Agencies ready for possible flu outbreak

With the Monday death of a Texas toddler, concerns are mounting over the possibility of a swine flu pandemic; however local public health officials and civic leaders continue taking steps to ensure Archuleta County and the Pagosa Springs area are prepared and its citizens protected.

Officials at the Centers For Disease Control and Prevention (CDC) confirmed the death Wednesday as the first H1N1-related death in the U.S.

“Right now, several of us at San Juan Basin Health are on a seven-day-a-week work schedule. All potential partners are involved in this, everyone is trying to get their plans in place so that we are all on the same page and stay on the same page as this thing progresses and in whatever direction it goes,” said Joe Fowler, RN epidemiologist at San Juan Basin Health Department.

Yesterday, in response to the intensifying outbreak, the World Health Organization (WHO) raised the worldwide pandemic alert level to Phase 5. A Phase 5 alert is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

As of press time Wednesday, the CDC reported no confirmed cases of swine flu in Colorado, yet Mark DeVoti, superintendent of Archuleta County School District 50 Joint said he and district officials are taking all precautions to protect the safety of students and their families.

“We’ve had direct contact from the governor’s office on recommendations. We’ve sent a message to all staff and talked to our district nurse. We’re being proactive with getting information and with paying attention,” DeVoti said. “In reality, we have no confirmed cases in Colorado. But in reality, we also have a lot of kids who travel to Mexico. We just had a spring break about three weeks ago. However, the people that took trips and came back infected had their spring break well after Pagosa had theirs. Theoretically, had any of our students picked it up while in Mexico, they would have shown signs or symptoms in advance of the national concern.”

According to the CDC, the incubation period for swine flu is two to seven days.

Like DeVoti , emergency managers with the Archuleta County Sheriff’s Department and staff at Pagosa Mountain Hospital are maintaining nearly constant contact with their colleagues at San Juan Basin Health Department (SJBHD), the Colorado Department of Public Health and Environment (CDPHE) and the CDC.

Brad Cochennet, chief executive officer of Pagosa Mountain Hospital said, “We are on high alert.”

Judy Cole, RN and infectious disease nurse at Pagosa Mountain said the hospital obtained funding about nine months ago to purchase key equipment as part of their pandemic preparedness efforts.

“We secured a grant about nine months ago to purchase $10,000 worth of pandemic supplies,” Cole said.

Through that purchase, Cole said the hospital acquired a ventilator, an oxygen delivery system for adults and pediatrics, “all the supplies to take care of patients with influenza” and protective gear for staff.

Cole said the hospital has 11 acute care beds but can accommodate more patients if circumstances warrant it.

“In the event of a pandemic, we’re able to house 30 patients here. It’s all a part our emergency preparedness plan,” Cole said.

Drew Petersen, director of emergency management for the Archuleta County Sheriff’s Office, said his department provides one of the main connections to the state for information and is working to keep accurate, up-to-date information flowing to other emergency managers and the appropriate partner agencies.

“The biggest thing I’m doing is working to keep everybody on the same page and the message consistent,” Petersen said. “We’re taking the appropriate steps and building up our knowledge base.”

Like many monitoring the situation, Petersen said there “are lots of huge ‘ifs,’” but he said his department is ready to adapt their role as the situation changes.

Among the many “if’s” is the swine flu’s virulence, the speed with which the virus can spread from human contact and the availability and efficacy of antivirals such as Tamiflu and Relenza (oseltamivir and zanamivir respectively).

According to Fowler, swine flu A (H1N1) is susceptible to Tamiflu and Colorado is well stocked.

“Colorado has loads of Tamiflu on hand right now. Commercially we have at least 23,000 courses, which is much more than is needed to treat all the cases in Mexico right now — and that 23,000 is not part of the national reserve.”

In addition to the availability of commercial sources, Gov. Bill Ritter requested Colorado’s allotment of antiviral medication from the federal stockpile on Sunday.

Since Sunday, the number of cases in the U.S. has more than quadrupled.

According to the governor’s office and as of Sunday, there were 20 confirmed cases of swine influenza spread across California, Texas, Kansas, New York and Ohio.

By Wednesday, 11 a.m. Eastern Time the CDC reported 91 confirmed cases — 51 in New York, 14 in California, 16 in Texas, two in Kansas, one in Ohio, one in Indiana, one in Nevada, two in Massachusetts, two in Michigan and one in Arizona.

The number of confirmed cases in Texas between Tuesday and Wednesday jumped from six to 16, while New Mexico, another state with significant cross border traffic still reports zero confirmed cases.

The CDC issued a travel advisory April 27, recommending that U.S. travelers avoid all non-essential travel to Mexico. CDC travel updates and recommendations can be found at www.cdc.gov/travel/.

In the meantime, as health agencies in the U.S. and around the globe continue to monitor the situation, public health officials from Paris to Pagosa Springs are reciting the same mantra: Take normal personal precautions to decrease chances of getting flu — wash your hands frequently; keep your hands away from your face; cover your sneezes and coughs with your sleeve (not your hand); and avoid others with respiratory illnesses.

According to the CDC, influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. The CDC recommends that those exhibiting symptoms or who are sick should stay home from work or school and limit their contact with others to keep from infecting them.

The symptoms of swine flu in people are similar to symptoms of seasonal flu including: fever greater than 100 degrees, sore throat, cough, stuffy nose, chills, headache and body aches and fatigue. Some people have reported diarrhea and vomiting associated with swine flu.

Colorado Chief Medical Officer Ned Calonge said, “We are asking all individuals with mild flu-like illness to stay home. This is regardless of travel history. Children and adolescents with fever should not go to day care or school. Adults with fever should not go to work until their symptoms resolve. If your symptoms become more severe, call your healthcare provider.”

“The one message we want to get out are the everyday things we can do to stay healthy. It’s the everyday steps, the things our mothers taught us, that we can take to protect ourselves which will go a long way in protecting ourselves from swine flu,” Fowler added.

And the buzz around Pagosa Mountain Hospital, “Wash your hands, wash your hands, wash your hands,” said Cole.

Web links:

www.mypagosachools.com

www.sjbhd.org

www.cdphe.state.co.us/

www.cdc.gov/swineflu/

james@pagosasun.com