Novel H1N1 Consistently Present in the High Country

ASU Students, Priority Groups Encouraged to Get H1N1 Vaccination

Story by Corinne Saunders

Seasonal Flu Update

Seasonal flu vaccines are not available for adults at either the Appalachian District Health Department or ASU at this time.

Seasonal flu vaccines for children ages six months to 18 years are offered free of charge at the Appalachian District Health Department.

The health department expects a shipment of seasonal flu vaccine in late November or early December, said Jennifer Greene, Appalachian District Health Department’s health promotion supervisor and public information officer.

The seasonal flu vaccine requires only one dose for children of any age. Children ages 2 to 18 can get the nasal vaccine for seasonal flu, and children six months to 18 years can receive the injectable vaccine for seasonal flu, Greene said.

Adults in the community should focus on preventing the spread of the flu, Greene said.

“We pre-order seasonal flu [vaccines] based on how many injections we gave in the previous year,” said Robert Ellison, a staff physician with ASU Student Health.

The supply of about 700 doses of seasonal vaccine has already been distributed because of increased interest in the vaccine this year, he said, adding that he is unsure as to whether the university will be able to receive more.

Usually students come to be vaccinated for seasonal flu in December and January, and medical staff is pleased about the earlier interest this year, Ellison said.

The nasal spray vaccine for seasonal flu provides protection for nine to 12 months, and the injection protects for six to eight months, Ellison said, adding that either is “very adequate for the months of the year associated with the wintertime flu.”

The virus strain is different each year, so a new vaccine is given each year, he said.

H1N1 Clinic at Boone Mall Saturday

Maxim Healthcare Services, a home care agency in Boone, will offer H1N1 injectable shots to priority groups for $15 in the center court of the Boone Mall this Saturday, November 21, from 11:00 a.m. to 4:00 p.m.

The agency offered its first H1N1 clinic last week at the Boone Mall, said Josh Spriggs, a healthcare recruiter with Maxim Healthcare Services.

Priority groups are ages 10 to 24 and ages 25 to 64 if they have any chronic health conditions or any condition affecting the immune, pulmonary or respiratory systems, Spriggs said.

Priority groups also include any emergency medical service personnel, healthcare workers, from athletic trainers to doctors, or anyone who has contact with children ages six months old or younger, he added.

This week, the agency has approximately 220 doses of H1N1 available, Spriggs said, and the $15 fee is payable by cash, check or insurance.

Payment by the following insurance plans is accepted: Medicare Part B, Aetna, SummaCare, UniCare, United Healthcare (various plan names), BCBS of North Carolina, Partners—BCBSNC and Humana Gold Choice—Southeast.

Of the 90 H1N1 injections given last week, about 85 percent were covered by insurance, Spriggs said.

Want To Go?

Date: Saturday, November 21
Time: 11:00 a.m. to 4:00 p.m.
Location: Boone Mall’s center court
Cost: $15

The Centers for Disease Control (CDC) estimates that from April to October 17, novel H1N1, commonly known as swine flu, has sickened about 22 million Americans. In that six-month period, the CDC estimates that about 98,000 people nationwide have been hospitalized for H1N1, including 36,000 children, and that about 4,000 people have died from the disease, including 540 children.

According to www.cdc.gov, “the proportion of younger people being impacted by 2009 H1N1 is much greater than what occurs during seasonal flu and people 65 and older are much less affected by this virus than what routinely occurs with seasonal influenza.”

Locally, both ASU Student Health and the Appalachian District Health Department are receiving weekly shipments of the H1N1 vaccine, and full-time ASU students and children are able to receive the vaccine at the two respective locations.

“We’ve seen people with influenza-like illness in the community,” said Gillian Baker, vice president of marketing for Appalachian Regional Healthcare System.

“We are seeing it in the emergency department,” Baker said, adding that on any given day, up to 10 percent of those seen demonstrate symptoms of influenza.

“We started tracking this in mid-August,” Baker said, “the unusual part of this is it’s the numbers we’d see in normal flu season, but [we are] not in normal flu season.”

Some days the percentage of patients seen in the emergency department with flu-like symptoms “has spiked up to 15 percent,” but since mid-August, the slightly less than 10 percent figure has been fairly consistent, Baker said.

H1N1 at ASU
“We’ve been seeing influenza-like illness since September in large numbers,” said Robert Ellison, a staff physician with ASU Student Health, adding that “influenza-like illness” is the proper term because no test is given to determine if the illness is H1N1 or seasonal flu.

ASU Student Health keeps weekly statistics on the number of students seen with influenza-like illness and reports to university systems and to the state health department.

“We have seen as many as 150 students per week with influenza-like illness,” Ellison said.

The number of students with influenza-like illness per week has consistently been at least 70 to 90, and does not seem to be diminishing, he added.

“The volume of students we’re seeing in mid- to late-fall is very similar to the typical pattern in January, February [and] March,” Ellison said. “The national trend is very similar to what North Carolina is seeing and what we’re experiencing.”

The first week in November, ASU Student Health received 300 doses of the nasal spray H1N1 vaccine and 100 doses of the H1N1 injection, Ellison said.

A few weeks prior to that shipment, ASU Student Health received 100 doses, Ellison added.

The vaccine is supplied through the government free of charge, and although administering entities are allowed to charge an administrative fee for the vaccine, “we have chosen not to do that here,” Ellison said.

While supplies last, either form of the H1N1 vaccine is offered free of charge to full-time ASU students.

“The state is trying to distribute [the vaccine] to each of the 100 counties in a way [that is] as equitable as possible,” Ellison said, adding that he does not know how many doses or how often shipments of the vaccine will arrive.

The H1N1 vaccine is distributed on a first-come, first-serve basis at ASU, Ellison said, adding that high-risk students are notified to let them know limited injections are reserved for them.

High-risk students, as defined by the ASU website, includes those with asthma, diabetes, HIV or chronic heart, lung or kidney disease.

ASU cooperates with the state health department, and the vast majority of the illness on campus that has been tested by the state was determined to be H1N1; the seasonal flu has not started to show up, Ellison said.

“We are restricted to two flu cultures to be submitted per week,” Ellison said, adding that the results come back two weeks later.

By that time, the student whose culture was submitted is already well, so the test is not to determine treatment, but to help keep a record of the illness pattern across the state, Ellison explained.

“Very few hospitalizations have resulted from this,” Ellison said of the H1N1 cases on campus. “Less than three to five [students] have received hospital care.”

H1N1 at the Health Department
The health department has begun receiving H1N1 vaccination shipments of 100 to 200 doses on a weekly basis, said Jennifer Greene, Appalachian District Health Department’s health promotion supervisor and public information officer.

Currently, Appalachian District Health Department is following the CDC recommendations for vaccinating priority groups first. Priority groups include pregnant women, people who live with or care for children younger than six months, healthcare and emergency medical services personnel, people ages six months to 24 years old and adults ages 25 to 64 with chronic health disorders or compromised immune systems. There is currently no charge for H1N1 vaccine for anyone.

Children ages 2 to 18 can get the nasal vaccine for H1N1, and children six months to 18 years can receive the injectable vaccine for H1N1, Greene said.

A four-week waiting period is required between vaccinations for children receiving both the nasal seasonal flu and nasal H1N1 vaccinations, she added.

Shipments of the H1N1 vaccination have been arriving on Tuesdays, so Wednesdays are typically good days to call the clinic and possibly be vaccinated, Greene said.

“We know we’re continuing to receive shipments of vaccine, so if we don’t have it [at the time], call back,” Greene advised.

Another way to check availability is by clicking to www.flu.nc.gov, the “Flu Clinic Finder,” and then entering in the zip code, because the health department is one of the listed locations.

It is recommended that children under 10 receive two doses of the H1N1 vaccine, but only one dose is required for children ages 10 and older, she said.

Children under six months cannot get flu vaccines.

Tips for preventing the spread of all flu viruses, as listed by the Appalachian District Health Department, include: frequent hand-washing with soap and warm water, especially after coughing or sneezing; using alcohol-based hand cleaners when you cannot wash your hands; covering your nose and mouth with a tissue when you cough or sneeze and throwing away tissues immediately after use; coughing or sneezing in the crook of your upper arm, not your hands, when you do not have a tissue; avoiding touching your eyes, nose or mouth; and trying to avoid close contact with sick people.

The health department recommends singing “Happy Birthday” two times while washing your hands to be sure you’ve washed long enough to be most effective.

For more information about H1N1, call the Appalachian District Health Department at 828-264-6635 or the N.C. Care Line at 1-800-662-7030 (TTY 1-877-452-2514) or click to www.flu.nc.gov.

For more information on local updates, click to www.emergency.appstate.edu, www.apprhs.org, www.apphealth.com or www.apprhs.org and click to H1N1.

To view the CDC estimates, click to www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm.