The Coming Flu

Following Humboldt County's first H1N1 death, officials ramp up for mass inoculation



The sad news that a local woman had died last Friday, likely from complications from the H1N1 virus -- the swine flu -- prompted the Humboldt County Public Health Branch to gather in the news folks on Monday for a war briefing.

Your job, Humboldt County Health Officer Dr. Ann Lindsay told us newsies, is going to be to get the word out there that, come this fall, there could be a surge in H1N1 cases in the county -- unless people actively engage in prevention measures, including practicing good hygiene and getting vaccinated when the time comes if they're in one of the high-risk categories.

Lindsay noted that the death rate for H1N1 is no higher than that for the regular seasonal flu. In the United States, an estimated 36,000 people die each year from seasonal flu. As of April 28, five people have been hospitalized in Humboldt County with H1N1.

But this was Humboldt County's first fatality related to the virus. At Monday's briefing, the county didn't know the exact cause of the woman's death. But on Tuesday, health department spokesperson Heather Muller said that they'd received the cause-of-death certificate. It listed three causes of death: the immediate cause was cardiovascular collapse; two underlying causes were septic shock and H1N1 influenza. It also said she had significant conditions contributing to her death but which did not result in the underlying causes of her death, including adult respiratory distress syndrome.

"She probably would not have died" if she did not have H1N1, said Lindsay Tuesday afternoon.

The 58-year-old woman, whose identity the department did not disclose, became ill at the end of July. She was hospitalized at Redwood Memorial for several weeks before her death on the afternoon of Aug. 21. She tested positive for the H1N1 virus on Aug. 9. It is unknown where she contracted the virus. Nobody who has been around her has shown symptoms of H1N1, and the threat to them is likely past now, Lindsay said.

Statewide, 1,153 people have been hospitalized and 115 have died since the beginning of the swine flu outbreak. Nationwide, there have been 7,983 hospitalizations and 522 deaths. But it's likely the death rate is smaller: More people probably have had a mild case of the swine flu and recovered without ever going to the hospital, according to the Centers for Disease Control and Prevention.

Nevertheless, county officials are preparing for the worst.

"We're focusing on prevention efforts," Lindsay said. "We expect up to 30 percent of our school age population could get sick if we don't vaccinate."

Lindsay said that the people who are getting sick from H1N1 at a higher rate, and who should get vaccinated, are pregnant women, young people ages 6 months to 24 years old, people who care for children under 6 months old (because those children can't be vaccinated), health workers and people 24 to 64 years old who have chronic diseases such as lung and heart disease, diabetes and significant obesity.

The county public health department is expecting state and federal money to come in soon to help pay for the vaccination campaign and for laboratory work and monitoring of the virus. The first batch of vaccinations are expected to arrive at the end of October, and more shipments will come in the weeks following that. The vaccination is a two-dose procedure, and is taken in addition to the standard seasonal flu shot.

Lindsay said Public Health will hold vaccination clinics at its office for free. And there likely will be free clinics at other places convenient to the people who most need it, including schools -- where Lindsay hopes parents will sign the consent forms for their children to be immunized -- and at Humboldt State University and College of the Redwoods because of the significant number of 18-24 year olds. As well, medical providers will have the vaccine, and perhaps pharmacies. Providers may charge an administration fee to insurance companies.

"And with the kids we're hoping to use a nasal spray rather than a shot because that's more palatable for kids," Lindsay said. She added that, for those parents who fear a suspected (but recently refuted) link between thimerosal-containing vaccines and autism, the county offers vaccines without thimerosal.

Lindsay said the swine flu outbreak -- classified as a global pandemic -- is the biggest thing she's ever been involved with while working in public health.

"If you add up all the risk groups, there's the potential that half the population of Humboldt County needs to be immunized -- twice," she said. "And that's a huge, huge undertaking. And if we're successful at vaccinating people, and also having people wash their hands and cover their cough and stay home when they're sick, we can limit the impact in Humboldt County. So it's a real challenge to the community, not just for Public Health."

That last bit -- covering your mouth and nose when you cough and sneeze, and washing your hands and staying home when you're sick -- bears repeating. Same goes for the seasonal flu. And, as for that, Lindsay recommends that those in the high risk categories also get the seasonal flu shot. It will be available in Humboldt County in September.


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