatically increases the risk for kids and families."
Theoretically, up to 30 percent of a school’s population could be missing in action at one time, he said.
Which is why his district has been busy educating the educators, said Tim Payne, superintendant of College Place School District.
Curriculum includes watching for any tissue sharing, enforcing hand washing and looking for signs of fever and other symptoms.
Perhaps the most important lesson will be to stay home when sick. That goes for students and staff, Payne said.
Public health guidelines call for people to be fever-free for 24 hours and not using fever-reducing medication before returning to school or the workplace.
If staff becomes aware of sick kids at school — that will usually mean seeing students with two or more flu symptoms — temperatures will be taken and children sent home, the superintendant said.
"It is ‘go home and stay home.’ This is going to be a big issue, tremendously challenging for parents. A lot of families are two working-parents and if we send kids home, that’s tremendous stress."
The rule is clear in the case of flu, he added. "Do not congregate. That means kids can’t go to day care. There are no mass solutions. That means they don’t want you at the library or the community center. That is how you eradicate the thing."
Parents with sick leave will burn through that fast when they or their children are home sick for seven days or so, Payne speculated.
Public schools have the majority of the nation’s kids, and some parents believe such institutions should be the solution for nearly everything, he feels.
"We should be part of the solution, but not ‘the’ solution. What amount of our resources should go into this? Should I send a note home with all the regulations and rules? Then I have put resources into it, copying costs and staff time ... at what level should we be part of the solution?"
It’s a question every budget-conscious school district will have to answer as schools open before a vaccine is ready.
He and his staff don’t have time to borrow trouble, Payne added. "I appreciate Harvey’s lead on the front end of this so we don’t have to panic later."
Planning for a possible viral event has been on the front burner for at least four years at her school, said Ruth Wardwell, director of communications for Whitman College.
Back then the potential threat was avian influenza, she said. "That was our jump start, and we’ve continued from there."
The college opens Sept. 1, but preparation has been under way all summer, starting with posters distributed around campus highlighting personal care in avoiding the flu. "Soon we’ll branch out a bit and communicate about self-isolation in addition to simply staying home from class or work."
Whitman’s health-care team has taken a multi-pronged approach to monitor information and guidelines, Wardwell said.
This summer when the Centers for Disease Control and Prevention decided campuses should stay open during a pandemic, that allowed the team to go forward with tailoring plans accordingly, "as opposed to also having to plan for shipping people home, she said, calling that the team’s "aha" moment.
For months, planners had to float between two worlds of action, but with the CDC decision in July, they can now focus on how to house sick students on campus, Wardwell explained.
No one wants fear and panic to pervade the student body, and the administration believes the possibility of pandemic flu offers students a chance to use the critical thinking skills Whitman students are known for, Wardwell pointed out.
�"We want them to be knowledgeable and act accordingly, but we don’t want to overload them with messaging. We’re trying to find the balance and trying to focus communication on action steps."
As well, the team is preparing for whatever self-isolation adjustments may be needed, such as delivery of food as opposed to sick individuals coming to the cafeteria. "We feel really good about the effort we’ve made. We hope (pandemic flu) doesn’t happen, but if it does we will be as ready as possible."
The Milton-Freewater School District, without the benefit of a city-based public health clinic, is asking Umatilla County Public Health to come to the schools and provide immunizations, said Marilyn McBride, superintendant. "And it’s my anticipation they would come and do the same for our H1N1 vaccinations."
As well, the district has ordered hand sanitizer by the bulk and is preparing to drill into students the importance of hand washing and covering coughs, she said.
Like every other school superintendant, McBride is concerned that her staff and students hear the message loud and clear� — "Stay home when you’re sick."
The state of Oregon has estimated up to 40 percent of its population could be impacted, or about 1.5 million people, she added. "That’s a large number, that’s huge. So we’re doing everything we can — that’s our first line of defense."