Monday, March 29, 2010

Health Issues - H1N1 flu may be on rebound in Southeast

Vaccine still plentiful, TN health officials say
By Christina E. Sanchez • THE TENNESSEAN • March 29, 2010

The fresh smell of newly cut grass is in the air, birds are bustling and the temperature is heating up. Signs abound that it is spring, a time many equate with the end of flu season.

But the H1N1 flu virus isn't gone. In fact, the southeastern United States, including Tennessee, has seen a slight increase in H1N1 cases. Clusters of cases have been reported in Nashville and Knoxville, according to Tennessee health officials.

The pandemic virus can last for up to two years. This spring marks the end of year one.
Health officials are hoping people will get one of the million remaining H1N1 vaccine shots, especially since another wave of H1N1 cases could be looming.

About two-thirds of Americans have not gotten the vaccine. The shot is free and is available at local health departments, retail stores and doctors' offices.

"H1N1 never went away; the disease is still out there," said Dr. Kelly Moore, director of the state immunization program. "Because this is a new strain of flu, it could hang around and cause local flare-ups for weeks or months to come."

In Knoxville, several recent deaths could be linked to H1N1, said Knox County Medical Director Dr. Martha Buchanan.

It's hard to say how many, Buchanan said. "They may get sick at home and come to the hospital with something else and not even know they have" the flu.

Health officials aren't sure whether the recent rise in the number of H1N1 cases in this region represents the expected third wave of the pandemic.

Tennessee has seen two waves, as has much of the rest of the country. The first wave occurred in April 2009. The spread of the virus slowed over the summer and picked up again when school resumed in August.

Flu is unpredictable, said Dr. William Schaffner, an infectious disease expert at Vanderbilt University and liaison member of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.

"The southeastern part of the U.S. is seeing a small increase in cases again," Schaffner said, stopping short of saying the spike would continue. "I would still say the best thing people can do to protect themselves is to get vaccinated against H1N1."

Tennessee health officials don't track how many H1N1 cases the state sees, but they check a sample of flu tests sent to their lab each week. About 23 percent of samples are testing positive for H1N1. The state knows that H1N1 in Tennessee has killed 66 people, of whom 13 were children.

Nationwide estimates of the impact of H1N1 show that the virus has made about 60 million people sick, has led to 265,000 hospitalizations and has caused more than 17,000 deaths, according to the CDC.

"The H1N1 flu virus has caused substantial outbreaks of disease outside of the normal influenza seasons," said Dr. Tim Jones, state epidemiologist. "Our surveillance systems show that the virus is still active in Tennessee and could continue to cause local outbreaks for weeks or months."

There's still plenty of vaccine to go around. The federal government has shipped 124 million doses of the H1N1 vaccine around the country and will order more if people want it; about 70 million doses have been given nationwide. Tennessee's health department distributed 2.5 million doses, though the agency does not track how many have been given out to people

Reid Huffman, a sophomore at Belmont University, is one person who has not gotten the vaccine. He was surprised to hear that H1N1 was still an issue, and he doesn't think he'll get the shot.

"I just didn't want to bother with it," Huffman said about why he initially didn't get it. "You can spend your time worrying about every bad thing that might happen … but that can take up a lot of time."

Combo shot planned
Next year, people won't have to get two flu shots. The regular seasonal flu shot, which includes up to three flu strains each year, will include H1N1. The timing will be good, since the CDC believes that's when the next wave could hit.

Health officials are watching the Southern Hemisphere to see how H1N1 plays out there. The countries there are in the fall season.

Health officials are asking doctors or clinics with the H1N1 vaccine to hold on to the solo H1N1 vaccine in case the next wave hits before the seasonal vaccine becomes available.

"We're concerned about people who haven't been vaccinated, particularly pregnant women and young adults with underlying health conditions," Moore said. "The vaccine doesn't do anyone any good sitting on a shelf, and people shouldn't wait to get it."