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The flu is a 'serious concern,' but not too unusual

New Hampshire Union Leader

January 12. 2013 11:30PM

NH flu deaths
Dr. Jose Montero, the state's public health director, says these number are deaths by year, though talk of flu is usually about the season, which typically runs from October through March. For example, 2005's 14 deaths reflects 13 in December 2012 and 1 in January 2013.

2013: 1
2012: 19
2011: 17
2010: 5
2009: 4
2008: 21
2007: 7
2006: 4
2004: 9
2003: 8
2002: 9

NH Department of Health and Human Services

While the number of deaths from flu is high for this early in the season, the spread of the illness is not the runaway train it might appear to be.

"I think it feels that way to people because last year flu season got such a late start," said Beth Daley, chief of infectious disease surveillance for the New Hampshire Department of Health and Human Services. "You compare the current reports with last year, and it looks like we're seeing a lot more than usual. Plus, it has come on quickly, with the number of cases jumping over the last few weeks.

"But when you look at a 10-year period, we're right about where you would expect the state to be statistically."

As of Friday, 14 people - all adults - had died of the flu since the beginning of December.

"The amount of illness we are seeing here in New Hampshire is not yet to the point of alarming," said state Public Health Director Dr. Jose Montero. "However, it is cause for serious concern, especially since we have now seen 14 influenza-related deaths so far this season, which is unusually high for this early in the season.''

New Hampshire is one of the 47 states in the country designated as having "widespread" influenza, according to the national Centers for Disease Control and Prevention (CDC).

Daley said influenza is being detected statewide. Levels of acute respiratory illness, which includes the flu, are "very high" in Cheshire, Coos, Merrimack and Rockingham counties, according to a report dated Jan. 5. Levels are "high" in Hillsborough and Grafton counties and "elevated'' in Belknap and Carroll counties. Strafford and Sullivan counties report "moderate" activity.

"There was only sporadic activity a month ago,'' Daley said, "and we're not predicting whether it has peaked yet. It has not reached epidemic level yet."

According to a weekly report issued Jan. 4 by state epidemiologist Sharon Alroy-Preis, historically in New Hampshire, there are between 10 to 30 outbreaks of influenza-like-illnesses (ILI) reported during the flu season. Since the beginning of December, there have been 40 ILI outbreaks reported to public health officials.

These outbreaks were reported primarily from health care centers, such as long-term care facilities, rehabilitation centers and assisted-living sites. As of Friday, public health laboratories had tested 408 specimens, with 238 testing positive for influenza.

Four flu cases were reported at the New Hampshire Veterans Home in Tilton.

"We have stopped new admissions to the facility and closed the home to visitors until further notice," said Karen Kearney, the home's infection control nurse. "We are being cautious with this illness to prevent it from spreading. We're asking residents to stay in their rooms as much as possible. We're also limiting activities."

Huggins Hospital marketing manager Mariann Murphy said December brought an uptick in reported flu cases in Wolfeboro, along with people reporting the norovirus stomach bug.

"Both Portsmouth Regional Hospital and Parkland Medical Center are seeing an influx of flu patients, significantly higher numbers than in the last few years," said Nancy E. Notis, spokesman for HCA America. "Our medical professionals are advising people that it is not too late to get a flu shot."

Joni Spring, vice president of nursing for Elliot Hospital in Manchester, says their pediatric offices have been flooded with calls.

"They are reporting 120 to 150 calls a day," said Spring.

St. Joseph Hospital in Nashua also reports having a lot of patients with flu-like symptoms.

"We're seeing higher than usual numbers of patients with respiratory illnesses," said Karen Beinhauer, director of St. Joseph Hospital's Emergency Services. "We're also seeing a lot of patients complaining of digestive issues."

Daley said symptoms include sudden fever, aches and pains, headache, chills, sore throat, cough, head and lung congestion, fatigue and nausea. They can last between four and seven days in most cases.

Both St. Joseph and Elliot hospital report restricting visitors to two per patient.

"We are closely watching flu outbreaks around the state, and have taken steps to protect our patients and staff," said Jodi Dionne-Odom, an infectious disease specialist at Dartmouth-Hitchcock in Lebanon, and a New Hampshire deputy state epidemiologist. "We are also asking visitors to any health care facility to consider the health and safety of our patients. If you are a visitor with a cough or a fever, please consider delaying your visit until your symptoms have cleared up."

John Cruikshank, absentee coordinator for the Manchester School District, said absences are up across the city's 22 schools.

"It's tough to keep up with the calls we are getting," said Cruikshank. "I'd say we're getting 15 to 20 more calls for absent students a day than we typically would, and the majority of them are illness-related."

Doreen Lindoff, who manages Gold's Gym branches in Manchester, Goffstown and Merrimack, said employees make sure they clean the equipment thoroughly every night.

"We also have signage posted asking members to wipe down the equipment when they are done working out," said Lindoff.

The common flu vaccine this year protects against the three most predominant strains - H1N1; influenza A, known as strain H3N2; and influenza B. The vaccine is recommended for everybody 6 months old and older and is free for New Hampshire residents younger than 18. Daley said 90 percent of the cases that have tested positive for influenza in New Hampshire this year have been the H3N2 strain. The rest were influenza B.

"The good news is there is plenty of the vaccine in the state," said Daley. "We aren't concerned about supplies running out."

Adult flu vaccine is available on a walk-in basis at the Manchester Health Department at 1528 Elm St. between 8 a.m. and 5 p.m. Monday through Friday. The fee is $20.

"We encourage everyone to get a vaccine shot," said Daley. "Even if you think you may have already had the flu, you could come down with a different strain. No vaccine is perfect, but it reduces your chances of getting the flu."

Daley also said if you have received the vaccine and get the flu anyway, the vaccination can be expected to lessen the severity of your symptoms. She also said taking Tamiflu after contracting the flu could reduce the duration of the symptoms, but "only by about a day," said Daley.

Public health officials urge everyone to cover their coughs and sneezes with a tissue, and throw the tissue in the trash after it is used. People exhibiting symptoms of a cold should isolate themselves from others at work and in their homes. The public is urged to wash their hands often with soap and water and to avoid touching their eyes, nose and mouth to prevent the spread of germs.

DHHS recommends bedside tables, children's toys and kitchen and bathroom surfaces be wiped with disinfectant and any tissues and other disposable items used by sick people in a household be thrown away as soon as possible.

Montero said: "It's important for people to remember to take steps to prevent becoming ill; most important is vaccination. It can take up to two weeks for your immune system to fully respond to the vaccine, so it's important to get the shot or nasal version of the vaccine as soon as possible."

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