Modesto Bee Article

By Ken Carlson, Modesto Bee Staff Writer
last updated: September 6, 2009


Modesto Bee - Dr. John Walker from the Stanislaus County Health Services announces that the H1N1 (swine flu) inoculations will arrive this October. September 4, 2009 (BART AH YOU/bahyou@modbee.com)

Since the first cases were reported in the spring, the H1N1 influenza, also known as swine flu, has created tragedy for some families in the Northern San Joaquin Valley and anxiety for many other residents.

Dr. John Walker is the public health director for Stanislaus County, where five people have died from complications of H1N1. He leads the county's public health response and planning for the flu pandemic, an effort that involves coordination with schools, health care providers and emergency services.

The Bee asked him to discuss the illness that causes annoying symptoms for most patients but is capable of causing serious illness or death.

Q: What should local residents know about H1N1 influenza?

A: It is important to know that H1N1 is a new virus against which most people have very little immunity. It is contagious like the seasonal flu and people should take precautions to prevent from getting it, or spreading it, by doing the following:

- Wash hands often with soap and water. Or use alcohol-based hand sanitizer.

- Cough into sleeves, not the hands. Germs can be spread by the hands.

- Stay home when you are sick, and until you are 24 hours free of fever by not taking any fever reducing medications.

- Stay away from sick people.

- Practice self-care when sick.

Currently, there are no vaccines for this virus. Vaccine is in production and is expected to be available late fall.

Interview continues below video player.

Q: How worried are you that, as these cases increase, there will be growing anxiety in the community and even panic? What do you tell people who ask how worried they should be?

A: "Don't be scared, be prepared." The public needs to know that there is no cause for anxiety or panic. Everyone needs to treat this virus as a contagious flu virus and take every precaution to prevent from getting it and/or spreading it.

Q: Stanislaus County has large numbers of people with chronic illnesses such as diabetes and heart disease and large numbers of people with limited access to health care. Does that make our county more vulnerable to the H1N1 pandemic?

A: These are the people who are at a higher risk of developing complications from the flu and they do need to be mindful of taking precautions.

Q: It seems most people who have died from this illness had another health issue, such as chronic illness or pregnancy. If you are a healthy individual, what are the chances you will become seriously ill?

A: Severity of the H1N1 illness is comparable to seasonal flu, meaning that most people have mild symptoms, but in some people it can be serious and even fatal. For a healthy person who has the flu, they are at a lower risk of developing complications from it. It is also important to stay healthy, by eating right, drinking plenty of water, being active every day, and getting enough sleep.

Q: If my child comes down with flu symptoms, what should I do to ensure my child doesn't become seriously ill?

A: As with the seasonal flu, the child should stay home from school and away from other children. Phone the physician's office to ask for guid- ance on treating the symptoms. In most cases, a fever-reducing medicine, plenty of fluids, and plenty of rest will help. The physician may prescribe an "anti-viral" such as Tamiflu. Monitor the child to watch for emergency warning signs.

Q: When will a vaccine for H1N1 be available and how will it be distributed?

A: We are still waiting for guidance from the federal government regarding the status of the delivery date to the states, and how the vaccine will be available to the public.

Q: Federal, state and local health agencies adopted new guidelines for controlling flu outbreaks in schools. Instead of closing the campuses where cases arise, schools are supposed to isolate sick students until they are taken home. Is this a good policy?

A: The latest guidance on schools was designed to decrease exposure to regular seasonal influenza and 2009 H1N1 influenza while limiting the disruption of day-to-day activities and the vital learning that goes on in schools. Based on the experience and knowledge gained in spring 2009, the potential benefits of pre-emptively dismissing students from schools are often outweighed by negative consequences, including students being left home alone, health workers missing shifts when they must stay home with their children, students missing meals, and interruption of students' education.

Q: If health agencies no longer run tests for potential cases at schools, how can parents know if H1N1 influenza is spreading at their children's school?

A: H1N1 is considered a pandemic and is widespread. As such, it is not a reportable illness, unless meeting the criteria of a hospitalized case. It is not necessary to get tested for H1N1 when a person displays flulike symptoms. It is important for the public to know that we should prevent H1N1 just like we prevent the seasonal flu, which is to take all the precautions mentioned.

Q: How does the county health department monitor for H1N1 influenza activity?

A: One thing we do know is that the virus is widespread in our commu- nity. Our communicable disease nurses provide follow-up to all reported H1N1 confirmed and probable cases, following communicable disease protocols. In addition, we have been working with schools to monitor their absenteeism rates, as well as the area hospitals and the health care community to conduct surveillance.

Public health staff and the county Office of Emergency Services are working together to develop a plan on preparedness and mitigation. Activities include risk communication to the public, planning with schools, providing guidance to the health care community, as well as preparing for vaccination clinics.

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.