Health Officials Prepared For Worst With H1N1 Virus

OCEAN CITY – Amid growing concern about the potential spread of the H1N1 virus, representatives from nearly every segment of the population gathered this week in Ocean City for a public health emergency preparedness summit to gain a better understanding of the disease and organize a coordinated response to the first pandemic of the 21st Century.

Hosted by the Worcester County Health Department, in conjunction with Worcester County and Ocean City Emergency Services, the H1N1 summit was held at the Princess Royale Hotel in Ocean City on Wednesday morning and included members from every corner of the local public and private sectors including government, health, business, churches, schools, media, non-profit organizations and other groups. Throughout the day, the 100-plus participants were given updated information on H1N1 virus and were briefed on the ongoing preparations and planned response to the pandemic.

“This is an effort on the part of the Worcester County Health Department, along with Worcester County and Ocean City, to bring together all sectors of the community,” said Worcester County Health Officer Debbie Goeller. “We want to try to anticipate the impacts we might feel this fall and winter. Responding to a pandemic will require a coordinated response from all sectors of the community.”

Based on the most recent information available, the H1N1 virus is expected to make its presence felt across Maryland and the Lower Shore including Worcester County with the coming of the traditional seasonal flu season. Thus far, there have been 30 confirmed cases in Worcester County after the late spring and summer months, but those numbers will likely increase this fall and winter. While the number of reported cases in Worcester is comparatively low compared to other areas in Maryland and across the country, the H1N1 virus will likely accelerate locally with the coming of the traditional spike in seasonal flu, according to Deputy Health Officer Dr. Andrea Matthias.

“There will be more cases, more hospitalizations and more deaths,” she said. “Fortunately, we’re better prepared than ever.”

The novel H1N1 virus, a strain identified as swine flu at first, made its presence felt in early March with a spike in respiratory illness reported in Mexico. In late March, the first case of the still unidentified illness in the U.S. was reported. In April, the Centers for Disease Control (CDC) determined it was a variation of the swine flu and identified it as the H1N1 virus and the first cases were reported in the U.S., including Maryland, were reported later that month.

Over the course of the summer, the virus spread with cases reported in nearly every state. To date, there have been over 9,000 confirmed cases of H1N1 in the U.S. including nearly 600 deaths. The most current data available shows 30 confirmed cases in Worcester County. In June, as the virus spread around the globe, the World Health Organization (WHO) classified the spread of H1N1 as a pandemic level 6.

While the numbers for Worcester are comparatively low, health officials anticipate a continued spread of the virus as summer turns into fall and fall turns into winter. For that reason, the county health department organized the H1N1 conference in an effort to stay out in front of the anticipated spread of the virus.

“If we had a guarantee H1N1 would remain a mild illness, we wouldn’t be here today,” said Goeller. “The fact is we have no such guarantee. While the opinions vary, most experts tell us to expect greater impacts and to be prepared.”

Pandemics such as the current H1N1 virus historically occur about three times a century. In 1918, the Spanish Flu, also classified as an H1N1 virus, resulted in an estimated 40 million deaths worldwide including 675,000 in the U.S. In 1957, the Asian Flu swept around the globe resulting in as many as four million deaths worldwide including 70,000 in this country. The Hong Kong Flu made its presence felt around the world in 1968 and resulted as many as four million deaths worldwide including 34,000 in the U.S.

In 1976, panic spread about the possible outbreak of Swine Flu and a fourth pandemic of the 20th century but it proved to be a false alarm. In almost all cases, the timeline between the first reported cases and the spread to pandemic status was much longer that with this current strain of H1N1 virus.

“This is the first pandemic of the 21st Century and it’s seen a fairly rapid progression,” said Matthias. “It only took about three months from when it was first detected to reach pandemic status.”

As the virus spread throughout the summer, researchers raced to develop a vaccine for the new H1N1 strain. The vaccine was recently approved by the Federal Drug Administration (FDA) and is being readied for distribution. Maryland, as one of 11 states with the highest incidence of the virus, will be among the first to receive the vaccine, which should be available as soon as the middle of next month.

Those targeted for the first wave of the H1N1 vaccine includes all people ages six months to 24 years of age, pregnant women, parents or caregivers of children under six months old or those who live in homes with children under six months old, and healthcare and emergency services personnel and people ages 25 to 64 who have health conditions associated with higher risk of complications from influenza.

In Worcester County, there are currently 35,000 residents that fit into the demographics targeted with the first wave of the vaccine. Oddly, the elderly are not among them.

“People over 65 are not in the immediate target group,” said Matthias. “We don’t anticipate a vaccine shortage, and we wouldn’t turn anyone away, but this is the group we’re targeting first.”

Unlike past pandemic viruses, the novel H1N1 strain appears to target younger demographic groups. For example, in the U.S., the largest illness case rate by age demographic is the 5-24 range by far, with the second largest group the infant to four-year-old age range. Similarly, the largest number of reported deaths in the U.S. by age group is the 25-49 demographic.

In response to a question about the potential for pulling the trigger too early on the H1N1 vaccine, Matthias said the research and preparation for the distribution of the immunizations has been far greater than during earlier pandemics.

“There have been ill-fated decisions to vaccinate in the past,” she said, referring to the public health scare related to a different strain of swine flu in 1976. “They made a decision to vaccinate in that incident after about 11 weeks. This year, there have been several months of testing and there still hasn’t been one vaccination. The testing is extensive and ongoing. It’s very safe.”

In the meantime, county health officials on Wednesday urged those in attendance to take the message back to their respective segments of the population to continue to monitor the virus, continue to practice common sense approaches such as frequent hand-washing, covering one’s nose and mouth when coughing and sneezing, staying home from work or school if mild symptoms occur, and seeing a healthcare provider if the symptom worsen or persist.

Health officials also warned those at Wednesday’s summit to expect an increased strain on the healthcare system as doctor visits and emergency room visits increase. They also said to prepare for an increase in absenteeism from work and school and even possible isolation and quarantine recommendations. 

“Moving forward, there might come a time when we have to take a look at church services, meetings, holiday parties and other gatherings,” said County Health Department Communicable Disease and Emergency Preparedness Manager Debra Stevens. “If there is a high incidence of flu in the community, people are going to have to decide if that’s what they really want to do.”