Doug Thompson illustration
Since the first human cases of swine flu — so named because a strain of the virus was previously detected in pigs — in the United States in April, H1N1 has morphed into an epidemic of fear. Its rapid spread has prompted the World Health Organization to declare the first influenza pandemic in more than 40 years. Yet local health officials say that this year's flu season should be viewed and handled with the same precautions as in previous years.
"The severity [of H1N1] has not been too high," says Dr. Margaret Roberson, director of Virginia Commonwealth University Student Health Services.
Dr. Clifton Lee, associate medical director with Henrico Doctors' Hospital's pediatric program, says the new ailment includes consistent but mild flu symptoms: a runny nose, cough and sore throat.
About 30,000 deaths in the United States annually are attributed to the standard influenza strains, mainly affecting elderly people who have another underlying physical condition. As of early September, about 9,000 hospitalizations had occurred nationally for swine flu, and more than 590 deaths resulted from the illness, according to the federal Centers for Disease Control and Prevention.
Dr. Donald Stern, Richmond's director of public health, says H1N1 is already prevalent across Virginia. Four deaths associated with the virus have occurred statewide — though none in Richmond. In each Virginia death, the patient had an underlying health problem, a pattern in deaths nationwide.
Unlike with previous flu strains, people 24 and younger are particularly susceptible to H1N1, while people 65 and older seem more immune to it.
"Because there was somewhat of an epidemic of swine flu back in the '70s, older [people] may have had some contact with the virus," Lee says.
Stern adds that risk groups include pregnant women, children 6 months old and younger, people who care for young children, health-care or emergency personnel, and anyone with a compromised immunize system. The CDC reports that groups at higher risk also include those with chronic heart, lung, liver or blood disease and neurological or neuromuscular disorders.
Prevention is the key for these risk groups, Lee says, a top priority being the H1N1 vaccination, which will be available at 1,700 locations statewide beginning this month, including private medical practices and some grocery stores and pharmacies. Stern recommends that everyone get the vaccine, which is free. Doctors also recommend that people get a regular flu shot.
So how do patients know whether they have swine flu or another strain of flu? "They won't," Stern says. Fever is an indication of flu in general, and H1N1 can also involve nausea and vomiting. The worst symptoms have accelerated into fatigue, shortness of breath and body chills.
Stern recommends that patients use drugs such as ibuprofen and cough medicine to treat the flu and to see a doctor if symptoms continue more than three days. A patient can be diagnosed through a rapid nasal-swab test or a blood test.
"Common sense should prevail above everything else," Lee says, emphasizing the need for proper hand washing and coughing. To avoid contaminating your hands, Lee suggests coughing into the crook of your elbow, and adds that hand washing is necessary if a tissue is used. Patients "should not go back to work until 24 hours after the symptoms stop," Stern warns.
VCU, with its more than 32,000 students, has had at least 20 cases of swine flu so far, Roberson says. Students who have swine flu are being asked to go home if possible or to stay isolated. Hand-sanitation dispensers have been placed in high-traffic areas.
Lee also encourages parents of young children to carry portable hand sanitizers and to wipe down places kids might touch.
But even if a person is in close contact with H1N1, there is only an 8 percent to 12 percent chance of contracting the disease, which is lower than the chance of catching the seasonal flu, Stern says.
"Are we going to see a workplace where 50 percent of workers are out due to the disease? I do not think so," he says