Oct. 28, 2009

H1N1 (swine) flu activity has been mild this fall in Westchester. Small quantities of the H1N1 vaccine have been arriving weekly and are being shipped directly to a limited number of health care providers for the most at-risk patients. As more of the vaccine becomes available, it will be shipped to other health care providers, pharmacies and health clinics. Please check back with your provider or pharmacist about availability.

Meanwhile, residents should continue to follow preventive measures to keep their families flu-free. Wash hands as often as needed, cough into your elbow and above all, stay home when sick to avoid spreading the flu to others. Read more tips on fighting the flu.

For more information about the H1N1 vaccine, specifically, and who should get it, read H1N1 Vaccine Questions and Answers.

The county continues to follow the comprehensive plan set in place earlier this fall to cope with a flu epidemic–  small or large –  if one should develop. The plan involves hospitals, health providers, emergency workers, local governments, schools, businesses, public information  – and most of all the public itself.

Specifics range from updating Web sites to help with ambulance diversion in the event a hospital ER is overcrowded; hotlines to connect hospitals to each other and to the Department of Emergency Services so that any medical facility can get quick assistance; collaboration with the Westchester Medical Center to monitor patient census; and monitoring supplies and medical staff, including emergency medical workers, that could be needed in the event of an epidemic.

While all suspected cases of H1N1 will not be sent to a lab for testing, the county Department of Labs and Research is prepared with its sophisticated equipment to take samples as needed to stay on top of any epidemic.

The outreach also includes conference calls as needed with businesses, school  representatives and community leaders stressing the need to encourage sick employees and students to stay home until 24 hours after fever symptoms have disappeared and to let employees work from home if their children are sick.

This is supplemented by the county’s ongoing public information effort, including publishing information online. Bus card campaigns and other measures will advocate good personal hygiene to prevent the spread of germs.

For more information including and FAQs, go to www.westchestergov.com/health or call the Health Department at (914) 813-5000 or the state Health Department Hotline at (800) 808-1987.

At a press conference in September, County Executive Andy Spano added: “Most people who have had H1N1 flu have recovered within a week on their own with no need for medication or to even see their doctors. We remain hopeful that we will not get a severe epidemic, particularly as people take preventive measures. But our effort must – and does – focus on making sure our residents get the medical services and help they need if there is a serious outbreak.”

Commissioner of Emergency Services Anthony Sutton said, “Westchester has been planning for the return of the H1N1 flu this fall since it first surfaced in the county this past spring. At that time, County Executive Spano set up a special task force under the direction of my department that included subcommittees addressing topics such as public information, flu monitoring, laboratory procedures, vaccination efforts, hospital surge capacity and other specialty areas.”

“Westchester County had 130 documented cases of novel H1N1 flu last spring and this summer, most of these cases very mild,” said Commissioner of Health Joshua Lipsman. “The first wave of vaccine for this flu should begin to arrive in Westchester in mid-October and will be first available to people considered most at risk. In the meantime I urge residents, particularly those who are pregnant or age 50 and over to schedule their regular flu shots now. Parents with children ages 6 months to 18 years old who have not already had their children vaccinated should do so, too. Getting the novel H1N1 flu shot will not protect you from regular flu, and more people become ill or die from regular flu each year than have so far from novel H1N1 flu.”

Lipsman noted that people who think they have either mild cases of seasonal or H1N1 flu should stay home and rest and call their doctors with concerns rather than overwhelming hospitals and medical practices.

Revised guidelines put in place by the U.S. Centers for Disease Control and Prevention last spring call for anyone with fever and a cough or sore throat to stay home for at least 24 hours after the fever subsides to avoid infecting others. Cases of mild H1N1 flu are not expected to result in school dismissals unless so many students and staff are absent that classes cannot continue effectively. 

Each year, 36,000 Americans die from regular flu and more than 200,000 people are hospitalized. By comparison, at the end of August, 556 died in the U.S. and 8,843 people were hospitalized with novel H1N1 flu

Flu vaccine distribution
Providers who need to register should do so with the New York State Health Department. Both preservative-free single doses and multi-dose vials with preservative will be available. It is likely that residents will need two doses of the vaccine for it to be fully effective. 

The vaccine will be given first to the groups that are thought by the federal CDC to be most at-risk of complications. They are: pregnant women, people caring for or living with an infant younger than six months old, health care and emergency workers, people six months – 24 years old;  people 25-64 with health conditions associated with higher risk of medical complications from influenza. If there is not enough vaccine at the outset, these groups will be further limited, based on national guidelines.

While the vaccine will be provided free by the state to health care providers who sign up with the campaign, providers can charge patients for administering the vaccine and for an office visit.

Dr. Lipsman said,  “We also are recommending people ask their doctors whether they should get pneumonia shots at the same time, as pneumonia can be a deadly complication of the flu” Residents with questions about whether the regular flu shot or H1N1 flu shot is right for them should speak with their medical providers.

“People who get the flu, whether novel H1N1 flu or regular flu, usually don’t need medical attention but should stay at home and rest,” Dr. Lipsman said. “Unless you are so sick that you must be hospitalized, there is no need to be tested for novel H1N1 flu. Residents who have already had novel H1N1 flu also have developed natural immunity to it.”

Anyone who does develop flu symptoms is urged to stay home until 24 hours after a fever resolves to avoid infecting others. Cases of mild novel H1N1 flu are not expected to result in school dismissals.

The symptoms of novel H1N1 flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.  Some people infected with novel H1N1 flu have also reported diarrhea and vomiting. Like regular flu, novel H1N1 flu can vary in severity from mild to severe, and may worsen underlying chronic medical conditions.

Prevention Measures
 “I can't stress enough how important hand washing is in preventing the spread of illness,” Dr. Lipsman said. “Frequent hand washing with soap and warm water is the single, best thing that we can all do keep germs from spreading. In addition, if you have flu symptoms, it’s important that you stay home from school or work so as not to spread illness to others. If you do get severely ill, seek medical attention.’’

The CDC has determined that the H1N1 flu virus spreads from person to person and is thought to occur in the same way as seasonal flu – mainly through coughing or sneezing by infected people. To help prevent the spread of germs that cause respiratory illnesses like flu:

• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.  If you cannot use a tissue, cough into your sleeve rather than your hands.
• Try to avoid close contact with sick people.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
•  If you get sick with influenza, stay home from work or school and limit contact with others to keep from infecting them.

“No one in Westchester should panic about the swine flu,” said Spano. “While we don't know how severe this swine flu season will be, so far reports from the southern hemisphere – where winter is already almost ended – are encouraging. Cases there have been generally mild, just as our cases were last spring.”

Information available in Spanish can be found at the Centers for Disease Control and Prevention.