You may never know
By Gwendolynne Larson (Contact), Bobbi Mlynar (Contact)
Friday, September 11, 2009
Emporia High School has at least one confirmed case of Type A influenza, but it will never be confirmed whether it’s the H1N1 strain, which has been causing concern since first diagnosed last spring.
That’s because the Kansas Department of Health and Environment changed its testing guidelines earlier this month.
“KDHE will continue collecting specimens from hospitalized patients, as well as a limited number of specimens from a network of clinics and hospitals across the state that are submitting weekly information on the number of patients they are seeing with flu-like symptoms,” the department announced in a Sept. 2 news release. “Those sites will also submit a random sample of specimens from patients, for testing that will allow KDHE to monitor the spread of disease in the state.”
That means schools won’t necessarily know why a student is absent and what exposure risks that might cause for others in the buildings.
“We have no way of knowing whether it is this new strain of flu or regular flu,” said Nancy Horst, community relations director for the school district. “I am certain we have students and employees who have had the flu, and I mean multiple (cases), as they do every single year. ... You do the exact same thing for whatever strain of flu you have.”
Staff in each school has been told to question parents or guardians about symptoms their children are exhibiting when they call in to have them excused from classes.
At best, said Ann Mayo, Lyon County health officer, doctors can run a test that screens for Type A influenza of which H1N1 is a strain. And, she added, doctors may tell patients they “probably have H1N1.”
But only a lab test by a state-certified lab will give specific results for H1N1.
Health officials say the reason for the change in testing procedures is that H1N1 influenza is treated with the same common-sense steps as other Influenza A strains. According to Mayo, those steps include washing hands frequently to prevent the spread of germs, sneezing into your elbow or a tissue then discarding it properly and, most importantly, staying away from other people.
“They should stay away from people until 24 hours after their fever breaks,” Mayo said.
That also is the rule in Emporia Public Schools — students and staff are required to be fever-free for 24 hours before returning to school.
Horst said that at least one youngster recently was sent home again because she came back to class too soon. The student had been sent home with a fever one day and returned the following morning. That prompted the school nurse to call the parent to pick up the child again, with a caution to not return to school until he or she had been fever-free for the required 24 hours.
“You have to be fever-free without any kind of fever-reducing medication before you can come back to school,” she said.
Providing information to classmates about possible exposure, however, is trickier. Care must be taken not to disseminate information that could reveal health information about any individual.
“The HIPAA privacy rule protects all individual identifiable health information about any individual, a student or employee,” Horst said.
The spread of H1N1 cases initially caused concern because the strain had never been seen in humans before. Because of that, people have no natural resistance. But, Mayo said, the risk is not severe.
“The vast majority of people who get H1N1 get mild cases, at least right now,” she said.
The bottom line, according to Dr. Jason Eberhart-Phillips, state health officer and director of the Division of Health at KDHE, is that unreported cases are occuring in Kansas and across the United States.
Mayo agreed.
“We do have it in Emporia,” she said. “At least two cases have been confirmed.”
The first case came in June when a young adult who had been living elsewhere returned home to Emporia; the second case came just last week in an Emporia State University student.
The symptoms of influenza are:
• Fever greater than 100 degrees
• Body aches
• Coughing
• Sore throat
• Respiratory congestion
• In some cases, diarrhea and vomiting
The Emporia school district began its education on sickness protocols the first day of school, in grades K through 12, Horst said. Teachers talked to students about personal hygiene to help stop the spread of flu, what to do if they became sick and the necessity of staying home until they are well.
“The position is the same: Whether you are an employee or a student, we don’t want you at school if you have the flu,” Horst said.
The district also has provided information to parents about how to keep their families healthier, and school nurses and staff have become especially vigilant in watching out for symptoms.
Staff members have been encouraged to be innoculated with the traditional flu shot, which will be offered to employees in each building, as is done every year. The drive to get flu shots started earlier this year because of the anticipated harshness of the flu season.
Besides staying home when sick, Mayo said, those with severe symptoms should see their doctors.
But, unless they are hospitalized and have their lab tests sent to the state, they’ll never know whether they have H1N1 or just regular seasonal flu.
Comments
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Posted by callalily (anonymous) on September 11, 2009 at 1:19 p.m. (Suggest removal)
If you read news articles from places where this flu is already much more rampant (i.e., the Southeastern United States) you will notice a much different take on this "confirmed" vs "suspected" debate.
At the very least, they are saying that all Influenza-A positives are assumed to be H1N1. Some are taking that one step further and saying that anyone who presents with flu-like symptoms is assumed to have H1N1.
Why would they take that approach? Because according to the CDC, 97-99% of the Influenza A positives end up testing positive for H1N1. It's not "regular" flu season right now. The only flu that is currently in wide circulation is H1N1...because pandemic flu doesn't follow the same patterns as seasonal flu.
The danger of *not* taking the above approach is it leads to many people being misdiagnosed as having "regular flu" or "just a cold." In some cases, that has lead to deaths of individuals who could have possibly been saved with prompt antiviral treatment.
I hope that the public and medical professionals here in Emporia start to study more what is going on in other parts of the country and learn those lessons NOW before we have to learn the hard way. :(
Posted by madpoet (anonymous) on September 11, 2009 at 2:43 p.m. (Suggest removal)
I'm sorry, but you're going to treat both types of the flu the same way so what difference does it make? If the person is very sick or has other health problems, the antivirals work on both types. Regular flu kills people. I wish I knew what the mortality rates are for seasonal vs. H1N1. I wouldn't be surprised if they're very similar. I'll get my flu shot and practice good hygiene etc like I do every year. People are freaking for no good reason, in my humble opinion.
Posted by callalily (anonymous) on September 11, 2009 at 10:15 p.m. (Suggest removal)
Regular flu kills primarily the aged and infirm. Pandemic flu kills the young--mostly those between the ages of 5 and 49. That's the difference.
Posted by madpoet (anonymous) on September 12, 2009 at 9:21 a.m. (Suggest removal)
The people being killed are mostly those with underlying medical problems of all ages. The older population may have some natural resistance due to the "swine flu" exposure they had decades ago. The 2 who died in Kansas were not that old but both had medical conditions. The woman had weak lungs and a trach. Her siblings got sick with a mild case but all survived.
Posted by kseyetie (anonymous) on September 22, 2009 at 8:47 a.m. (Suggest removal)
The flu is the flu. People should stay home when sick, wash their hands and get some rest (in between deep breaths.) If this is a typical year, 30-some thousand people will die of the flu. H1N1 is nasty, but we'll get through this if people are responsible and don't spread it through arrogance or negligence.
Posted by create (anonymous) on September 22, 2009 at 9:31 a.m. (Suggest removal)
That's the problem, kseyetie, too many people are irresponsible and they do spread viruses as a result. Last week, while standing in a checkout line at a nearby grocery store, I heard one young lady discussing ESU's closing policy for the flu. She said she didn't feel responsible for the rest of society. She paid her tuition and didn't like missing classes. This is exactly the kind of attitude that spreads flu and other kinds of communicable diseases. I don't want this little jerk anywhere near me.
Posted by giggles (anonymous) on September 22, 2009 at 10:09 a.m. (Suggest removal)
Create, I'm not sure about the student you were speaking of, but many people cannot afford to miss work or do not have sick time to use, many companies do not offer it. Some companies will also count it as a strike against those who miss work.
That is a sad fact of how laborers are treated in this country. Does it endanger everyone? Yes, but how else are they going to survive without going to work, even when sick?
Just put that on the growing list of reforms the country needs.
Posted by create (anonymous) on September 22, 2009 at 5:10 p.m. (Suggest removal)
Yes, giggles, I see your point. I do know that the federal government has been urging companies to be more flexible and not dock workers who have to stay home with the flu. Whether companies honor the request remains to be seen. I agree that laborers are poorly treated.
But the young lady I spoke of originally was arrogant for stating that she didn't want to be responsible to the rest of society. If we all had such an attitude, no one would care one bit about who lived or died, or who ate or starved. One day, when she is no longer a college student, she will have to join a society that pays taxes in order to support the community. Will she refuse? It would be interesting to know whether she paid cash for her tuition or is on some kind of scholarship.
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