Health officials expect to see swine flu in Tennessee and Georgia

Public health agencies in Tennessee and Georgia have ratcheted up state and local disease surveillance programs to monitor a strain of influenza that could become a global pandemic, public health officials said Monday.

On a worldwide scale, “we are currently at the stage of this outbreak that we are no longer able to contain it, and now our strategy is basically to slow down the spread,” said Dr. Tim Jones, medical epidemiologist with the Tennessee Department of Health, in a media conference call Monday. “We fully expect to have cases in Tennessee and throughout the U.S. I think the harder we look, the more we’ll detect.”

U.S. public health officials on Sunday declared a public health emergency due to an outbreak of a new strain of swine flu, though no cases have been confirmed in Tennessee or Georgia. The swine flu is believed to have sickened 1,600 and killed 149 people in Mexico, where it originated, according to the Associated Press.

Declaring a national public health emergency opens access to emergency funding and flu medications from the federal stockpile. The government has released 25 percent of its stockpile of antivirals medications, or about 11 million doses.

As of Monday, 40 cases have been confirmed in New York, California, Kansas, Ohio and Texas over the past week. The U.S. cases all have been mild, with only one resulting in hospitalization, and all who were sickened have recovered, federal health officials said.

This year’s flu vaccine is not effective against this new variation of the H1N1 flu virus. But antiviral medications such as Tamiflu are effective in treating it, though the flu bug is known for its ability to mutate and build resistance to treatments, according to the U.S. Centers for Disease Control and Prevention.

North Georgia has a large Hispanic population, many of whom may have roots in Mexico and reason to travel there, said Logan Boss, public information officer for Northwest Georgia Public Health, the 10-county public health district.

“We’re certainly cognizant of the large Hispanic population we have in Northwest Georgia, and that’s another reason we’ve stepped up the syndromic surveillance monitoring system,” he said.

Health officials want people to be prepared for deaths to result from swine flu in the United States, despite the mildness of cases confirmed in the nation so far. Even if the swine flu now circulating does not exceed the severity level of a common flu variation, public health officials still expect deaths to result from the disease, Dr. Jones said.

The common flu bug kills 36,000 people every year, including 700 Tennesseans, Dr. Jones said.

Experts have not yet raised the global pandemic alert level, but on Monday the CDC issued a travel advisory, recommending avoidance of nonessential travel to Mexico “out of an abundance of caution,” Dr. Richard Besser, acting director of the CDC, said in a Monday media call.

VACCINE DISTRIBUTION

Tennessee and Georgia have had plans in place for years to distribute antiviral medications en masse in the case of a widespread outbreak of the flu. Pharmacists and private physicians will be the public’s first point of access to prescription medication unless it is determined that additional points of access to drugs are necessary.

“If things really escalate and we need to start setting up community clinics or special facilities for getting the drugs out, we’re certainly prepared to do that,” Dr. Jones said.

If mass distribution of medicines was necessary in Georgia, public health officials would create points of distribution, likely at schools or health facilities, that could get medications to the entire population within 48 hours, Mr. Boss said.

“We have tested plans in place in each county to deal with something like this, should the problem reach the point where we do have to administer drugs to our entire population, but we're a long way from that point right now,” he said.

POTENTIAL ‘BIG DEAL’

Swine flu is “potentially a big deal for the United States,” said Dr. Mark Anderson, infectious disease specialist in Chattanooga.

In a “worst-case scenario,” person-to-person spread of the disease would skyrocket, he said.

“At that point, we would begin to limit public gatherings and basically stop people from coming together in large groups and inside,” he said.

Dr. Besser of the CDC recommended that parents consider what to do for child care if schools are closed and that business owners prepare for employee absences.

“It’s time to think about that,” he said.

Just like the regular flu, vigilance about hand washing and avoiding contact with sick people is key to preventing the spread of disease, health officials said.

Six months ago, the Georgia Emergency Management Agency launched a Web site at ready.ga.gov with recommendations of how to prepare for emergencies including tornadoes, terrorist attacks and pandemic illness, Mr. Boss said.

“This is probably the first chance we’ve really had to refer citizens to it,” he said.

This particular variation of the H1N1 virus is not “radically” different from other strains that have been introduced in the human population in the past, said Dr. Mark Sangster, flu expert in the department of microbiology at the University of Tennessee in Knoxville.

Avian flu, on the other hand, was a virus that never had been seen in the human population when it first was detected in humans in 2003, he said.

This swine flu is “a variant of what we have been exposed to,” he said. “I think it’s very unlikely that you’d get a situation where you need to stockpile anything and bunker down in your home for a long period of time.”