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Second wave of swine flu pandemic begins to hit US

Surge in cases closes schools, strains hospitals

Technician Heather Bickley tested samples for H1N1 flu at the Arizona State Health Lab in Phoenix. At least 26 states are now reporting widespread flu activity, federal officials said. Technician Heather Bickley tested samples for H1N1 flu at the Arizona State Health Lab in Phoenix. At least 26 states are now reporting widespread flu activity, federal officials said. (Matt York/ Associated Press)
By Rob Stein
Washington Post / September 28, 2009

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WASHINGTON - After months of warnings and frantic preparations, the second wave of the swine flu pandemic is starting to be felt around the country. Doctors, health clinics, hospitals, and schools are reporting rapidly increasing numbers of patients experiencing flu symptoms.

While most cases so far are mild, and the health care system is handling the load, officials say the number of people seeking treatment for the flu is unprecedented for this time of year.

In Austin, so many parents are rushing their children to Dell Children’s Medical Center of Central Texas with swine flu symptoms that the hospital had to set up tents in the parking lot to cope with the onslaught.

In Memphis, the Le Bonheur Children’s Medical Center emergency room got so crowded with feverish, miserable youngsters that it had to do the same thing.

And in Manning, S.C., a private school where an 11-year-old girl died shut down after the number of pupils who were out sick with similar symptoms reached nearly a third of the student body.

“It just kind of snowballed,’’ said Kim Jordan, a teacher at Laurence Manning Academy, which closed Wednesday after Ashlie Pipkin died and the number of ill students hit 287. “We had several teachers out also.’’

“H1N1 is spreading widely throughout the US,’’ said Thomas Frieden, director of the federal Centers for Disease Control and Prevention in Atlanta. The CDC reported last week that at least 26 states are now reporting widespread flu activity, up from 21 a week earlier.

Even though some parts of the Southeast that started seeing a surge of cases first now seem to be showing a decline, that could be a temporary reprieve, Frieden said. And other parts of the country are probably just starting to feel the second wave.

“Influenza is perhaps the most unpredictable of all infectious diseases,’’ Frieden said.

The pandemic has prompted scattered school closings around the country in recent weeks, including 42 schools that closed in eight states Friday, affecting more than 16,000 students.

Many colleges and universities have been hit particularly hard, forcing some to open separate dorms for sick students. Ninety-one percent of the 267 colleges and universities being surveyed by the American College Health Association are now reporting cases.

The government is starting an unprecedented system to track possible side effects as mass flu vaccinations begin next month. The idea is to detect any rare but real problems quickly, and explain the inevitable coincidences that are sure to cause some false alarms.

In just a few months, health authorities hope to vaccinate well over half the population against swine flu, which doctors call the 2009 H1N1 strain. No more than 100 million Americans usually get vaccinated against regular winter flu, and never in such a short period.

The last mass inoculations against a different swine flu, in 1976, were marred by reports of a rare paralyzing condition, Guillain-Barré syndrome, a sometimes fatal paralysis. Other possible side effects could potentially include heart attacks, strokes, seizures, and miscarriages.

On top of routine vaccine tracking, these government-sponsored monitoring projects are planned:

■ Harvard Medical School scientists are linking large insurance databases that cover up to 50 million people with vaccination registries around the country for real-time checks of whether people see a doctor in the weeks after a flu shot and why. The huge numbers make it possible to quickly compare rates of complaints among the vaccinated and unvaccinated, said the project leader, Dr. Richard Platt, Harvard’s population medicine chief.

■ Johns Hopkins University will direct e-mails to at least 100,000 vaccine recipients to track how they’re feeling, including the smaller complaints that wouldn’t prompt a doctor visit. If anything seems connected, researchers can call to follow up with detailed questions.

■ The Centers for Disease Control and Prevention is preparing take-home cards that tell vaccine recipients how to report any suspected side effects to the nation’s Vaccine Adverse Event Reporting system.

“Every day, bad things happen to people. When you vaccinate a lot of people in a short period of time, some of those things are going to happen to some people by chance alone,’’ said Dr. Daniel Salmon, a vaccine safety specialist at the Department of Health and Human Services.

Material from the Associated Press was included in this report.

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