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Saturday, Oct. 10, 2009

H1N1 surge is raising concern

'Be prepared in the months ahead,' health expert warns

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California has seen a surge of people sickened by influenza in the past several weeks, leading state officials to believe more hospitalizations and deaths are going to occur.

Dr. Mark Horton, the state's public health director, said this week that outbreaks of H1N1 influenza are occurring in more than half of the regions of California.

The novel flu virus remains a leading health concern because people younger than 60 are believed to have no immunity to it, Horton said. As of Thursday, the pandemic flu had caused 206 deaths statewide and more than 2,700 Californians have been hospitalized.

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  • MOST AT RISK

    Officials say these groups most need swine flu vaccine:

    • Pregnant women
    • People who live with or care for babies younger than 6 months
    • Health care and emergency services workers
    • People ages 6 months to 24 years
    • People ages 25 to 64 with chronic health disorders or compromised immune systems
  • KEY INFORMATION

    About a third of the 170 students at St. Stanislaus School in Modesto missed class this week because they were sick. Stanislaus County health officials expect that cases of swine flu, or H1N1 influenza, will increase in the coming weeks and months. Here is what you need to know:

    • THE ILLNESS: H1N1 influenza is contagious. It's mainly spread by coughing or sneezing and infected droplets coming into contact with another person. People also can pick up the virus from a desk, a doorknob or other infected surfaces.
    • SYMPTOMS: Fever, cough, sore throat, body aches, headache, chills, fatigue. Patients may have diarrhea and vomiting. Symptoms are usually mild to moderate; most patients fully recover.

    PRECAUTIONS

    • Cover coughs and sneezes with an elbow, sleeve or tissue. Coughing into hands can spread germs to others.
    • Wash hands often with soap and water, or use an alcohol-based hand sanitizer.
    • Avoid touching your eyes, nose and mouth, even after washing your hands.
    • Avoid close contact with sick people.
    • Stay home if you are sick.

    ON THE NET

    For more information: www.stanemergency.com or www.cdc.gov/h1n1flu.

    Sources: Stanislaus County Health Services Agency, Centers for Disease Control and Prevention

  • Swine Flu vaccine

    The first doses of H1N1 vaccine will begin arriving this week. However, the initial doses will be in nasal spray form, which will be used for some children.

    • What: H1N1 nasal spray vaccine. When: Some will arrive as early as Tuesday. Check with your health care provider. Who: The first shipment is for children ages 2 to 9 and caretakers of children under 6 months. People 10 and older will need only one dose.
    • Cost: Free, but providers can charge an administration fee of about $25.

Horton dismissed a suggestion that the public was unduly alarmed.

"We don't think we are exaggerating the seriousness and the concern," he said. "We face an unusual challenge that requires all of us to be prepared in the months ahead."

Horton's news conference Thursday was timed with the release of 400,000 doses of nasal spray vaccine to health care providers in California. Most of the nasal vaccine is being given to targeted groups such as children ages 2 and older and parents or caregivers of infants younger than 6 months.

The nasal spray is designed for healthy people ages 2 to 49. It is not recommended for pregnant women and people with asthma.

Injectable form coming soon

Officials said more doses are expected in the coming weeks, including the injectable form of the vaccine. It should be more widely available from private physicians, health clinics and community flu shot clinics.

In addition, Walgreens, Target, Rite-Aid and Safeway pharmacies have told the state they will give vaccinations when supplies are available.

"Clearly, vaccination is the most effective preventive measure," Horton said.

Patients stricken with H1N1 can be given Tamiflu or similar drugs to slow down the viral infection or antibiotics if they have a secondary bacterial infection. Getting a prescription for Tamiflu usually requires an H1N1 diagnosis or the patient to have an underlying health condition.

A fair amount of people have gone to drugstores to buy over-the-counter products to alleviate symptoms.

Ted Smernes, owner of Ceres Drug Store, said periodic surges of customers have come through the doors. They often are looking for products such as Kaopectate or Imodium for diarrhea or Robitussin to alleviate chest congestion.

Tamiflu in demand

Smernes said the pharmacy keeps busy filling prescriptions for Tamiflu. The liquid version of the medication for children has been unavailable from suppliers for weeks, so the pharmacists grind Tamiflu capsules to make the pediatric medicine.

"The manufacturers didn't make enough of the liquid form," he said. "When the epidemic in Mexico occurred (in March and April) there was a shortage of the medication."

Jose Carranza, who owns independent drugstores in Modesto and Hughson, said that with the warm weather this fall, not many customers have had runny noses and sniffles. At his store on Crows Landing Road in south Modesto, he fills six to eight prescriptions a day for anti-viral drugs, most for flu patients given prescriptions at hospital emergency rooms, he said.

The Modesto store also fills a lot of prescriptions for antibiotics to treat flu sufferers who have bronchitis or other secondary infections.

"Before this, we hadn't seen prescriptions for Tamiflu for years," Carranza said. "I think people are getting scared and going to the emergency rooms."

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.