THIS STORY HAS BEEN FORMATTED FOR EASY PRINTING

Increase in flu is called dramatic

H1N1 hitting hard, Mass. officials say

Grafton High School will be closed through at least Wednesday. Grafton High School will be closed through at least Wednesday. (Rick Cinclair/ Worcester Telegram & Gazette)
By Elizabeth Cooney
Globe Correspondent / October 24, 2009

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Massachusetts has seen a jump in flu activity this week that has led one Central Massachusetts high school to close and that appears to signify the arrival of the second wave of swine flu.

For the first time this fall, public health authorities described the state’s influenza outbreak yesterday as widespread, the highest category on the scale of disease spread. In a weekly surveillance report, officials said they had seen a “dramatic increase in influenza-like illnesses over the past few weeks’’ compared with early fall levels in previous years.

“We had always been predicting this,’’ Dr. Lauren Smith, medical director of the state Department of Public Health, said yesterday. “We knew the H1N1 [swine flu] virus was going to be increasing. We didn’t know when, but now we do. It’s here.’’

Grafton High School closed late yesterday morning after more than a third of its students and nearly half its staff stayed home sick. It is the only school in the state to suspend classes and other activities, according to the state public health and education departments, but school absenteeism has also been elevated in other communities.

When swine flu emerged last spring, health officials at first urged schools to close as soon as H1N1 cases were confirmed, in an effort to slow its transmission, and classes were canceled at more than 40 Massachusetts schools.

But once the flu is fairly widespread, closings are not believed to slow the disease. At the beginning of this school year, state officials urged schools to close only as a last resort and to focus instead on keeping sick students isolated at home. Grafton school and public health officials were in close contact with the state Public Health Department before yesterday’s decision, Smith said.

Over the past few days, there has been an increase statewide in people going to their doctors with flulike symptoms, Smith said. The levels are still only half as high as during the H1N1 outbreak in the spring and a third as high as the seasonal flu’s peak last winter.

Patients are not routinely tested for the strains of flu they may be infected with, but signs point to swine flu. “This is very early for seasonal flu,’’ Smith said. “We can safely assume that flu activity this early, in October, is probably due to H1N1.’’

In Boston, which was hit hard by swine flu in the spring, absenteeism in the public schools is not high, according to Dr. Anita Barry, director of the infectious disease bureau of the Boston Public Health Commission.

“Attendance is pretty normal,’’ she said. “We also monitor visits to school nurses. We see no big spike in influenza-like illnesses.’’

In Grafton, Superintendent Joseph F. Connors said that this week brought “five days of escalating absenteeism for staff, faculty, and students.’’

On Thursday, 236 students, or about 36 percent of the high school’s enrollment, and 15 of 54 faculty members were out sick with flulike symptoms. Yesterday morning, 23 teachers were ill, along with four custodians and several administrative staff members, Connors said. “Since 43 percent of our teachers were out, we turned to Plan B,’’ he said.

The schools will be closed through at least Wednesday, and Connors urged parents not to allow high school students to socialize with one another during that time. “We want to see some level of isolation in place for these four days,’’ he said.

In nearby Milford, a pediatrician said her office experienced an increase in calls in the last few days from parents of children with flulike symptoms. The number of such calls now rivals those from parents looking for the flu vaccine, said Dr. Margaret Hunt of Community Pediatrics of Milford.

“The parents who two weeks ago were calling very fearful about the vaccine now want the vaccine and are desperate to get it,’’ Hunt said. “We’ve had an unbelievable number of calls.’’

Hunt, whose son attends Grafton High School, said some parents may be keeping healthy children home to keep them from catching the flu. “Some of it may be that people are being very cautious and more apt to keep kids home than in previous years,’’ she said.

Hospitals also are being cautious. Some are limiting who can visit their patients, the Associated Press reported yesterday. Children 13 or younger and adults with flu symptoms will not be allowed to visit patients at UMass Memorial Medical Center’s three Worcester campuses. Southcoast Hospitals Group is keeping anyone under the age of 18 from visiting patients in the pediatric and maternity wards at its hospitals in New Bedford, Fall River, and Wareham.

Massachusetts is one of 46 states now considered to have widespread flu activity, according to the US Centers for Disease Control and Prevention.

“This remains largely a young person’s disease, but we are seeing it increasingly affect young adults, as well as children,’’ the CDC director, Dr. Thomas Frieden, said yesterday in a conference call with reporters.

Since Sept. 1, more than half the people hospitalized with swine flu and almost a quarter of those who died have been under 25 years old, Dr. Anne Schuchat of CDC said earlier this week, based on data gathered from 27 states reporting lab-confirmed cases. Almost two-thirds of deaths are among people from 25 to 64 years old; seasonal flu is most lethal to people over 65.

Frieden said recent swine flu cases appear to be about as severe as they were in the spring, calling it comparable to seasonal influenza.

“We expect that influenza will occur in waves,’’ Frieden said. “We can’t predict how high, how far, or how long the wave will go or when the next will come. We are now in the second wave of pandemic influenza.’’

Globe correspondent Michaela Stanelun contributed to this report. Cooney can be reached at lizcooney@gmail.com.

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