State: H1N1 toll at six; medicine expected soon

Posted May 01, 2009, at 8:28 p.m.

AUGUSTA, Maine — The number of Mainers identified with swine flu rose to six on Friday as the state’s top public health officer announced that 50,000 doses of flu medication from federal stockpiles are expected to arrive this weekend.

As of Friday evening, two adults in Kennebec County, two adults and one youth in York County, and one youth in Penobscot County were identified as having H1N1 flu, according to Dr. Dora Anne Mills. All are recovering, she said.

Mills also announced Friday that a youngster who attended the Crayon Academy day care center in York County has tested negative for the H1N1 virus. The center, which was closed earlier this week because of the possibility the child had swine flu, is now cleared to reopen Monday.

However, the Kennebunk Elementary School, where another youth with H1N1 is a student, will remain closed for at least seven days. Mills added that officials with the U.S. Centers for Disease Control and Prevention this weekend are reviewing federal guidelines for slowing the spread of swine flu and that the length of the school’s closure could grow to 14 days.

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The state’s official count of Mainers with the virus has fluctuated this week, with Mills attributing the confusion Friday to the terminology used to describe cases of H1N1.

Cases have been described as “confirmed,” “probable” and “suspicious.”

When tests performed by the Maine CDC indicate someone has H1N1, the case is considered probable. Samples then are sent to the U.S. CDC to be confirmed.

Suspicious cases, according to Mills, involve individuals who, because of a combination of factors, are considered to have H1N1 without final confirmation through testing.

For instance, the second child in York County who had been described as “suspicious” did not test positive for H1N1. Though the day care center the child attended will reopen Monday, that child will not return until cleared, she said.

“As we see more individuals with H1N1, the actual number of probable cases will become less important,” Mills said. “We know the flu is in Maine and our priority is to slow its transmission and to treat those who are ill.”

She did confirm that other cases are under investigation and that Maine’s numbers are in line with the other New England states.

While Mills did not reveal what town the Penobscot County youth was from, Bangor Superintendent of Schools Betsy M. Webb told parents in a memorandum dated Friday that there is a “probable case identified by the CDC [Center for Disease Control and Prevention] within the Bangor community. However, the person has not been in school since April 17, the Friday before April vacation, and the CDC has determined that there was no exposure to others at the school. Because there was no exposure to others at the school, the CDC informed me that the school should not be identified.”

The two-page memo outlines the steps public health officials have suggested school superintendents take if a case of H1N1 involving a student is confirmed. That includes shutting down the school for seven days, more if additional cases are confirmed. Should a student have a sibling in another school that building also would be closed.

In another precautionary measure, James F. Doughty School Principal Robert MacDonald called off a dance scheduled for Friday night at the Bangor middle school.

In a letter to parents, MacDonald explained that “to assemble students in a small confined area such as the cafeteria for a Fun Night where dancing would draw students in close proximity to one another seems inconsistent with the precautionary measures being emphasized this week.”

At the state level, Mills advised anyone who feels ill to stay home and contact their primary care physician.

“Our goal is to reduce the impact of H1N1 and slow its transmission,” she said.

In a conference call Friday afternoon with medical officials and media, Mills said her office has been handling 400 telephone calls a day from medical providers, hospitals, schools and the public, but she did not believe the swine flu issue is being over sensationalized.

“This is a very novel, very unique virus,” she said. “We believe most people have no immunity. I would love to say in a few weeks that we missed the big one but I don’t think we can take any chances.”

Mills said the disease is transmitted “quite rapidly” although, for reasons still unclear, cases as far north as Maine are less severe than cases in Southern or warmer states. “Also, spring vacation was last week and a lot of people were traveling,” she said. That increased the probability of a faster spread of the virus.

On Monday, the state tested 12 people for H1N1, Mills said. On Tuesday, that number jumped to three dozen, and now it is about 100 people a day. But Mills said the testing would slow down once it is determined where the disease has spread.

“Not everyone needs a test,” Mills said. “The most important thing is to stay home. We do not need to know each and every case. We just want to know where the virus is.”

At this point, she said, only three counties have been affected. “Once we have established that an area is affected, we will reduce testing there,” she said.

She also said the people with H1N1 all are recovering at home. “No one has been hospitalized,” she said.

She reminded people that the symptoms of H1N1 are fever and respiratory problems, such as a cough and sore throat, as well as a runny nose. She said the most important thing a victim can do is to stay home. It is expected that the disease will run its course in 10 days from onset, she said.

Originally, that span was thought to be seven days, but “specific guidance from the U.S. [Centers for Disease Control and Prevention] is changing by the hour as we learn more about this disease, both its severity as well as how it is spread.”

People who suspect they have the flu, Mills said, should stay home and stay away from other people. If they become very ill or have a travel history, they should contact their primary medical provider.

Officials at Eastern Maine Medical Center in Bangor, meanwhile, indicated Friday that the hospital’s Emergency Department and Walk-In Care Center have seen an increase in unnecessary visits from people asking to be tested for H1N1.

Karen Clements, patient care administrator of Emergency Services, requested that area residents contact their primary care physician if they exhibit flu symptoms.

According to a hospital news release, emergency services might become warranted if “a person becomes dehydrated, has trouble breathing, has blue lips or fingertips, or becomes disoriented.”

Mills said a pandemic flu coordinator’s position, which has not been funded in the state budget for more than a year, was reinstated this week, and advertising and hiring will take place. She also said money to stockpile flu medications, such as Tamiflu, was not included in the state budget for several years but was included in this year’s proposal.

“We haven’t passed that budget yet,” she said, “but Gov. [John] Baldacci signed an emergency order several days ago to purchase the medication.”

The Maine Center for Disease Control and Prevention also has mobilized its staff, as well as several recent retirees, to respond to the public’s calls for information.

Up-to-the-minute national updates on swine flu can be found at www.cdc.gov. Information specific to Maine can be found by calling the Maine CDC at 888-257-0990 or by visiting www.mainepublichealth.gov and www.pandemicflu.gov.

The Red Cross in Maine and the Maine CDC offer these tips: Wash hands often with soap and water, especially after a cough or sneeze. Alcohol-based hand cleaners are effective when soap and water are not available. Cover your nose and mouth with a tissue or sleeve when you cough or sneeze. Throw the tissue into the trash after you use it. Avoid touching your eyes, nose or mouth; germs spread that way. Try to avoid close contact with people who are sick. Be aware that flu is thought to spread mainly person-to-person through coughing or sneezing. If you get sick, stay home from work or school and limit contact with others to keep from infecting them.

Consult your health care provider if you develop symptoms of the flu, such as fever, cough, sore throat, body aches, headache, chills, extreme tiredness or vomiting and diarrhea.

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