As the H1N1 strain of swine flu spread to every corner of New Jersey, and just days before the first New Jersey resident died of the disease, doctors at the University Medical Center at Princeton canceled a planned staff meeting. Carol Norris, a spokeswoman for the hospital, said that the meeting was expected to draw “a couple hundred people, and the thought was, why bring together a very large group of people in a very contained area if it’s not necessary?”
No doctors at UMC princeton have contracted H1N1, she said, but many felt that with cases on the rise it was wiser not to expose anyone. The hospital itself has installed additional sanitizing stations and has asked anyone who might be sick not to visit patients.
The H1N1 strain of influenza, better known as “swine flu” officially reached global pandemic status on June 11 when the World Health Organization declared a Phase 6 (pandemic underway) alert. In New Jersey the number of cases continues to grow in no discernible pattern. Almost every other area of the country — which has confirmed more than 13,000 cases of swine flu since it broke out in April — contains pockets of infected people. According to the Centers for Disease Control in Atlanta, New Jersey is experiencing widespread outbreaks and has reported 235 case of H1N1 as of Sunday, June 14.
These numbers, however, do not necessarily reflect an accurate total. Valerie Sellers of the New Jersey Hospital Association, headquartered on Alexander Road, said Monday that a number of cases of swine flu are not reflected in the state-released totals because they are being diagnosed and treated in the doctor’s office. “When a patient presents symptoms of a flu,” Sellers said, “he is given what is called a ‘rapid response’ test.” If that test shows the possibility of swine flu, the patient is treated for it and the state lab is not made aware.
Clinical symptoms involve a fever breaking 100 degrees, a sore throat, and cough.
According to the Department of Health and Senior Services’ “Influenza-Like Illnesses,” or ILI, protocols, physicians should use the rapid response test only if it will influence management of the illness. Otherwise, treatment for the flu, as with any strain of flu, is mandated. If hospitalization is required, then the state’s labs are made aware.
Swine flu has gained an enormous amount of press coverage, which has surprised some in the medical field. Don McNeil, a spokesman for Capital Health Systems in Trenton, said the attention to H1N1 has made it seem as if this strain is worse than any other strain of flu. It is serious in the sense that more people than usual have contracted H1N1, and because it is not traditional flu season, McNeil said. But the illness itself has not proven any worse than any other type of flu.
There have been some fears, so far unrealized, that H1N1 could combine with other communicable illnesses and become deadly. In Europe, where swine flu first became a major issue in early April, some were worried that H1N1 could combine with MRSA, a treatment-resistant staph, and kill thousands.
Peter Sandman, a risk management consultant based on Ridgeview Road, has called the outbreak “a lot worse than mild but still a lot milder than catastrophic.” In a recent interview in U.S. News & world Report, Sandman stated that he does not fear what H1N1 is so much as what it could become, which is anyone’s guess. He advises keeping an eye on Australia and the southern hemisphere, where outbreaks are just beginning and where it is about to be winter and flu season.
“Do a little planning and stay vigilant for the fact that the situation could get worse,” he said.
Marc Whitman, an infectious disease specialist at Capital Health, said that H1N1 so far has not caused great concern among doctors because most cases have been mild. There is, however, concern that H1N1 could mutate over the summer, perhaps in the southern hemisphere, and reappear as a more dangerous strain in the fall, Whitman said. He believes doctors will stay on top of the matter and that drug makers will be able to have vaccines ready by fall. Last week drug manufacturer Novartis, which has offices in the Carnegie Center, released its first batch of flu vaccine.
Despite the flu’s rampant spread through many parts of the world, and its propensity for spreading where people are gathered in groups, travel has not slowed a bit, according to Tracy Noble of AAA in Hamilton. Noble, who admits she was surprised to learn that travel plans have not fallen regardless of talk about the flu and the economy, said Monday that people are more interested in taking advantage of “some really fantastic deals” on travel than on taking cover. “Some of the destinations have changed,” she said. “But people are still traveling and booking cruises.”
Still, H1N1 is deadly. On Monday, June 15, state health commissioner Heather Howard announced that a 49-year-old Essex County man became New Jersey’s first swine flu death, bringing the worldwide number to 146. Howard said the man had been hospitalized on May 30 with pneumonia. He had “multiple underlying medical conditions,” she said.
It is, however, the reach, rather than the death toll, that has gotten the news. The first global flu pandemic since the Hong Kong flu wiped out a million people in 1968 has affected thousands on six continents. It has spurred governments to beef up public awareness of the spread and nature of the illness, and has led to increased demand for medicines to treat it.
With schools letting out, the spread of swine flu could cool. In Mercer and Middlesex counties, where there have been a combined 25 state-reported cases of H1N1, schools have accounted for about half of all cases. There have been three cases reported in Lawrence public schools, three at the Lawrenceville School boarding school on Route 206, two in the Princeton district, and another in West Windsor-Plainsboro.
Sellers said that hospitals across the state have not changed their message or their actions regarding H1N1. “Some people coming into the emergency department are worried, but I have not hear one word of worry from any hospitals.”
The responsibility for curbing the spread of the flu has been put directly in the hands of the public. According to the state, the easiest way to contain H1N1 is to stay home if you think you have it or might have been exposes to it. The illness can be in your system up to seven days before symptoms appear and can be spread long before you even know you are sick. The DHSS urges employees to remain home when sick, and for all employees to wash their hands and clean their work areas. CDC studies have shown that H1N1 virus can live on surfaces for up to two hours.
A full range of guidelines for employers and employees can be found at www.cdc.gov/h1n1flu/guidance/workplace.htm.